Frequent Ear Infections Research Articles

Frequent ear infections and child care.

Frequent ear infections and child care.

Headphones increase risk of deafness

Young people who suffered from frequent ear infections as children should refrain from using personal stereo headphones or risk losing their hearing, according to French researchers. Investigators conducted a cross-sectional study of risk factors for deafness in 1,208 men between the ages of 18 and 24 who were entering the Army.

Day care and the incidence of otitis media in young children

OBJECTIVE: This study assesses whether day care is a significant risk variable for otitis media in children younger than 2 years in the United States after controlling for the number of children in the day care group. DESIGN: The computerized data source used is the 1988 Child Health Supplement ( N = 17,110) of the National Health Interview Survey (NHIS-CH). SETTING: The NHIS-CH data is a multistage probability sample with clustering and stratification. It represents the civilian, noninstitutionalized population of the United States. PARTICIPANTS: The NHIS-CH sample consists of one randomly selected child from each NHIS household containing a child younger than 18 years. The overall response rate for the NHIS-CH was approximately 90%. For this analysis the focus is on children younger than 2 years ( N = 2294). MAIN OUTCOME MEASURES: The NHIS-CH includes a direct questioning of an adult member of the household, usually the mother, about whether the child has ever had frequent or repeated ear infections. RESULTS: After controlling for the total size of the day care group for children younger than 12 months, the previously established relationship between attending a day care center and frequent ear infections is reduced from an odds ratio of 3.17 (95% confidence interval, 1.50 to 6.71) to an odds ratio of 1.34 (not significant; p = 0.60). CONCLUSION: The total size of the day care group is an important intervening variable in the relationship between attending day care and frequent ear infections for children younger than 12 months. The size of the day care group rather than the day care per se is the primary "modifiable risk variable" for many working parents. (OTOLARYNGOL HEAD NECK SURG 1995;112:695-99.)

Day Care and the Incidence of Otitis Media in Young Children

This study assesses whether day care is a significant risk variable for otitis media in children younger than 2 years in the United States after controlling for the number of children in the day care group. The computerized data source used is the 1988 Child Health Supplement (N = 17,110) of the National Health Interview Survey (NHIS-CH). The NHIS-CH data is a multistage probability sample with clustering and stratification. It represents the civilian, noninstitutionalized population of the United States. The NHIS-CH sample consists of one randomly selected child from each NHIS household containing a child younger than 18 years. The overall response rate for the NHIS-CH was approximately 90%. For this analysis the focus is on children younger than 2 years (N = 2294). The NHIS-CH includes a direct questioning of an adult member of the household, usually the mother, about whether the child has ever had frequent or repeated ear infections. After controlling for the total size of the day care group for children younger than 12 months, the previously established relationship between attending a day care center and frequent ear infections is reduced from an odds ratio of 3.17 (95% confidence interval, 1.50 to 6.71) to an odds ratio of 1.34 (not significant; p = 0.60). The total size of the day care group is an important intervening variable in the relationship between attending day care and frequent ear infections for children younger than 12 months. The size of the day care group rather than the day care per se is the primary "modifiable risk variable" for many working parents.

Cognitive skills in achondroplasia.

Increased intracranial pressure and ventricular and subarachnoidal dilatation are common manifestations in achondroplasia. They rarely lead to major neurologic and/or psychomotor deficits and neurosurgical intervention is seldom needed. The present study was undertaken to detect signs of minor cerebral dysfunction and discuss possibilities of their prevention. Thirty children with achondroplasia were compared to 3 control groups: their next-born sibs, 30 children with other forms of dwarfism, and 30 children with normal height. Early development was assessed by means of questionnaires. Cognitive skills were evaluated with the German version of the Cognitive Abilities Test and the Lorge-Thorndike Intelligence Test. Personality data were tested using standardized neuroticism, extraversion, and anxiety scales. Children with achondroplasia had more frequent histories of delayed motor development, retarded speech development, and lower school grades in language-related specialties. Psychometric testing disclosed total and subtest scores in the population-based normal range. In comparison with their sibs and matched controls children with achondroplasia had significantly lower total scores mainly caused by low scores in the subtest "verbal comprehension." We conclude that verbal comprehension is significantly impaired in children with achondroplasia. This partial deficiency is probably related to frequent middle ear infections and resulting conductive hearing loss. Hypotonia with delayed oropharyngeal muscle coordination and parental response to an altered, more infantile instinctive releasing pattern may be contributing factors.

Serum Albumin, Retinol‐binding Protein, Thyroxin‐binding Prealbumin and Acute Phase Reactants as Indicators of Undernutrition in Children with Undue Susceptibility to Acute Infections

This study was conducted in order to test the usefulness of measuring the concentrations of selected serum proteins and acute phase reactants in assessing the nutritional status of children with undue susceptibility to acute infections. The concentrations of serum proteins were determined by an immunodiffusion technique in 28 children with undue susceptibility to infections and were compared with those in healthy children. The patients were grouped according to the clinical pattern, i.e. into children with mainly upper respiratory tract infections, with frequent middle ear infections and with lower respiratory tract infections. The total group and all three subgroups of patients had not only significantly lower (p less than 0.001 or p less than 0.01) mean serum levels of albumin and retinol-binding protein, but also of the acute phase reactants alpha 2-macroglobulin and ceruloplasmin (p less than 0.01) than the controls. No differences were observed between the patients and the controls in respect of the acute phase reactant orosomucoid. This study indicates that the concentrations of albumin and RBP along with selected acute phase reactants are rapidly influenced by altered nutritional status in children with undue susceptibility to acute infections.

Defects in polymorphonuclear neutrophil function and susceptibility to infection in children.

Polymorphonuclear neutrophil (PMN) migration, phagocytosis, chemiluminescence production and chemotactic and chemokinetic activities in serum were investigated in 38 infection-prone children, aged 1 month to 15 years, and in healthy controls. The patients were grouped according to the clinical pattern, that is, into children with mainly upper respiratory tract infections, with frequent middle ear infections, with lower respiratory tract infections and with 'multifocal' infections occasionally accompanied by complications, and according to the severity of the infections. Forty-two defects were found in 28 of the 38 patients examined. Good accordance was found between clinical symptoms and abnormal PMN function. Several of the observed abnormalities are most likely inherited and primary causes of the increased susceptibility, but some of them probably occur as a consequence of the infections. The results indicate that defects in oxidative PMN metabolism and defects in Fc-receptor-dependent phagocytosis are major determinants of susceptibility to infection and that such defects seem to be especially common in patients with severe 'multifocal' infections.

Subclinical trace element deficiency in children with undue susceptibility to infections.

Serum concentrations of iron, copper, zinc and magnesium and also serum transferrin and ceruloplasmin were investigated in 28 children aged 10 months to 10 years with undue susceptibility to infections. None of the children had any classical immune defect. Seven of them had had frequent upper respiratory tract infections, 16 had suffered from frequent infections of the middle ear and five from mainly lower respiratory tract infections. Thirteen healthy children aged 9 to 18 years residing in the same area served as controls. The children with undue susceptibility to infections had significantly lower mean serum iron (p less than 0.05) and zinc (p less than 0.001) levels than the healthy controls. The mean serum concentrations of copper and magnesium and of transferrin and ceruloplasmin did not differ between the patients and controls. Children with frequent middle ear infections seemed to account for most of the differences in the serum levels of iron and zinc. An inverse correlation was observed between duration of breast feeding and serum concentration of zinc, and between weight as well as height and serum magnesium. The reasons for these changes and the possible role of trace element deficiency as a factor predisposing to or perpetuating undue susceptibility to infections in children are discussed.

Interferon production in children with undue susceptibility to infections.

The interferon-producing ability of peripheral blood mononuclear leukocytes obtained from children with undue susceptibility to infections was investigated. Patients were grouped according to three clinical patterns, i.e. children with mainly upper respiratory tract infections, with lower respiratory tract infections and with frequent middle ear infections. There was no evidence of impaired mean interferon-alpha responses to the inducers Sendai virus and beta-hemolytic Group G streptococci in patients compared with control children, and there were no differences in this respect between the patient subgroups. A tendency to increased Concanavalin A-induced interferon-gamma production was seen in patients, particularly those with middle ear infections. Leukocytes from patients displayed a higher proliferative response to the T cell mitogens Concanavalin A and Lens culinaris lectin. In a minority of patients (5/28) reproducibly low interferon responses to Sendai virus were found but only one of these patients showed a response below the -2 SD limit for the control group. The results therefore indicate no major defects in the interferon responses of infection-prone children, and at the most suggest that a minority of such patients may be low responders to a viral interferon inducer.

Risk Factors for Persistent Middle-Ear Effusions

To ascertain risk factors for persistent middle-ear effusions (PMEE), we interviewed the parents of two groups of children. The first consisted of 76 children with PMEE who were admitted to the hospital for tympanostomy-tube insertion. The second, a control group, consisted of 76 children admitted for other types of surgery, who were matched for age, sex, season, and surgical ward. Nearly all (97%) of the children admitted for insertion of tympanostomy tubes had one or more episodes of suppurative otitis media. Only 59% of the control children had previous ear infections. Frequent ear infections sharply increased the risk for persistent effusions. Catarrh, household cigarette smoke exposure, and atopy also occurred more frequently in children with PMEE. The risk for middle-ear effusions was greatest when these three factors were all present. The avoidance of daily exposure to domestic tobacco smoke and, if atopic, of specific allergens should be included in the medical treatment of children with PMEE.

Unscientific Treatment

Dr. North raises a most interesting question as to the status of treatments which have not been subjected to scientific scrutiny. There are many common pediatric problems which are being dealt with in an "experimental" fashion, there being no controlled studies to define the ideal therapy, if any. Among these are the child with frequent sore throats, colds, or ear infections; the child with flat feet, pronation, tibial torsion or intoeing; the child with bed-wetting, meatal "structure," labial synechiae, and so forth.