Detection of Helicobacter pylori in Children with Otitis Media with Effusion: A Preliminary Report
ABSTRACT To determine the presence of Helicobacter pylori in the middle ear effusion of patients with otitis media with effusion (OME) by polymerase chain reaction (PCR).
A prospective study in patients with OME.
The study was performed in 38 patients with OME who were admitted to the ENT Clinic, Firat University from June 2003 to April 2004. In all cases, a myringotomy operation (with or without placement of a ventilation tube) was carried out. The effusion samples aspirated from the middle ear were analyzed with PCR assay.
A total of 55 aspiration samples collected from 38 children ranging in age from 2 to 12 were included in the study. Fifteen of the subjects were girls, and 23 were boys. In 17 patients, both ears demonstrated effusions, whereas in 21 patients, only one ear had effusions. Nine (16.3%) of 55 the middle ear effusion samples were shown to be H. pylori positive by PCR.
H. pylori was detected in the middle ear effusion of some patients with OME. These results may have interesting implications for a possible role of H. pylori in OME. In addition, these results suggest that further studies are needed to investigate the role of H. pylori in the etiology of OME.
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ABSTRACT: The aim of this study was to compare the efficacy of antireflux therapy with both conventional management and those with no treatment in children with chronic otitis media with effusion (COME). In this prospective randomized clinical trial ninety children with COME which lasted more than 3 months or more, documented by physical examination and Type B tympanogram in at least one ear without clinical signs and symptoms of active infection that were refractory to 3 period of antibacterial treatment, were randomly allocated to receive a 3 month course in three groups of antireflux treatment (AR group, Cisapride 1 mg/kg/day), conventional antibacterial treatment (AB group, Co-amoxiclave 40 mg/kg/day TID) and those with no treatment (Control group, no medication). All patients were followed every month. The favorable response was considered as complete resolution of effusion clinically and type A or more than -200 peak in tympanometry. Of the 30 patients assigned to AR group, 10 (33.3%) were judged to be clinically cured and in AB group 12 (40%) were cured while only 3 (10%) in control group were cured. The cure rate in AR and AB groups was significantly higher compared with control group but there was no significant difference between cure rates in AR and AB groups (P=0.59). No subjects experienced complications during or after the study. There may be a possible role for GER medical management in patients with COME. Further investigations are necessary in order to confirm this hypothesis.
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ABSTRACT: This paper critically reviews the current literature on extragastric diseases associated with Helicobacter pylori infection, with an emphasis on methodologic issues that complicate interpretation of study findings. This review reveals common study limitations and overall uncertainty that H. pylori infection plays a role in extragastric diseases, although such a role has not been clearly ruled out for specific diseases of relevance. Evidence suggests that anti-H. pylori therapy may lead to improvement of a few extragastric diseases, in particular, idiopathic thrombocytopenic purpura, iron deficiency anemia, and chronic idiopathic urticaria, but the data from randomized controlled trials are insufficient to confirm this beneficial effect; if the benefit of anti-H. pylori therapy for specific diseases is real, it is not clear if it results from removing H. pylori-specific injurious effects, eliminating some other infectious pathogen, or reducing the total infectious burden.Current Gastroenterology Reports 01/2007; 8(6):458-64. DOI:10.1007/s11894-006-0035-3