Subject(s)
Health Care Costs , Hearing Loss/surgery , Ossicular Prosthesis/economics , Ossicular Replacement/economics , Adolescent , Adult , Aged , Cohort Studies , Cost-Benefit Analysis , Female , Hearing Loss/diagnosis , Humans , Male , Middle Aged , Norway , Ossicular Replacement/methods , Patient Satisfaction/statistics & numerical data , Prognosis , Prospective Studies , Severity of Illness Index , Sweden , Treatment Outcome , Young AdultABSTRACT
We have investigated if features in the diffuse reflectance spectra from in vivo spectroscopic measurements of the tympanic membrane could aid the diagnosis of otitis media in children. Diffuse reflectance spectroscopy, in the visible wavelength range, was used in 15 ears from children with otitis media with effusion before and after myringotomy and in 15 healthy ears as a reference. Two previously published erythema detection algorithms yielded numerical quantities of haemoglobin content. With a combination of the algorithms, induced erythema (after myringotomy) was distinguished from healthy ears using Student's t-test (p < 0.01). Otitis media with mucous effusion was distinguished from (1) otitis media with serous effusion, (2) induced erythema and (3) healthy ears, (p < 0.05) using Student's t-test for independent groups and the paired t-test for dependent groups. Our results imply that reflectance spectroscopy is a promising technique to be used for the diagnosis of otitis media.
Subject(s)
Algorithms , Diagnosis, Computer-Assisted/methods , Otitis Media/diagnosis , Otitis Media/physiopathology , Otoscopy/methods , Spectrum Analysis/methods , Tympanic Membrane/physiopathology , Acute Disease , Child , Child, Preschool , Female , Humans , Male , Myringoplasty , Otitis Media/surgery , Otitis Media with Effusion/diagnosis , Otitis Media with Effusion/physiopathology , Otitis Media with Effusion/surgery , Prognosis , Reproducibility of Results , Sensitivity and Specificity , Severity of Illness Index , Treatment OutcomeABSTRACT
The in-vitro activity of five new fluoroquinolones, WIN 57273, sparfloxacin, fleroxacin, temafloxacin and ciprofloxacin was determined against 543 recent clinical isolates and eight quinolone resistant strains derived by mutation and their five parent strains. WIN 57273 was the most active compound against Gram-positive bacteria, sparfloxacin had a broad spectrum which was similar to that of ciprofloxacin. Ciprofloxacin showed the greatest activity against Gram-negative bacteria. Temafloxacin showing some activity against Gram-positive organisms and Acinetobacter spp. Fleroxacin was the least active compound studied. Compared to wild type parent strains, the mutated strains produced the following results. In Enterobacter cloacae OmpF deficiency increased the MICs of all quinolones by 8-32-fold. In Pseudomonas aeruginosa OmpF deficiency had a limited effect, Omp D2 deficiency combined with an increased lipopolysaccharide content produced greater resistance, i.e. 4-16-fold; mutations in gyrase were associated with variously increased MICs, depending on the strain and compound tested.
