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22 - Otitis media and sinusitis
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- By Ellen R. Wald, Division Allergy, Immunology and Infectious Diseases, Children's Hospital of Pittsburgh, Pittsburgh, PA, Barry Dashefsky, Division of Pulmonology, Allergy, Immunology and Infectious Diseases, UMDNJ – New Jersey Medical School, Newark, NJ, USA
- Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read
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- Book:
- Handbook of Pediatric HIV Care
- Published online:
- 23 December 2009
- Print publication:
- 04 May 2006, pp 543-553
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- Chapter
- Export citation
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Summary
Introduction and background
Otitis media and sinusitis are among the most common minor bacterial infections affecting children with normal immune function. To date, there has been a paucity of systematic study of these infections in immunocompromised hosts in general. However, substantial experience and a limited literature suggest that, in their acute, chronic, and recurrent forms, they also occur commonly in children who are infected with HIV.
Epidemiology of acute otitis media and sinusitis
Acute otitis media (AOM) is a very common occurrence in immunocompetent children, with peak frequency during the first 2 years of life. In addition to young age, risk factors for AOM include male gender, a history of severe or recurrent AOM in siblings, early age of first AOM, absence of breast feeding, winter season, race (with high rates among Eskimos and other Native Americans, as well as Australian aborigines), daycare attendance, lower socioeconomic status, and craniofacial anomalies [1].
There are three controlled studies that describe the relative frequency of AOM among HIV-infected children [2–4]. All clearly indicate that, although this common childhood condition does not affect a greater proportion of children infected with HIV than normal children, it does recur significantly more often among children with symptomatic HIV infection.
Acute sinusitis is an extremely common problem among young children with normal immunity. It has been estimated that 5%–10% of viral upper respiratory infections (URIs) in young children (which occur six to eight times annually) are complicated by bacterial sinusitis [5].
Influenza Vaccine: Immunization Rates, Knowledge, and Attitudes of Resident Physicians in an Urban Teaching Hospital
- A. Patricia Wodi, Sawsan Samy, Echezona Ezeanolue, Rytza Lamour, Rakesh Patel, Lawrence D. Budnick, Barry Dashefsky
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 26 / Issue 11 / November 2005
- Published online by Cambridge University Press:
- 21 June 2016, pp. 867-873
- Print publication:
- November 2005
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- Article
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Background:
Because resident physicians (RPs) frequently have direct patient contact, those who are unimmunized against influenza potentially subject patients to unnecessary risk of infection.
Objective:To determine the rates of, knowledge regarding, and attitudes toward influenza immunization among RPs. We hypothesized that rates of and knowledge about influenza immunization did not differ between primary care (PC) and non-PC RPs.
Methods:A self-administered, anonymous questionnaire distributed to a convenience sample of 300 RPs (150 PC and 150 non-PC). The questionnaire requested influenza immunization status in the 2003-2004 and previous seasons and factors influencing respondents' decisions whether to be immunized. It included a 20-item test of knowledge about influenza immunization.
Results:Two hundred five (68.3%) of 300 distributed questionnaires (196 that were evaluable) were returned. Response rates of PC and non-PC RPs did not differ (P = .79). The overall immunization rate of RPs in 2003-2004 was 38.3% and rates did not differ between PC (38.9%) and non-PC (37.6%) RPs. RPs most often cited “self-protection” as a reason for electing (93.3%) and “lack of time” for declining (47.1%) influenza immunization. Their ability to correctly answer questions about influenza immunization varied; their mean knowledge score was 13.7 (perfect = 20). PC and non-PC trainees did not differ by knowledge score (P = .48). However, RPs “ever vaccinated” had a higher knowledge score than those “never vaccinated” (P = .01).
Conclusion:RPs have low immunization rates and significant gaps in knowledge regarding influenza immunization. These problems should be addressed during their training by education on the importance, effectiveness, and safety of influenza vaccine for them and their patients.
29 - Otitis media and sinusitis
- from Part IV - Clinical manifestations of HIV infection in children
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- By Ellen R. Wald, University of Pittsburgh School of Medicine; Division of Allergy, Immunology and Infectious Diseases, Children's Hospital of Pittsburgh, Pittsburgh, PA, Barry Dashefsky, Division of Pulmonology, Allergy, Immunology and Infectious Diseases, UMDNJ — New Jersey Medical School, Newark, NJ
- Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read, National Cancer Institute, Bethesda, Maryland
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- Book:
- Textbook of Pediatric HIV Care
- Published online:
- 03 February 2010
- Print publication:
- 28 April 2005, pp 460-467
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- Chapter
- Export citation
-
Summary
Introduction and background
Otitis media and sinusitis are among the most common minor bacterial infections affecting children with normal immune function. To date, there has been a paucity of systematic study of these infections in immunocompromised hosts in general. However, substantial experience and a limited literature suggest that, in their acute, chronic, and recurrent forms, they also occur commonly in children who are infected with HIV. Although the causes, manifestations, and clinical courses of most episodes of otitis media and sinusitis in HIV-infected children are indistinguishable from those in immunocompetent children, unusually frequent, prolonged, severe, or otherwise problematic episodes, or those caused by unusual or opportunistic pathogens, can be the sentinel expressions of immunodeficiency that should prompt an assessment for HIV infection.
Epidemiology of acute otitis media and sinusitis
Acute otitis media (AOM) is a very common occurrence in immunocompetent children with peak frequency during the first 2 years of life. In addition to young age, risk factors for AOM include male gender, a history of severe or recurrent AOM in sibling(s), early age of first AOM, absence of breast feeding, winter season, race (with high rates among Eskimos and other Native Americans, as well as among Australian aborigines), day-care attendance, lower socioeconomic status, and craniofacial anomalies [1].
There are three controlled studies that describe the relative frequency of AOM among HIV-infected children [2–4].