Submitted by Sandra Pereira (srpereira@ufrrj.br) on 2017-02-15T15:46:57Z No. of bitstreams: 1 2015 - Ana?s Gabriela Villarreal Laguna.pdf: 1531103 bytes, checksum: 8567bc787b67e1d16f71708035dbfc97 (MD5) / Made available in DSpace on 2017-02-15T15:46:58Z (GMT). No. of bitstreams: 1 2015 - Ana?s Gabriela Villarreal Laguna.pdf: 1531103 bytes, checksum: 8567bc787b67e1d16f71708035dbfc97 (MD5) Previous issue date: 2015-12-21 / Otitis is defined as an inflammation, acute or chronic, of the ear canal and it?s considered one of the most common diseases in small animal practice. It possesses various perpetuating agents, bacteria and yeast being the most common. Treatment is based in the recognition of the primary causes and predisposing factors, and the resolution of secondary infections. A greater sensitivity in feline ear canal has also been shown, when compared to dogs. With this in mind, a product with the least possible active ingredients would be the ideal topical treatment in felines. However, the majority of available products combine antibiotics and antifungals, this combination not being necessary in all cases; for bacterial otitis, very few specific products exist, and some of them present a proven ototoxic potential. In face of this problem, the efficacy of a new formulation using levofloxacin for the specific treatment of bacterial otitis was made by the Farmacologia e Farmacometria sector of the LQEPV ? UFRRJ, using isopropylic alcohol as vehicle. Eighteen adult felines, belonging to the Laborat?rio de Quimioterapia Experimental em Parasitologia Veterin?ria (LQEPV-UFRRJ), diagnosed with bacterial otitis according to clinical signs (erythema, inflammation, pruritus, hyperpigmentation and secretions), as well as cytological exams and video-otoscopy, were chosen. Individual data was registered in specific formularies for comparison of pretreatment and post treatments evaluations. After the initial evaluation the animals were divided into three groups, according to treatment: in Group A or control (6 animals) a placebo (vehicle) was used; in Group B (6 animals) a formulation of levofloxacin 0, 5% was used; Group C (6 animals) a formulation of de levofloxacin 0, 5% + dexamethasone 0, 02% was used. In every case 0, 5 ml was applied to each ear, once a day for 15 consecutive days. Post treatment video-otoscopies were performed on day +21, and post treatment cytologies were performed on days +7, +14 and +21. The animals were always observed by the same evaluator, avoiding errors of concordance and checking for possible reactions to the product. None of the animals presented adverse reactions to the product during the treatment period, besides slight discomfort immediately after application. Animals from Group A continued with the same scores until the end of the experiment. Animals from Group B presented an initial clinical improvement, but some of them developed a fungal otitis as time passed. Animals from Group C presented a significant improvement since day +7, with no secondary alterations through time. It is demonstrated that a formulation of de levofloxacin + dexamethasone can be efficient and safe for the treatment of feline bacterial otitis / A otite ? definida como uma inflama??o, aguda ou cr?nica, do conduto auditivo e ? uma das doen?as mais frequentes na cl?nica de animais de companhia. Possui diversos agentes perpetuantes, sendo mais comuns as bact?rias e leveduras. O tratamento e baseado no reconhecimento de causas principais e fatores predisponentes, assim como a resolu??o de infec??es secund?rias. Tem sido relata uma sensibilidade maior nos condutos auditivos dos gatos, quando comparados com c?es. Deste modo, um produto com poucos ingredientes farmacologicamente ativos seria o tratamento t?pico ideal em felinos. No entanto, a maioria dos produtos para otite dispon?veis no mercado combina tanto antibi?ticos, como antif?ngicos, n?o sendo esta combina??o necess?ria em todos os casos; especificamente para otites bacterianas, existem poucos produtos espec?ficos, e muitos apresentam um potencial otot?xico j? comprovado. Perante este problema, foi avaliada a efic?cia de uma nova formula??o a utilizando levofloxacina para o tratamento espec?fico da otite bacteriana em felinos, o produto foi confeccionado pelo setor de Farmacologia e Farmacometria do LQEPV ? UFRRJ, utilizando como ve?culo ?lcool isoprop?lico. Foram selecionados 18 felinos adultos pertencentes ao Laborat?rio de Quimioterapia Experimental em Parasitologia Veterin?ria (LQEPV-UFRRJ), diagnosticados com otite bacteriana de acordo com sinais cl?nicos (eritema, inflama??o, prurido, hiperpigmenta??o e presen?a de secre??o), exame citol?gico e v?deo-otoscopia. Os dados individuais foram registrados em formul?rios espec?ficos para compara??o das avalia??es inicias e p?s-tratamento. Ap?s as avalia??es iniciais, os animais foram divididos em tr?s grupos experimentais: no grupo A, controle, seis animais utilizaram um Placebo (ve?culo); no grupo B, seis animais utilizaram a formula??o contendo Levofloxacina a 0,5%; e no grupo C, seis animais foram medicados com a associa??o de Levofloxacina 0,5% com dexametasona 0,02%. Em todos os casos foram instilados 0,5ml em ambas as orelhas uma vez por dia, durante 15 dias consecutivos. Exames vide-otosc?picos p?s-tratamento foram realizadas no dia +21, e citologias nos dias +7, +14 e +21. Os animais foram observados diariamente sempre pelo mesmo avaliador, evitando assim erros de concord?ncia e acompanhando poss?veis rea??es adversas ao produto. Nenhum animal apresentou rea??o adversa ao produto durante o per?odo de tratamento, al?m de incomodo no momento imediato ap?s a aplica??o. Os animais do grupo A continuaram com o mesmo score registrado no dia 0 at? finalizado o experimento. Os animais do grupo B apresentaram melhoria inicial, porem alguns deles desenvolveram otite f?ngica ao decorrer do tempo. J? os animais do grupo C apresentaram uma melhora significativa desde o dia +7, sem altera??es secund?rias no decorrer do experimento. Demostra-se assim que a associa??o de levofloxacina 0,5% com dexametasona 0,02% pode ser eficaz e segura para o tratamento da otite bacteriana em felinos

ABSTRACT External otitis and its treatment. Is a group III steroid without antibiotics sufficient therapy? – Experimental and clinical studies Per Emgård, Department of Otorhinolaryngology, University of Umeå and Ystad Hospital, Umeå and Ystad, Sweden External otitis is one of the most common ear, nose and throat (ENT) diagnoses in out-patient clinics. The clinical course of external otitis includes itching, pain, redness, swelling and effusion of the external auditory canal (EAC) with normal tympanic membrane status. The inflammatory condition is often associated with infection by bacteria, e.g. Pseudomonas aeruginosa, or skin bacteria such as Staphylococcus species. Fungi are present only in a low percentage of cases and if present Candida albicans infection is the most frequent in northern countries such as Sweden and the UK. Topical therapy is recommended in most countries and dominates the therapy in most studies. Topical drugs used are usually a combination of antibiotics and a steroid. However, external otitis is treated with surprisingly many strategies – eleven different ones in Sweden, for example, and 18 in the UK. The aims of the present studies were to – -establish an animal model, infected and uninfected, suitable for testing various treatment strategies of external otitis; and -perform a clinical study in patients to elucidate whether a group III steroid alone is as efficient for treatment of external otitis as is the commonly used topical drug containing a combination of a steroid and antibiotics. The animal model was established through mechanical irritation of the external ear canal skin of Sprague-Dawley rats. An evaluation scale for characterization of the clinical status of the ear canal was introduced, recording redness, swelling and occurrence of effusion in a standardized way. Specimens of the ear canal skin were analysed by histological techniques. A topical solution of 0.05% bethametasone dipropionate (BD) was compared with a 1% hydrocortisone solution with antibiotics oxytetracycline and polymyxin B added (HCPB), administered in the external otitis model infected or non-infected with bacteria (P. aeruginosa) and a fungus (C. albicans). The same drugs were tested in a randomized parallel-group multi-centre study in 51 patients. The clinical status of the external otitis patients was evaluated on a similar scale as used in the animal model. Early normalization of the ear canal skin status and frequency of relapses during the 6-month follow-up period were used as end-points of the study. The studies showed the following: -An animal model for external otitis, infected or uninfected, could be established. -A new scale for evaluation of the external ear canal status with regard to redness, swelling and occurrence of effusion was introduced for the animal model as well as for the investigations in patients. -Treatment with a group III steroid topical solution without antibiotics was superior to treatment with a group I steroid with antibiotics added in achieving resolution of external otitis. -The effectiveness of the topical drugs in the clinical studies in external otitis patients was similar to that in animal external otitis models. We conclude that a group III steroid solution cures external otitis more effectively than does a solution containing a group I steroid combined with antibiotics, whether infected by bacteria or by fungi. No difference was evident regarding adverse effects. Furthermore, costs favour a solution without any antibiotic components. In view of these observations a group III steroid solution is preferred for remedy of external otitis in the clinical situation. Key words: external otitis, external auditory canal (EAC), animal model, treatment, betamethasone, hydrocortisone, antibiotics, human study, Pseudomonas aeruginosa, Candida albicans.

Made available in DSpace on 2014-08-20T14:37:59Z (GMT). No. of bitstreams: 1 dissertacao_graziela_wilhelm.pdf: 1275443 bytes, checksum: 5ac7d92c65d4c9206a6a7f09cb6abe47 (MD5) Previous issue date: 2010-04-30 / The external otitis corresponds to all inflammatory process, acute or chronic, that reaching the external auditory epithelium, may also affect the pinna. In chronic or recurrent cases of canine otitis, not responsive to therapy with drugs, the surgical treatment is indicating, thus, lateral resection to external auditory canal one of the techniques applied. The objective of this work was evaluated the clinical, microbiological and histopathological aspects of the resection of the lateral external auditory canal in the treatment of chronic external otitis in dogs and compared the surgical wounds healing process of the external auditory and the lumbar region skin of rabbits using in the suture tissue adhesives and nylon yarn. In the first experiment was studying seven canines with chronic recurrent, with time course of a year or more, not responsive to drug treatment, presenting vertical conduit stenosis, ceruminous secretion (moderate to abundant) or purulent secretion and presence of erythema (moderate to intense). In the 0 day the dogs were evaluated clinically and collected samples of ear secretion for microbiological analysis and, after, submitted to lateral resection of external auditory canal procedure. In the 45, 60, 90 days postoperative, the dogs were reassessed clinically and micorbiologically as the evolution of otitis. The auditory pinna was evaluated as the purid and erythema presence. The external auditory canal was evaluated considering the presence of erythema, secretion, stenosis, tumor and growth offungi and bacteria. In the second experiment 12 rabbits was used (n=24 ears) submitted to lateral resection of external auditory canal and to two cutaneous incision in the dorsal region. The surgical wounds suture were realized with monofilament nylon and tissue adhesives. The clinical aspects of the surgical wounds healing process in the 1º, 3º, 7º, 14º and 21º postoperative day (pod) were evaluated. At the end of the experiment (21º postoperative day) were collected surgical wounds samples for hystopathology analysis. The results of the experiment with dogs demonstrated that the lateral resection technical of external auditory was effective in the chronic external otitis treatment, it shown a significant reduce (p<0,000) of the erythema, pruritus and secretion when compared the 0 day with 45, 60 and 90 postoperative day. In the experiment realized with rabbits, the surgical wounds of the ears and the skin clinical evaluations indicating no significant difference (p >0,05) between the treatments, with a tendency towards outcome in the healing process, of etyl-cyanocrylate. When compared the surgical wounds healing of the ears and the skin, was evidenced that in the skin the three treatments were greatest than in the ear. The results demonstrated that the lateral resection of the external auditory conduit was effective in the chronic external otitis treatment and that both the monofilament nylon 5-0 and the n-butyl cyanoacrylate adhesives (Vetbond®) and etyl-cyanoacrylate (Super Bonder®) were acted in similar form in the surgical wounds healing, with a tendency to better the healing evolution when using the etyl-cyanocrylate. / A otite externa corresponde a todo processo inflamatório, agudo ou crônico, que atinge o epitélio do conduto auditivo externo, podendo também acometer o pavilhão auricular. Em casos crônicos ou recidivantes de otite canina, não responsivos a terapia com medicamentos, o tratamento cirúrgico é indicado, sendo, a ressecção lateral do conduto auditivo externo uma das técnicas aplicadas. Neste trabalho objetivou-se avaliar os aspectos clínicos, microbiológicos e histopatológicos da ressecção lateral do conduto auditivo externo no tratamento da otite externa crônica em cães e comparar o processo de cicatrização de feridas cirúrgicas do conduto auditivo externo e da pele da região lombar de coelhos utilizando na síntese adesivos teciduais e o fio de náilon. No primeiro experimento foram estudados sete caninos com otite externa crônica recidivante, com tempo de evolução de um ano ou mais, não responsiva a tratamento medicamentoso, apresentando estenose do conduto vertical, secreção ceruminosa (moderada a abundante) ou purulenta e presença de eritema (moderado a intenso). No dia 0 os cães foram avaliados clinicamente e coletadas amostras de secreção auricular para análise microbiológica e, posteriormente, submetidos ao procedimento de ressecção lateral do conduto auditivo externo. Nos dias 45, 60 e 90 pós-operatório foram reavaliados clinicamente e microbiologicamente quanto à evolução da otite. O pavilhão auricular foi avaliado quanto à presença de prurido e eritema. O conduto auditivo externo foi avaliado considerando a presença de eritema, secreção, estenose, tumorações e crescimento de fungos e bactérias. A técnica foi efetiva no tratamento da otite externa crônica canina. No segundo experimento, foram utilizados 12 coelhos (n=24 orelhas) submetidos à ressecção lateral do conduto auditivo externo e a duas incisões cutâneas na região dorsal. A síntese das feridas cirúrgicas foram realizadas com náilon monofilamentar e adesivos teciduais. Foram avaliados os aspectos clínicos do processo cicatricial das feridas cirúrgicas no 1º, 3º, 7º, 14º e 21º dia pós-operatório. No final do experimento (21º dia pós-operatório) foram coletadas amostras das feridas cirúrgicas para análise histopatológica. Os resultados do experimento com cães demonstraram que a técnica de ressecção lateral do conduto auditivo externo foi efetiva no tratamento da otite externa crônica demonstrando redução significativa (p<0,000) do eritema, prurido e secreção quando comparado o dia 0 com os dias 45, 60 e 90 dias pós-operatório, bem como redução no crescimento de fungos e bactérias. No experimento realizado com coelhos, as avaliações clínicas das feridas cirúrgicas das orelhas e da pele indicaram não haver diferenças significativas (p >0,05) entre os tratamentos, apesar de apresentar tendência de melhor evolução no processo cicatricial do etil-cianoacrilato. Quando comparado à cicatrização das feridas cirúrgicas da orelha e da pele, foi evidenciando que na pele os três tratamentos foram melhores do que na orelha. Os resultados demonstraram que tanto o náilon monofilamentar 5-0 quanto os adesivos n-butil cianoacrilato (Vetbond®) e etil-cianoacrilato (Super Bonder®) atuaram de forma semelhante na cicatrização das feridas cirúrgicas, com tendência para melhor evolução cicatricial quando utilizado o etil-cianoacrilato.