Eosinophilic otitis media (EOM) shows a very high rate of association with asthma, and intractable otitis media involves marked eosinophil infiltration into the middle ear. The middle ear space is connected to the nasopharynx by the Eustachian tube, and it is considered a part of the upper respiratory tract. Allergic rhinitis and asthma often coexist as chronic inflammatory diseases of the upper and lower airways, respectively, and have an impact on each other. In fact, inhaled corticosteroids reduce seasonal eosinophilia systemically in the circulation and locally in the nasal mucosa, as well as attenuate seasonal nasal symptoms. We report a case of EOM associated with adult-onset asthma that improved following optimal asthma therapy after changing the treatment from inhaled fluticasone propionate (FP) (200 microg b.i.d.) to a combination of FP/salmeterol (250/50 microg b.i.d.). This result supports the hypothesis that EOM and asthma are closely linked, presenting as different manifestations of a similar disease syndrome.
Adrenal Cortex Hormones ; Androstadienes ; Asthma ; Diethylpropion ; Ear, Middle ; Eosinophilia ; Eosinophils ; Eustachian Tube ; Nasal Mucosa ; Nasopharynx ; Otitis ; Otitis Media ; Respiratory System ; Respiratory Therapy ; Rhinitis ; Rhinitis, Allergic, Perennial ; Seasons ; Fluticasone

This study investigated the difficulties that single caregivers face while providing home health care for a parent while continuing to work. Semi-structured interviews were conducted with 9 single caregivers who balanced working while providing home health care for more than 3 months for a parent discharged from the hospital. The interview contents were inductively analyzed. One core category with 2 factors was extracted, revealing the characteristics of difficulties that single caregivers face while balancing work and providing home health care. The factor [psychological stress associated with care] had the categories [opportunity to provide care] and [an environment where there is no one to take over caregiving. The factor [care reporting system of persons experienced in providing care] had the categories [presence of a person to talk to about troubles] and [areas to watch and respite system]. For single caregivers providing home health care for a parent for 3 months while continuing to work, the care burden was found to increase over time. The presence of a person whom they could talk to when they experienced difficulties influenced their ability both to provide care and to continue working. Establishing a system that allows for cooperation between medical institutions, the workplace, and society is necessary so that single caregivers can more easily provide care for a parent while continuing to work.