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Biomedical subjects

D W Teele

Publications and source records attributed to D W Teele.

At least 19 recordsLinked to original sources
PubMed1994

Serious bacterial infections in febrile infants and children selected for lumbar puncture.

Lumbar puncture (LP) is performed frequently in pediatric emergency departments to diagnose meningitis in infants and young children with fever. Children selected to have LP who do not have meningitis may, however, have other serious bacterial infections. We surveyed lumbar punctures performed in the Boston City Hospital Pediatric Emergency Department and monitored the incidence of meningitis and other serious bacterial infections. Meningitis was diagnosed in 8% of children who underwent LP. An additional 10.5% of children who underwent LP and had normal cerebrospinal fluid had positive cultures of blood (3.1%), urine (4.1%) or stool (3.3%). The decision to perform lumbar puncture identifies children at risk of having not only meningitis but other serious bacterial illnesses. Those children 2 years of age and younger with normal cerebrospinal fluid should be considered for cultures of blood, urine and possibly stool.

Adolescent↗
PubMed1993

Neurocysticercosis in a child with no history of travel outside the continental United States.

We present a case of neurocysticercosis in a 16-month-old girl who had no history of travel outside the continental United States. Immunoblot assays of serum and CSF were both reactive. The patient's father was found to be shedding Taenia ova in his stools, a finding that suggested direct fecal-oral transmission between himself and the patient. Given the possibility of this mode of transmission, the diagnosis of CNS cysticercosis should be considered for patients with compatible clinical presentations even if they do not have obvious risk factors such as travel to an area endemic for the parasite.

Animals↗
PubMed1991

Strategies to control recurrent acute otitis media in infants and children.

Recurrent AOM is a plague in many societies. The considerable attendant morbidity is best reduced through extended periods of antimicrobial prophylaxis. Children who are not helped by this intervention and who are experiencing sufficiently severe disease become candidates for surgical management with tympanostomy tubes. Should both strategies fail, then an adenoidectomy should be considered. In every case, the practitioner must weigh the severity of the recurrent illness against the real costs and risks of surgery.

Anti-Bacterial Agents↗
PubMed1990

Otitis media in infancy and intellectual ability, school achievement, speech, and language at age 7 years. Greater Boston Otitis Media Study Group.

To determine intellectual and linguistic sequelae of middle ear disease, 207 children were randomly selected from a cohort of 498 followed prospectively from birth until age 7 years. After controlling for confounding variables, estimated time spent with middle ear effusion (MEE) during the first 3 years of life was significantly associated with lower scores on tests of cognitive ability, speech and language, and school performance at age 7 years. The adjusted mean full-scale WISC-R were 113.1 for those with least time with MEE, 107.5 for those with moderate time, and 105.4 for those with most time. Similar significant differences were found for verbal and performance IQ scores. For the Metropolitan Achievement Test, we found that middle ear disease in the first 3 years of life was associated with significantly lower scores in mathematics and reading. Similar differences were found for articulation and use of morphologic markers. After considering time spent with MEE during the first 3 years of life, time spent after age 3 years was not a significant predictor of scores on any of the tests administered.

Child↗
PubMed1990

Acoustic reflectometry for assessment of hearing loss in children with middle ear effusion.

We sought associations between acoustic reflectometry and hearing loss in ears with and without middle ear effusion in 137 New Zealand children ages 3 to 16 years. Reflectometry was significantly associated with conductive hearing loss. These associations were present in the entire sample; correlation coefficients varied between 0.31 at 2000 Hz (P less than 0.001) and 0.55 for a three frequency pure tone average (P less than 0.001). The associations persisted for the sample of ears deemed to be filled entirely by effusion; correlation coefficients varied between 0.27 at 4000 Hz (P = 0.026) and 0.47 at 500 Hz (P less than 0.001). Using a reflectivity of 6.0 or greater to detect a three frequency pure tone average loss of 30 dB or more, the sensitivity was 88% and the specificity was 44%. The technique of acoustic reflectometry should be explored and extended to permit rational decisions about management of middle ear effusions.

Adolescent↗
PubMed1989

Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study.

To determine the epidemiology of acute otitis media (AOM) and duration of middle ear effusion (MEE), we followed consecutively enrolled children from shortly after birth until 7 y of age. Because some children dropped out of the study, data were analyzed for 877 children observed for at least 1 y; 698 were observed for at least 3 y, and 498 were observed until 7 y of age. By 1 y of age, 62% of the children had greater than or equal to 1 episode of AOM and 17% had greater than or equal to 3 episodes; by 3 y of age, 83% had greater than or equal to 1 episode of AOM and 46% had greater than or equal to 3 episodes. The peak incidence occurred during the second 6-mo period of life. Significantly increased risk (by multivariate analysis) for AOM was associated with male gender, sibling history of recurrent AOM, early occurrence of AOM, and not being breast fed. MEE persisted after onset of AOM for weeks to months; prolonged duration of MEE was associated with male gender, sibling history of ear infection, and not being breast fed.

Acute Disease↗
PubMed1986

In vitro activities of selected new and long-acting cephalosporins against Pasteurella multocida.

The activities of six agents commonly used in treating infections of the skin and soft tissues and the action of selected cephalosporins against 15 isolates of Pasteurella multocida were assessed by a macro-broth dilution method. Broad-spectrum cephalosporins, including ceftriaxone and cefixime, had excellent in vitro activities (MIC less than or equal to 0.098) against the isolates tested.

Cefaclor↗