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Biomedical subjects

D W Teele

Publications and source records attributed to D W Teele.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1984

Detection of middle ear effusion by acoustic reflectometry.

Existing diagnostic methods for otitis media with effusion are inadequate. We designed, built, and tested an acoustic reflectometer to overcome such inadequacies. The probe is placed at the entrance to the external auditory canal, whereupon a swept tone (1800 to 7000 Hz) is generated. The device records sound amplitude representing the sum of incident and reflected sound. This sum reaches a nadir at a frequency for which the quarter wave length corresponds to the distance from the microphone to the tympanic membrane; at this frequency reflected sound is maximally out of phase with incident sound. We measured this nadir (in decibels) and correlated the decrease in sound level at the nadir with the presence or absence of middle ear effusion. With a diagnosis confirmed by acoustic admittance and pneumatic otoscopy (n = 290), and using a breakpoint of 4.0 dB, the sensitivity was 94.4% and the specificity was 79.2%. Acoustic reflectometry can be portable, results are virtually instantaneous, and the method is reliable independent of age, crying, cerumen, and lack of cooperation from the child.

Acoustic Impedance Tests↗
PubMed1984

Otitis media with effusion during the first three years of life and development of speech and language.

To determine the association between time spent with middle ear effusion and development of speech and language, 205 three-year-old children were studied. Each child had been followed prospectively from birth to record the number of episodes of middle ear disease and to document time spent with middle ear effusion. Standardized tests of speech and language were administered at age 3 years to children who had spent much time with middle ear effusion and to children who had spent little or no time with middle ear effusion. Children who had spent prolonged periods of time with middle ear effusion had significantly lower scores when compared with those who had spent little time with middle ear disease. The correlation was strongest in children from higher socioeconomic strata. Time spent with middle ear effusion in the first 6 to 12 months of life was most strongly associated with poor scores.

Acute Disease↗
PubMed1983

Middle ear disease and the practice of pediatrics. Burden during the first five years of life.

To determine the burden on pediatricians imposed by disease of the middle ear, we analyzed data from 2,570 children followed up prospectively since birth. Disease of the middle ear accounted for a large proportion of all visits made during the first five years of life, rising from 22.7% during the first year to about 40% in years 4 and 5. About one visit in three made for illness of any kind resulted in the diagnosis of disease of the middle ear. Approximately three fourths of all visits to follow up any illness were made to follow up disease of the middle ear. Disease of the middle ear was diagnosed at between 5% and 10% of all well-baby visits. Children from private practice averaged fewer visits for all reasons than did children using a large neighborhood health center, but the proportions of visits accounted for by disease of the middle ear were similar in both settings.

Age Factors↗
PubMed1983

Infectious disease problems in indochinese refugees.

It is necessary to systematically anticipate and sympathetically address a number of both emotional and physical problems with which Indochinese refugees commonly enter our society. Their infectious medical problems are generally common rather than exotic, although unusual diagnoses must occasionally be considered. If diagnosed, they are generally amenable to treatment. They pose little risk to the public health, and the little danger that they do represent can largely be obviated by attention to principles of infection control, personal hygiene, and public sanitation. Table 9 summarizes the screening and management recommendations appropriately applied to clinical care of this population.

Adolescent↗
PubMed1981

Bacteriology of acute otitis media unresponsive to initial antimicrobial therapy.

To determine the microbiology of acute otitis media unresponsive to initial antimicrobial therapy, we performed tympanocentesis on 43 children. All had failed to improve after at least 36 hours of therapy. Initial therapy was ampicillin or amoxicillin (31), trimethoprim-sulfamethoxazole (5), erythromycin and sulfisoxazole (5), erythromycin (1), and ampicillin and gentamicin (1). Among these children, 19% had isolates from middle ear fluid resistant to initial therapy. Bacteria sensitive to initial therapy were isolated from ten children (24%). The majority of children (57%) had bacteriologically negative middle ear fluid. Resistant isolates from children initially treated with ampicillin or amoxicillin were sensitive to trimethoprim-sulfamethoxazole or to erythromycin and sulfisoxazole, and vice versa. Critically ill children should have tympanocentesis to guide therapy; other children who fail to respond to antimicrobial therapy may receive alternative therapy as indicated by the results of this study.

Acute Disease↗