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Biomedical subjects

E M Hearne

Publications and source records attributed to E M Hearne.

15 recordsLinked to original sources
PubMed1986

Medical treatment of chronic otitis media with effusion (secretory otitis media).

To determine whether antimicrobial therapy is of value in the treatment of chronic otitis media with effusion (secretory otitis media), we treated 1,429 4- to 8-year-old children--2224 affected ears--with a fixed regimen of an antibiotic mixture (Pediazole) for 10 days and a decongestant (Novafed) for 30 days. We observed the children monthly to determine the rate of clearance. Validity of diagnosis was greater than 90% with an algorithm of pneumatic otoscopy and tympanometry. Medication compliance was not measured. At 1 month, 45% of the children (48% of the ears) had cleared and at 2 months, 60% of the children (63% of the ears) had cleared. Factors such as sex and prior treatment in the preceding 3 months were no different in the cured vs. the uncured groups. Age significantly influenced the cure rate (P less than 0.0001); the older the child, the higher the clearance rate. Tympanograms type 5, 8, and 12-14 were significantly more prevalent in the uncleared group (P = 0.0001). The clear rate for unilateral cases was 76% and for bilateral cases, 47% (P less than 0.0001). Children with chronic otitis media with effusion are most likely to be cured by medical therapy/time if they are older, have unilateral disease, or a peaked tympanogram. Surgery should be withheld in these children for 2 or more months to permit the highest rate of spontaneous resolution.

Age Factors↗
PubMed1983

A test for serial correlation in univariate repeated-measures analysis.

A popular design in biostatistics and psychometrics is the time-factor experiment involving one grouping factor, e.g. treatment or drug, and one repeated-measures factor, e.g. time or visit. If F tests involving the repeated-measures factor are to be valid, univariate analytic procedures require special assumptions for covariance matrices across groups. The robustness of these univariate procedures is investigated when the covariance matrices do not satisfy these assumptions but have a frequently occurring form, namely the serial correlation or simplex pattern. A table is presented which shows that, for some matrices that fit the pattern, the main-effect repeated-measures estimated actual probability level is more than three times the .05 nominal level. A likelihood ratio test for the serial correlation pattern is presented, along with an example from the field of biostatistics.

Biofeedback, Psychology↗
PubMed1982

Eustachian tube function. Children with otitis media.

The relationship between middle ear disease and eustachian tube function was studied in 24 children with persistent otitis media with effusion and with pressure-equalization tubes in place using the pressure system of an impedance bridge. Five measurements of function were correlated with a child's age and six indexes of disease. The highest multiple correlation squared accounted for only 27% of the variability in results, indicating that knowledge of tubal function by this technique has little useful correlation with other indicators of disease.

Child↗
PubMed1981

The effect of preoperative adriamycin and dihydroxyanthracenedione on wound healing.

Preoperative adjuvant chemotherapy is being used with increasing frequency in advanced head and neck cancer; however, the effects of chemotherapy on wound healing have not been fully elucidated. To evaluate the effect of preoperative chemotherapy, experimental animals were given chemotherapeutic drugs, wounded, and the subsequent wound breaking strength determined. Rats received a single dose of intravenous tumoricidal drugs (adriamycin or or dihydroxyanthracenedione) either one week before or simultaneously with wounding. Wound breaking strength of treated animals and control animals receiving no chemotherapy was measured one and two weeks after wounding. All wounds, regardless of treatment, were stronger at two weeks than at one week after wounding. Wound breaking strength was reduced at both times when chemotherapy was administered one week before wounding. Wound breaking strength in animals that were simultaneously wounded and received chemotherapy was similar to controls. Both adriamycin and dihydroxyanthracenedione have a deleterious effect on one parameter of wound healing--wound breaking strength--when administered one week before wounding.

Animals↗
PubMed1980

Pre-test and post-test in a medicine clerkship.

Offered the opportunity to take the previous quarter's post-test as a pre-test at the beginning of their 3-month medicine clerkship with the understanding it would have no effect on their final grades, 132 of 148 students (89%) took this opportunity. Post-test means for each quarter's group were significantly greater than pre-test means (P=0.0001). Pre-test means did not increase over the four quarters of the year of this study despite increasing student experience in other clinical disciplines. For this entire year correlations were as follows: Pre-test vs post-test r=0.591 (P=0.0001), pre-test vs clinical r=0.306 (P=0.0004), and post-test vs clinical r=0.329 (P=0.0001). By quarter these correlations were generally consistent. An interesting and unexpected finding was that students in the autumn quarter had significantly lower pre-test and clinical scores than students in the winter quarter. This may indicate that students highly motivated to medicine take this as their first clinical clerkship and those least motivated as their last first clinical-year clerkship.

Education, Medical, Undergraduate↗
PubMedDate not supplied

Validity and power investigation of a test for serial correlation in univariate repeated measures analysis.

A common design in biostatistics and psychometrics is the repeated measures design. A popular example is a clinical trial with one grouping factor, e.g. treatment or drug, and one repeated measures factor, e.g. time or visit. For selected 'real world' parameter sets, we performed a validity and power study on a test for serial correlation in repeated measures analysis and also conducted a similar study of a test for sphericity. Simulation showed that the serial correlation test identified the serial correlation structure, whereas the sphericity test, for some parameter sets, failed to detect this non-spherical pattern as often as 85 per cent of the time.

Analysis of Variance↗
PubMedDate not supplied

Current status of laryngectomee rehabilitation: III. understanding of esophageal speech.

To assess those aspects of esophageal speech that contribute to effective communication, a series of measures were applied to the esophageal speech of a prospectively studied group of recent laryngectomees (n = 20) six months following completion of their cancer therapy and to that of a second group (n = 27) studied retrospectively 6.6 years postoperatively. Ages of the two groups did not differ, but there were more whites and more males in the group studied retrospectively. The technical proficiency of the subjects studied prospectively was slightly but significantly less than that of those studied retrospectively. Measures of technical proficiency correlated well with other measures of quality of esophageal speech and were much easier to perform. The understandability of the esophageal speech of the group studied retrospectively was significantly superior. For both groups, understandability was enhanced significantly during audiovisual compared with audio-only presentations. Naive judges had great variability in understanding esophageal speech.

Esophagus↗
PubMedDate not supplied

Treatment of chronic otitis media with effusion: results of tympanostomy tubes.

Insertion of tympanostomy tubes to provide prolonged aeration and drainage of the tympanum in cases of chronic secretory otitis media has become the most commonly performed operation in children. To investigate the therapeutic efficacy of current treatments of chronic secretory otitis media, the authors undertook a randomized clinical trial with four treatment arms: myringotomy alone, tympanostomy tubes, adenoidectomy and myringotomy, and the combination of adenoidectomy and tympanostomy tubes. This report describes the preliminary (one-year) outcome in the group of children who were treated with tympanostomy tubes. The observed average differences between the myringotomy and tympanostomy tube groups were small, with the exception of one variable (time to first recurrence). Although the clinical importance of these differences remains to be established, the authors believe they are substantial enough to justify continued use of tympanostomy tubes in the primary surgical therapy of chronic secretory otitis media, when medical therapy and observation indicate the need for drainage to improve hearing or correct anatomic deformities of the tympanum.

Audiometry, Pure-Tone↗
PubMedDate not supplied

Normal tympanometric shape.

Computer-assisted curve-fitting techniques were used to describe quantitative and qualitative characteristics of normal tympanometric shape. The data base consisted of set of triplicate tympanograms, obtained at 2-week intervals, from 72 ears of children with normal middle ears enrolled in the first through the fifth grades. A nonlinear equation produced significantly better prediction of normal tympanograms (R2 = 0.70) than did linear equations (R2 less than 0.44), bringing into question the use of the latter in determining normality. The complexity of applying curve fitting in clinical practice led to the development of a qualitative technique to determine normality. An initial application of the technique as a screen in 76 ears subjected to myringotomy produced a sensitivity of 96% and a specificity of 83% with respect to identification of the presence of middle ear fluid.

Acoustic Impedance Tests↗
PubMedDate not supplied

Predicting esophageal speech.

Patients undergoing laryngectomy in the 1980s have a low rate of acquisition of esophageal speech. The interaction of the factors of postoperative physical performance status, preoperative phonation duration, postoperative dysphagia, site of lesion, patient income, and postoperative radiation therapy correctly predict the acquisition of esophageal speech in 83% of cases and the failure to acquire esophageal speech in 96%. Such information may be helpful in selecting patients for alternative forms of postlaryngectomy speech rehabilitation.

Humans↗
PubMedDate not supplied

Effect of beta blockade on singing performance.

The symptoms associated with performance anxiety, or the so-called stage fright syndrome, are similar to those of alpha and beta adrenergic stimulation. Suppression of symptoms and improvement in instrumentalist's performance after beta blockade suggest that this modality would be of benefit for singers as well. To evaluate the dose-effect relationship of beta blockade upon singing performance and the possible effect of these agents upon performance maturation, we studied 34 singing students during end of semester juries, using a double-blind crossover paradigm. Students performed once with either placebo, 20, 40, or 80 mg of nadolol, and again 48 hours later, with placebo. There was a significant dose-related, limiting effect upon intraperformance cardiac rate. A small, but statistically significant, dichotomous effect upon performance rating was noted: low-dose nadolol tended to enhance performance, whereas larger doses impaired performance. We conclude that the effects of low dose beta blockade upon singing are minimally helpful and high doses may detract from performance ability.

Adolescent↗
PubMedDate not supplied

Predictive value of tympanometry in middle ear effusion.

The presence of middle ear effusion may be inferred from a tympanogram by the configuration of the pressure compliance curve. Not infrequently, however, effusion is absent at the time of surgery when strongly indicated by preoperative tympanometry. We evaluated this discrepancy by contrasting preoperative tympanograms with the findings at surgery in 462 children, aged 4 to 8 years, with clinical evidence of persistent effusion in 909 ears. Based on these results we can classify tympanograms as to high risk for effusion, intermediate, and low risk. The proportion of ears with effusion was 83%, 47%, and 34%, respectively. The proportion of ears with fluid in the high risk tympanogram group did not change appreciably over a 1- to 8-week period, ie, no trend toward spontaneous resolution occurred. The high incidence of effusion at surgery in our low risk group is far higher than expected and is presumably due to reinfection of these ears during the time between examination and operation.

Acoustic Impedance Tests↗