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Biomedical subjects

S E Stool

Publications and source records attributed to S E Stool.

At least 73 records · Page 4Linked to original sources
PubMed1983

Lack of efficacy of a decongestant-antihistamine combination for otitis media with effusion ("secretory" otitis media) in children. Results of a double-blind, randomized trial.

In a double-blind, randomized trial of 553 infants and children who had otitis media with effusion ("secretory" otitis media), we compared the efficacy of a four-week course of an oral decongestant-antihistamine combination (pseudoephedrine hydrochloride, 4 mg per kilogram of body weight per day, and chlorpheniramine maleate, 0.35 mg per kilogram per day) with that of placebo. Among patients with initially unilateral disease, resolution of middle-ear effusion occurred at four weeks in 38 per cent of those treated with placebo and 34 per cent of those treated with drug (P = 0.74). Among patients with initially bilateral disease the corresponding proportions were 19 and 21 per cent, respectively (P = 0.67). Side effects were reported more often among drug-treated than placebo-treated patients. Decongestant-antihistamine combinations do not appear to be indicated for the treatment of otitis media with effusion in infants and children.

Child↗
PubMed1983

Otolaryngology and deafness.

Results of a survey of 113 departments of otolaryngology chairmen indicated that, in general, otolaryngologists are inexperienced in treating deaf children. Moreover, the education of residents is marginal in some topics related to deafness. We conclude that didactic work in these deficient areas should be included in the curriculum of otolaryngology residents so that the needs of patients with such problems will be better met. This study was stimulated by the results of a survey of schools for the deaf regarding the otologic care of deaf children. Questions arose as to what extent otolaryngology residents are instructed in topics related to deafness.

Child↗
PubMed1981

Acute otitis media: toward a more precise definition.

Eighty-five infants and children presenting with acute otitis media who had normal tympanic membrane landmarks and mobility within 1 month before entry into the study were studied. These criteria were used in order to avoid including children with prior otitis media with effusion (secretory otitis media). A diagnosis of suppurative otitis media was made in each case based on pneumo-otoscopic findings of diminished mobility, contour, and color of the tympanic membrane. The diagnosis was validated by myringotomy and positive culture of the middle ear fluid. A poorly mobile, bulging, yellow, opacified tympanic membrane was the most common type of tympanic membrane visualized; whereas a poorly mobile, bulging, red tympanic membrane was seen in ony 19%. The color of the tympanic membrane did not correlate with a specific pathogen isolated from the middle ear exudate. Sixty-seven per cent of children had no fever; 28% had no pain or querulous behavior.

Acute Disease↗
PubMed1981

Acute management of laser-ignited intratracheal explosion.

The laser-ignited airway explosion is a shocking emergency. Techniques available for prevention of an airway fire minimize the risk, but they are not applicable in all circumstances. The severity of the patient's injury depends on the duration and intensity of the burn. Prompt, appropriate management is facilitated if the operating team has previously discussed and "rehearsed" this potential disaster. The distal airway burn produced by an ignited endotracheal tube differs from an inhalation burn in character and severity. The anatomic and respiratory effects occurring subsequent to the laser-induced burn are examined. Emergency care requires immediate elimination of the fire, removal of the tube and any foreign body or debris, and usually a tracheostomy. A program of medical and endoscopic management is suggested.

Bronchoscopy↗
PubMed1980

Temporal bone histopathologic features in Fanconi's anemia syndrome.

A histopathologic study of the temporal bones from a 7-year-old girl with Fanconi's anemia syndrome demonstrated (1) hemorrhage in the submucosal layer and the cavity of the middle ear and mastoid, massive in the right ear; (2) hypocellularity of the bone marrow; (3) minor but multiple anomalies of the middle ear; and (4) hypodevelopment of the hook portion of the cochlea and reduced overall length of the cochlear duct. The histopathologic features of these temporal bones appears to suggest that congenital anomalies of the inner ear, as well as those of the external and middle ears, would be possible causes of the deafness that accompanies Fanconi's anemia syndrome.

Anemia, Aplastic↗
PubMed1979

Cefaclor compared with amoxycillin acute otitis media with effusion: a preliminary report.

A double-blind, randomized clinical trial comparing cefaclor with amoxycillin in the treatment of acute otitis media with effusion (OME) in infants and children is being conducted at Children's Hospital of Pittsburgh. Although the randomization code has not yet been broken, the results of treating the first 55 children are reported, since they appear to be of interest. Of the 62 ears with acute OME on which an initial tympanocentesis was performed, 41 positive cultures were isolated from the middle ear aspirates. Of the 10 ears from which Haemophilus influenzae was isolated, one had a type b strain, and of the remaining unencapsulated strains, one was resistant to both penicillin G and ampicillin. In the one ear from which Staphylococcus aureus was isolated, the organism was found to be resistant to ampicillin. However, all of the organisms were sensitive in vitro to cefaclor. In 88% of all subjects observed for the first 2 weeks, the initial symptomatic response was excellent. Six children had persistent signs and symptoms of acute OME and received a second tympanocentesis; however, none of the effusions from the repeat aspiration revealed an organism. An effusion was still present in 97% of the ears after 3 days, in 69% after 2 weeks, and in 48% 6 weeks after initiation of the study. Tympanocentesis did not appear to affect either the initial clinical response or the persistence of effusion. There were no adverse reactions to either drug in this study. Because an apparent increase in the incidence of ampicillin-resistant strains of H. influenzae is being reported, and because of the presence of ampicillin-resistant S. aureus in some ears with acute OME, a new antimicrobial effective against all the common pathogens causing acute middle ear disease would be desirable. In this respect, the preliminary findings of treatment with cefaclor from this study appear promising.

Acoustic Impedance Tests↗
PubMed1978

History of recurrent sore throat as an indication for tonsillectomy. Predictive limitations of histories that are undocumented.

As part of a prospective study of indications for tonsillectomy and adenoidectomy, we followed closely 65 children with histories of recurrent throat infection that seemed impressive (at least seven episodes in one year, five in each of two consecutive years or three in each of three consecutive years), but lacked documentation. During the first year of observation, only 11 children (17 per cent) had episodes of throat infection with clinical features and patterns of frequency conforming to those described in their presenting histories. Of the remaining 54 children, 43 (80 per cent) experienced no, one or two observed episodes each, and most of the episodes were mild. We conclude that undocumented histories of recurrent throat infection do not validly forecast subsequent experience and hence do not constitute an adequate basis for subjecting children to tonsillectomy.

Adenoidectomy↗