william hendrickse | University of Texas Southwestern Medical Center at Dallas (original) (raw)
Papers by william hendrickse
BMJ, Oct 2, 1982
The energy intake and weight gain of low birthweight infants (under 1500 g) fed expressed breast ... more The energy intake and weight gain of low birthweight infants (under 1500 g) fed expressed breast milk were measured. Between the second and fourth weeks of life the mean energy intake was 577 kJ (138 kcals)/kg/day and the mean weekly increase in weight 119 g/week. Feeding energy-rich hind milk to two babies increased their energy intake but had little effect on their rate of weight gain. There appeared to be no correlation between energy intake and weight gain, probably owing to variation in the absorption of nutrients from expressed breast milk. This study forms a basis for a comparison of weight gain in babies fed alternative regimens of artificial milks.
BMJ, May 1, 1982
vegetations. Cardiac catheterisation showed good left ventricular function and fully competent ao... more vegetations. Cardiac catheterisation showed good left ventricular function and fully competent aortic and mitral valves. Comment Candidal endocarditis rarely responds to medical treatment alone. 2-4Uttley et al reported excellent results by removing the infected valve and giving systemic antifungal treatment, and this is now the preferred approach. Patients with acute lymphoblastic leukaemia now have a good prognosis because of modern chemotherapy; therefore if there is a need for major surgery, it should be considered. References Gee TS. Acute lymphoblastic leukaemia in adults and children. Differences in response with similar therapeutic regimens.
Psychiatric Services, 1996
The study examined characteristics associated with substance abuse among patients on a VA general... more The study examined characteristics associated with substance abuse among patients on a VA general inpatient psychiatry unit. Methods: A total of 452 consecutive discharge summaries from a six-month period were examined for a recorded diagnosis of psychoactive substance abuse or dependence and evidence of negative social or health effects from the use of drugs or alcohol within one month of admission. The summaries were divided into three groups-no active substance abuse, active alcohol dependence, and two or more active substance dependencies. The demographic, diagnostic, and treatment outcome characteristics of the three groups were cornpared. Results: Fifty-eight percent of the summaries included evidence of dependence on at least one substance. The three study groups differed in age, gender, racial mix, and psychiatric comorbidity. The group with no active substance abuse had an older mean age, included a higher proportion of women, and had a higher proportion of patients with bipolar disorder (manic), unipolar depression, and dementia. The group with two or more substance dependencies had a younger mean age, a higher proportion of African Americans, and a higher proportion of patients with cluster B personality disorders and schizophrenia. The group with alcohol dependence only was intermediate in age between the other two groups and had a racial mix similar to that of the group with no substance abuse. Conclusions: A high proportion ofveterans seeking mental health care have substance dependencies. The relatively distinct profiles of the patients who abuse alcohol only and those who abuse more than one substance suggest the need for programs specifically taibred to each of these two groups.
Journal of Infection, 1997
4 patients with tuberculosis, 3 of whom had tuberculous meningitis, were noted to have tuberculom... more 4 patients with tuberculosis, 3 of whom had tuberculous meningitis, were noted to have tuberculomas on computed tomographic scanning. During antituberculous chemotherapy the intracranial lesions increased in size in all 4 patients at a time when the clinical state and cerebrospinal-fluid abnormalities were improving; in 2 of the patients the regional lymph nodes also enlarged greatly. Though the expansion of the cerebral lesions caused anxiety and led to some changes in chemotherapy, the lesions eventually diminished in size.
Previous studies indicate that high frequency power (>20Hz) in the electroencephalogram (EEG) ... more Previous studies indicate that high frequency power (>20Hz) in the electroencephalogram (EEG) are associated with feature binding and attention. It has been hypothesized that hallucinations and perceptual abnormalities might be linked to irregularities in fast frequency activity. This study examines the power and distribution of high frequency activity (HFA) during sleep in healthy control subjects and unmedicated patients with schizophrenia and depression. This is a post-hoc analysis of an archival database col-iected under identical conditions. Groups were compared using multivariate analyses of covariance (MANCOVA) using group frequency by stage analysis. A multiple regres-sion analyzed the association between HFA power and clinical symptoms. Schizophrenic (SZ) and major depressive disorder (MDD) patients showed significantly greater high frequen-cy (HF) power than healthy controls (HC) in all sleep stages (p<O.OOOI). SZs also exhibited significantly greater HF power than M...
SUMMARY Serial computed tomographic scanswereperformed during thecourseoftuberculous meningitis i... more SUMMARY Serial computed tomographic scanswereperformed during thecourseoftuberculous meningitis in25patients aged1-70 years.Hydrocephalus rarely occurred without other abnormalities. Markedventricular enlargement was associated withextensive basal enhancement. Basal meningeal enhancement was notagoodindicator oftheclinical state although markedenhancement was arisk factor forthedevelopment ofbasal ganglia infarction. Infarcts weremuchmore common inchildren thaninadults andweresometimes asymptomatic. Radiological abnormalities sometimes developed during treatment andoften didnotresolve completely. Manypatients hadsevereresidual neurological problems. Tuberculous meningitis (TBM)isarelatively uncommoncondition intheUnited Kingdom sothatfew centres havesufficient experience toassess thevalue ofcomputed tomography (CT)inmanagement. The typical CTappearance ofenhancement of' theleptomeninges after intravenous contrast hasbeenwell documented`6 butthere islittle information regardingth...
European Journal of Pediatrics, 1984
The calorie intake and weight gain of 24 low birth weight (LBW) infants, less than 33 weeks gesta... more The calorie intake and weight gain of 24 low birth weight (LBW) infants, less than 33 weeks gestation and less than 1500 g birth weight, was studied prospectively. Fourteen infants were fed on a commercially available LBW formula milk and ten were fed on their own mother&amp;amp;amp;amp;amp;#39;s fresh unpasteurised expressed breast milk (EBM). The difference between the two feeding groups in the intake of milk and calories was not significant, but from the third week onwards those fed on the LBW formula gained weight faster. The mean (+/- SEM) weight increments for weeks 3-6 (inclusive) for LBW formula and EBM fed infants was 189.3 (+/- 7.9) and 139.6 (+/- 11.1) g/wk respectively (P less than 0.001). The LBW formula was well tolerated and is a suitable feed for LBW infants. However some babies thrived well on fresh EBM and so we are continuing to encourage mothers who wish, to breast feed their own preterm infants. When such infants fail to thrive it is appropriate to supplement with a LBW formula.
BJOG: An International Journal of Obstetrics and Gynaecology, 1985
Thirty-three matched maternal venous and umbilical cord vein and artery plasma samples were obtai... more Thirty-three matched maternal venous and umbilical cord vein and artery plasma samples were obtained at elective caesarean section and the concentrations of the individual free fatty acids determined. The maternal levels were 1.009 (SEM 0.043) and the umbilical vein-artery difference was 0.036 (SEM 0.011) mmol/l. There was a significant correlation between the mean concentration in maternal venous blood and the vein-artery difference for myristic, palmitic, stearic, linoleic and docosahexaenoic acids but not for oleic acid. When arachidonic acid concentration in the fetus was high, then the vein-artery difference was negative (flow to the placenta), when it was low, the difference was positive (flow to the fetus). Thus whilst there appears in general to be a flow of fatty acid to the fetus dependent on maternal free fatty acid concentrations, the transfer of arachidonic acid is largely determined by other factors. The reasons why oleic acid does not behave like the other fatty acids is not clear.
Computational intelligence and neuroscience, 2015
Recent findings suggest that specific neural correlates for the key elements of basic emotions do... more Recent findings suggest that specific neural correlates for the key elements of basic emotions do exist and can be identified by neuroimaging techniques. In this paper, electroencephalogram (EEG) is used to explore the markers for video-induced emotions. The problem is approached from a classifier perspective: the features that perform best in classifying person's valence and arousal while watching video clips with audiovisual emotional content are searched from a large feature set constructed from the EEG spectral powers of single channels as well as power differences between specific channel pairs. The feature selection is carried out using a sequential forward floating search method and is done separately for the classification of valence and arousal, both derived from the emotional keyword that the subject had chosen after seeing the clips. The proposed classifier-based approach reveals a clear association between the increased high-frequency (15-32 Hz) activity in the left ...
Psychiatry research, Jan 11, 2000
Both major depressive disorders (MDD) and schizophrenia (SZ) have been associated with reductions... more Both major depressive disorders (MDD) and schizophrenia (SZ) have been associated with reductions in slow-wave (Stages 3 and 4) sleep, although these findings are controversial. The present study compared quantitative EEG measures of slow-wave activity (0.5-4 Hz) during non-REM (NREM) sleep among age-matched, symptomatic but unmedicated, depressed, schizophrenic and healthy control men (n=13/group). The amplitude of slow-wave activity (SWA) in the first NREM sleep period was significantly lower in both the MDD and SZ groups compared with controls. However, the time course of SWA, its accumulation and dissipation over all NREM sleep time, was abnormal in the MDD group but not in those with SZ. These findings suggest that the regulation of SWA is impaired in men with MDD but not in SZ. Thus, although those with SZ show reduced amplitude SWA in the first NREM period, there is no evidence that homeostatic regulation of SWA is impaired in this psychiatric group.
Psychiatry, 1997
This article synthesizes theoretical material from psychology research into a practical model for... more This article synthesizes theoretical material from psychology research into a practical model for conceptualizing violence in psychiatric settings. Relevant research and theory are reviewed, focusing on two important behavioral models of aggressive behavior, hostile aggression and instrumental aggression. The concepts of reinforcement, anticipated rewards, specific and nonspecific stimulus-driven aggression, intermediary emotional states in aroused persons, and the aggression stimulus threshold are developed into a bimodal model applicable to the clinical management of violence. The model provides a broad framework for categorizing, understanding, and addressing aggressive behavior in clinical settings.
Journal of developmental physiology, 1981
In five separate experiments in which single placental lobes were perfused, [14C] antipyrine, [3H... more In five separate experiments in which single placental lobes were perfused, [14C] antipyrine, [3H] dextran and a fatty acid mixture containing [14C] linoleic and [3H] palmitic acids were added to the maternal circuit. Samples of fetal and maternal perfusate, taken at intervals, were analysed for radioactivity and fatty acid content. The relative placental transport rates of antipyrine, linoleic and palmitic acids and the changes in maternal and fetal circuit content of linoleic, palmitic and arachidonic acids were measured. Mean transfer rates of 150, 0.023 and 0.034 mumol min-1 were obtained for [14C] antipyrine, [3H] palmitic and [14C] linoleic acids, respectively. The transfer of [3H] dextran was negligible. The transfer rates of linoleic and palmitic acids did not differ significantly from one another. The maternal circuit content of palmitic and arachidonic acids increased, whereas linoleic acid content decreased. The fetal content of all three acid increased but in the case of...
Lancet, 1984
A simple latex particle agglutination test for the rapid detection of Mycobacterium tuberculosis ... more A simple latex particle agglutination test for the rapid detection of Mycobacterium tuberculosis plasma membrane antigen in cerebrospinal fluid was evaluated in 18 children with tuberculous meningitis and 134 control children with other disorders. The antigen was detected in all 18 patients with tuberculous meningitis, although an initial sample from 1 patient did not contain detectable antigen before it was concentrated. 133 of 134 control samples gave negative results.
Biology of Depressive Disorders. Part A, 1993
Depressionstherapie, 1991
Journal of pediatric …, 1989
... Presented at the 19th Annual Meeting of theAmerican Pediatric Surgical Association, Tucson, A... more ... Presented at the 19th Annual Meeting of theAmerican Pediatric Surgical Association, Tucson, Arizona, May 11-14, 1988. Address reprint requests to WS Andrews, MD, 5323Harry Hines Blvd, Department of Pediatric Surgery, Dallas, TX 75235-9031. ...
Schizophrenia Research, 1993
The Pediatric Infectious Disease Journal, 1988
In a double blind study 175 patients with acute otitis media were randomized into 2 treatment gro... more In a double blind study 175 patients with acute otitis media were randomized into 2 treatment groups: 10 days of therapy with cefaclor or 5 days of therapy followed by 5 days of placebo. The dosage of cefaclor was 40 mg/kg/day administered orally in equally divided doses at 12-hour intervals. Tympanocentesis before treatment yielded specimens that contained Streptococcus pneumoniae or Haemophilus influenzae or both in 55% of specimens. Branhamella catarrhalis was isolated from 21% of specimens. Culture of material from the ear canal of patients with spontaneous perforation of the tympanic membrane of less than 24 hours duration yielded pneumococci or H. influenzae or both in 38% of specimens and staphylococci in 31%. Patients were scheduled for follow-up examinations at 5 or 6, 10, 30, 60 and 90 days. Of the 175 children 151 were evaluable at 10 days. There were 123 patients with both tympanic membranes intact at the time of diagnosis. There were 6 (10%) treatment failures of therapy in the 59 patients assigned to 5 days of therapy and 4 (6%) failures and 1 (2%) early relapse in the 64 assigned to 10 days of therapy (difference not significant). There were 28 evaluable patients with spontaneous perforation. There were 8 (53%) failures in the 15 children assigned to 5 days of therapy and only 1 (8%) failure in the 13 children assigned to receive 10 days of therapy (P = 0.016, Fisher exact test). Rates of reinfection and persistent middle ear effusion at 10, 30, 60 and 90 days follow-up were not significant different in patients assigned to 5 to 10 days of therapy. In patients with acute otitis media with intact tympanic membranes we have not been able to show any advantage of the standard duration of 10 days of therapy over a shortened course of 5 days. A 5-day course of antibiotic therapy does not appear to be sufficient for children with acute otitis media and spontaneous purulent drainage.
BMJ, Oct 2, 1982
The energy intake and weight gain of low birthweight infants (under 1500 g) fed expressed breast ... more The energy intake and weight gain of low birthweight infants (under 1500 g) fed expressed breast milk were measured. Between the second and fourth weeks of life the mean energy intake was 577 kJ (138 kcals)/kg/day and the mean weekly increase in weight 119 g/week. Feeding energy-rich hind milk to two babies increased their energy intake but had little effect on their rate of weight gain. There appeared to be no correlation between energy intake and weight gain, probably owing to variation in the absorption of nutrients from expressed breast milk. This study forms a basis for a comparison of weight gain in babies fed alternative regimens of artificial milks.
BMJ, May 1, 1982
vegetations. Cardiac catheterisation showed good left ventricular function and fully competent ao... more vegetations. Cardiac catheterisation showed good left ventricular function and fully competent aortic and mitral valves. Comment Candidal endocarditis rarely responds to medical treatment alone. 2-4Uttley et al reported excellent results by removing the infected valve and giving systemic antifungal treatment, and this is now the preferred approach. Patients with acute lymphoblastic leukaemia now have a good prognosis because of modern chemotherapy; therefore if there is a need for major surgery, it should be considered. References Gee TS. Acute lymphoblastic leukaemia in adults and children. Differences in response with similar therapeutic regimens.
Psychiatric Services, 1996
The study examined characteristics associated with substance abuse among patients on a VA general... more The study examined characteristics associated with substance abuse among patients on a VA general inpatient psychiatry unit. Methods: A total of 452 consecutive discharge summaries from a six-month period were examined for a recorded diagnosis of psychoactive substance abuse or dependence and evidence of negative social or health effects from the use of drugs or alcohol within one month of admission. The summaries were divided into three groups-no active substance abuse, active alcohol dependence, and two or more active substance dependencies. The demographic, diagnostic, and treatment outcome characteristics of the three groups were cornpared. Results: Fifty-eight percent of the summaries included evidence of dependence on at least one substance. The three study groups differed in age, gender, racial mix, and psychiatric comorbidity. The group with no active substance abuse had an older mean age, included a higher proportion of women, and had a higher proportion of patients with bipolar disorder (manic), unipolar depression, and dementia. The group with two or more substance dependencies had a younger mean age, a higher proportion of African Americans, and a higher proportion of patients with cluster B personality disorders and schizophrenia. The group with alcohol dependence only was intermediate in age between the other two groups and had a racial mix similar to that of the group with no substance abuse. Conclusions: A high proportion ofveterans seeking mental health care have substance dependencies. The relatively distinct profiles of the patients who abuse alcohol only and those who abuse more than one substance suggest the need for programs specifically taibred to each of these two groups.
Journal of Infection, 1997
4 patients with tuberculosis, 3 of whom had tuberculous meningitis, were noted to have tuberculom... more 4 patients with tuberculosis, 3 of whom had tuberculous meningitis, were noted to have tuberculomas on computed tomographic scanning. During antituberculous chemotherapy the intracranial lesions increased in size in all 4 patients at a time when the clinical state and cerebrospinal-fluid abnormalities were improving; in 2 of the patients the regional lymph nodes also enlarged greatly. Though the expansion of the cerebral lesions caused anxiety and led to some changes in chemotherapy, the lesions eventually diminished in size.
Previous studies indicate that high frequency power (>20Hz) in the electroencephalogram (EEG) ... more Previous studies indicate that high frequency power (>20Hz) in the electroencephalogram (EEG) are associated with feature binding and attention. It has been hypothesized that hallucinations and perceptual abnormalities might be linked to irregularities in fast frequency activity. This study examines the power and distribution of high frequency activity (HFA) during sleep in healthy control subjects and unmedicated patients with schizophrenia and depression. This is a post-hoc analysis of an archival database col-iected under identical conditions. Groups were compared using multivariate analyses of covariance (MANCOVA) using group frequency by stage analysis. A multiple regres-sion analyzed the association between HFA power and clinical symptoms. Schizophrenic (SZ) and major depressive disorder (MDD) patients showed significantly greater high frequen-cy (HF) power than healthy controls (HC) in all sleep stages (p<O.OOOI). SZs also exhibited significantly greater HF power than M...
SUMMARY Serial computed tomographic scanswereperformed during thecourseoftuberculous meningitis i... more SUMMARY Serial computed tomographic scanswereperformed during thecourseoftuberculous meningitis in25patients aged1-70 years.Hydrocephalus rarely occurred without other abnormalities. Markedventricular enlargement was associated withextensive basal enhancement. Basal meningeal enhancement was notagoodindicator oftheclinical state although markedenhancement was arisk factor forthedevelopment ofbasal ganglia infarction. Infarcts weremuchmore common inchildren thaninadults andweresometimes asymptomatic. Radiological abnormalities sometimes developed during treatment andoften didnotresolve completely. Manypatients hadsevereresidual neurological problems. Tuberculous meningitis (TBM)isarelatively uncommoncondition intheUnited Kingdom sothatfew centres havesufficient experience toassess thevalue ofcomputed tomography (CT)inmanagement. The typical CTappearance ofenhancement of' theleptomeninges after intravenous contrast hasbeenwell documented`6 butthere islittle information regardingth...
European Journal of Pediatrics, 1984
The calorie intake and weight gain of 24 low birth weight (LBW) infants, less than 33 weeks gesta... more The calorie intake and weight gain of 24 low birth weight (LBW) infants, less than 33 weeks gestation and less than 1500 g birth weight, was studied prospectively. Fourteen infants were fed on a commercially available LBW formula milk and ten were fed on their own mother&amp;amp;amp;amp;amp;#39;s fresh unpasteurised expressed breast milk (EBM). The difference between the two feeding groups in the intake of milk and calories was not significant, but from the third week onwards those fed on the LBW formula gained weight faster. The mean (+/- SEM) weight increments for weeks 3-6 (inclusive) for LBW formula and EBM fed infants was 189.3 (+/- 7.9) and 139.6 (+/- 11.1) g/wk respectively (P less than 0.001). The LBW formula was well tolerated and is a suitable feed for LBW infants. However some babies thrived well on fresh EBM and so we are continuing to encourage mothers who wish, to breast feed their own preterm infants. When such infants fail to thrive it is appropriate to supplement with a LBW formula.
BJOG: An International Journal of Obstetrics and Gynaecology, 1985
Thirty-three matched maternal venous and umbilical cord vein and artery plasma samples were obtai... more Thirty-three matched maternal venous and umbilical cord vein and artery plasma samples were obtained at elective caesarean section and the concentrations of the individual free fatty acids determined. The maternal levels were 1.009 (SEM 0.043) and the umbilical vein-artery difference was 0.036 (SEM 0.011) mmol/l. There was a significant correlation between the mean concentration in maternal venous blood and the vein-artery difference for myristic, palmitic, stearic, linoleic and docosahexaenoic acids but not for oleic acid. When arachidonic acid concentration in the fetus was high, then the vein-artery difference was negative (flow to the placenta), when it was low, the difference was positive (flow to the fetus). Thus whilst there appears in general to be a flow of fatty acid to the fetus dependent on maternal free fatty acid concentrations, the transfer of arachidonic acid is largely determined by other factors. The reasons why oleic acid does not behave like the other fatty acids is not clear.
Computational intelligence and neuroscience, 2015
Recent findings suggest that specific neural correlates for the key elements of basic emotions do... more Recent findings suggest that specific neural correlates for the key elements of basic emotions do exist and can be identified by neuroimaging techniques. In this paper, electroencephalogram (EEG) is used to explore the markers for video-induced emotions. The problem is approached from a classifier perspective: the features that perform best in classifying person's valence and arousal while watching video clips with audiovisual emotional content are searched from a large feature set constructed from the EEG spectral powers of single channels as well as power differences between specific channel pairs. The feature selection is carried out using a sequential forward floating search method and is done separately for the classification of valence and arousal, both derived from the emotional keyword that the subject had chosen after seeing the clips. The proposed classifier-based approach reveals a clear association between the increased high-frequency (15-32 Hz) activity in the left ...
Psychiatry research, Jan 11, 2000
Both major depressive disorders (MDD) and schizophrenia (SZ) have been associated with reductions... more Both major depressive disorders (MDD) and schizophrenia (SZ) have been associated with reductions in slow-wave (Stages 3 and 4) sleep, although these findings are controversial. The present study compared quantitative EEG measures of slow-wave activity (0.5-4 Hz) during non-REM (NREM) sleep among age-matched, symptomatic but unmedicated, depressed, schizophrenic and healthy control men (n=13/group). The amplitude of slow-wave activity (SWA) in the first NREM sleep period was significantly lower in both the MDD and SZ groups compared with controls. However, the time course of SWA, its accumulation and dissipation over all NREM sleep time, was abnormal in the MDD group but not in those with SZ. These findings suggest that the regulation of SWA is impaired in men with MDD but not in SZ. Thus, although those with SZ show reduced amplitude SWA in the first NREM period, there is no evidence that homeostatic regulation of SWA is impaired in this psychiatric group.
Psychiatry, 1997
This article synthesizes theoretical material from psychology research into a practical model for... more This article synthesizes theoretical material from psychology research into a practical model for conceptualizing violence in psychiatric settings. Relevant research and theory are reviewed, focusing on two important behavioral models of aggressive behavior, hostile aggression and instrumental aggression. The concepts of reinforcement, anticipated rewards, specific and nonspecific stimulus-driven aggression, intermediary emotional states in aroused persons, and the aggression stimulus threshold are developed into a bimodal model applicable to the clinical management of violence. The model provides a broad framework for categorizing, understanding, and addressing aggressive behavior in clinical settings.
Journal of developmental physiology, 1981
In five separate experiments in which single placental lobes were perfused, [14C] antipyrine, [3H... more In five separate experiments in which single placental lobes were perfused, [14C] antipyrine, [3H] dextran and a fatty acid mixture containing [14C] linoleic and [3H] palmitic acids were added to the maternal circuit. Samples of fetal and maternal perfusate, taken at intervals, were analysed for radioactivity and fatty acid content. The relative placental transport rates of antipyrine, linoleic and palmitic acids and the changes in maternal and fetal circuit content of linoleic, palmitic and arachidonic acids were measured. Mean transfer rates of 150, 0.023 and 0.034 mumol min-1 were obtained for [14C] antipyrine, [3H] palmitic and [14C] linoleic acids, respectively. The transfer of [3H] dextran was negligible. The transfer rates of linoleic and palmitic acids did not differ significantly from one another. The maternal circuit content of palmitic and arachidonic acids increased, whereas linoleic acid content decreased. The fetal content of all three acid increased but in the case of...
Lancet, 1984
A simple latex particle agglutination test for the rapid detection of Mycobacterium tuberculosis ... more A simple latex particle agglutination test for the rapid detection of Mycobacterium tuberculosis plasma membrane antigen in cerebrospinal fluid was evaluated in 18 children with tuberculous meningitis and 134 control children with other disorders. The antigen was detected in all 18 patients with tuberculous meningitis, although an initial sample from 1 patient did not contain detectable antigen before it was concentrated. 133 of 134 control samples gave negative results.
Biology of Depressive Disorders. Part A, 1993
Depressionstherapie, 1991
Journal of pediatric …, 1989
... Presented at the 19th Annual Meeting of theAmerican Pediatric Surgical Association, Tucson, A... more ... Presented at the 19th Annual Meeting of theAmerican Pediatric Surgical Association, Tucson, Arizona, May 11-14, 1988. Address reprint requests to WS Andrews, MD, 5323Harry Hines Blvd, Department of Pediatric Surgery, Dallas, TX 75235-9031. ...
Schizophrenia Research, 1993
The Pediatric Infectious Disease Journal, 1988
In a double blind study 175 patients with acute otitis media were randomized into 2 treatment gro... more In a double blind study 175 patients with acute otitis media were randomized into 2 treatment groups: 10 days of therapy with cefaclor or 5 days of therapy followed by 5 days of placebo. The dosage of cefaclor was 40 mg/kg/day administered orally in equally divided doses at 12-hour intervals. Tympanocentesis before treatment yielded specimens that contained Streptococcus pneumoniae or Haemophilus influenzae or both in 55% of specimens. Branhamella catarrhalis was isolated from 21% of specimens. Culture of material from the ear canal of patients with spontaneous perforation of the tympanic membrane of less than 24 hours duration yielded pneumococci or H. influenzae or both in 38% of specimens and staphylococci in 31%. Patients were scheduled for follow-up examinations at 5 or 6, 10, 30, 60 and 90 days. Of the 175 children 151 were evaluable at 10 days. There were 123 patients with both tympanic membranes intact at the time of diagnosis. There were 6 (10%) treatment failures of therapy in the 59 patients assigned to 5 days of therapy and 4 (6%) failures and 1 (2%) early relapse in the 64 assigned to 10 days of therapy (difference not significant). There were 28 evaluable patients with spontaneous perforation. There were 8 (53%) failures in the 15 children assigned to 5 days of therapy and only 1 (8%) failure in the 13 children assigned to receive 10 days of therapy (P = 0.016, Fisher exact test). Rates of reinfection and persistent middle ear effusion at 10, 30, 60 and 90 days follow-up were not significant different in patients assigned to 5 to 10 days of therapy. In patients with acute otitis media with intact tympanic membranes we have not been able to show any advantage of the standard duration of 10 days of therapy over a shortened course of 5 days. A 5-day course of antibiotic therapy does not appear to be sufficient for children with acute otitis media and spontaneous purulent drainage.