Biomedical subjects

M Ledwith

Publications and source records attributed to M Ledwith.

5 recordsLinked to original sources

PubMed2001

Pneumococcal conjugate vaccine.

Pneumococcal infections account for a significant proportion of bacterial infections in infants and children. The growing threat from pneumococci resistant to penicillin and other antimicrobials has led to increased pressure for the development of an effective vaccine. The only vaccine available until recently, a purified polysaccharide vaccine, is limited in that it fails to induce adequate and long-lasting immunity in infants under 2 years of age, the age group most at risk from this disease. Polysaccharide antigens conjugated to certain proteins induce effective immunity with a rapid response to subsequent infection or antigen challenge. The success of the protein-conjugated haemophilus influenzae vaccine supports the strategy of protein-conjugated polysaccharide vaccines. Currently, published trials of conjugated pneumococcal vaccines have shown the effectiveness and safety of these vaccines. Conjugate vaccines also provide protection against otitis media and may eliminate nasopharyngeal carriage of this organism. Widespread use of this vaccine is both cost effective and safe.

Age Factors↗

PubMed1997

Management of rabies exposure in pediatric practice.

The incidence of human rabies in the United States has fallen dramatically over the past 4 decades. This is directly related to the universal immunization of domestic cats and dogs. Recently, a number of cases of human rabies have been associated with the appearance of a previously rare strain of the virus in the silver-haired bat. There have been other recent changes in the epizoology of rabies with the expansion of raccoon rabies from a small pocket around northern Virginia to most of the northeastern United States. Postexposure prophylaxis using rabies immune globulin and rabies vaccine is effective in preventing rabies following a bite by a rabid animal when given according to current recommendations. There has been considerable debate, however, surrounding the cost of prophylaxis and the possibility of reducing the recommended number of doses of rabies immune globulin.

Animals↗

PubMed1995

Clinical course of pertussis in immunized children.

To describe the clinical course of Bordetella pertussis infection in a highly immunized childhood population, we studied prospectively endemic and epidemic pertussis in a metropolitan population with an immunization rate > 90% during an 8-year period from 1987 through 1994. Patients with a possible diagnosis of pertussis were referred by family or emergency room physicians for nasopharyngeal culture. Patients with a culture positive for B. pertussis were contacted by a nurse who completed a detailed questionnaire for the index case and all family members. Repeat home visits were made each week for 4 weeks. Of the 189 patients with pertussis who were evaluated 103 subjects were < 5 years of age. Congestion predated the onset of cough by up to 1 week in 35 (34%) cases. Seventy (68%) subjects < 5 years of age developed a paroxysmal cough within the first week of their illness. Ninety-one (88%) cases < 5 years old had a persistent paroxysmal cough for > 21 days. Coughing in this group lasted from 16 to 91 days (median 48). Erythromycin therapy appeared to shorten the duration of cough; however, patients were not randomized to receive erythromycin at a specific time. Despite adequate immunization some children develop pertussis. The clinical course in these patients is milder than in unimmunized subjects. Nevertheless the symptomatology in these children should still be readily identified by most physicians using classical clinical criteria of pertussis.

Anti-Bacterial Agents↗

PubMed1988

A database management system for residency applicant files.

An automated system for recording information pertaining to applicants to the Internal Medicine Residency Program at Temple University Hospital was developed in 1983. Major objectives were to improve recordkeeping, filing, communication with applicants, and efficiency of the review committee's process. Reports generated have permitted tracking of the applicant pool throughout the recruiting season and collection of statistics which may be compared with prior years. The capacity of the Residency Office to market the Internal Medicine Residency Program through prompt, accurate, and personal communication with each applicant has been facilitated.

Database Management Systems↗

PubMed1984

The perception of control in loud noise.

Perception of control is known to affect performance under stress. Two experiments are reported the object of which was to find out how loud noise during a contingency assessment task influences perceived control. Subjects were required to choose one of two responses, note one of two results, and then provide an overall percentage estimation of the degree of contingency present after 40 trials. Subjects made these judgments for one of three levels of objective contingency (25%, 50%, 75%), either in quiet (55 dBA) or in loud noise (95 dBA) conditions. The first experiment involved a series of randomly chosen, preprogrammed outcomes for noncontingent trials. An unexpected effect of noise was that subjects improved their successes in predicting events, and could only have done so by finding sequential structure in the preprogrammed alternations. They also overestimated control relative to contingency data actually received, at the 25% objective contingency level, but the result could have been dependent on different base levels of data actually received. A second experiment, with a random generation of outcomes for noncontingent trials, resulted in no differences in success levels, but confirmed that noise is associated with the overestimation of contingency at the 25% objective contingency level and demonstrated the same effect for the 50% level. The results are discussed in the context of the 'illusion of control'.

Association↗