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Biomedical subjects

N M Bennett

Publications and source records attributed to N M Bennett.

At least 19 recordsLinked to original sources
PubMed1992

Pneumococcal bacteremia in Monroe County, New York.

OBJECTIVES: Knowledge of the epidemiology of pneumococcal disease is critical for public health planning, evaluation of preventive strategies, and development of immunization recommendations. METHODS: We studied the incidence and case-fatality rates of pneumococcal bacteremia as a proxy for pneumococcal disease in Monroe County, New York, from 1985 through 1989 by reviewing the laboratory and clinical care records of all cases occurring among residents. RESULTS: There were 671 cases identified, for an overall yearly rate of 18.8 per 100,000. The rates were highest in the very young, in the very old, and in non-White populations. Age-specific rates were consistently higher in Blacks than in Whites. Predisposing medical conditions were present in 61% of cases. Case-fatality rates were 15% overall, 27% in those with predisposing medical conditions, and approximately 30% in Blacks older than 55 years and Whites older than 65 years. CONCLUSIONS: This study documents the incidence of and mortality from pneumococcal bacteremia. It supports previous observations that Black populations have an increased risk of invasive pneumococcal infection and suggests that immunization should be considered for Blacks older than 55 years.

Black or African American↗
PubMed1992

The effects of a hospital policy and state legislation on resuscitation orders for geriatric patients.

In 1983, The Genesee Hospital, Rochester, NY, enacted a do-not-resuscitate (DNR) policy that was revised in 1988 because of complex state legislation. Using a retrospective chart review, we studied DNR ordering for all patients older than 79 years who died in the hospital during the 6 months before the policy and compared it with two 6-month intervals after the policy and three 6-month intervals after the law. The hospital policy was associated with an increase in explicit ordering of DNR from 21% in 1982 to 76% for the 2 years thereafter. A further nonsignificant increase to 84% was seen in the 3 years after the law. When cardiopulmonary resuscitation (CPR) was ordered, it was performed in 29% before the policy, 56% in the 2 years after, and 92% for the 3 years after the law. We reviewed all CPR attempts for 1988 and found that the overall survival rate for patients older than 79 years was 39% and probably was the result of careful patient selection. Our hospital policy was not adversely affected and may even have been enhanced by the New York State legislation. Despite this progress, we found that less than 25% of decisions about CPR or DNR were the result of informed decision making by patients themselves.

Aged↗
PubMed1990

The status of women at one academic medical center. Breaking through the glass ceiling.

Despite recent gains in admission to medical school and in obtaining junior faculty positions, women remain underrepresented at senior academic ranks and in leadership positions in medicine. This discrepancy has been interpreted as evidence of a "glass ceiling" that prevents all but a few exceptional women from gaining access to leadership positions. We analyzed data from Columbia University College of Physicians & Surgeons, New York, NY, for all faculty hired from 1969 through 1988 and found that the likelihood of promotion on the tenure track was 0.40 for women and 0.48 for men (ratio, 0.82; 95% confidence interval, 0.56 to 1.20); on the clinical track the likelihood of promotion was 0.75 for women and 0.72 for men (ratio, 1.04; 95% confidence interval, 0.56 to 1.94). Additional analysis of current faculty showed that in the academic year 1988-1989 the proportion of women at each tenure track rank at the College of Physicians & Surgeons equaled or exceeded the national proportion of women graduating from medical school, once allowance was made for the average time lag necessary to attain each rank. On the clinical track women were somewhat overrepresented, particularly at the junior rank. National data that describe medical school faculty, which combine tenure and clinical tracks, showed that in 1988 women were proportionately represented at each rank once the lead time from graduation was considered. We conclude that objective evidence shows that women can succeed and are succeeding in gaining promotions in academic medicine.

Career Mobility↗
PubMed1988

Hypertensive emergency: case criteria, sociodemographic profile, and previous care of 100 cases.

To study the frequency, cost, sociodemographic profile, and previous care correlates of hospital admissions for hypertensive emergency, we used specific case criteria to identify a series of 100 cases at Presbyterian Hospital in New York City. Approximately 58 cases were admitted per year. Mean length of hospital stay was 11.8 days, 75 per cent of patients received intensive care, and estimated annual hospital charges were $438,828 (1986 dollars). Cases had severe hypertension on admission (mean systolic blood pressure, 229.8 mmHg; mean diastolic blood pressure, 143 mmHg). Two-thirds had clinical evidence of acute arteriolitis. Cases were predominantly young, male, Black or Hispanic, and of lower socioeconomic status. At least 93 per cent of cases were previously diagnosed, and at least 83 per cent were aware of their diagnosis of hypertension. Improved management of chronic hypertension rather than more intensive screening may be a useful strategy to reduce the incidence of hypertensive emergency.

Adult↗
PubMed1985

An assessment of the prevalence of hepatitis B among health care personnel in Victoria.

The prevalence of past infection with hepatitis B virus in health care personnel was investigated by questionnaire and by a serological survey of personnel in a representative selection of Victorian hospitals and institutions. According to the available data, hepatitis B does not appear to have been a major infection problem among health care personnel in Victoria. The only occupational group that clearly is at an increased risk of acquiring the infection is the dental profession. Nursing staff members in institutions for the mentally retarded may also be at a higher risk. The findings of this investigation were used as a basis to frame recommendations for the vaccination of health care workers in Victoria against hepatitis B.

Australia↗
PubMed1985

Hospital outbreak of multiresistant Staphylococcus aureus in Victoria, 1979-1984.

The outbreak of nosocomial infection caused by multiresistant Staphylococcus aureus (MRSA) strains in Victoria has been monitored by a continuing programme of collecting monthly statistics from all hospitals on new patients who have been either colonized or infected by these strains. Data collected during the period from November 1980 to September 1984 have been plotted on graphs. Whereas the prevalence of MRSA strains has remained virtually unchanged, the number of infections attributed to them appears to have gradually decreased since November 1982.

Australia↗
PubMed1979

Viral hepatitis and intrahepatic cholestasis of pregnancy.

Specific serological tests which are now available for the diagnosis of infection with hepatitis A and hepatitis B viruses, were used to distinguish viral hepatitis from other causes of liver disease in pregnancy. Forty-nine (51.6%) of 95 pregnant patients had viral hepatitis, 24 hepatitis A and 25 hepatitis B. The majority of patients (26 of 28) presenting before 22 weeks gestation had viral hepatitis. By contrast, 23 (34.3%) of the remaining 67 patients presenting with abnormal liver function tests at greater than or equal to 22 weeks gestation, had viral hepatitis; the majority of the remainder had features compatible with intrahepatic cholestasis of pregnancy. Although there were significant clinical and biochemical differences between the two groups, accurate diagnosis was only possible by using specific virological tests.

Adult↗
PubMed1979

Does viral hepatitis cause aplastic anaemia?

The sera of six of seven patients with aplastic anaemia following "hepatitis" admitted to Fairfield Hospital, Melbourne, since 1954 were examined for serological evidence of infection by HAV or HBV, with negative results. We conclude that at present there is insufficient evidence to presume that infection with any of the hepatitis viruses predisposes to aplastic anaemia.

Adult↗
PubMed1977

Diagnosis of leprosy in Victoria--a non-endemic area of Australia.

There have been at least 70 cases of leprosy in Victoria since 1950; the occurrence of 40 of these in the last seven years indicates that the disease is no longer rare in this State. The diagnosis was delayed in most patients, the average period of time between development of symptoms and diagnosis being 28 months. The most common presentations among these patients emphasize the point that a diagnosis of leprosy should be considered in patients who are suffering either from chronic skin diseases which are atypical and have not responded to therapy, of from localized disturbances of skin sensation.

Adolescent↗
PubMed1977

Studies with a live influenza A vaccine in army personnel.

A live attenuated influenza A vaccine, produced from an inhibitor-resistant recombinant strain, was administered intranasally to 46 volunteers from the Army during the southern winter of 1973. To compare the acceptibility, immunogenicity and efficacy of this vaccine, a killed subunit vaccine was administered to 20 volunteers, and an intranasal placebo to 45 others. Results indicate that the live intranasal vaccine was as well tolerated as the killed vaccine and that there was no evidence of shedding of virus from the nose in the 14 days following vaccination. Both the killed and the live vaccines stimulated the production of circulating haemagglutination-inhibition antibody, but antibody to neuraminidase was induced only by the live vaccine. No conclusions could be drawn about the efficacy of the two vaccines in producing local antibodies because these were largely undetectable by the methods used. Volunteers were followed for a 12-month period, which included the 1973 and 1974 influenza seasons, and an attempt was made to determine the virological aetiology of all their respiratory infections during this period. Epidemic influenza did not occur in thepopulation group from which these volunteers were drawn, so the comparative protection rates of the two vaccines could not be assessed.

Antibodies↗
PubMed1976

Murray Valley encephalitis, 1974: clinical features.

Of the 58 patients who developed Murray Valley encephalitis (MVE) during 1974, 22 were admitted to Fairfield Hospital, Melbourne. The patients were of all ages, but the disease was most common in children. Calculations suggest that the incubation period of MVE is from one to four weeks. The severity of brain damage varies considerably; 11 patients recovered almost completely, seven had severe residual damage and four patients died. There are no special features which distinguish MVE from any other form of encephalitis. The survival of five of eight patients who required artificial respiration suggests that patients with suspected MVE should be transported at an early stage to a hospital where artificial respiration is available if necessary. There is no evidence that infection with the MVE virus can cause clinical manifestations of a disease other than acute encephalitis.

Adolescent↗