Search PubMed⌕ Search

Biomedical subjects

E R Wald

Publications and source records attributed to E R Wald.

180 records · Page 10Linked to original sources
PubMedDate not supplied

Gonococcal conjunctivitis in a four-month-old infant.

Classic neonatal gonococcal ophthalmia usually manifests during the first week of life with a purulent ocular discharge accompanied by periorbital edema and erythema. This case report describes a 4-month-old child with chronic but minimal ocular discharge and intermittent mild conjunctival infection who proved to be infected with Neisseria gonorrhoeae. This experience emphasizes the need for the physician to evaluate for gonococcal infection any child with conjunctivitis.

Conjunctivitis↗
PubMedDate not supplied

Gonorrheal disease among children in a university hospital.

In the current veneral disease epidemic the pediatrician may observe every clinical expression of gonococcal infection. Review of outpatient records at the University of Maryland Pediatric Clinic (Baltimore, Md.) showed frequent utilization of this health-care facility by girls with genitourinary complaints and a high rate of recovery of Neisseria gonorrhoeae from those patients from whom specimens were obtained for culture. The adolescent girl is the most likely pediatric patient to have genitourinary complaints that indicate a diagnosis of gonorrhea. Overall, 16.3% of girls and 37.2% of boys who had speciments cultured for N. gonorrhoeae had positive results. Although the older teenager (15--18 years of age) was most likely to have a positive culture, high rates comparable to those reported in venereal disease clinics were found for all age groups. Half of the cases of gonorrhea in girls aged 15 to 18 years took the clinical form of pelvic inflammatory disease. Most gonococcal infections in prepubertal children were in girls 2 to 5 years of age and resulted from presumed sexual abuse. Vulvovaginitis was the initial symptom in all cases. Prepubertal boys infected with N. gonorrhoeae all had urethritis; three of seven admitted to voluntary sexual activity.

Adolescent↗
PubMedDate not supplied

Pertussis, pertussis vaccine, and care of exposed persons.

BACKGROUND: Pertussis is a highly contagious bacterial infection caused by Bordetella pertussis. Before routine vaccination against pertussis was available, most persons were infected during childhood. After widespread vaccination, however, the incidence of pertussis in the United States dropped by more than 95 percent, though localized outbreaks continue to occur. METHODS: A multidisciplinary team developed a set of review articles as part of continuing medical education modules in the Teaching Immunization in Medical Education (TIME) Project. The team developed the materials using expert judgment and selected materials from the literature and the Centers for Disease Control and Prevention (CDC). The first step was the creation of specific learning objectives that used the spectrum of Bloom's taxonomy, when possible. After the materials were developed, they were pilot-tested and revised. Subsequently they underwent summative evaluation by field-testing the materials with 24 other primary care physicians. Then the materials were reviewed by the CDC and national vaccine experts and revised based on their comments. RESULTS AND CONCLUSIONS: The efficacy of whole-cell pertussis vaccine is about 70 to 90 percent, though local adverse events are common. Since 1990 several purified, acellular pertussis vaccines have been developed that have one quarter to one half of the common adverse events associated with whole-cell vaccine and have similar efficacy rates. The incidence of pertussis can be further reduced by increasing age-appropriate vaccination rates.

Child↗
PubMedDate not supplied

Development and multicenter evaluation of Multistation Clinical Teaching Scenarios on immunization: the ATPM-CDC Teaching Immunization for Medical Education (TIME) Project.

INTRODUCTION: The objective of this project was to develop and evaluate case-based immunization education materials that use a new teaching method called Multistation Clinical Teaching Scenarios (MCTS) for use in medical school clerkships and primary care residencies. METHODS: A multidisciplinary team developed objectives, abstracted clinical cases, and created MCTS modules, which use contextual learning, problem solving, and small-group interaction. RESULTS: Mean scores increased from the 10-item pretest to the posttest by 3.2 (95% confidence interval [CI] of 2.8 to 3.6) items for measles, 3.8 (CI = 3.4 to 4.1) for influenza, and 1.8 (CI = 1.4 to 2.1) for hepatitis B (P < .01 for each). To evaluate the materials, we administered questionnaires and conducted focus groups. Most (99%) of the students and residents rated the materials highly, as did most (89%) facilitators. CONCLUSIONS: This new method has been widely tested, increases content mastery, and is well received.

Clinical Clerkship↗