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Biomedical subjects

M Edmond

Publications and source records attributed to M Edmond.

15 recordsLinked to original sources
PubMed1998

Predicting pass rates on the American Board of Internal Medicine certifying examination.

Our objective was to determine the ability of the internal medicine In-Training Examination (ITE) to predict pass or fail outcomes on the American Board of Internal Medicine (ABIM) certifying examination and to develop an externally validated predictive model and a simple equation that can be used by residency directors to provide probability feedback for their residency programs. We collected a study sample of 155 internal medicine residents from the three Virginia internal medicine programs and a validation sample of 64 internal medicine residents from a residency program outside Virginia. Scores from both samples were collected across three class cohorts. The Kolmogorov-Smirnov z test indicated no statistically significant difference between the distribution of scores for the two samples (z = 1.284, p = .074). Results of the logistic model yielded a statistically significant prediction of ABIM pass or fail performance from ITE scores (Wald = 35.49, SE = 0.036, df = 1, p < .005) and overall correct classifications for the study sample and validation sample at 79% and 75%, respectively. The ITE is a useful tool in assessing the likelihood of a resident's passing or failing the ABIM certifying examination but is less predictive for residents who received ITE scores between 49 and 66.

Internal Medicine↗
PubMed1997

Isolation.

Patients infected or colonized with certain microorganisms must be placed in isolation while hospitalized to prevent nosocomial transmission of these pathogens. Isolation systems enable healthcare workers to identify patients who need to be isolated and to institute the appropriate precautions. This article presents an overview of isolation precautions, emphasizing the latest guidelines from the Centers for Disease Control and Prevention.

Centers for Disease Control and Prevention, U.S.↗
PubMed1996

Bacteremia due to Stenotrophomonas (Xanthomonas) maltophilia: a prospective, multicenter study of 91 episodes.

We identified 91 cases of bacteremia due to Stenotrophomonas (Xanthomonas) maltophilia in a prospective, multicenter observational study. The patients were highly compromised; the majority had an underlying malignancy, had received immunosuppressive therapy, and had indwelling venous catheters. Although 94% of patients received an antimicrobial agent to which the blood isolate was susceptible, the mortality among these patients 14 days after the onset of bacteremia was 21%. Mortality was significantly correlated with the presence of a hematologic malignancy or neutropenia or transplantation, immunosuppressive therapy, and a severity-of-illness score of > 4. S. maltophilia infection is associated with substantial morbidity and mortality among highly compromised patients. The organism is typically resistant to expanded spectrum beta-lactam agents and aminoglycoside antibiotics. Trimethoprim-sulfamethoxazole should be administered if the isolate is susceptible to this combination; addition of another agent to which the isolate is susceptible should be considered in treating patients who are neutropenic, immunocompromised, or critically ill.

Bacteremia↗
PubMed1991

Physical activity at work and duodenal ulcer risk.

To determine whether the social class differences in duodenal ulcer frequency may be explained by differences in physical activity at work, the energy expenditure during work, smoking habits, and social class were compared in 76 recently diagnosed duodenal ulcer patients and in age and sex matched community controls. As anticipated, the relative risk of duodenal ulcer showed significant associations with smoking and social class. Social class and physical activity at work were associated with one another. After adjusting for age, sex, smoking, and social class, physically active work was still associated with duodenal ulcer, with relative risks for moderate and high activity compared with sedentary work being 1.3 (0.6-3.0) and 3.6 (1.3-7.8) respectively. Within each social class stratum, the relative risk of having a duodenal ulcer was greater in those with a high level of occupational activity than in those undertaking sedentary work.

Adult↗
PubMed1990

Duodenal ulcer and refined carbohydrate intake: a case-control study assessing dietary fibre and refined sugar intake.

An association between duodenal ulceration and a low fibre intake and a high refined carbohydrate diet has been reported. We therefore compared the current diet, smoking habits, social class, and possible other risk factors of 78 patients with duodenal ulcer and a community control group matched for age and sex. Logistic regression for matched sets was used to calculate the relative risks for successive quintiles of dietary fibre and sugar intake before and after adjustment for total calorie intake and for the possible confounding effect of other known risk factors. Relative risks did not differ materially or consistently for total dietary fibre or for the cereal moiety whether adjusted or not for calorie intake. By contrast, relative risks tended to be reduced with high vegetable fibre intake and with low refined sugar intake. After controlling for smoking and social class, both of which were associated with ulcer disease, and for relative weight (Quetelet's index), the relation between ulcer disease and low refined sugar intake persisted, while that with high vegetable fibre intake was reduced. The results of this study indicate that a lack of cereal or total fibre intake plays no part in duodenal ulcer development but that a low refined sugar intake may be a protective factor.

Adult↗
PubMed1988

Effect of bedside needle disposal units on needle recapping frequency and needlestick injury.

Needle recapping has been shown to be one of the leading causes of needlestick injuries. Frequency of recapping has not been reported. This study was designed to determine the frequency of needle recapping by nursing personnel and the effect of bedside needle disposal units on the frequency of recapping and needlesticks. Seventy-four nurses carrying out 312 activities involving use of needles were observed. The subjects were not aware of the nature of the study. The recapping frequency was 93.9%. The study was repeated after educational programs and following installation of a hospital-wide bedside needle disposal system. Fifty-three nurses performing 151 activities with needles were observed. Frequency of recapping was 94%. There was no significant difference in the rate of recapping or needlestick injuries after installation of the new needle disposal system. Educational programs regarding recapping, a very common practice, may be ineffective. Alternate methods for preventing needlesticks may be necessary.

Accidents, Occupational↗
PubMed1988

Smoking and sugar intake are separate but interactive risk factors in Crohn's disease.

Previous studies have consistently found strong positive associations between refined sugar intake and Crohn's disease (CD) and recently between smoking and CD. As refined sugar intake and smoking are themselves associated we have enquired about smoking and added sugar intake (AS) and smoking in CD using a postal questionnaire sent to 104 CD patients and 153 community controls. Smoking and AS were associated with one another. After adjusting for AS, smoking showed a significant association with CD with a relative risk of 1.8. After adjusting for smoking habit, AS was also strongly associated with CD in never and exsmokers and in a dose response pattern, with the relative risks for no AS, less than 50 g/day and greater than 50 g/day being respectively 1.0, 1.8, and 4.6 (chi 2 = 12.1; p less than 0.005). No association between CD and AS was evident in smokers. The AS relationship was supported by a separate association between frequency of confectionery consumption and CD. These findings indicate that while smoking and AS are individually associated with CD combined exposure results in no further increase in risk, suggesting that they may operate through a common mechanism.

Adolescent↗
PubMed1984

Smoking and Crohn's disease.

In a case-control study 82 patients with Crohn's disease and matched controls drawn from general practice lists were questioned about their smoking habits. Patients with Crohn's disease were significantly more likely to be smokers than the controls, and the association was stronger for smoking habit before the onset of the disease than for current smoking habit, the relative risks for smokers compared with non-smokers being 4.8 and 3.5 respectively. Taken in conjunction with earlier data showing an association between non-smoking and ulcerative colitis, these results suggest that smoking habit may be an important determinant of the type of inflammatory bowel disease that develops in predisposed subjects.

Adolescent↗
PubMed1984

Smoking and ulcerative colitis.

In a case-control study of smoking and ulcerative colitis patients with the disease were much less likely to smoke than community controls matched for age and sex. The difference was substantial, with an estimated relative risk of 3.8 for non-smoking on current habits, was even larger (6.2) when habits at onset of the disease were examined, and was mainly accounted for by 42 of 55 patients who had given up smoking a mean of eight years before onset. The association could not be explained by confounding by social class. These findings suggest that smoking directly or indirectly confers protection against ulcerative colitis.

Adolescent↗
PubMedDate not supplied

Inbreeding effects on prereproductive mortality: a case-control study in Saguenay-Lac-Saint-Jean (Québec, Canada) based on a population registry 1838-1971.

Effects of inbreeding on the prereproductive mortality, excluding spontaneous abortions, were investigated among offspring of 251 marriages between first-degree cousins (2:2) and 358 marriages between first-degree cousins once removed (2:3) from Saguenay-Lac-Saint-Jean. A control group matched on the demographic and socioeconomic characteristics of the consanguineous marriages was created. The mortality rates were calculated from a computerized population registry. The stillbirth rate was not significantly higher in the 2:2 and 2:3 groups compared with their respective control groups (p > 0.05). Mortality during the first year was significantly higher in both consanguineous groups (p < 0.01) whereas mortality between 1 and 15 years was not (p > 0.05). In Saguenay-Lac-Saint-Jean, less than 1% of the prereproductive mortality, excluding spontaneous abortions, can be attributed to consanguineous marriages. This study is in agreement with previous reports showing that inbreeding had a minor impact in prereproductive mortality.

Case-Control Studies↗
PubMedDate not supplied

Inbreeding effects on fertility and sterility: a case-control study in Saguenay-Lac-Saint-Jean (Québec, Canada) based on a population registry 1838-1971.

Effects of inbreeding on couples' fertility and primary sterility were investigated in five marriages between uncle and niece, 251 marriages between first-degree cousins, and 358 marriages between first-degree cousins once removed from Saguenay-Lac-Saint-Jean. Three control groups matched on the demographic and socioeconomic characteristics of the consanguineous couples were created. The number of children born to each couple was extracted from a computerized population registry. The level of primary sterility was found to be similar in all consanguineous and non-consanguineous groups. The mean number of children in all three consanguineous groups was not found to be significantly different from that calculated in their respective control groups (p > 0.05). These results are compatible with those obtained in virtually all the studies reported thus far in different populations.

Case-Control Studies↗