Assessing gender equity in a large academic department of pediatrics.

PURPOSE: To determine the extent of gender inequity in a large academic pediatrics department and to demonstrate an assessment methodology other departments can use. METHOD: Using deidentified data, the authors evaluated all promotion track faculty in the University of Colorado School of Medicine's Department of Pediatrics in 2009 by five parameters: promotion, tenure, leadership roles, faculty retention, and salary. Outcome metrics included time to promotion and at rank; awards of tenure, time to tenure, and time tenured; departmental leadership positions in 2009; attrition rates from 2000 to 2009; and salary in academic year 2008-2009 compared with national benchmarks. RESULTS: Women constituted 54% (60/112) of assistant professors and 56% (39/70) of associate professors but only 23% (19/81) of professors. Average years to promotion at each rank and years at assistant and associate professor were identical for men and women; male professors held their rank six years longer. Only 18% (9/50) of tenured faculty were women. Men held 75% (18/24) of section head and 83% (6/7) of vice chair positions; women held 62% (13/21) of medical director positions. More women than men retired as associate professors and resigned/relocated as professors. Women's pay (98% of national median salary) was lower than men's (105% of median) across all ranks and specialties. CONCLUSIONS: These gender disparities were due in part to women's later start in academics and the resulting lag time in promotion. Differences in the awarding of tenure, assignment of leadership roles, faculty retention, and salary may also have played important roles.

Evaluation of a rapid and completely automated real-time reverse transcriptase PCR assay for diagnosis of enteroviral meningitis.

Nucleic acid amplification tests (NAATs) for enterovirus RNA in cerebrospinal fluid (CSF) have emerged as the new gold standard for diagnosis of enteroviral meningitis, and their use can improve the management and decrease the costs for caring for children with enteroviral meningitis. The Xpert EV assay (Cepheid, Sunnyvale, CA) is a rapid, fully automated real-time PCR test for the detection of enterovirus RNA that was approved by the U.S. Food and Drug Administration for in vitro diagnostic use in March 2007. In this multicenter trial we established the clinical performance characteristics of the Xpert EV assay in patients presenting with meningitis symptoms relative to clinical truth. Clinical truth for enteroviral meningitis was defined as clinical evidence of meningitis, the absence of another detectable pathogen in CSF, and detection of enterovirus in CSF either by two reference NAATs or by viral culture. A total of 199 prospectively and 235 retrospectively collected specimens were eligible for inclusion in this study. The overall prevalence of enteroviral meningitis was 26.04%. The Xpert EV assay had a sensitivity of 94.69% (90% confidence interval [CI] = 89.79 to 97.66%), specificity of 100% (90% CI = 99.07 to 100%), positive predictive value of 100%, negative predictive value of 98.17, and an accuracy of 98.62% relative to clinical truth. The Xpert EV assay demonstrated a high degree of accuracy for diagnosis of enteroviral meningitis. The simplicity and on-demand capability of the Xpert EV assay should prove to be a valuable adjunct to the evaluation of suspected meningitis cases.

Germ proof your school.

Schools can be made safer from germs by: 1. Reinforcing students' personal health and hygiene practices such as hand washing, proper wound care, timely immunizations, nutritious diet, adequate sleep, reducing long-term stress, regular moderate exercise, and matching wardrobe to the weather; 2. Adherence to health department exclusion/inclusion policies for students who are infected, symptomatic, exposed to infection, or susceptible to infection; 3. Practicing sound environmental hygiene, with particular attention to surface disinfecting and food safety.

Prospective study of enteroviral infections and development of beta-cell autoimmunity. Diabetes autoimmunity study in the young (DAISY).

OBJECTIVE: To determine whether there is association between infection with enteroviruses and beta-cell autoimmunity in children at elevated risk of developing type 1 diabetes. BACKGROUND: Recent prospective and case-control studies of children who are at high risk of developing type 1 diabetes have suggested that enterovirus (EV) infections are a risk factor for beta-cell autoimmunity and type 1 diabetes. METHODS: A nested matched case-control study of incident cases of beta-cell autoimmunity within two prospective cohorts of genetically high-risk children (cases=26, controls=39). EV infection was detected by PCR of serum, saliva and rectal swab samples. RESULTS: Prior to autoimmunity conversion (or the equivalent age in controls), 11.5% of cases and 17.9% of controls were positive for EV infection. EV was detected in 19.5% of cases and 25.6% of controls over the whole follow-up period. Conditional logistic regression gave no evidence that the frequency of EV infection was associated with beta-cell autoimmunity. There was a trend for the mean number of EV infections found in EV-positive cases (2.2/case) to be higher than in EV-positive controls (1.2/control, P=0.08). However, there were no multiple infections prior to conversion in either cases or controls. CONCLUSIONS: There is no evidence from this study that EV infection is a risk factor for development of beta-cell autoimmunity. Further study is needed to assess whether persistent or repeated EV infections occur frequently in individuals with beta-cell autoimmunity.

Treatment of picornavirus infections.

The picornaviruses are a diverse group of viral pathogens that together comprise the most common causes of infections of humans in the developed world. Within the picornavirus family are three well-known groups of human pathogens-the enteroviruses (including polioviruses, coxsackieviruses, and echoviruses), the rhinoviruses, and the hepatoviruses (including hepatitis A). Recently, the parechoviruses (formerly, echoviruses 22 and 23) have been classified as a fourth genus of human picornaviruses. This article will focus on the enteroviruses and rhinoviruses agents, for which substantial effort has been expended and recent successes reported towards the development of safe and effective antiviral therapy.