Sex differences in academic advancement. Results of a national study of pediatricians.

BACKGROUND: Although the numbers of women in training and in entry-level academic positions in medicine have increased substantially in recent years, the proportion of women in senior faculty positions has not changed. We conducted a study to determine the contributions of background and training, academic productivity, distribution of work time, institutional support, career attitudes, and family responsibilities to sex differences in academic rank and salary among faculty members of academic pediatric departments. METHODS: We conducted a cross-sectional survey of all salaried physicians in 126 academic departments of pediatrics in the United States in January 1992. Of the 6441 questionnaires distributed, 4285 (67 percent) were returned. The sample was representative of U.S. pediatric faculty members. Multivariate models were used to relate academic rank and salary to 16 independent variables. RESULTS: Significantly fewer women than men achieved the rank of associate professor or higher. For both men and women, higher salaries and ranks were related to greater academic productivity (more publications and grants), more hours worked, more institutional support of research, greater overall career satisfaction, and fewer career problems. Less time spent in teaching and patient care was related to greater academic productivity for both sexes. Women in the low ranks were less academically productive and spent significantly more time in teaching and patient care than men in those ranks. Adjustment for all independent variables eliminated sex differences in academic rank but not in salary. CONCLUSIONS: Lower rates of academic productivity, more time spent in teaching and patient care and less time spent in research, less institutional support for research, and lower rates of specialization in highly paid subspecialties contributed to the lower ranks and salaries of female faculty members.

Development and implementation of a health surveillance system.

With the formation of Shell Oil Company's Health, Safety and Environment Organization in 1976, an expanded employee health surveillance program was started. A computerized system was developed to facilitate collecting, storing, retrieving, and analyzing employee medical, exposure and work history records. System requirements included large storage capacity, confidentiality, operability, flexibility, quality assurance, and minimum impact on user locations. A key element of the system is the Job Exposure Profile (JEP). A JEP describes the work tasks and identifies the chemical and physical agents associated with individual jobs at a location. Employee work history data are collected by utilizing existing payroll systems in conjunction with the JEP. Successful implementation of the system within our manufacturing (refineries, chemical plants and complexes) and products distribution locations has been completed. This was done by obtaining top management support and commitment at each location. A team consisting of corporate industrial hygienists, computer experts, and location staff was responsible for developing JEP's and setting up a system to collect data on the work histories. The system can now be used to prepare reports for location or corporate use, conduct statistical analysis of exposure data and maintain an exposure/work history record for epidemiologic studies.

Cytomegalovirus vaccine: a realistic appraisal.

The possible benefits and dangers of a vaccine program for CMV infection, especially congenital infection, cannot be rationally analyzed until more is known about the virus itself, including its manner of spread and the nature of host responses. Until then, trials with the experimental vaccines under development should be limited to patients at unusually high risk, such as those receiving renal transplants.

Gasoline vapor exposure during bulk handling operations.

The survey evaluated gasoline vapor concentrations in the employees, breathing zone at five bulk handling facilities. Charcoal tube samples were analyzed by a special GLC/flame ionization/flasher technique which coupled with a computer program identified up to 142 constituents. A time-weighted limit of 240 ppm/10-hour day was only exceeded for five percent of the time at one location.

Cytomegalovirus encephalitis in immunologically normal adults. Successful treatment with vidarabine.

Acute cytomegalovirus (CMV) encephalitis developed in two immunologically normal adults. The diagnosis was confirmed by isolation of CMV from the CSF and urine in one case and from temporal lobe biopsy tissue, CSF, and urine in the second case. Both patients were treated with vidarabine and showed dramatic clinical improvement. Virus excretion, which had been chronic in one case, cleared after therapy. To our knowledge, these are the first persons with CMV encephalitis evidenced by isolation of the virus from the CNS. The response to vidarabine was impressive and warrants further evaluation.

Puncture wound of the eyelid causing brain abscess.

A case of brain abscess following an apparently trival puncture wound to the eyelid is presented to emphasize the importance of meticulous examination of eye wounds in children to look for penetration into the cranial vault. Any suggestion of such penetrating injury either by history, examination, or X-ray should dictate neurosurgical consultation, and immediate local culture and debridement of the wound. If nonoperative management is elected, a careful watch must be kept for signs of infection, which dictate early exploration, and broad-spectrum antibiotic coverage of Gram-positive and Gram-negative organisms common to penetrating skull trauma.

Vidarabine therapy for severe herpesvirus infections. An unusual syndrome of chronic varicella and transient immunologic deficiency.

Six patients with severe herpesvirus infections were successfully treated with vidarabine. One patient had a previously undescribed syndrome of chronic cutaneous varicella infection of eight months' duration, associated with transient but complete duppression of lymphocyte response to conconavalin A. Other diagnoses were severe varicella pneumonia, progressive cytomegalovirus pneumonia associated with acute lymphocytic leukemia, herpes simplex encephalitis, severe zoster associated with stage IV lymphoma, and disseminated herpes simplex in a patient receiving high doses of steroids. All patients showed cessation of new lesions or abrupt clinical improvement between days 2 and 4 after initiation of therapy, and all were cured of their clinical infection. Dramatic improvement in all of our patients and the minimal toxicity observed make vidarabine suitable for use in severe herpesvirus infections.

Biochemical values in the normal and hypothermic baboom Papio cynocephalus/anubis.

Seventeen biochemical parameters were measured in the venous and arterial blood of normal adolescent baboons (P. cynocephalus/anubis) under normothermic sedation and normothermic and hypothermic anesthesia. Statistical comparisons of the results were made between sexes and between the two temperatures under anesthesia. Six parameters differed significantly between males and females and five varied significantly between normothermia and hypothermia. Comparisons to the existing literature and the differences under hypothermia are briefly discussed.