SUSAN POLLART - Academia.edu (original) (raw)

Papers by SUSAN POLLART

Clinical Reviews in Allergy, 1988

Clinical Reviews in Allergy, 1988

American family physician, 2007

Cerumen is a naturally occurring, normally extruded product of the external auditory canal. It is... more Cerumen is a naturally occurring, normally extruded product of the external auditory canal. It is usually asymptomatic, but when it becomes impacted it can cause complications such as hearing loss, pain, or dizziness. It also can interfere with examination of the tympanic membrane. Depending on available equipment, physician skill, and patient circumstances, treatment options for cerumen impaction include watchful waiting, manual removal, the use of ceruminolytic agents, and irrigation with or without ceruminolytic pretreatment. The overall quality of the evidence on treatment is limited. Referral to an otolaryngologist for further evaluation is indicated if treatment with a ceruminolytic agent followed by irrigation is ineffective, if manual removal is not possible, if the patient develops severe pain or has vertigo during irrigation, or if hearing loss is still present after cerumen has been removed. The use of cotton swabs and ear candles should be avoided.

Toxicology and Industrial Health, 1990

ABSTRACT

JMIR medical education, Jan 23, 2018

The number of women entering medical school and careers in science is increasing; however, women ... more The number of women entering medical school and careers in science is increasing; however, women remain the minority of those in senior faculty and leadership positions. Barriers contributing to the shortage of women in academics and academic leadership are numerous, including a shortage of role models and mentors. Thus, achieving equity in a timelier manner will require more than encouraging women to pursue these fields of study or waiting long enough for those in the pipelines to be promoted. Social media provides new ways to connect and augments traditional forms of communication. These alternative avenues may allow women in academic medicine to obtain the support they are otherwise lacking. In this perspective, we reflect on the role of Twitter as a supplemental method for navigating the networks of academic medicine. The discussion includes the use of Twitter to obtain (1) access to role models, (2) peer-to-peer interactions, and continuous education, and (3) connections with t...

American Review of Respiratory Disease, 1993

To investigate the role of indoor allergens in adult patients with acute asthma, we conducted a c... more To investigate the role of indoor allergens in adult patients with acute asthma, we conducted a case-controlled study on patients presenting to an emergency room. One hundred and fourteen patients and 114 control subjects were enrolled over a 1-yr period in Wilmington, Delaware. Sera were assayed for total IgE, and for IgE antibodies to dust mites, cat dander, cockroach, grass pollen, and ragweed pollen. Dust was obtained from 186 homes and assayed for dust mite, cat, and cockroach allergens. IgE antibodies to mite, cat, and cockroach were each significantly associated with asthma, and this association was very strong among participants without medical insurance and among African Americans. Among 99 uninsured participants, sensitization to one of the indoor allergens (> 200 RAST units) was present in 28 of 57 asthmatics and in one of 42 control subjects (odds ratio, 39; confidence interval, 9.4 to 166). For cat and cockroach the combination of sensitization and presence of allergen in the house was significantly associated with asthma. Furthermore, there was a strong inverse relationship between IgE antibodies to cat and to cockroach, and the risk of this sensitization was in large part restricted to homes or areas with high levels of allergen. Thirty-eight percent of the asthmatics, but only 8% of the control subjects, were allergic to one of the three indoor allergens, and had high levels of the relevant allergen in their houses (odds ratio, 7.4; confidence interval, 3.3 to 16.5).(ABSTRACT TRUNCATED AT 250 WORDS)

American family physician, 2011

Asthma exacerbations can be classified as mild, moderate, severe, or life threatening. Criteria f... more Asthma exacerbations can be classified as mild, moderate, severe, or life threatening. Criteria for exacerbation severity are based on symptoms and physical examination parameters, as well as lung function and oxygen saturation. In patients with a peak expiratory flow of 50 to 79 percent of their personal best, up to two treatments of two to six inhalations of short-acting beta2 agonists 20 minutes apart followed by a reassessment of peak expiratory flow and symptoms may be safely employed at home. Administration using a hand-held metered-dose inhaler with a spacer device is at least equivalent to nebulized beta2 agonist therapy in children and adults. In the ambulatory and emergency department settings, the goals of treatment are correction of severe hypoxemia, rapid reversal of airflow obstruction, and reduction of the risk of relapse. Multiple doses of inhaled anticholinergic medication combined with beta2 agonists improve lung function and decrease hospitalization in school-age ...

American family physician, 2009

The Expert Panel Report 3 of the National Asthma Education and Prevention Program represents a ma... more The Expert Panel Report 3 of the National Asthma Education and Prevention Program represents a major advance in the approach to asthma care by emphasizing the monitoring of clinically relevant aspects of care and the importance of planned primary care, and by providing patients practical tools for self-management. Treatment of asthma should be guided by a new system of classification that assesses severity at initial evaluation and control at all subsequent visits. Asthma severity is determined by current impairment (as evidenced by impact on day-to-day activities) and risk of future exacerbations (as evidenced by frequency of oral systemic corticosteroid use), and allows categorization of disease as intermittent, persistent-mild, persistent-moderate, and persistent-severe. Initial treatment is guided by the disease-severity category. The degree of control is also determined by the analysis of current impairment and future risk. Validated questionnaires can be used for following the...

American family physician, Jan 15, 2005

The prevalence of childhood asthma has risen significantly over the past four decades. A family h... more The prevalence of childhood asthma has risen significantly over the past four decades. A family history of atopic disease is associated with an increased likelihood of developing asthma, and environmental triggers such as tobacco smoke significantly increase the severity of daily asthma symptoms and the frequency of acute exacerbations. The goal of asthma therapy is to control symptoms, optimize lung function, and minimize days lost from school. Acute care of an asthma exacerbation involves the use of inhaled beta2 agonists delivered by a metered-dose inhaler with a spacer, or a nebulizer, supplemented by anticholinergics in more severe exacerbations. The use of systemic and inhaled corticosteroids early in an asthma attack may decrease the rate of hospitalization. Chronic care focuses on controlling asthma by treating the underlying airway inflammation. Inhaled corticosteroids are the agent of choice in preventive care, but leukotriene inhibitors and nedocromil also can be used as ...

Academic medicine : journal of the Association of American Medical Colleges, 2015

To explore the relationship between clinical faculty members' time/effort in four mission are... more To explore the relationship between clinical faculty members' time/effort in four mission areas, their assessment of the distribution of that time/effort, and their intent to leave the institution and academic medicine. Faculty from 14 U.S. medical schools participated in the 2011-2012 Faculty Forward Engagement Survey. The authors conducted multivariate logistic regression analyses to evaluate relationships between clinical faculty members' self-reported time/effort in each mission area, assessment of time/effort, and intent to leave the institution and academic medicine. Of the 13,722 clinical faculty surveyed, 8,349 (60.8%) responded. Respondents reported an average of 54.5% time/effort in patient care. The authors found no relationship between time/effort in patient care and intent to leave one's institution. Respondents who described spending "far too much/too much" time in patient care were more likely to report intent to leave their institution (odds rat...

Obstetrics & Gynecology, 2013

Focus on medical school mission a50.903 and workplace culture a50.826 Medical school governance O... more Focus on medical school mission a50.903 and workplace culture a50.826 Medical school governance Opportunities for faculty participation in governance; communication from the dean's office; medical school's explanation of finances to faculty Medical school governance a50.933 Department governance Opportunities for faculty participation in decision-making; communication from the department chair; department's explanation of finances to faculty Department governance a50.936 Collegiality and collaboration Opportunities to collaborate with other faculty; personal "fit" (ie, sense of belonging); interactions with colleagues; intellectual vitality within the department and medical school; appreciation by colleagues

Journal of Allergy and Clinical Immunology, 1991

Journal of Allergy and Clinical Immunology, 1988

To examine the relationship between allergy ana' acute attacks of asthma, we have examined adult ... more To examine the relationship between allergy ana' acute attacks of asthma, we have examined adult patients with acute asthma presenting during a defined pollen season. Sera from 59 patients presenting with acute asthma to the David Grant Medical Center emergency room at Travis Air Force Base during the spring "epidemic" of asthma were assayed for IgE antibody (Ab) to jive allergens (mite, cat, cockroach, ryegrass pollen, and ragweed) with BAST. Control sera were obtainedfrom 34 patients without asthma and 25 employees. The results demonstrate that 92% of the patients with asthma had >200 units of IgE Ab to ryegrass pollen (-20 ng of IgE Ab per milliliter) compared to 14% of the control subjects (x2 = 69; p < 0.0001; odds ratio = 69). Some of the grass pollen-allergic patients also had increased levels of IgE Ab to ragweed, but only 25% had >200 units. In contrast, there was no significant difference between subjects with asthma and control subjects in the prevalence of IgE Ab to the three indoor allergens (mite, cockroach, and cat). Twelve percent of the patients with asthma compared to 5% of the control subjects had >200 units of IgE Ab to one of these three (x' = 0.98; p > 0.1; odds ratio = 2.5). Dust samples porn the homes of 15 of the patients with asthma demonstrated very high levels of grass pollen (13115 houses with >lO pg of allergen per gram of dust), low levels of mite (13115 homes with <2 Kg of allergen per gram of dust), and no detectable cockroach allergen. These results demonstrate that the development of IgE Ab to an inhalant allergen (i.e., grass pollen) increased the patients' odds of developing acute asthma during a period of increased exposure. (J ALLERGY CLIN IMMUNOL 1988;82:224-30.) There are many case-control studies on clinic patients and population surveys that demonstrate that there is a high prevalence of allergy among patients with asthma.'" In some outpatient clinics, inhalant allergy is actively investigated as a possible etiology in all cases of reversible airway disease. By contrast, recognized medical authorities suggest that only 10%

Journal of Allergy and Clinical Immunology, 2005

Journal of Allergy and Clinical Immunology, 1991

Quantitative two-site monoclonal antibody (MAb)-based enzyme-linked immunoassays for two cockroac... more Quantitative two-site monoclonal antibody (MAb)-based enzyme-linked immunoassays for two cockroach (CR) allergens, Bla g I and Bla g II, have been developed and used to measure allergen levels in house-dust samples. Dust collected from the CR-infested homes of two patients with asthma from Charlottesville, Va., demonstrated wide variation in the levels of Bla g I, depending on the location of dust collection. Dust from kitchen floors and cabinets contained 50-fold more allergen (mean, 10,755 U/gm of dust) than dust from bedrooms and upholstered furniture (mean, 204 U/gm). One hundred forty-five dust samples were collected from the bedrooms and living rooms of 22 children with asthma and 16 control subjects without asthma living in Atlanta, Ga. Twenty-seven of the 38 homes (17/22 children with asthma; 10/16 control subjects) had detectable Bla g I (4 to 1340 U/gm of dust). Bla g II levels were assayed in 40 kitchen, bedroom, and living room samples from homes in Wilmington, Del. Highest levels of Bla g II were detected in kitchen-floor dust (300 U/gm of dust). Additionally, approximately 20% of homes with no visual evidence of CR infestation had significant levels of Bla g II in at least one dust sample (greater than 4 U/gm of dust). Our results demonstrate that CR may be an occult allergen in homes. The kitchen appears to be the primary site of CR-allergen accumulation, but significant CR-allergen levels can also be found at other sites in the home. The MAb-based assays can be used for quantitation of environmental exposure to CR allergens.(ABSTRACT TRUNCATED AT 250 WORDS)

Journal of Allergy and Clinical Immunology, 1987

Clinical Reviews in Allergy, 1988

Clinical Reviews in Allergy, 1988

American family physician, 2007

Cerumen is a naturally occurring, normally extruded product of the external auditory canal. It is... more Cerumen is a naturally occurring, normally extruded product of the external auditory canal. It is usually asymptomatic, but when it becomes impacted it can cause complications such as hearing loss, pain, or dizziness. It also can interfere with examination of the tympanic membrane. Depending on available equipment, physician skill, and patient circumstances, treatment options for cerumen impaction include watchful waiting, manual removal, the use of ceruminolytic agents, and irrigation with or without ceruminolytic pretreatment. The overall quality of the evidence on treatment is limited. Referral to an otolaryngologist for further evaluation is indicated if treatment with a ceruminolytic agent followed by irrigation is ineffective, if manual removal is not possible, if the patient develops severe pain or has vertigo during irrigation, or if hearing loss is still present after cerumen has been removed. The use of cotton swabs and ear candles should be avoided.

Toxicology and Industrial Health, 1990

ABSTRACT

JMIR medical education, Jan 23, 2018

The number of women entering medical school and careers in science is increasing; however, women ... more The number of women entering medical school and careers in science is increasing; however, women remain the minority of those in senior faculty and leadership positions. Barriers contributing to the shortage of women in academics and academic leadership are numerous, including a shortage of role models and mentors. Thus, achieving equity in a timelier manner will require more than encouraging women to pursue these fields of study or waiting long enough for those in the pipelines to be promoted. Social media provides new ways to connect and augments traditional forms of communication. These alternative avenues may allow women in academic medicine to obtain the support they are otherwise lacking. In this perspective, we reflect on the role of Twitter as a supplemental method for navigating the networks of academic medicine. The discussion includes the use of Twitter to obtain (1) access to role models, (2) peer-to-peer interactions, and continuous education, and (3) connections with t...

American Review of Respiratory Disease, 1993

To investigate the role of indoor allergens in adult patients with acute asthma, we conducted a c... more To investigate the role of indoor allergens in adult patients with acute asthma, we conducted a case-controlled study on patients presenting to an emergency room. One hundred and fourteen patients and 114 control subjects were enrolled over a 1-yr period in Wilmington, Delaware. Sera were assayed for total IgE, and for IgE antibodies to dust mites, cat dander, cockroach, grass pollen, and ragweed pollen. Dust was obtained from 186 homes and assayed for dust mite, cat, and cockroach allergens. IgE antibodies to mite, cat, and cockroach were each significantly associated with asthma, and this association was very strong among participants without medical insurance and among African Americans. Among 99 uninsured participants, sensitization to one of the indoor allergens (&amp;amp;gt; 200 RAST units) was present in 28 of 57 asthmatics and in one of 42 control subjects (odds ratio, 39; confidence interval, 9.4 to 166). For cat and cockroach the combination of sensitization and presence of allergen in the house was significantly associated with asthma. Furthermore, there was a strong inverse relationship between IgE antibodies to cat and to cockroach, and the risk of this sensitization was in large part restricted to homes or areas with high levels of allergen. Thirty-eight percent of the asthmatics, but only 8% of the control subjects, were allergic to one of the three indoor allergens, and had high levels of the relevant allergen in their houses (odds ratio, 7.4; confidence interval, 3.3 to 16.5).(ABSTRACT TRUNCATED AT 250 WORDS)

American family physician, 2011

Asthma exacerbations can be classified as mild, moderate, severe, or life threatening. Criteria f... more Asthma exacerbations can be classified as mild, moderate, severe, or life threatening. Criteria for exacerbation severity are based on symptoms and physical examination parameters, as well as lung function and oxygen saturation. In patients with a peak expiratory flow of 50 to 79 percent of their personal best, up to two treatments of two to six inhalations of short-acting beta2 agonists 20 minutes apart followed by a reassessment of peak expiratory flow and symptoms may be safely employed at home. Administration using a hand-held metered-dose inhaler with a spacer device is at least equivalent to nebulized beta2 agonist therapy in children and adults. In the ambulatory and emergency department settings, the goals of treatment are correction of severe hypoxemia, rapid reversal of airflow obstruction, and reduction of the risk of relapse. Multiple doses of inhaled anticholinergic medication combined with beta2 agonists improve lung function and decrease hospitalization in school-age ...

American family physician, 2009

The Expert Panel Report 3 of the National Asthma Education and Prevention Program represents a ma... more The Expert Panel Report 3 of the National Asthma Education and Prevention Program represents a major advance in the approach to asthma care by emphasizing the monitoring of clinically relevant aspects of care and the importance of planned primary care, and by providing patients practical tools for self-management. Treatment of asthma should be guided by a new system of classification that assesses severity at initial evaluation and control at all subsequent visits. Asthma severity is determined by current impairment (as evidenced by impact on day-to-day activities) and risk of future exacerbations (as evidenced by frequency of oral systemic corticosteroid use), and allows categorization of disease as intermittent, persistent-mild, persistent-moderate, and persistent-severe. Initial treatment is guided by the disease-severity category. The degree of control is also determined by the analysis of current impairment and future risk. Validated questionnaires can be used for following the...

American family physician, Jan 15, 2005

The prevalence of childhood asthma has risen significantly over the past four decades. A family h... more The prevalence of childhood asthma has risen significantly over the past four decades. A family history of atopic disease is associated with an increased likelihood of developing asthma, and environmental triggers such as tobacco smoke significantly increase the severity of daily asthma symptoms and the frequency of acute exacerbations. The goal of asthma therapy is to control symptoms, optimize lung function, and minimize days lost from school. Acute care of an asthma exacerbation involves the use of inhaled beta2 agonists delivered by a metered-dose inhaler with a spacer, or a nebulizer, supplemented by anticholinergics in more severe exacerbations. The use of systemic and inhaled corticosteroids early in an asthma attack may decrease the rate of hospitalization. Chronic care focuses on controlling asthma by treating the underlying airway inflammation. Inhaled corticosteroids are the agent of choice in preventive care, but leukotriene inhibitors and nedocromil also can be used as ...

Academic medicine : journal of the Association of American Medical Colleges, 2015

To explore the relationship between clinical faculty members' time/effort in four mission are... more To explore the relationship between clinical faculty members' time/effort in four mission areas, their assessment of the distribution of that time/effort, and their intent to leave the institution and academic medicine. Faculty from 14 U.S. medical schools participated in the 2011-2012 Faculty Forward Engagement Survey. The authors conducted multivariate logistic regression analyses to evaluate relationships between clinical faculty members' self-reported time/effort in each mission area, assessment of time/effort, and intent to leave the institution and academic medicine. Of the 13,722 clinical faculty surveyed, 8,349 (60.8%) responded. Respondents reported an average of 54.5% time/effort in patient care. The authors found no relationship between time/effort in patient care and intent to leave one's institution. Respondents who described spending "far too much/too much" time in patient care were more likely to report intent to leave their institution (odds rat...

Obstetrics & Gynecology, 2013

Focus on medical school mission a50.903 and workplace culture a50.826 Medical school governance O... more Focus on medical school mission a50.903 and workplace culture a50.826 Medical school governance Opportunities for faculty participation in governance; communication from the dean's office; medical school's explanation of finances to faculty Medical school governance a50.933 Department governance Opportunities for faculty participation in decision-making; communication from the department chair; department's explanation of finances to faculty Department governance a50.936 Collegiality and collaboration Opportunities to collaborate with other faculty; personal "fit" (ie, sense of belonging); interactions with colleagues; intellectual vitality within the department and medical school; appreciation by colleagues

Journal of Allergy and Clinical Immunology, 1991

Journal of Allergy and Clinical Immunology, 1988

To examine the relationship between allergy ana' acute attacks of asthma, we have examined adult ... more To examine the relationship between allergy ana' acute attacks of asthma, we have examined adult patients with acute asthma presenting during a defined pollen season. Sera from 59 patients presenting with acute asthma to the David Grant Medical Center emergency room at Travis Air Force Base during the spring "epidemic" of asthma were assayed for IgE antibody (Ab) to jive allergens (mite, cat, cockroach, ryegrass pollen, and ragweed) with BAST. Control sera were obtainedfrom 34 patients without asthma and 25 employees. The results demonstrate that 92% of the patients with asthma had >200 units of IgE Ab to ryegrass pollen (-20 ng of IgE Ab per milliliter) compared to 14% of the control subjects (x2 = 69; p < 0.0001; odds ratio = 69). Some of the grass pollen-allergic patients also had increased levels of IgE Ab to ragweed, but only 25% had >200 units. In contrast, there was no significant difference between subjects with asthma and control subjects in the prevalence of IgE Ab to the three indoor allergens (mite, cockroach, and cat). Twelve percent of the patients with asthma compared to 5% of the control subjects had >200 units of IgE Ab to one of these three (x' = 0.98; p > 0.1; odds ratio = 2.5). Dust samples porn the homes of 15 of the patients with asthma demonstrated very high levels of grass pollen (13115 houses with >lO pg of allergen per gram of dust), low levels of mite (13115 homes with <2 Kg of allergen per gram of dust), and no detectable cockroach allergen. These results demonstrate that the development of IgE Ab to an inhalant allergen (i.e., grass pollen) increased the patients' odds of developing acute asthma during a period of increased exposure. (J ALLERGY CLIN IMMUNOL 1988;82:224-30.) There are many case-control studies on clinic patients and population surveys that demonstrate that there is a high prevalence of allergy among patients with asthma.'" In some outpatient clinics, inhalant allergy is actively investigated as a possible etiology in all cases of reversible airway disease. By contrast, recognized medical authorities suggest that only 10%

Journal of Allergy and Clinical Immunology, 2005

Journal of Allergy and Clinical Immunology, 1991

Quantitative two-site monoclonal antibody (MAb)-based enzyme-linked immunoassays for two cockroac... more Quantitative two-site monoclonal antibody (MAb)-based enzyme-linked immunoassays for two cockroach (CR) allergens, Bla g I and Bla g II, have been developed and used to measure allergen levels in house-dust samples. Dust collected from the CR-infested homes of two patients with asthma from Charlottesville, Va., demonstrated wide variation in the levels of Bla g I, depending on the location of dust collection. Dust from kitchen floors and cabinets contained 50-fold more allergen (mean, 10,755 U/gm of dust) than dust from bedrooms and upholstered furniture (mean, 204 U/gm). One hundred forty-five dust samples were collected from the bedrooms and living rooms of 22 children with asthma and 16 control subjects without asthma living in Atlanta, Ga. Twenty-seven of the 38 homes (17/22 children with asthma; 10/16 control subjects) had detectable Bla g I (4 to 1340 U/gm of dust). Bla g II levels were assayed in 40 kitchen, bedroom, and living room samples from homes in Wilmington, Del. Highest levels of Bla g II were detected in kitchen-floor dust (300 U/gm of dust). Additionally, approximately 20% of homes with no visual evidence of CR infestation had significant levels of Bla g II in at least one dust sample (greater than 4 U/gm of dust). Our results demonstrate that CR may be an occult allergen in homes. The kitchen appears to be the primary site of CR-allergen accumulation, but significant CR-allergen levels can also be found at other sites in the home. The MAb-based assays can be used for quantitation of environmental exposure to CR allergens.(ABSTRACT TRUNCATED AT 250 WORDS)

Journal of Allergy and Clinical Immunology, 1987