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      Lobar pneumonia treated by Musgrave Park physicians

      research-article
      ,
      The Ulster Medical Journal
      The Ulster Medical Society
      Sera, Sulpha, Penicillin

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          Abstract

          In the decade 1935-45 the treatment of lobar pneumonia in the developed and warring world underwent a series of evolutions—anti-sera, specific anti-sera, refinement of sulpha drugs, sulpha and anti-sera, the introduction of penicillin for bacteriology, then ophthalmology, and then for penicillin-sensitive bacterial infections such as lobar pneumonia with its many Cooper types of Streptococcus pneumoniae. Penicillin for civilian use was essentially banned in World War II, a ban that early in 1941 two Musgrave Park physicians tried to circumvent. Strict secrecy on the details of penicillin production was enforced. The treatment option chosen by the Musgrave Park physicians in 1941, and the non-availability of penicillin led to sequelae affecting the post-Belfast careers of both patient and physicians.

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          Most cited references89

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          Pneumococcal conjugate vaccine for childhood immunization--WHO position paper.

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            Invasive pneumococcal disease caused by nonvaccine serotypes among alaska native children with high levels of 7-valent pneumococcal conjugate vaccine coverage.

            With routine childhood vaccination using heptavalent pneumococcal conjugate vaccine, one concern has been the potential for emergence and expansion of replacement disease caused by serotypes not contained in the heptavalent conjugate vaccine. To determine whether replacement disease is associated with the overall decline in invasive pneumococcal disease among Alaska Native children. Alaska statewide longitudinal population-based laboratory surveillance of invasive Streptococcus pneumoniae infections from January 1, 1995, through December 31, 2006. Incidence and types of pneumococcal disease in children younger than 2 years. In the first 3 years after introduction of routine vaccination with heptavalent pneumococcal conjugate vaccine, overall invasive pneumococcal disease decreased 67% in Alaska Native children younger than 2 years (from 403.2 per 100,000 in 1995-2000 to 134.3 per 100,000 per year in 2001-2003, P<.001). However, between 2001-2003 and 2004-2006, there was an 82% increase in invasive disease in Alaska Native children younger than 2 years to 244.6/100,000 (P = .02). Since 2004, the invasive pneumococcal disease rate caused by nonvaccine serotypes has increased 140% compared with the prevaccine period (from 95.1 per 100,000 in 1995-2000 to 228.6 in 2004-2006, P = .001). During the same period, there was a 96% decrease in heptavalent vaccine serotype disease. Serotype 19A accounted for 28.3% of invasive pneumococcal disease among Alaska children younger than 2 years during 2004-2006. There was no significant increase in nonvaccine disease in non-Native Alaska children younger than 2 years. Alaska Native children are experiencing replacement invasive pneumococcal disease with serotypes not covered by heptavalent pneumococcal conjugate vaccine. The demonstration of replacement invasive pneumococcal disease emphasizes the importance of ongoing surveillance and development of expanded valency vaccines.
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              23-valent pneumococcal polysaccharide vaccine. WHO position paper.

              (2008)
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                Author and article information

                Journal
                Ulster Med J
                The Ulster Medical Journal
                The Ulster Medical Society
                0041-6193
                May 2009
                : 78
                : 2
                : 119-128
                Affiliations
                simpleDavid S Sheridan Professor of Anaesthesia and Respiratory Therapy, Harvard University 1400 VFW Parkway, Boston, MA 02132-4927. USA
                Author notes
                Correspondence to Prof Hedley-Whyte john_hedley-whyte@ 123456hms.harvard.edu
                Article
                2699200
                19568449
                60de65a2-f550-4f3e-a416-52123d45e4bd
                © The Ulster Medical Society, 2009
                History
                : 05 January 2009
                Categories
                Medical History

                Medicine
                sulpha,penicillin,sera
                Medicine
                sulpha, penicillin, sera

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