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>>> MEDSCAPE's Infectious Diseases MedPulse(R) <<<

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MedPulse is a weekly index of key news and features on Medscape's specialty sites compiled by Medscape's Editors. _______________________________________________________________________

___________________________________ CME _______________________________

Welcome to Medscape's Infectious Diseases Medpulse. Since you last

visited Medscape, we've posted a number of new CME activities that you

may find of interest, including:

MEDSCAPE CONFERENCE COVERAGE:

9TH CONFERENCE ON RETROVIRUSES AND OPPORTUNISTIC INFECTIONS http://www.medscape.com/viewprogram/1724?srcmp=id-040502

<a href="http://www.medscape.com/viewprogram/1724?srcmp=id-040502"> Read it Here</a>

MEDSCAPE CONFERENCE COVERAGE:

41ST INTERSCIENCE CONFERENCE ON ANTIMICROBIAL AGENTS AND CHEMOTHERAPY http://www.medscape.com/viewprogram/507?srcmp=id-040502

<a href="http://www.medscape.com/viewprogram/507?srcmp=id-040502"> Read it Here</a>

ANTHRAX: CDC WEBCAST AND OUR CURRENT KNOWLEDGE http://www.medscape.com/viewprogram/980?srcmp=id-040502

<a href="http://www.medscape.com/viewprogram/980?srcmp=id-040502"> Read it Here</a>

MEASLES, HAEMOPHILUS INFLUENZAE TYPE B, VARICELLA: PRE- AND POSTVACCINE EPIDEMIOLOGY IN THE UNITED STATES http://www.medscape.com/viewprogram/596?srcmp=id-040502

<a href="http://www.medscape.com/viewprogram/596?srcmp=id-040502"> Read it Here</a>

_______________________________________________________________________

___________________ NEW FEATURE ARTICLES THIS WEEK ____________________

-- MEDSCAPE ORIGINAL ARTICLES --

FOODBORNE DISEASE UPDATE - DOES YOUR PATIENT HAVE A FOODBORNE DISEASE? Symptoms and foods eaten can provide significant clues to the most likely cause of disease. Medscape Infectious Diseases 4(1) 2002 http://www.medscape.com/viewarticle/429465?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/429465?srcmp=id-040502">

Read it Here</a>

CURRENT TREATMENT OF CHRONIC HEPATITIS C

Emmet B. Keeffe, MD, discusses the current state of the field in HCV management. Medscape Gastroenterology eJournal 4(2) 2002 http://www.medscape.com/viewarticle/429322?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/429322?srcmp=id-040502">

Read it Here</a>

JOURNAL SCAN - GASTROENTEROLOGY, MARCH 2002

Highlights include effect of long-term H2RAs on nocturnal acid breakthrough and long-term sulindac for FAP. Medscape Gastroenterology 2002 http://www.medscape.com/viewarticle/431060?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431060?srcmp=id-040502">

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KIDNEY TRANSPLANTATION IN HCV-POSITIVE PATIENT?

Should patients with HCV receive kidney transplants?

Medscape Transplantation 4(1) 2002 http://www.medscape.com/viewarticle/430696?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/430696?srcmp=id-040502">

Read it Here</a>

-- MMWR --

PROGRESS TOWARD GLOBAL ERADICATION OF POLIOMYELITIS, 2001 Current challenges include intense transmission in India, importations of wild virus, and vaccine-derived virus. MMWR 51(12) 2002 http://www.medscape.com/viewarticle/430927?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/430927?srcmp=id-040502">

Read it Here</a>

REPORTING OF LABORATORY-CONFIRMED CHLAMYDIAL INFECTION AND GONORRHEA BY PROVIDERS AFFILIATED WITH THREE LARGE MANAGED CARE ORGANIZATIONS -- UNITED STATES, 1995-1999 Network model MCOs, which provide most STD care in the US, should evaluate surveillance quality. MMWR 51(12) 2002 http://www.medscape.com/viewarticle/430928?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/430928?srcmp=id-040502">

Read it Here</a>

-- INFECTIONS in MEDICINE --

AN INFECTED LACERATION

A 44-year-old man presents to the emergency department for reevaluation of a 2-week-old infected leg wound. Infect Med 19(2) 2002 http://www.medscape.com/viewarticle/429659?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/429659?srcmp=id-040502">

Read it Here</a>

PUBLIC HEALTH BENEFITS OF PESTICIDES

One author advocates the use of pesticides as an essential part of disease control. Infect Med 19(2) 2002 http://www.medscape.com/viewarticle/429658?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/429658?srcmp=id-040502">

Read it Here</a>

TUBERCULOUS OTITIS

A 34-year-old woman presented with dizziness and left ear drainage of 7 months' duration. Infect Med 19(2) 2002 http://www.medscape.com/viewarticle/429660?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/429660?srcmp=id-040502">

Read it Here</a>

CDC ADDS VACCINE TO ANTHRAX TREATMENT OPTIONS, ETC.

Read summaries of the latest news in infectious disease.

Infect Med 19(2) 2002 http://www.medscape.com/viewarticle/429655?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/429655?srcmp=id-040502">

Read it Here</a>

-- SOUTHERN MEDICAL JOURNAL --

SALVAGE OF LIMB AND FUNCTION IN NECROTIZING FASCIITIS OF THE HAND: ROLE OF HYPERBARIC OXYGEN TREATMENT AND FREE MUSCLE FLAP COVERAGE Modern abilities extend the goals of treatment for necrotizing fasciitis to include maximal preservation of function. South Med J 95(2) 2002 http://www.medscape.com/viewarticle/429548?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/429548?srcmp=id-040502">

Read it Here</a>

-- THE AIDS READER --

A CLINICAL CHALLENGE IN SAGAMU, NIGERIA

Dr. Susan C. Ball gives an update on a treatment program she and colleagues started last summer in a small Nigerian city. AIDS Read 12(2) 2002 http://www.medscape.com/viewarticle/429885?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/429885?srcmp=id-040502">

Read it Here</a>

HIV DISEASE MANAGEMENT: NEW TECHNOLOGIES IMPROVE OUTCOMES AND CONTAIN COSTS This article discusses the contributions of 2 recent technologies: viral load testing and resistance testing. AIDS Read 12(2) 2002 http://www.medscape.com/viewarticle/429886?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/429886?srcmp=id-040502">

Read it Here</a>

PRIMARY NOCARDIA OSTEOMYELITIS AS A PRESENTATION OF AIDS

A previously healthy 35-year-old man presented with spontaneous, right-sided hip pain, fever, chills and anorexia. AIDS Read 12(2) 2002 http://www.medscape.com/viewarticle/429888?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/429888?srcmp=id-040502">

Read it Here</a>

_______________________________________________________________________

FOCUS ON UTI's

Medscape's UTI-Zone gives you the most timely

medical news and clinical information available on Medscape,

with an emphasis on treatment and prevention of urinary

tract infections.

http://www.medscape.com/mp/rc/usmd/uti

 

_______________________________________________________________________

___________________________________ NEWS ______________________________

-- HEPATITIS --

ADOPTIVE TRANSFER OF HEPATITIS B CORE ANTIGEN IMMUNITY RESOLVES CHRONIC HEPATITIS B Transfer of hepatitis B core antigen immunity in the course of bone marrow transplantation is associated with the resolution of chronic hepatitis B infection in the recipient, according to a report in the March issue of Gastroenterology. Reuters Health Information 2002 http://www.medscape.com/viewarticle/430949?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/430949?srcmp=id-040502">

Read it Here</a>

KLEBSIELLA PNEUMONIAE SEROTYPE K1 LINKED WITH LIVER ABSCESS

K pneumoniae is associated with abscess of the liver and endophthalmitis, particularly among diabetics. Reuters Health Information 2002 http://www.medscape.com/viewarticle/430856?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/430856?srcmp=id-040502">

Read it Here</a>

-- BIOTERRORISM --

US EMERGENCY PHYSICIANS PROPOSE 'EARLY-WARNING' SYSTEM FOR BIOTERRORISM In light of the recent acts of terror against the US, the Frontlines of Medicine Project is proposing a system that links emergency departments with regional centers that can rapidly analyze standardized data for various public health initiatives, including surveillance for chemical and biological terrorism. Reuters Health Information 2002 http://www.medscape.com/viewarticle/430954?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/430954?srcmp=id-040502">

Read it Here</a>

-- VACCINES & IMMUNIZATION --

VARICELLA VACCINE PROTECTS ADULTS AGAINST SERIOUS DISEASE OVER LONG TERM The varicella vaccine provides adults with durable protection against serious varicella-zoster virus disease, according to a report in the March 15th issue of Clinical Infectious Diseases. Reuters Health Information 2002 http://www.medscape.com/viewarticle/430955?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/430955?srcmp=id-040502">

Read it Here</a>

GAG PROTEIN AND P24 CAPSID SUBUNIT WOULD OPTIMIZE ANTI-HIV-1 VACCINE HIV-1-specific CD8+ T cell responses to HIV Gag are inversely correlated with viral RNA loads and directly correlated with absolute CD4+ T cell counts. Reuters Health Information 2002 http://www.medscape.com/viewarticle/430932?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/430932?srcmp=id-040502">

Read it Here</a>

RE-IMMUNIZATION FOR PNEUMOCOCCAL DISEASE HAS LIMITED BENEFIT IN HIV-1 PATIENTS HIV-1-positive patients who are re-immunized with the current 23-valent vaccine pneumococcal have only a limited response, which highlights the need for new vaccines or other more effective interventions. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431045?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431045?srcmp=id-040502">

Read it Here</a>

PARENTS OF AUTISTIC CHILDREN SUE DRUG FIRMS, DENTAL GROUPS

The parents of a group of children with autism on Wednesday sued several drug companies and dental associations in the United States for allegedly exposing their children to vaccines and dental fillings containing mercury. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431238?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431238?srcmp=id-040502">

Read it Here</a>

-- GI TRACT --

GASTROENTERITIS IS ASSOCIATED WITH ELEVATED SERUM AMYLASE LEVELS A significant proportion of patients with gastroenteritis have mild to moderately elevated levels of serum amylase, according to a report in the March 25th issue of the Archives of Internal Medicine. Reuters Health Information 2002 http://www.medscape.com/viewarticle/430952?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/430952?srcmp=id-040502">

Read it Here</a>

E. COLI PATCH VACCINE ELICITS SYSTEMIC IMMUNE RESPONSE

A transcutaneously administered vaccine against enterotoxigenic Escherichia coli (ETEC) can elicit a strong systemic immune response that may protect against traveler's diarrhea, according to a report published in the April issue of Infection and Immunity. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431026?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431026?srcmp=id-040502">

Read it Here</a>

-- MALARIA --

PROTON PUMP INHIBITORS MAY PROVIDE STRUCTURAL BASIS FOR ANTIMALARIALS Proton pump inhibitors show activity against Plasmodium falciparum clones in vitro, which suggests a basis for novel antimalarial drugs, according to Army researchers. Reuters Health Information 2002 http://www.medscape.com/viewarticle/430855?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/430855?srcmp=id-040502">

Read it Here</a>

-- POLIO --

ONLY 10 COUNTRIES LEFT WITH ENDEMIC POLIO

During 2001, there were 473 laboratory-confirmed cases of polio worldwide, down from 719 cases in 2000, the US Centers for Disease Control and Prevention reports. Reuters Health Information 2002 http://www.medscape.com/viewarticle/430857?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/430857?srcmp=id-040502">

Read it Here</a>

-- RESPIRATORY TRACT --

IMMUNE RESPONSE TO M. CATARRHALIS AFTER COPD FLARE-UPS CHARACTERIZED Following chronic obstructive pulmonary disease (COPD) exacerbations, new serum and mucosal antibody responses to Moraxella catarrhalis are often observed, according to a report published in the March 1st issue of The Journal of Infectious Diseases. Reuters Health Information 2002 http://www.medscape.com/viewarticle/430859?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/430859?srcmp=id-040502">

Read it Here</a>

-- TUBERCULOSIS --

TB RATES DROPPING IN SPAIN

Cases of tuberculosis in Spain dropped 7% in 2000 from the preceding year, according to a study on the current situation of this disease, published by the National Epidemiological Centre, part of the Carlos III Institute of Health. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431042?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431042?srcmp=id-040502">

Read it Here</a>

-- PEDIATRIC ID --

INFECTION RISK AFTER PEDIATRIC STEM CELL TRANSPLANTATION HIGHEST IN FIRST MONTH The results of a retrospective study of stem cell transplantation in children reveal that infections within 30 days of transplantation are increased, regardless of type of transplantation. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431180?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431180?srcmp=id-040502">

Read it Here</a>

-- DENGUE --

US TRAVELERS TO TROPICS CONTINUE TO CONTRACT DENGUE FEVER Dengue, the mosquito-transmitted acute viral disease, continues to occur in US residents returning from tropical areas, officials with the US CDC warn in the April 5th MMWR. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431217?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431217?srcmp=id-040502">

Read it Here</a>

-- CJD/BSE --

CJD PATIENTS MAY HAVE 'UNIQUE HEART SIGNATURE'

A medical researcher said on Wednesday that people suspected of having variant Creutzfeldt Jakob disease (vCJD), the human form of 'mad cow' disease, in Britain are to be offered a novel diagnostic test that may confirm the disease by measuring their heart rate. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431176?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431176?srcmp=id-040502">

Read it Here</a>

JAPAN'S KOIZUMI RESISTS CALLS TO FIRE FARM MINISTER

Japanese Prime Minister Junichiro Koizumi on Wednesday defied calls to fire his farm minister over the government's mishandling of an outbreak of mad cow disease, laid bare in an official report this week. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431149?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431149?srcmp=id-040502">

Read it Here</a>

-- HIV/AIDS - CLINICAL NEWS --

VIRAL LOAD TESTING INADEQUATE IN HIV-INFECTED DRUG USERS

Many HIV-infected drug users on antiretroviral therapy do not receive regular viral load monitoring, according to Pennsylvania-based researchers. Reuters Health Information 2002 http://www.medscape.com/viewarticle/430950?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/430950?srcmp=id-040502">

Read it Here</a>

GOOD RESPONSE TO HAART SUSTAINED BY HIV-INFECTED CHILDREN FOR 2 YEARS HIV-infected children who are treated with highly active antiretroviral therapy (HAART) for 2 or more years often achieve optimal clinical, virologic, and immunologic responses, according to a recent report by Dutch researchers. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431227?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431227?srcmp=id-040502">

Read it Here</a>

EMERGENCY DEPARTMENT STAFF GIVE HIGH PRIORITY TO ACUTE HIV EXPOSURE Patients presenting for post-exposure prophylaxis (PEP) to HIV appear to be given higher priority than other patients, based on time until medical treatment is initiated, based on findings from a French study. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431147?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431147?srcmp=id-040502">

Read it Here</a>

MEDICATION ADHERENCE QUESTIONNAIRE EFFECTIVE IN MONITORING HIV-POSITIVE PATIENTS A simplified medication adherence questionnaire (SMAQ) is effective in identifying HIV-positive patients who adhere or do not adhere to their medication regimens, Spanish researchers report. Reuters Health Information 2002 http://www.medscape.com/viewarticle/430874?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/430874?srcmp=id-040502">

Read it Here</a>

NRTI-ASSOCIATED MITOCHONDRIAL DEPLETION A FACTOR IN HIV-ASSOCIATED LIPOATROPHY A quantitative reduction of mitochondrial DNA (mtDNA) caused by nucleoside analogue reverse transcriptase inhibitor (NRTI) therapy may be involved in the pathogenesis of HIV-associated lipoatrophy, study findings suggest. Reuters Health Information 2002 http://www.medscape.com/viewarticle/430880?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/430880?srcmp=id-040502">

Read it Here</a>

RESISTANCE TESTING IN HIV-INFECTED CHILDREN PREDICTS NELFINAVIR RESPONSE Resistance testing in heavily pretreated children infected with HIV-1 predicts their response to nelfinavir as salvage for ritonavir-based therapy, according to a report in the March issue of The Pediatric Infectious Disease Journal. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431219?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431219?srcmp=id-040502">

Read it Here</a>

SHORT-COURSE ZIDOVUDINE DOES NOT ADVERSELY AFFECT MATERNAL HIV STATUS A short-course of zidovudine given late in gestation to prevent mother-to-child transmission of HIV-1 has no adverse effects on a woman's health and does not produce zidovudine resistance mutations, researchers report. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431159?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431159?srcmp=id-040502">

Read it Here</a>

RURAL BLACK WOMEN IN US NOT WORRIED ABOUT HIV INFECTION

Many African-American women who live in rural areas do not perceive themselves to be at risk for HIV infection, new study results suggest. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431163?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431163?srcmp=id-040502">

Read it Here</a>

FOUR-DRUG REGIMEN SUPERIOR FOR PEDIATRIC HIV-1 INFECTION

A four-drug regimen including nucleoside reverse transcriptase inhibitors (NRTIs) plus nevirapine and nelfinavir offers more durable suppression of HIV-1 viremia in children than does a variety of three-drug regimens, according to a report in the April 1st Clinical Infectious Diseases. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431179?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431179?srcmp=id-040502">

Read it Here</a>

-- HIV/AIDS - INTERNATIONAL NEWS --

S. AFRICAN GOVERNMENT APPEALS AIDS COURT RULING

South Africa's government appealed for a second time on Wednesday against a court ruling saying it must provide a key anti-HIV drug that cuts the risk of mother-to-child infection. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431153?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431153?srcmp=id-040502">

Read it Here</a>

S. AFRICA COURT SAYS GOVT MUST GIVE ANTI-AIDS DRUG

South Africa's highest court dealt a significant blow on Thursday to the government's controversial AIDS policy, with an interim ruling that it must supply a key anti-AIDS drug to HIV-infected pregnant mothers. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431236?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431236?srcmp=id-040502">

Read it Here</a>

US GRANTS MONEY TO SOUTH AFRICAN TRADE UNIONS TO FIGHT AIDS

The United States on Thursday granted South African trade unions almost $1 million to fight the spread of AIDS and pledged to work with the government even if it disagrees with Pretoria's stance on key antiretroviral drugs. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431210?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431210?srcmp=id-040502">

Read it Here</a>

HONDURAN GOVERNMENT ORDERED TO PAY DAMAGES TO AIDS VICTIM

In an unprecedented ruling, a Honduran court has ordered the state to pay damages to a woman who contracted HIV from blood transfusions received at a public hospital, a court official said on Monday. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431054?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431054?srcmp=id-040502">

Read it Here</a>

EAST TIMOR HOPES TO AVOID AIDS EPIDEMIC

The East Timor government and the United Nations on Wednesday launched an AIDS awareness campaign on television, radio and print media, hoping the country can avoid the explosion in HIV/AIDS seen elsewhere in the region. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431209?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431209?srcmp=id-040502">

Read it Here</a>

-- OTHER ID NEWS --

CDC DEPUTY DIRECTOR IS NAMED ACTING AGENCY HEAD

A current deputy director of the CDC, Dr. David Fleming, is taking over as acting head of the federal agency. Reuters Health Information 2002 http://www.medscape.com/viewarticle/430957?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/430957?srcmp=id-040502">

Read it Here</a>

BANNED ANTIBIOTICS STILL SOLD IN THAILAND

Thailand, under threat of a partial food trade embargo from Europe, will tighten enforcement of antibiotic import rules after banned chemicals were found on sale in shops, an official said on Tuesday. Reuters Health Information 2002 http://www.medscape.com/viewarticle/431059?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/431059?srcmp=id-040502">

Read it Here</a>

POLL REFLECTS AMERICANS' CONCERNS ABOUT CLINICAL TRIALS Americans are not fully confident that patients who take part in clinical studies will get the best medical care or be told honestly of all the risks involved, a Harris Interactive survey released this week shows. Reuters Health Information 2002 http://www.medscape.com/viewarticle/430854?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/430854?srcmp=id-040502">

Read it Here</a>

MECHANISM OF CELLULAR EPSTEIN-BARR VIRUS SURVIVAL UNCOVERED Researchers from the Wistar Institute, Philadelphia, have discovered that when Epstein-Barr virus (EBV) is within the nucleus of its host cell, the virus uses telomeric proteins to preserve its integrity and ability to survive. Reuters Health Information 2002 http://www.medscape.com/viewarticle/430935?srcmp=id-040502

<a href="http://www.medscape.com/viewarticle/430935?srcmp=id-040502">

Read it Here</a>

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