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MedPulse is a weekly index of key news and features on Medscape's

specialty sites compiled by Medscape's Editors.

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___________________ NEW FEATURE ARTICLES THIS WEEK ____________________

-- MEDSCAPE ORIGINAL ARTICLES --

ANGELS IN OUR MIDST - TRAINING VILLAGERS TO BECOME HEALTHCARE WORKERS

Improved healthcare in underdeveloped countries starts with education.

Read about one successful program in Africa.

Medscape Infectious Disease, 2001

http://id.medscape.com/41703.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41703.rhtml?srcmp=id-081701"> Read it

Here</a>

JOURNAL SCAN - INFECTIOUS DISEASES 4(8)

David Haburchak, MD, summarizes and comments on important new

publications, including:

ï A Newly Discovered Human Pneumovirus in Children

ï Patient-Initiated UTI Treatment

ï Treating Chronic Lyme Disease

ï Treatment of Multidrug-Resistant Tuberculosis in Turkey

http://id.medscape.com/41718.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41718.rhtml?srcmp=id-081701"> Read it

Here</a>

REGIMENS FOR THE ERADICATION OF HELICOBACTER PYLORI: A META-ANALYSIS OF

META-ANALYSES

Exactly how these meta-analyses and clinical trials contribute to

medical practice may be debatable, but they have paved the way for

formulation of international guidelines.

Medscape Pharmacotherapy, 2001

http://id.medscape.com/41705.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41705.rhtml?srcmp=id-081701"> Read it

Here</a>

-- MMWR --

EFFECTIVENESS OF A MIDDLE SCHOOL VACCINATION LAW --- CALIFORNIA,

1999--2001

When school entrance requirements are enforced, high vaccination

coverage can be achieved.

MMWR 50(31):660-663, 2001. Centers for Disease Control

http://id.medscape.com/41617.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41617.rhtml?srcmp=id-081701"> Read it

Here</a>

-- INFECTIONS in MEDICINE --

NEW ORLEANS CITYWIDE ROUNDS: A FIREMAN WITH CELLULITIS

A 39-year-old fireman who was previously healthy awoke with stiffness in

his right shoulder and redness over his right forearm.

Infect Med 18(6):297-301, 2001

http://id.medscape.com/41729.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41729.rhtml?srcmp=id-081701"> Read it

Here</a>

MYCOTIC (INFECTED) ANEURYSM CAUSED BY STREPTOCOCCUS PNEUMONIAE

Signs and symptoms of mycotic aneurysms may often be misleading during

the early stages, resulting in misdiagnosis and delay in treatment.

Mortality is greater than 90% in untreated patients.

Infect Med 18(6):317-320, 2001

http://id.medscape.com/41696.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41696.rhtml?srcmp=id-081701"> Read it

Here</a>

TYMPANOCENTESIS IN THE DIAGNOSIS AND TREATMENT OF OTITIS MEDIA

Before the discovery of antimicrobial agents, tympanocentesis was a

common procedure used not only by otolaryngologists but also by

pediatricians.

Infect Med 18(7):363-366, 2001

http://id.medscape.com/41697.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41697.rhtml?srcmp=id-081701"> Read it

Here</a>

ANTIMICROBIAL RESISTANCE AMONG PATHOGENS CAUSING ACUTE UNCOMPLICATED

UTIS

Acute uncomplicated urinary tract infection in adults includes episodes

of acute cystitis and acute pyelonephritis occurring in otherwise

healthy persons, most of whom are women with none of the risk factors

known to increase the likelihood of treatment complications or failure.

Infect Med 18(7):358-362, 2001

http://id.medscape.com/41748.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41748.rhtml?srcmp=id-081701"> Read it

Here</a>

-- THE AIDS READER --

ABDOMINAL CARCINOMAS MIMICKING HIV-ASSOCIATED LIPODYSTROPHY

Two cases of abdominal distention and extremity muscle wasting in

HIV-infected men who were receiving HAART are reported.

The AIDS Reader 11(6):329-332, 2001

http://id.medscape.com/41693.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41693.rhtml?srcmp=id-081701"> Read it

Here</a>

MANAGING MANAGED CARE: HAART IS COST-EFFECTIVE AND IMPROVES OUTCOME

Two recent studies have focused on the overall value of antiretroviral

therapy for HIV infection.

The AIDS Reader 11(5):260-262, 2001

http://id.medscape.com/41706.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41706.rhtml?srcmp=id-081701"> Read it

Here</a>

FULL RECOVERY FROM SEVERE DILATED CARDIOMYOPATHY IN AN HIV-INFECTED

PATIENT

HIV-related cardiomyopathy is usually seen in persons with advanced HIV

disease and carries a very poor prognosis.

The AIDS Reader 11(6):333-335, 2001

http://id.medscape.com/41724.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41724.rhtml?srcmp=id-081701"> Read it

Here</a>

-- OTHER JOURNALS --

GRAND ROUNDS: 49-YEAR-OLD-MAN WITH A 'SUMMER FLU'

A 49-year-old man presented to the emergency department complaining of

shortness of breath upon minimal exertion, headache, myalgia, fever, and

chills.

Clinician Reviews 11(6):65-67, 72, 2001.

http://id.medscape.com/41482.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41482.rhtml?srcmp=id-081701"> Read it

Here</a>

DIFFUSE PULMONARY DISEASE CAUSED BY NONTUBERCULOUS MYCOBACTERIA IN

IMMUNOCOMPETENT PEOPLE (HOT TUB LUNG)

The clinicopathologic spectrum of infections due to nontuberculous

mycobacteria includes cavitary disease, opportunistic infection, and

nodular disease associated with bronchiectasis.

Am J of Clin Pathology 115(5), 2001

http://id.medscape.com/41687.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41687.rhtml?srcmp=id-081701"> Read it

Here</a>

CUNNINGHAMELLA BERTHOLLETIAE INFECTION IN A BONE MARROW TRANSPLANT

PATIENT: AMPHOTERICIN LUNG PENETRATION, MIC DETERMINATIONS, AND REVIEW

OF THE LITERATURE

Cunninghamella bertholletiae, an opportunistic fungal organism that

causes infections in immunocompromised patients, is being reported in

the medical literature with growing frequency, with nearly all reports

presenting devastating results.

Pharmacotherapy 21(7):855-860, 2001

http://id.medscape.com/41699.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41699.rhtml?srcmp=id-081701"> Read it

Here</a>

LEVOFLOXACIN AND WARFARIN INTERACTION

Levofloxacin, an S-enantiomer of racemic ofloxacin, has become widely

used for treating upper respiratory tract infections and

community-acquired pneumonia.

Pharmacotherapy 21(7):884-885, 2001

http://id.medscape.com/41731.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41731.rhtml?srcmp=id-081701"> Read it

Here</a>

TREATMENT EXPERIENCE OF MULTIDRUG-RESISTANT TUBERCULOSIS IN FLORIDA,

1994-1997

Retrospective chart review of all patients (n = 81) with diagnoses of

MDR-TB in Florida between January 1, 1994, and July 31, 1997.

CHEST 120(2):33-348, 2001

http://id.medscape.com/41738.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41738.rhtml?srcmp=id-081701"> Read it

Here</a>

CYTOMEGALOVIRUS INFECTIVITY IN WHOLE BLOOD FOLLOWING LEUKOCYTE REDUCTION

BY FILTRATION

CMV may be transmitted by transfusion of whole blood and cellular

components processed according to standard processing procedures. A need

exists to develop new procedures to remove CMV and other leukocyte-borne

viruses from donor blood.

Am J of Clin Pathology 116(1), 2001

http://id.medscape.com/41745.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41745.rhtml?srcmp=id-081701"> Read it

Here</a>

_______________________________________________________________________

___________________________________ NEWS ______________________________

-- VACCINES AND IMMUNIZATION --

MMR VACCINE AND AUTISM: DISPELLING THE MYTH

Despite proof to the contrary, many people still believe there is a link

between MMR vaccine and autism. Stay up to date on the latest

developments in this debate.

http://id.medscape.com/41754.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41754.rhtml?srcmp=id-081701"> Read it

Here</a>

AIDS VACCINE SHOWS EFFICACY IN PRIMATES

The latest preclinical trial findings of a DNA/poxvirus vaccine were

presented at the 2001 National HIV Prevention Conference.

http://id.medscape.com/41664.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41664.rhtml?srcmp=id-081701"> Read it

Here</a>

FIRST SYNTHETIC MALARIA VACCINE ELICITS STRONG IMMUNE RESPONSE IN HUMANS

Immunization with the first synthetic malaria vaccine results in

unprecedentedly strong lymphocyte and antibody responses, according to

the results of a phase I trial.

http://id.medscape.com/41665.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41665.rhtml?srcmp=id-081701"> Read it

Here</a>

-- PRION DISEASE --

QUINACRINE, CHLORPROMAZINE REPRESENT A NEW CLASS OF PRION DISEASE

TREATMENT

Acridine and phenothiazine derivatives inhibit the formation of

pathogenic prion proteins and may even enhance their clearance from

infected cells, investigators at the University of California at San

Francisco report in the August 14th issue of the Proceedings of the

National Academy of Sciences.

http://id.medscape.com/41595.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41595.rhtml?srcmp=id-081701"> Read it

Here</a>

ANTIBODIES INHIBIT PRION REPLICATION AND CLEAR INFECTION

Antibodies bound to endogenous cellular prion protein not only prevent

the formation of pathogenic prion protein, they allow cells to rid

themselves of preexisting infection, investigators report in the August

16th issue of Nature.

http://id.medscape.com/41684.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41684.rhtml?srcmp=id-081701"> Read it

Here</a>

-- WEST NILE ENCEPHALITIS --

NEW YORK CONFIRMS FIRST HUMAN WEST NILE VIRUS CASE OF SUMMER

An elderly New York woman has been confirmed as the area's first case

this summer of the mosquito-born West Nile virus infection, which killed

seven people in the metropolitan area when it first appeared in 1999.

http://id.medscape.com/41598.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41598.rhtml?srcmp=id-081701"> Read it

Here</a>

-- HEPATITIS --

HEPATITIS C SUBTYPE DETERMINES INTERFERON RESPONSIVENESS FACTORS

The factors that determine the responsiveness of the hepatitis C virus

(HCV) to interferon treatment depend on the HCV subtype, according to a

report in the August issue of Gut.

http://id.medscape.com/41631.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41631.rhtml?srcmp=id-081701"> Read it

Here</a>

-- HIV/AIDS --

US AGENCY ISSUES DRAFT GUIDELINES ON CHEMOPROPHYLAXIS FOR HIV-INFECTED

PATIENTS

The AIDS Treatment and Information Service, a project of the US

Department of Health and Human Services, invites comments on the latest

revision of its guidelines for preventing opportunistic infections in

HIV-infected individuals.

http://id.medscape.com/41789.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41789.rhtml?srcmp=id-081701"> Read it

Here</a>

NUMBER OF NEW AIDS CASES AND DEATHS HOLD STEADY

The number of new AIDS cases and deaths continues to decline but the

rate of decline has slowed dramatically, according to new figures

released today by the US CDC.

http://id.medscape.com/41597.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41597.rhtml?srcmp=id-081701"> Read it

Here</a>

RISKY HETEROSEXUAL BEHAVIOR COMMON AMONG MEN WHO HAVE SEX WITH MEN

Nearly one in three young men who have sex with men had had unprotected

anal sex with a man in the past 3 months, and nearly one in five had

also had sex with a woman, according to a study conducted by the CDC.

http://id.medscape.com/41607.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41607.rhtml?srcmp=id-081701"> Read it

Here</a>

HIV INFECTION UNLIKELY AS A RESULT OF ORAL SEX WITH A MAN

Individuals who perform oral sex, even unprotected oral sex, on a male

partner are at low risk of HIV infection, according to data from a small

study.

http://id.medscape.com/41637.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41637.rhtml?srcmp=id-081701"> Read it

Here</a>

INDIA CONTINUES TO DETAIN NGO STAFFERS WHO PROVIDED HIV OUTREACH TO GAY

MEN

Activists from nearly 40 organizations held a sit-in demonstration in

Delhi on Monday protesting against the arrest and continued detention

since July 7 of four individuals in Lucknow (Uttar Pradesh state), north

India.

http://id.medscape.com/41604.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41604.rhtml?srcmp=id-081701"> Read it

Here</a>

HIV HEALTHCARE ACCESS LIMITED IN CENTRAL AMERICA

Many people in Central America have limited access to HIV care and

almost no access to AIDS drugs, according to a new report published in

the August 15th issue of The Journal of the American Medical

Association.

http://id.medscape.com/41791.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41791.rhtml?srcmp=id-081701"> Read it

Here</a>

This is only a selection of this week's HIV/AIDS NEWS. Read all the

latest news about advances in this field, from Reuters and Medscape

Wire.

http://www.medscape.com/hiv/news

And you can subscribe to the HIV/AIDS Medpulse, as well as other

specialty Medpulses, by updating your profile at the following link:

http://www.medscape.com/profile

-- OTHER STDs --

MORE FREQUENT SCREENING ADVISED FOR YOUTH AT HIGH RISK FOR STIS

Researchers from Indiana University School of Medicine in Indianapolis

are recommending that adolescents and young adults with a history of a

sexually transmitted infection (STI) and their uninfected sexual

contacts should be screened every 6 months for certain organisms.

http://id.medscape.com/41646.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41646.rhtml?srcmp=id-081701"> Read it

Here</a>

METRONIDAZOLE DOES NOT PREVENT PRETERM DELIVERY IN WOMEN WITH T.

VAGINALIS

In pregnant women with asymptomatic Trichomonas vaginalis, treatment

with metronidazole does not appear to prevent preterm delivery and may

even increase it, according to a report in the New England Journal of

Medicine for August 16.

http://id.medscape.com/41773.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41773.rhtml?srcmp=id-081701"> Read it

Here</a>

-- RESPIRATORY TRACT INFECTIONS --

MONOTHERAPY MAY BE SUBOPTIMAL FOR SEVERE BACTEREMIC PNEUMOCOCCAL

PNEUMONIA

Treatment with a single effective antibiotic agent may not be adequate

therapy for patients with severe bacteremic pneumococcal pneumonia,

according to a report published in the August 13/17th issue of the

Archives of Internal Medicine.

http://id.medscape.com/41657.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41657.rhtml?srcmp=id-081701"> Read it

Here</a>

CYSTIC FIBROSIS PATIENTS ARE SUSCEPTIBLE TO PSEUDOMONAS CROSS-INFECTION

CF patients are often chronically colonised with Pseudomonas aeruginosa,

but cross-infection of these individuals with transmissible strains of

the bacteria has not been reported.

http://id.medscape.com/41776.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41776.rhtml?srcmp=id-081701"> Read it

Here</a>

NEW WHO PROTOCOL NEEDED FOR HIV-1-ASSOCIATED PNEUMONIA

The World Health Organization algorithm for managing respiratory tract

infection in HIV-1-infected adults fails in nearly one third of patients

with pneumonia, according to the results of a study conducted in

Nairobi, Kenya.

http://id.medscape.com/41557.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41557.rhtml?srcmp=id-081701"> Read it

Here</a>

HIV STATUS INFLUENCES CAUSES OF COMMUNITY-ACQUIRED PNEUMONIA

The causes of CAP -- and its empiric treatment -- differ in patients

with and without HIV infection, according to a report in the August 1st

issue of the Journal of Infectious Diseases.

http://id.medscape.com/41624.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41624.rhtml?srcmp=id-081701"> Read it

Here</a>

-- DRUG NEWS --

CENTOCOR'S REMICADE TO CARRY BOXED WARNING

Johnson & Johnson's Centocor said on Wednesday that labeling for its

rheumatoid arthritis drug Remicade (infliximab) will be updated with a

boxed warning stressing that the drug can increase the risk of

infections.

http://id.medscape.com/41683.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41683.rhtml?srcmp=id-081701"> Read it

Here</a>

NO SUBSTANTIAL TERATOGENICITY LINKED TO AMPICILLIN USE DURING PREGNANCY

The use of ampicillin during pregnancy appears not to pose any

substantial risk for cardiovascular defects or other congenital

abnormalities in infants, according to the results of a population-based

study.

http://id.medscape.com/41630.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41630.rhtml?srcmp=id-081701"> Read it

Here</a>

-- OTHER ID NEWS --

INFANT FORMULA RECALLED OVER BOTULISM LINK

Batches of two popular brands of infant formula are being recalled in

the UK because of a possible link to a recent case of botulism in a

5-month-old infant.

http://id.medscape.com/41648.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41648.rhtml?srcmp=id-081701"> Read it

Here</a>

MOST WOMEN OF CHILDBEARING AGE IN US SUSCEPTIBLE TO T. GONDII INFECTION

The United States has a low rate of Toxoplasma gondii seroprevalence

compared with other countries, and most US women of childbearing age are

susceptible to T. gondii infection, according to a report in the August

15th issue of the American Journal of Epidemiology.

http://id.medscape.com/41568.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41568.rhtml?srcmp=id-081701"> Read it

Here</a>

UK STUDY SHOWS TOO FEW MENINGITIS PATIENTS RECEIVE PENICILLIN

Only one in five meningitis patients in the UK receives potentially

life-saving penicillin from their GP before being admitted to hospital,

according to a new study by researchers at the University of Birmingham

in England.

http://id.medscape.com/41679.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41679.rhtml?srcmp=id-081701"> Read it

Here</a>

PNEUMOCOCCAL INFECTIONS RARELY FATAL IN PEDIATRIC TRANSPLANT RECIPIENTS

Although bacterial infection is a major cause of morbidity and mortality

after bone marrow or solid organ transplant, Streptococcus pneumoniae

leads to death in only a small portion of children after such

procedures, a multicenter team reports.

http://id.medscape.com/41623.rhtml?srcmp=id-081701

<a href="http://id.medscape.com/41623.rhtml?srcmp=id-081701"> Read it

Here</a>

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