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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 --
EARLY INITIATION OF ANTIRETROVIRAL THERAPY: THE CASE
FOR CONFIDENCE
Kimberly Y. Smith, MD, MPH, outlines the case in favor
of early initiation of antiretroviral therapy.
Medscape HIV/AIDS 8(1), 2002
http://id.medscape.com/47226.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47226.rhtml?srcmp=id-011802"> Read it
Here</a>
. . . THE CASE FOR CAUTION
Pablo Tebas, MD, outlines the case in favor of
deferred initiation of antiretroviral therapy.
Medscape HIV/AIDS 8(1), 2002
http://id.medscape.com/47229.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47229.rhtml?srcmp=id-011802"> Read it
Here</a>
-- MMWR --
RAPID ASSESSMENT OF INJURIES AMONG SURVIVORS OF THE
TERRORIST ATTACK ON THE WTC
Among 790 survivors with injuries, 49% had inhalation
and 26% had ocular injuries. Most inhalation and ocular injuries were
attributed to smoke, dust, debris, or fumes.
MMWR 51(01):1-5, 2002. Centers for Disease Control
http://id.medscape.com/47196.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47196.rhtml?srcmp=id-011802"> Read it
Here</a>
OUTBREAK OF SALMONELLA SEROTYPE KOTTBUS INFECTIONS
ASSOCIATED WITH EATING ALFALFA SPROUTS
S. Kottbus is a rarely reported cause of salmonellosis
in the US. This
was the second outbreak since 1985 and the first
outbreak associated
with sprouts.
MMWR 51(01):7-9, 2002. Centers for Disease Control
http://id.medscape.com/47209.rhtml?srcmp=id-011802
<a href="http://id.medscape.com/47209.rhtml?srcmp=id-011802">
Read it
Here</a>
NUTRITIONAL ASSESSMENT OF CHILDREN AFTER SEVERE WINTER
WEATHER -
MONGOLIA
This report indicates a high prevalence of growth
stunting, indicating chronic malnutrition, but no evidence of excess wasting,
indicating acute malnutrition.
MMWR 51(01):5-7, 2002. Centers for Disease Control
http://id.medscape.com/47077.rhtml?srcmp=id-011802
<a href="http://id.medscape.com/47077.rhtml?srcmp=id-011802">
Read it
Here</a>
-- EMERGING INFECTIOUS DISEASES --
TRICHOMONAS VAGINALIS, HIV, AND AFRICAN AMERICANS
Trichomonas vaginalis may be emerging as one of the
most important cofactors in amplifying HIV transmission, particularly in
African-American communities of the US.
Emerging Infectious Diseases 7(6):927-932, 2001
http://id.medscape.com/47203.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47203.rhtml?srcmp=id-011802"> Read it
Here</a>
-- INFECTIONS in MEDICINE --
BIOTERRORISM PREPAREDNESS: WHAT PRACTITIONERS NEED TO
KNOW
A premeditated biologic attack against a civilian
population is now a real threat.
Infect Med 18(11):497-515, 2001
http://id.medscape.com/47189.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47189.rhtml?srcmp=id-011802"> Read it
Here</a>
STREPTOCOCCAL TONSILLOPHARYNGITIS: ADVANTAGES OF
SHORTER ANTIBIOTIC COURSES
Poor compliance with standard antibiotic regimens
contributes significantly to treatment failure in acute group A streptococcal
respiratory tract infection.
Infect Med 18(11):515-518, 2001
http://id.medscape.com/47207.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47207.rhtml?srcmp=id-011802"> Read it
Here</a>
ABSTRACTS IN HEPATITIS: RECENT FINDINGS IN THE
JOURNALS
- Clearance kinetics of HCV
- Comparing pegylated IFN alfa-2b to IFN alfa-2b as
initial treatment of chronic HCV
- Adult HBV vaccination using a novel triple antigen
recombinant vaccine
Infect Med 18(11):490-496, 2001
http://id.medscape.com/47242.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47242.rhtml?srcmp=id-011802"> Read it
Here</a>
-- OTHER JOURNALS --
MANAGING METABOLIC DISTURBANCES AND LIPODYSTROPHY:
DIET, EXERCISE, AND SMOKING ADVICE
Lipodystrophy is a stigmatizing consequence of HIV infection
and its treatment, for which no cause and no treatment are firmly established.
The AIDS Reader 11(12):589-592, 2001
http://id.medscape.com/47202.rhtml?srcmp=id-011802
<a href="http://id.medscape.com/47202.rhtml?srcmp=id-011802">
Read it
Here</a>
RATES OF TORSADES DE POINTES ASSOCIATED WITH
CIPROFLOXACIN, OFLOXACIN, LEVOFLOXACIN, GATIFLOXACIN, AND MOXIFLOXACIN
Four quinolones are widely prescribed in the United
States -- ciprofloxacin, levofloxacin, gatifloxacin, and moxifloxacin.
Pharmacotherapy 21(12):1468-1472, 2001
http://id.medscape.com/47206.rhtml?srcmp=id-011802
<a href="http://id.medscape.com/47206.rhtml?srcmp=id-011802">
Read it
Here</a>
ETIOPATHOGENESIS OF BILIARY ATRESIA
Biliary atresia, a progressive sclerosis of the
extrahepatic biliary tree that occurs only within the first 3 months of life,
is one of the most common causes of neonatal cholestasis and accounts for over
half of children who undergo liver transplantation.
Sem Liver Disease 21(4):517-524, 2001
http://id.medscape.com/47218.rhtml?srcmp=id-011802
<a href="http://id.medscape.com/47218.rhtml?srcmp=id-011802">
Read it
Here</a>
_______________________________________________________________________
New Online CME supported by Bristol-Myers Squibb
Evolution of Fluoroquinolones and Future Use: To
inform practitioners about recurrent pathogens, the newest fluoroquinolone
agents, their potential for use in the pediatric population, and the use of
these newer agents in both recurrent otitis media and meningitis.
CLICK HERE! http://www.medscape.com/cl/mp/sponsor10.1
_______________________________________________________________________
___________________________________ NEWS
______________________________
-- BIOTERRORISM --
WHO RECOMMENDS NOT DESTROYING SMALLPOX VIRUS STOCKS
FOR NOW
The World Health Organization's Executive Board today
unanimously agreed that the world's two known smallpox virus stocks should be
kept intact for the time being.
http://id.medscape.com/47266.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47266.rhtml?srcmp=id-011802"> Read it
Here</a>
BIOPORT SAYS IT PASSES ANOTHER FDA HURDLE
Bioport Corp., the sole US supplier of the anthrax
vaccine, said on Tuesday that it has received a letter from the US Food and
Drug Administration indicating the agency has accepted changes made to meet FDA
good manufacturing requirements.
http://id.medscape.com/47139.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47139.rhtml?srcmp=id-011802"> Read it
Here</a>
SMALLPOX VACCINE DILUTION STUDY RESULTS EXPECTED SOON
Experiments to determine whether the nation's existing
stores of smallpox vaccine can be diluted to cover millions more people are
largely complete and should be reported within the next couple of weeks,
President Bush's top bioterrorism advisor said Monday.
http://id.medscape.com/47108.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47108.rhtml?srcmp=id-011802"> Read it
Here</a>
-- DENGUE --
CUBA BATTLING BIGGEST DENGUE OUTBREAK SINCE 1981
Cuba began an emergency campaign over the weekend to
contain the worst outbreak of dengue fever since 1981, but did not give figures
on the number of infected individuals despite widespread public concern.
http://id.medscape.com/47104.rhtml?srcmp=id-011802
<a href="http://id.medscape.com/47104.rhtml?srcmp=id-011802">
Read it
Here</a>
-- VACCINES & IMMUNIZATION --
SAVE THE CHILDREN REPORT CRITICIZES VACCINATION
PROGRAM
In the first independent assessment of the Global
Alliance for Vaccines and Immunisations (GAVI), Save the Children UK takes the
program to task for less than optimal results.
http://id.medscape.com/47107.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47107.rhtml?srcmp=id-011802"> Read it
Here</a>
-- TUBERCULOSIS --
ADVERSE REACTION POSSIBLE WITH ISONIAZID PLUS SSRI
Drug discontinuation rates were high among patients
prescribed both isoniazid and a selective serotonin reuptake inhibitor, which
researchers believe indicates that the combination may cause an increase in
adverse effects.
http://id.medscape.com/47114.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47114.rhtml?srcmp=id-011802"> Read it
Here</a>
-- INFLUENZA --
RAPID INFLUENZA DIAGNOSIS IMPROVES MANAGEMENT IN
FEBRILE CHILDREN
The rapid diagnosis of influenza virus type A
infection in febrile infants and toddlers presenting to the emergency
department appears to decrease ancillary tests and antibiotic use, according to
a report in the January issue of the Archives of Pediatrics and Adolescent
Medicine.
http://id.medscape.com/47087.rhtml?srcmp=id-011802
<a href="http://id.medscape.com/47087.rhtml?srcmp=id-011802">
Read it
Here</a>
ROCHE CLAIMS TAMIFLU PRODUCTION PROBLEMS WERE
EXAGGERATED BY MEDIA
Switzerland's Roche Holding AG issued a statement
Wednesday clarifying that the company's recently disclosed production problems
would only affect the pediatric version of its influenza therapy Tamiflu
(oseltamivir).
http://id.medscape.com/47168.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47168.rhtml?srcmp=id-011802"> Read it
Here</a>
-- RESPIRATORY TRACT --
PATIENT EDUCATION REDUCES ANTIBIOTIC USE FOR
BRONCHITIS
Offering reassurance and education to patients about
the uncertain benefit of antibiotics in cases of acute bronchitis can reduce
the rate of antibiotic usage, according to British investigators.
http://id.medscape.com/47067.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47067.rhtml?srcmp=id-011802"> Read it
Here</a>
-- HIV/AIDS --
POOR ADHERENCE TO ANTI-HIV REGIMENS SEEN AMONG
MEDICAID RECIPIENTS
Medicaid recipients infected with HIV, particularly
younger and minority patients, adhere poorly to antiretroviral treatments over
time, according to a report in the December 2001 Journal of General Internal
Medicine.
http://id.medscape.com/47169.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47169.rhtml?srcmp=id-011802"> Read it
Here</a>
VACCINE-INDUCED CTL RESPONSE CONTROLS SHIV INFECTION,
BUT EVENTUAL
FAILURE SEEN
Vaccines that induce a strong CTL response against SIV
are able to control viremia in most macaque monkeys challenged with simian-HIV,
according to a report in the January 17th issue of Nature.
http://id.medscape.com/47180.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47180.rhtml?srcmp=id-011802"> Read it
Here</a>
BOUNTY DESCENDANTS MULL AIDS IMMIGRATION BAN
The descendants of the mutinous crew of the Bounty may
ban people with AIDS from moving to their isolated Pacific home.
http://id.medscape.com/47265.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47265.rhtml?srcmp=id-011802"> Read it
Here</a>
TREATMENT TIMING KEY FOR IMMUNE PRESERVATION IN
HIV-INFECTED PATIENTS
There appears to be a relatively narrow window of
opportunity during which antiretroviral therapy can be administered and still
produce meaningful immune preservation in HIV-infected patients, according to a
recent report.
http://id.medscape.com/47118.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47118.rhtml?srcmp=id-011802"> Read it
Here</a>
MENSTRUAL CYCLE DOES NOT AFFECT HIV-1 LEVELS IN
GENITAL TRACT
A report published in the January 15th issue of J
Infect Dis indicates that HIV-1 levels in vaginal secretions do not change
significantly throughout the menstrual cycle.
http://id.medscape.com/47082.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47082.rhtml?srcmp=id-011802"> Read it
Here</a>
GLAXO HOPES TO DEVELOP SCREEN FOR ABACAVIR TOXICITY
GlaxoSmithKline said on Wednesday it has 'proof of
principle' that a test could be developed to identify patients at risk of
serious allergic responses from abacavir.
http://id.medscape.com/47159.rhtml?srcmp=id-011802
<a href="http://id.medscape.com/47159.rhtml?srcmp=id-011802">
Read it
Here</a>
-- OTHER STDs --
TRICHOMONIASIS MAY FACILITATE HIV-1 ACQUISITION BY
ALTERING VAGINAL
FLORA
Infection with T vaginalis appears to play a prominent
role in the development of abnormal vaginal ecology, which, in turn, may lead
to more effective acquisition of HIV-1 infection.
http://id.medscape.com/47053.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47053.rhtml?srcmp=id-011802"> Read it
Here</a>
-- LYME DISEASE --
LYME DISEASE INCIDENCE IN US HAS DOUBLED OVER PAST
DECADE
The incidence of new cases of Lyme disease has doubled
in the US since 1991, according to the CDC.
http://id.medscape.com/47259.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47259.rhtml?srcmp=id-011802"> Read it
Here</a>
NO SINGLE DIAGNOSTIC TEST SUITABLE FOR EARLY LYME
DISEASE
Refinements in laboratory-based diagnostic assays
since the 1990s have made it easier to detect B burgdorferi infection in
patients with erythema migrans.
http://id.medscape.com/47079.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47079.rhtml?srcmp=id-011802"> Read it
Here</a>
-- DIABETES --
ORAL RIFAMPICIN-OFLOXACIN COMBINATION EFFECTIVE FOR
DIABETIC FOOT
OSTEOMYELITIS
An oral regimen containing rifampicin and ofloxacin is
effective and well-tolerated for elderly diabetic patients with infected foot
ulcers associated with osteomyelitis of the feet, French investigators have
found.
http://id.medscape.com/47083.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47083.rhtml?srcmp=id-011802"> Read it
Here</a>
-- URINARY TRACT --
MANY US PHYSICIANS DO NOT FOLLOW ESTABLISHED UTI
ANTIBIOTIC GUIDELINES
In recent years, US physicians have been prescribing
more fluoroquinolones for uncomplicated urinary tract infections in women, even
though these drugs are not the first choice and are not
cost-effective for UTIs, researchers report in the
January 14th issue of the Arch Intern Med.
http://id.medscape.com/47100.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47100.rhtml?srcmp=id-011802"> Read it
Here</a>
-- SEPSIS --
COMBINATION TEST SHOWS PROMISE IN EARLY DIAGNOSIS OF
NEONATAL SEPSIS
Determination of C-reactive protein levels and IL-6
levels appears to be useful in the early diagnosis of neonatal sepsis,
according to a report by Norwegian researchers.
http://id.medscape.com/47153.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47153.rhtml?srcmp=id-011802"> Read it
Here</a>
-- HEPATITIS --
SCHERING MAY USE WAITING LIST FOR HEPATITIS DRUG
Schering-Plough Corp., citing insufficient supplies of
its PEG-Intron treatment for chronic hepatitis C, said on Tuesday it may resort
to a waiting list for patients seeking the drug.
http://id.medscape.com/47166.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47166.rhtml?srcmp=id-011802"> Read it
Here</a>
COMBINATION LAMIVUDINE-FAMCICLOVIR NEEDED TO TREAT HBV
IN HIV-INFECTED PATIENTS
The addition of famciclovir to initial lamivudine
monotherapy is not an effective way to control hepatis B virus infection in
HIV-infected patients, according to a recent report.
http://id.medscape.com/47046.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47046.rhtml?srcmp=id-011802"> Read it
Here</a>
-- DRUG NEWS --
ROCHE TO DROP-SHIP LIMITED INVENTORY OF IV GANCICLOVIR
Due to the recent shortage of its CMV retinitis
therapy, Cytovene-IV (ganciclovir), Hoffman-La Roche is planning to drop-ship
the medication to certain physicians from its existing limited inventory.
http://id.medscape.com/47063.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47063.rhtml?srcmp=id-011802"> Read it
Here</a>
-- OTHER ID NEWS --
ASCORBIC ACID HELPS DRUGS CROSS BLOOD-BRAIN BARRIER
Ascorbic acid could provide a key to unlock the blood-brain
barrier, according to preliminary findings reported by researchers in Italy and
the US in the December 21st Web edition of the Journal of Medicinal Chemistry.
http://id.medscape.com/47116.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47116.rhtml?srcmp=id-011802"> Read it
Here</a>
NIH AND AHRQ TO COLLABORATE ON EVIDENCE USED TO CREATE
CONSENSUS REPORTS
The National Institutes of Health has asked the Agency
for Healthcare Research and Quality to help bring more evidence -- and a better
assessment of that evidence -- to the table for the creation of consensus
statements.
http://id.medscape.com/47131.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47131.rhtml?srcmp=id-011802"> Read it
Here</a>
CLOSTRIDIUM PERFRINGENS GENOME SEQUENCED
Japanese scientists announced on Monday that they have
sequenced the genome of C perfringens.
http://id.medscape.com/47144.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47144.rhtml?srcmp=id-011802"> Read it
Here</a>
NEW CONTACT LENS MATERIAL REDUCES INFECTION RISK
Hard and soft contact lenses made out of silicone
hydrogel may have a lower risk of infections associated with their use than
traditional extended-wear lenses, a study suggests.
http://id.medscape.com/47054.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47054.rhtml?srcmp=id-011802"> Read it
Here</a>
MOST CHILDREN IN ANGOLA MALNOURISHED--UNICEF
The United Nations said on Friday that most children
in Angola, which has the second highest mortality rate among children under age
5 years in the world, are chronically malnourished.
http://id.medscape.com/47068.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47068.rhtml?srcmp=id-011802"> Read it
Here</a>
BRITAIN TO DECLARE ITSELF FREE OF FOOT-AND-MOUTH
Britain said on Monday it had eradicated a prolonged
foot-and-mouth outbreak and would declare its last 'at-risk' region free of the
livestock disease at midnight, ending a devastating chapter for UK farmers.
http://id.medscape.com/47106.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47106.rhtml?srcmp=id-011802"> Read it
Here</a>
UK EXTENDS SHEEP SCRAPIE PREVENTION CAMPAIGN
The government says it will extend a programme aimed
at eradicating scrapie from sheep amid fears that the illness could mask 'mad
cow disease' in the national flock.
http://id.medscape.com/47177.rhtml?srcmp=id-011802
<a
href="http://id.medscape.com/47177.rhtml?srcmp=id-011802"> Read it
Here</a>
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