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medscape.com/infectiousdiseaseshome
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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 --

OPTIMIZATION OF ANTIMICROBIAL THERAPY TO MINIMIZE MEDICATION ERRORS
This article expands the definition of medication errors to include inappropriate/suboptimal use of antimicrobial drugs.
Medscape Pharmacists 3(1) 2002
medscape.com/viewarticle/436908?srcmp=id-062802

THE PUSH FOR ONCE-DAILY HAART: A CALL FOR CAUTION
Andrew D. Luber, PharmD, highlights unanswered pharmacologic questions and concerns about toxicity of a once-daily regimen.
Medscape HIV/AIDS eJournal 8(3) 2002
medscape.com/viewarticle/436567?srcmp=id-062802

CLINICAL UPDATE: URINARY TRACT INFECTION: PROVIDING THE BEST CARE
What's new in the evaluation and treatment of urinary tract infection?
medscape.com/viewprogram/1920?srcmp=id-062802

INTERACTIVE CASE STUDIES IN TRANSPLANTATION, CASE 1:
RENAL TRANSPLANT RECIPIENT WITH MALAISE, MYALGIA, AND LOW-GRADE FEVER
What's your diagnosis?
Medscape Transplantation 3(1) 2002
medscape.com/viewarticle/436825?srcmp=id-062802

DRUG-INDUCED GASTROINTESTINAL DISORDERS
Healthcare professionals need to be aware of the drugs commonly implicated in causing gastrointestinal complaints.
Medscape Pharmacotherapy 4(1) 2002
medscape.com/viewarticle/437034?srcmp=id-062802

-- EMERGING INFECTIOUS DISEASES --

BOOK REVIEW: DICTIONARY OF VIROLOGY (B. MAHY, AUTHOR)
If you are a clinician, an overly specialized senior faculty member, or a layman without a life, this book is for you.
Emerg Infect Dis 8(6) 2002
medscape.com/viewarticle/434427?srcmp=id-062802

CLUSTER OF AFRICAN TRYPANOSOMIASIS IN TRAVELERS TO TANZANIAN NATIONAL PARKS
Nine cases were recently reported and detected through TropNetEurop.
Emerg Infect Dis 8(6) 2002
medscape.com/viewarticle/434422?srcmp=id-062802

EXCRETION OF VANCOMYCIN-RESISTANT ENTEROCOCCI BY WILD MAMMALS
VRE were excreted by 5% of woodmice and 1% of badgers, but by none of the bank voles.
Emerg Infect Dis 8(6) 2002
medscape.com/viewarticle/434423?srcmp=id-062802

TWO NEW RHABDOVIRUSES (RHABDOVIRIDAE) ISOLATED FROM BIRDS DURING SURVEILLANCE FOR ARBOVIRAL ENCEPHALITIS, NORTHEASTERN UNITED STATES
Their importance for human health is unknown.
Emerg Infect Dis 8(6) 2002
medscape.com/viewarticle/434418?srcmp=id-062802

-- SOUTHERN MEDICAL JOURNAL --

RHABDOMYOLYSIS OF INFECTIOUS AND NONINFECTIOUS CAUSES
Learn more about a potentially lethal disease characterized by elevated concentrations of CK due to muscle injury.
South Med J 95(5) 2002
medscape.com/viewarticle/433872?srcmp=id-062802

-- OTHER JOURNALS --

PHARMACOKINETIC AND PHARMACODYNAMIC EVALUATION OF TWO DOSING REGIMENS FOR PIPERACILLIN-TAZOBACTAM
Which regimen is the best option for treating Pseudomonas aeruginosa infection?
Pharmacotherapy 22(5) 2002
medscape.com/viewarticle/434368?srcmp=id-062802

TORSADES DE POINTES ASSOCIATED WITH FLUOROQUINOLONES
The authors offer an alternative view on TdP in response to an article by Richard Frothingham, MD.
Pharmacotherapy 22(5) 2002
medscape.com/viewarticle/434467?srcmp=id-062802

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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.
medscape.com/mp/rc/uti

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___________________________________ NEWS ______________________________

-- OUTBREAKS --

MEASLES EPIDEMIC SPREADING IN ITALY
A measles epidemic that has killed three children and infected 17,000 people this year in the southern Italian region of Campania seems to be spreading to other Italian regions, according to data from the National Health Institute.
Reuters Health Information 2002
medscape.com/viewarticle/437138?srcmp=id-062802

-- TUBERCULOSIS --

ORAL SUBUNIT VACCINE AND ADJUVANT PROTECTS AGAINST EXPERIMENTAL TB INFECTION
An oral vaccine comprised of Mycobacterium tuberculosis antigens, combined with an adjuvant, induces type 1 responses when administered to mice and guinea pigs, investigators in Copenhagen report.
Reuters Health Information 2002
medscape.com/viewarticle/437295?srcmp=id-062802

HIGHER THAN STANDARD DOSES OF RIFAPENTINE WELL TOLERATED IN TB TREATMENT
Results of a double-blind tolerability study suggest that 900 mg rifapentine--300 mg more than the standard dose--plus isoniazid once-weekly is safe and well tolerated in the continuation phase of tuberculosis treatment.
Reuters Health Information 2002
medscape.com/viewarticle/437148?srcmp=id-062802

-- VACCINES & IMMUNIZATION --

ANTI-VACCINE WEB SITES USE EMOTION TO CONVEY MESSAGE
Many Web sites that oppose childhood vaccinations appeal to readers' emotions when trying to convey their message, and include claims about vaccination that are not supported by studies from peer-reviewed medical journals, according to researchers.
Reuters Health Information 2002
medscape.com/viewarticle/437251?srcmp=id-062802

HIV-1C CONSENSUS SEQUENCE MAY BYPASS PROBLEM OF VIRAL DIVERSITY FOR VACCINE DESIGN
Based on an analysis of genetic relationships between HIV-1C proteins, an international research team has developed an extended consensus sequence that might be used to design an HIV vaccine that should be effective against various strains of the virus circulating in different developing countries.
Reuters Health Information 2002
medscape.com/viewarticle/437153?srcmp=id-062802

-- INFLUENZA --

PHASE III RESULTS FIND PERAMIVIR INEFFECTIVE AGAINST INFLUENZA
Initial data analysis from a phase III trial showed no statistically significant difference between placebo and peramivir, an oral neuraminidase inhibitor designed to treat and prevent influenza types A and B, BioCryst Pharmaceuticals Inc said in a statement.
Reuters Health Information 2002
medscape.com/viewarticle/437253?srcmp=id-062802

-- FOOD-BORNE DISEASE --

DRUG-RESISTANT SALMONELLA OUTBREAK IN US LINKED TO RAW BEEF
Earlier this year, people in five states were infected with a multidrug-resistant strain of Salmonella, apparently from eating undercooked contaminated beef, the US Centers for Disease Control and Prevention reported Thursday.
Reuters Health Information 2002
medscape.com/viewarticle/437371?srcmp=id-062802

-- HEPATITIS --

LAMIVUDINE SUPERIOR TO FAMCICLOVIR AGAINST CHRONIC HEPATITIS B
Lamivudine effectively suppresses HBV DNA levels, whereas famciclovir is significantly less effective, according to a report in the July Journal of Medical Virology.
Reuters Health Information 2002
medscape.com/viewarticle/437147?srcmp=id-062802

RENAL TRANSPLANT OUTCOME NOT INFLUENCED BY HEPATITIS POSITIVITY
Long-term outcome in renal transplant is not influenced by coexistent hepatitis B and C in the recipient, researchers from India report.
Reuters Health Information 2002
medscape.com/viewarticle/437248?srcmp=id-062802

SEVERE ISONIAZID HEPATOTOXICITY MORE LIKELY IN PRESENCE OF ACTIVE HEPATITIS B
Hepatitis B e antigen (HBeAg), as a marker for infectivity and rapidly replicating virus, is an important risk factor for severe hepatotoxicity associated with isoniazid therapy for latent TB, according to results of screening immigrants from Vietnam.
Reuters Health Information 2002
medscape.com/viewarticle/437126?srcmp=id-062802

-- PEDIATRIC ID --

RSV IMMUNE GLOBULIN IN HIGH-RISK INFANTS IMPROVES RESPIRATORY STATUS YEARS LATER
Treating infants who have bronchopulmonary dysplasia or chronic lung disease with respiratory syncytial virus immune globulin (RSV IG) results in improved pulmonary function and reduced prevalence of atopy up to a decade later, report investigators from the University of Colorado Health Sciences Center in Denver.
Reuters Health Information 2002
medscape.com/viewarticle/437137?srcmp=id-062802

ENTEROVIRUS INFECTION LINKED TO JUVENILE-ONSET DIABETES
Most newly diagnosed children with type-1 diabetes have enterovirus RNA in their blood cells, suggesting that viral infection may contribute to the development of diabetes, according to a report in the June issue of Diabetes.
Reuters Health Information 2002
medscape.com/viewarticle/437247?srcmp=id-062802

-- CJD/BSE --

BRITAIN RECOMMENDS PRECAUTIONARY BAN ON SHEEP INTESTINES IN FOOD
Britain's Food Standards Agency said on Monday it had recommended to the European Commission that sheep intestines be banned from sausage casings and other foods as a precautionary measure against the theoretical risk of bovine spongiform encephalopathy in sheep.
Reuters Health Information 2002
medscape.com/viewarticle/437149?srcmp=id-062802

FDA ADVOCATES EXPANDING CJD BLOOD DONATION CRITERIA TO MAKERS OF HUMAN TISSUE
The US Food and Drug Administration (FDA) on Monday advised manufacturers of human tissue intended for transplantation to adopt the same donor deferral criteria as those previously adopted by blood collection centers to minimize the risk of transmitting Creutzfeldt-Jakob Disease (CJD) and variant Creutzfeldt-Jakob Disease (vCJD).
Reuters Health Information 2002
medscape.com/viewarticle/437152?srcmp=id-062802

UK SETS OUT RULES FOR HUMAN-DERIVED THERAPEUTICS
Britain's Medical Devices Agency on Wednesday released a new set of standards for medical products based on human tissue.
Reuters Health Information 2002
medscape.com/viewarticle/437284?srcmp=id-062802

-- LYME DISEASE --

STRUCTURE OF LYME DISEASE BORELLIA SURFACE PROTEIN DEFINES VARIABLE ANTIGENIC AREA
Investigators in Texas have determined the structure of the highly variable region of an outer lipoprotein of Borrelia burgdorferi that enables the spirochete to evade a mammalian host's immune response.
Reuters Health Information 2002
medscape.com/viewarticle/437239?srcmp=id-062802

-- BIOTERRORISM --

BROAD BIOTERRORISM AGENDA RECOMMENDED BY US PANEL
An expert report released on Tuesday calls on US officials and agencies to undertake a broad research and regulatory reform program to protect the country from biological and chemical terrorism.
Reuters Health Information 2002
medscape.com/viewarticle/437230?srcmp=id-062802

-- MALARIA --

HIGH-GRADE MALIGNANT TUMORS COMMON IN AREAS ENDEMIC FOR MALARIA
The results of a study published in the June 10th issue of the International Journal of Cancer suggest that there is an excess frequency of high-grade malignant tumors among individuals with lifelong exposure to malaria.
Reuters Health Information 2002
medscape.com/viewarticle/437238?srcmp=id-062802

-- HERPES VIRUSES --

K1 GENE OF HHV-8 PROMOTES MALIGNANT TRANSFORMATION
The K1 gene of human herpesvirus-8 (HHV-8), which is associated with Kaposi's sarcoma, produces aberrant intracellular signaling that leads to increased cell proliferation and potential malignant transformation, according to a report in the Journal of the National Cancer Institute for June 19.
Reuters Health Information 2002
medscape.com/viewarticle/437241?srcmp=id-062802

-- HIV/AIDS - GLOBAL & POLITICAL --

MORE MEN THAN WOMEN TAKE STEPS TO AVOID AIDS: UN REPORT
Most men living in developing nations have changed their behavior to reduce their risk of getting AIDS, but far fewer women have done so, according to a new UN report released on Saturday.
Reuters Health Information 2002
medscape.com/viewarticle/437136?srcmp=id-062802

WEST'S RESPONSE TO AIDS IN AFRICA ABYSMAL--UN ENVOY
The world's richest nations must commit billions more each year to fight AIDS in Africa or risk condemning millions on the continent to a perpetual cycle of disease, poverty and death, the United Nations special envoy for HIV/AIDS in Africa said on Wednesday.
Reuters Health Information 2002
medscape.com/viewarticle/437347?srcmp=id-062802

UN SAYS CHINA FACES AIDS CATASTROPHE
The United Nations Programme on AIDS/HIV, in one the harshest assessments yet of China's efforts to halt a looming epidemic, said on Thursday the country faced a catastrophe.
Reuters Health Information 2002
medscape.com/viewarticle/437355?srcmp=id-062802

HEROIN USE IN RUSSIA JUMPS, WITH RELATED RISE IN HIV INCIDENCE
The United Nations' drugs watchdog said on Wednesday the use of heroin and other opiates in Russia was soaring, helping the HIV/AIDS virus spread like wildfire among addicts who inject the drug.
Reuters Health Information 2002
medscape.com/viewarticle/437281?srcmp=id-062802

PFIZER TO PROVIDE DIFLUCAN TO AIDS PATIENTS IN MALAWI
US drug giant Pfizer Inc said on Wednesday it had signed an agreement with Malawi's government to provide its antifungal drug Diflucan (fluconazole) at no cost to AIDS patients for an unlimited period.
Reuters Health Information 2002
medscape.com/viewarticle/437282?srcmp=id-062802

UN SURVEY AIMS TO HELP POOR COUNTRIES GET CHEAP HIV DRUGS
A list designed to help poor countries and procurement agencies find the best value HIV medicines and diagnostics was updated on Wednesday by UN health agencies and Medecins Sans Frontieres (MSF).
Reuters Health Information 2002
medscape.com/viewarticle/437283?srcmp=id-062802

US SENATE COMMITTEE APPROVES GLOBAL AIDS FUND BILL
As the world prepares for the international AIDS/HIV conference in Spain next month, the US Senate Health, Education, Labor and Pensions Committee on Wednesday night approved a measure that would authorize and fund activities at the Departments of Labor and Health and Human Services to fight AIDS and HIV in developing nations.
Reuters Health Information 2002
medscape.com/viewarticle/437349?srcmp=id-062802

DRUG-RESISTANT HIV RARE IN TREATMENT-NAIVE PREGNANT WOMEN IN S. AFRICA
Genetic mutations associated with drug resistance in reverse transcriptase sequences are rare among isolates of HIV-1 subtype C obtained from untreated pregnant women in South Africa, according to researchers there.
Reuters Health Information 2002
medscape.com/viewarticle/437298?srcmp=id-062802

ACTIVISTS SAY POWERS HAVE BACKED OUT OF AIDS DRUG PLEDGE
AIDS advocacy organisations accused the European Union and the United States on Monday of backing out of a key pledge to ensure that poor countries could get cheap drugs to fight the epidemic.
Reuters Health Information 2002
medscape.com/viewarticle/437155?srcmp=id-062802

-- HIV/AIDS - CLINICAL --

KALETRA SAFE, EFFECTIVE IN INITIAL HIV TREATMENT
Lopinavir/ritonavir were superior to nelfinavir in a combination regimen.
Medscape Medical News 2002
medscape.com/viewarticle/437269?srcmp=id-062802

COXSACKIEVIRUS NOT TIED TO CARDIOMYOPATHY IN CHILDREN WITH HIV
Coxsackievirus appears not to play a role in cardiomyopathy in children with HIV-1 infection, researchers report in the June 15th issue of The Journal of Infectious Diseases.
Reuters Health Information 2002
medscape.com/viewarticle/437140?srcmp=id-062802

PTSD SYMPTOMS COMMON IN HIV-INFECTED WOMEN SEEKING MEDICAL CARE
More than half of a cohort of women with HIV seeking medical care in California reported symptoms associated with post-traumatic stress disorder, approximately an order of magnitude higher than the reported prevalence rate in the general population of women.
Reuters Health Information 2002
medscape.com/viewarticle/437359?srcmp=id-062802

AIDS-LIKE SYMPTOMS CAN APPEAR IN PRIMARY HIV INFECTION
Conditions that typically occur during advanced HIV infection can present in patients during primary HIV infection, investigators from Christiana Care Health Services in Wilmington, Delaware, report.
Reuters Health Information 2002
medscape.com/viewarticle/437255?srcmp=id-062802

RNA INTERFERENCE CAN PREVENT REPLICATION OF HIV, BEFORE MUTATIONS OCCUR
RNA interference can specifically degrade the HIV-1 genome in T cells extremely early in the viral replication cycle, according to a letter to Nature, published in the advance online publication for June 26.
Reuters Health Information 2002
medscape.com/viewarticle/437290?srcmp=id-062802

RAPID SQUAMOUS CELL SKIN CANCER GROWTH SEEN IN HIV-INFECTED PATIENTS
HIV-infected patients can develop rapidly growing cutaneous squamous cell carcinomas (SCCs), leading researchers to recommend aggressive management of the condition.
Reuters Health Information 2002
medscape.com/viewarticle/437226?srcmp=id-062802

CIGNA ADDS BENEFITS FOR ACCIDENTAL HIV EXPOSURE
Cigna Group Insurance said on Thursday that it is expanding its accident insurance benefits to cover healthcare workers who contract HIV on the job.
Reuters Health Information 2002
medscape.com/viewarticle/437342?srcmp=id-062802

-- OTHER ID NEWS --

PHYSICIANS WARNED TO TAKE ANIMAL BITES MORE SERIOUSLY
Even apparently minor animal bites can have major consequences, but they are frequently not taken seriously enough by patients or doctors, according to a new study.
Reuters Health Information 2002
medscape.com/viewarticle/437360?srcmp=id-062802

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Vaccination News Home Page

ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.