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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
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
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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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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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.
"A foolish faith in authority is the worst enemy of truth."
-- Albert Einstein, letter to a friend, 1901
"I know of no safe depository of the ultimate powers of the society but the people themselves, and if we think them not enlightened enough to exercise control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion by education."
-- Thomas Jefferson, letter to William C. Jarvis, September 28, 1820
"What's the point of vaccination if it doesn't protect you from the unvaccinated?"
-- Sandy Gottstein
"Who gets to decide what the greater good is and how many will be sacrificed to it?"
