MEDSCAPE's Infectious Diseases MedPulse 3-7-02

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

___________________ NEW FEATURE ARTICLES THIS WEEK ____________________

-- MEDSCAPE ORIGINAL ARTICLES --

CASE 11: COULD THIS BE GUILLAIN-BARRE SYNDROME?

What's wrong with this toddler?

Medscape Neurology & Neurosurgery 4(1) 2002 http://www.medscape.com/viewarticle/424997?srcmp=id-030102

Read it Here</a>

-- MMWR --

MEASLES -- UNITED STATES, 2000

Importation-associated cases accounted for 62% of all reported cases of measles. MMWR 51(6) 2002 http://www.medscape.com/viewarticle/425997?srcmp=id-030102

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-- INFECTIONS in MEDICINE --

USE OF LINEZOLID FOR GRAM-POSITIVE INFECTIONS

Favorable aspects include a relatively narrow spectrum and low potential for cross-resistance with other antimicrobials. Infect Med 19(1) 2002 http://www.medscape.com/viewarticle/423483?srcmp=id-030102

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SELECTING DRUG REGIMENS FOR URINARY TRACT INFECTIONS: CURRENT RECOMMENDATIONS E. coli remains the most common uropathogen, but its antibiotic susceptibility profile is becoming less predictable. Infect Med 19(1) 2002 http://www.medscape.com/viewarticle/423482?srcmp=id-030102

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-- THE AIDS READER --

HOT TOPICS IN AIDS THERAPEUTICS

World AIDS Day 2001 was a rather subdued affair, given the focus of most of the world on the Sep 11 terrorist attacks. AIDS Read 12 2002 http://www.medscape.com/viewarticle/423534?srcmp=id-030102

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ASSESSING HIV-ASSOCIATED DEMENTIA: MODIFIED HIV DEMENTIA SCALE VERSUS THE GROOVED PEGBOARD The M-HDS may be more useful than the GP for nonneurologists, as it requires no equipment and is simpler to administer. AIDS Read 12(1) 2002 http://www.medscape.com/viewarticle/423531?srcmp=id-030102

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-- OTHER JOURNALS --

WHICH IS THE MOST COST-EFFECTIVE COMBINATION THERAPY STRATEGY USING INTERFERON ALPHA-2B PLUS RIBAVIRIN FOR NAIVE PATIENTS WITH CHRONIC HEPATITIS C? New techniques such as viral genotyping and HCV RNA may be used in combination to treat chronic hepatitis C. Clin Drug Invest 21(1) 2002 http://www.medscape.com/viewarticle/422894?srcmp=id-030102

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EXTENDED-SPECTRUM BETA-LACTAMASES: FREQUENCY, RISK FACTORS, AND OUTCOMES Ambulatory patients with chronic conditions may also harbor ESBL-producing organisms. Pharmacotherapy 22(1) 2002 http://www.medscape.com/viewarticle/423208?srcmp=id-030102

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THE EFFECT OF AN ANTIMICROBIAL FORMULARY CHANGE ON HOSPITAL RESISTANCE PATTERNS This change resulted in significantly reduced use of ceftazidime and cefotaxime, and increased use of cefepime. Pharmacotherapy 22(1) 2002 http://www.medscape.com/viewarticle/423221?srcmp=id-030102

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CHRONIC ALLOGRAFT REJECTION (OBLITERATIVE BRONCHIOLITIS) Obliterative bronchiolitis is the foremost cause of morbidity and mortality after lung and heart lung transplantation. Semin Respir Crit Care Med 22(5) 2002 http://www.medscape.com/viewarticle/424730?srcmp=id-030102

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SEPSIS RESOURCE CENTER ON MEDSCAPE

The Sepsis Resource Center gives the latest on pathophysiology,

diagnosis, prevention, and treatment, plus news and related

resources for sepsis.

http://www.medscape.com/resource/sepsis

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___________________________________ NEWS ______________________________

-- BIOTERRORISM --

VACCINES AGAINST ANIMAL DISEASES SEEN AS VITAL TO FIGHT BIOTERRORISM Well-guarded national stocks of vaccines against animal diseases such as foot-and-mouth are vital to respond to a possible bioterrorist attack, Dutch farm minister Laurens Jan Brinkhorst said on Monday. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429123?srcmp=id-030102

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NEW UNIVERSITY CENTER ON BIOTERRORISM ANNOUNCED

The University of Michigan is creating a bioterrorism preparedness center for research, training, and policy. MedscapeWire 2002 http://www.medscape.com/viewarticle/429111?srcmp=id-030102

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-- TUBERCULOSIS --

MAJOR DEFICITS SEEN IN CONTACT INVESTIGATIONS OF TB PATIENTS

A survey of programs designed to investigate contacts of patients with acute tuberculosis (TB) turned up serious deficiencies, according to a report in The Journal of the American Medical Association for February

27.

Reuters Health Information 2002 http://www.medscape.com/viewarticle/429122?srcmp=id-030102

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-- ANTIBIOTIC RESISTANCE --

BILL WOULD BAN MOST ANTIBIOTIC USE IN FARM ANIMALS

Most 'nontherapeutic' use in livestock of antibiotics commonly used in humans would be banned under a bill introduced by US House Democrats Wednesday. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429214?srcmp=id-030102

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-- VACCINES & IMMUNIZATION --

GLAXO PULLS LYME DISEASE VACCINE FROM US MARKET

GlaxoSmithKline on Tuesday withdrew its Lyme disease vaccine Lymerix from the market, citing poor sales rather than concerns about the product. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429124?srcmp=id-030102

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ONLINE CLEARINGHOUSE AIMS TO CLARIFY VACCINE INFORMATION Physicians have an online information center that they can use to stay abreast of changes in immunization schedules, according to Dr. Bruce Gellin, speaking in San Antonio at the second annual meeting of the American College of Preventive Medicine. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429287?srcmp=id-030102

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HIV-1 VACCINE WITH ADENOVIRAL VECTOR MOVES FORWARD

Preliminary phase I data suggest that an HIV-1 vaccine, under development by Merck, which uses a replication-defective adenoviral vector that expresses gag, elicits at least a partial cellular immune response in humans. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429216?srcmp=id-030102

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VAXGEN, KOREAN FIRMS AGREE ON AIDS VACCINE VENTURE

VaxGen Inc. has agreed to set up a joint venture with Korean firms to manufacture AIDS vaccines, South Korea said on Monday. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429023?srcmp=id-030102

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NIH DROPS PHASE III STUDY USING AVENTIS PASTEUR, VAXGEN VACCINES The National Institutes of Health said on Monday that it has dropped plans to conduct a phase III clinical trial testing a combination of two HIV prophylactic vaccines, after an earlier trial of the vaccines failed to provide adequate immune response data. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429149?srcmp=id-030102

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ELAN CORP. HALTS ALZHEIMER'S VACCINE TRIAL

Embattled Irish drugmaker Elan Corp. has halted trials of an experimental Alzheimer's vaccine after 12 volunteers developed encephalitis, The Washington Post reported on Friday. Reuters Health Information 2002 http://www.medscape.com/viewarticle/428954?srcmp=id-030102

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-- FOODBORNE DISEASE --

EXTENDED ALERT SYSTEM URGED FOR EUROPEAN FOOD SAFETY

Food-borne diseases are increasing in Europe and a rapid alert system needs to be extended across the continent and beyond to protect consumers, delegates at a United Nations conference said on Monday. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429024?srcmp=id-030102

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RAPID ALERT SYSTEM FOR FOOD PRODUCT SAFETY SHOULD ENCOMPASS ALL OF EUROPE Central and Eastern European countries should join the rapid alert system for food products already operating in European Union countries, a UN-sponsored pan-European conference of food safety regulators said Thursday. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429285?srcmp=id-030102

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-- MALARIA --

TRANSIENT PSYCHOSIS CAN OCCUR FOLLOWING CEREBRAL MALARIA Self-limiting neurologic sequelae--most often, psychosis--can occur in cases of cerebral malaria, Indian researchers report. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429022?srcmp=id-030102

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AWARENESS OF CONGENITAL MALARIA, WHILE RARE, URGED IN US

US healthcare providers should be alert to the possibility of malaria in newborns and young infants--especially those with fever--according to the US CDC. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429301?srcmp=id-030102

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-- HEPATITIS --

PEGYLATED INTERFERON IMPROVES HEPATITIS C OUTCOME IN HIV+ PATIENTS Pegylated interferon alfa-2a plus ribavirin leads to a significantly better treatment response compared with conventional interferon alfa-2a plus ribavirin in patients infected with HIV and hepatitis C virus. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429321?srcmp=id-030102

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MATERNAL INJECTION DRUG USE INCREASES RISK OF VERTICAL HEPATITIS C TRANSMISSION Maternal injection drug use, but not co-infection with HIV, significantly increases the risk of HCV transmission to a fetus, according to results of a multicenter, prospective study conducted in Italy. Reuters Health Information 2002 http://www.medscape.com/viewarticle/428958?srcmp=id-030102

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HIV INFECTION PROLONGS COURSE OF ACUTE HEPATITIS A

Among patients co-infected with HIV, hepatitis A viremia is greater and lasts longer than it does in HIV-seronegative individuals, Japanese researchers have discovered. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429021?srcmp=id-030102

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-- FUNGAL INFECTIONS --

SKIN COLONIZATION WITH MALASSEZIA SPECIES COMMONLY OCCURS AT BIRTH Skin colonization with Malassezia species, yeast flora linked to the development of cephalic pustulosis, begins during the first days of life, according to a recent report by French investigators. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429320?srcmp=id-030102

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SELF-DIAGNOSIS OF CANDIDIASIS OFTEN LEADS TO MISUSE OF OTC ANTIFUNGAL DRUGS Many women purchase over-the-counter antifungal drugs based on a misperception that they have vulvovaginal candidiasis, researchers report in the March issue of Obstetrics and Gynecology. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429310?srcmp=id-030102

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-- HERPESVIRUSES --

DELAYED, SHORT-COURSE GANCICLOVIR PREVENTS CMV DISEASE AFTER LUNG TRANSPLANTATION Two weeks of ganciclovir therapy started 3 to 4 weeks after lung transplantation, plus virologic monitoring and preemptive therapy as warranted, provides protection against cytomegalovirus disease, researchers report. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429319?srcmp=id-030102

Read it Here</a>

-- MEASLES --

MEASLES OUTBREAK HITS GERMAN REGION, ATTRIBUTED TO MMR OPPOSITION 'Militant' opposition to the combined measles, mumps and rubella (MMR) vaccine is at least partly responsible for an outbreak of measles in a rural district of southern Bavaria, according to Germany's Professional Association of Pediatricians. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429286?srcmp=id-030102

Read it Here</a>

-- PNEUMONIA --

SPECIFIC STRAIN OF S. AUREUS TIED TO LETHAL NECROTIZING PNEUMONIA IN YOUNG PATIENTS A French research team has found that the strain of Staphylococcus aureus that carries the gene for Panton-Valentine leukocidin is associated with a rapidly progressive, hemorrhagic, necrotizing pneumonia found in children and young adults. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429317?srcmp=id-030102

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-- EBOLA VIRUS --

NEW DIAGNOSTIC TEST COULD HELP CURB EBOLA OUTBREAKS

A new test has been developed that can detect the Ebola virus within hours and may help to contain future outbreaks of the disease. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429140?srcmp=id-030102

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-- PEDIATRIC ID --

HEAD LICE IN US RESISTANT TO MOST COMMON PEDICULICIDES

Common treatments for head lice have become less effective as resistance to these products in the US has increased, researchers report in the February issue of the Archives of Dermatology. Reuters Health Information 2002 http://www.medscape.com/viewarticle/428975?srcmp=id-030102

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-- DRUG NEWS --

ANTIVIRAL ACTIVITY SEEN WITH COX-2 INHIBITORS

Cyclooxygenase 2 inhibitors block the growth of human CMV in human fibroblasts, investigators in New Jersey report. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429134?srcmp=id-030102

Read it Here</a>

LINK BETWEEN HIV PROTEASE INHIBITORS AND MI STILL UNCLEAR

The risk of MI appears to be increased by several-fold among HIV-infected patients being treated with a protease inhibitor, Dr. Scott D. Holmberg told participants here at the 9th Conference on Retroviruses and Opportunistic Infections. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429315?srcmp=id-030102

Read it Here</a>

-- HIV/AIDS --

COMBINATION TREATMENT SEEN AS EFFECTIVE FOR AIDS-RELATED KAPOSI'S SARCOMA Intravenous liposomal doxorubicin combined with topical alitretinoin gel seems to be a potent treatment for AIDS-related cutaneous Kaposi's sarcoma, researchers reported at the 60th annual meeting of the American Dermatological Society in New Orleans. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429213?srcmp=id-030102

Read it Here</a>

SOUTH AFRICA REPORT GIVES GREEN LIGHT FOR NEVIRAPINE PROGRAM South Africa released a report on Wednesday stating that its nevirapine trial programme to prevent vertical HIV transmission is safe and should be extended to other sites. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429207?srcmp=id-030102

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HAART INTERRUPTION INCREASES RISK OF AIDS AND DEATH FOR MOST PATIENTS HIV-infected patients who discontinue therapy have a several-fold risk of progression to AIDS or death, according to the results of a large cohort study presented on Tuesday at the 9th Conference on Retroviruses and Opportunistic Infections. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429227?srcmp=id-030102

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WHITE HOUSE CONSIDERING SHIFT IN HIV/AIDS PREVENTION STRATEGIES The Bush administration's task force on AIDS is contemplating a possible shift in the government's approach to HIV and AIDS prevention, promising better targeting of federal money to prisons and African-American communities. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429127?srcmp=id-030102

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TWO OUT OF THREE HIV-INFECTED AMERICANS BEGIN TREATMENT LATE Race, HIV risk factors, and gender appear to influence whether antiretroviral therapy (ART) for HIV infection is begun as recommended by current treatment guidelines. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429138?srcmp=id-030102

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HALF OF HIV-INFECTED PEOPLE IN US ARE UNTESTED OR UNTREATED Between 42% and 59% of HIV-infected individuals in the US, up to 500,000 people, are either unaware that they are infected or are not receiving ongoing treatment for their infection, according to new estimates by the US CDC presented on Monday. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429034?srcmp=id-030102

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PHARMACOGENETICS PREDICT ABACAVIR HYPERSENSITIVITY

In a demonstration of the potential clinical applications of recent progress in pharmacogenetics, two research teams have separately identified a genetic marker that may predict which HIV-infected patients are at risk of a hypersensitivity reaction to abacavir. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429228?srcmp=id-030102

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-- OTHER ID NEWS --

RECENT REPORTS OF RASHES IN SCHOOLCHILDREN REMAIN UNEXPLAINED State and local health departments in 14 states have been investigating unexplained rashes among schoolchildren since October of last year, according to the US CDC. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429308?srcmp=id-030102

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ANTIBIOTIC THERAPY IMPROVES ENDOTHELIAL FUNCTION IN CAD WITH C. PNEUMONIAE Results of a randomized trial indicate that azithromycin treatment benefits patients who have coronary artery disease and evidence of Chlamydia pneumoniae infection. Reuters Health Information 2002 http://www.medscape.com/viewarticle/429045?srcmp=id-030102

Read it Here</a>

DIRECTOR OF US CDC RESIGNS

Dr. Jeffrey Koplan, director of the US Centers for Disease Control and Prevention, announced on Thursday that he was resigning. Reuters Health Information 2002 http://www.medscape.com/viewarticle/428968?srcmp=id-030102

Read it Here</a>

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EBV ROLE IN PATHOGENESIS OF HODGKIN'S DISEASE?

Is Epstein-Barr virus (EBV) detectable in plasma of patients with

Hodgkin's disease? Investigators in Germany evaluated this association

at the molecular level, analyzing EBV status in peripheral blood of 40

children. Review findings in an original Medscape Journal Scan summary,

available at: http://www.medscape.com/viewarticle/412617

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MEDSCAPE's Infectious Diseases MedPulse 3-7-02