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MEDSCAPE's Infectious Diseases MedPulse(R)
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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 --

CLINICAL UPDATE - PREVENTION OF PNEUMOCOCCAL DISEASE IN CHILDREN
Pneumococcal disease in the young -- what can we do to stop Streptococcus pneumoniae infection?
medscape.com/viewprogram/1807?srcmp=id-050302

CLINICAL UPDATE - EXPLOITING PHARMACOKINETICS TO OPTIMIZE ANTIRETROVIRAL THERAPY
Fully updated: a comprehensive review of the underlying pharmacologic principles and clinical data on the use of pharmacokinetically enhanced antiretroviral regimens.
medscape.com/viewprogram/703?srcmp=id-050302

CME CIRCLE - PUBLIC-HEALTH IMPACT, NATURAL HISTORY, DIAGNOSIS, AND CLINICAL MANAGEMENT OF HEPATITIS C: EMERGING CLINICAL OPTIONS WITH INTERFERON-BASED THERAPIES
The newer treatment strategies for hepatitis C infection using pegylated interferons may prove effective in complicated and refractory cases.
medscape.com/viewprogram/1809?srcmp=id-050302

CONFERENCE COVERAGE - INTERNATIONAL SOCIETY FOR HEART AND LUNG TRANSPLANTATION 22ND ANNUAL MEETING AND SCIENTIFIC SESSIONS
Treatment protocols and clinical strategies for enhanced care of thoracic transplant recipients: Highlights from the ISHLT 2002.
medscape.com/viewprogram/1825?srcmp=id-050302

-- MMWR --

FATAL YELLOW FEVER IN A TRAVELER RETURNING FROM AMAZONAS, BRAZIL, 2002
Information from some commercial outfitters and travel agents might underestimate health risks.
MMWR 51(15) 2002
medscape.com/viewarticle/432129?srcmp=id-050302

-- EMERGING INFECTIOUS DISEASES --

IMMUNIZATION WITH HETEROLOGOUS FLAVIVIRUSES PROTECTIVE AGAINST FATAL WEST NILE ENCEPHALITIS
Immunity to JEV and SLEV was protective against clinical encephalitis and death after challenge with WNV.
Emerg Infect Dis 8(3) 2002
medscape.com/viewarticle/432059?srcmp=id-050302

ASSOCIATIONS BETWEEN INDICATORS OF LIVESTOCK FARMING INTENSITY AND INCIDENCE OF HUMAN SHIGA TOXIN-PRODUCING ESCHERICHIA COLI INFECTION
The strongest associations were the ratio of cattle to humans and the application of manure to agricultural land.
Emerg Infect Dis 8(3) 2002
medscape.com/viewarticle/432060?srcmp=id-050302

FEASIBILITY OF NATIONAL SURVEILLANCE OF HEALTH-CARE-ASSOCIATED INFECTIONS IN HOME-CARE SETTINGS
This article examines the rationale and strategies for surveillance of such infections in home-care settings.
Emerg Infect Dis 8(3) 2002
medscape.com/viewarticle/432057?srcmp=id-050302

-- INFECTIONS in MEDICINE --

INTERPRETATION OF THE MATERNAL WHITE BLOOD CELL COUNT IN THE POSTPARTUM PERIOD
The WBC count is neither specific nor highly sensitive for the detection of postpartum acute infectious processes.
Infect Med 19(3) 2002
medscape.com/viewarticle/431133?srcmp=id-050302

IMAGES in INFECTIOUS DISEASE - INTERNAL PYOCEPHALUS
Watery nasal discharge developed several hours before abrupt onset of fever, headache, and lassitude in this woman.
Infect Med 19(3) 2002
medscape.com/viewarticle/431134?srcmp=id-050302

PERTUSSIS RATES RISE; ANTHRAX VACCINE PRODUCTION RESUMES; HIV BLOOD SCREENING NOT 100%; HIV VACCINE TRIAL TO START
Read brief summaries of the latest news in infectious diseases.
Infect Med 19(3) 2002
medscape.com/viewarticle/431128?srcmp=id-050302

-- INFECTIONS in UROLOGY --

SEROLOGIC EVALUATION FOR HEPATITIS B, HEPATITIS C, AND HIV-1 OF SURGICAL PATIENTS AND HEALTH CARE PROVIDERS IN A UROLOGY CLINIC
Adherence to universal precautions should be emphasized among urology healthcare providers.
Infect Urol 15(1) 2002
medscape.com/viewarticle/431452?srcmp=id-050302

PYELODUODENAL FISTULA
A quadriplegic man with a nephrostomy tube in place presented with fever, chills, vomiting, and severe right flank pain.
Infect Urol 15(1) 2002
medscape.com/viewarticle/431454?srcmp=id-050302

GARDNERELLA VAGINALIS: A PREVALENT AND POTENTIALLY SERIOUS UROPATHOGEN IN MEN
This case report of a man with severe cystitis illustrates the potential for local and systemic illness in men.
Infect Urol 15(1) 2002
medscape.com/viewarticle/431453?srcmp=id-050302

-- OTHER JOURNALS --

COMMON COMPLICATIONS OF BODY PIERCING
What are the proper diagnoses and treatments for this series of pierced patients?
West J Med 176(2) 2002
medscape.com/viewarticle/431999?srcmp=id-050302

TYPE II CRYOGLOBULINEMIA
A 50-year-old man with Raynaud's phenomenon and numbness and tingling in his toes complained of purpuric lesions.
Wounds 14(2) 2002
medscape.com/viewarticle/430903?srcmp=id-050302

WEAPONS OF MASS DESTRUCTION: RADIATION
Read an overview of types of radiation, methods of dispersal, injury patterns, and treatment considerations in for WMD.
Neurosurg Focus 12(3) 2002
medscape.com/viewarticle/431313?srcmp=id-050302

_____________________________________________________________________

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/usmd/uti


_______________________________________________________________________
___________________________________ NEWS ______________________________

-- GREEK VIRAL MYOCARDITIS OUTBREAK --

GREECE REPORTS NEW CASES INVOLVING MYSTERY VIRUS
Greece said on Thursday that the number of people apparently infected with a potentially deadly, but unknown, virus had risen to 36, but that the incidence of new cases was receding.
Reuters Health Information 2002
medscape.com/viewarticle/432652?srcmp=id-050302

-- BIOTERRORISM --

REPORT URGES VOLUNTARY SMALLPOX VACCINATION IN US
Now that the US is assured a much larger stockpile of smallpox vaccine than recently thought, it should be used to launch a voluntary vaccination program to head off any potential bioterror attack, some policy analysts conclude.
Reuters Health Information 2002
medscape.com/viewarticle/432655?srcmp=id-050302

-- MALARIA --

WHO URGES AFRICA TO USE NEWER MALARIA DRUGS
The World Health Organization on Thursday stressed the need for African nations to use a new type of anti-malarial drug combination, as growing resistance makes older medicines ineffective.
Reuters Health Information 2002
medscape.com/viewarticle/432650?srcmp=id-050302

RIO DENGUE EPIDEMIC SLOWS, BUT MALARIA CASES INCREASE
An April drought appears to be slowing the progress of Rio de Janeiro's worst dengue epidemic on record, which has killed 56 people this year, but the Brazilian state now faces an increase in malaria cases.
Reuters Health Information 2002
medscape.com/viewarticle/432704?srcmp=id-050302

WEED-KILLER COMPOUND MAY PROVIDE NEW ANTIMALARIAL
Fosmidomycin, a chemical used in weed-killer, could be used to develop a cheap, fast-acting and safe treatment for malaria, German researchers report.
Reuters Health Information 2002
medscape.com/viewarticle/432669?srcmp=id-050302

-- STDs --

MANY PHYSICIANS BELIEVE STD COUNSELING IS NOT EFFECTIVE
Many primary care physicians in the US believe that counseling patients about sexually transmitted diseases does little good, new survey findings suggest.
Reuters Health Information 2002
medscape.com/viewarticle/432729?srcmp=id-050302

-- NOSOCOMIAL INFECTION --

NURSES' UNIFORMS A SOURCE OF NOSOCOMIAL INFECTIONS
UK nurses' uniforms are an infection risk in hospitals because of a lack of laundering and changing facilities, said senior members of the profession at the Royal College of Nurses congress in Harrogate on Wednesday.
Reuters Health Information 2002
medscape.com/viewarticle/432653?srcmp=id-050302

ALCOHOL-BASED HAND GELS DEEMED UNSUITABLE FOR ANTISEPSIS IN HEALTHCARE SETTING
Alcohol-based hand gels are inferior to hand rinses or a 60% solution of 2-propanol, European investigators report in the April 27th issue of The Lancet.
Reuters Health Information 2002
medscape.com/viewarticle/432703?srcmp=id-050302

-- DRUG NEWS --

SERIOUS DRUG TOXICITIES RECOGNIZED DURING POSTMARKETING SURVEILLANCE
The rate of serious adverse effects in drugs newly approved by the US Food and Drug Administration (FDA) is so high that physicians should view any new drug as a black box, researchers suggest in the May 1st issue of the Journal of the American Medical Association.
Reuters Health Information 2002
medscape.com/viewarticle/432857?srcmp=id-050302

ANTIBIOTIC USE FOR THE COMMON COLD REDUCED BY DELAYING PRESCRIPTIONS
A delayed prescription strategy can significantly reduce antibiotic use by patients who request antibiotics for common colds and may also provide an opportunity to educate patients about inappropriateness of taking antibiotics for colds, New Zealand researchers report.
Reuters Health Information 2002
medscape.com/viewarticle/432738?srcmp=id-050302

EUROPEAN DRUG AGENCY PROBES SAFETY OF GATIFLOXACIN AND NIMESULIDE
The European Medicines Evaluation Agency is investigating the risk-benefit profiles of Bristol-Myers Squibb's antibiotic Tequin (gatifloxacin) and the generic anti-inflammatory nimesulide--but is not saying why.
Reuters Health Information 2002
medscape.com/viewarticle/432824?srcmp=id-050302

ANTIBIOTICS SHOW ANTI-INFLAMMATORY PROPERTIES
Antibiotics appear to have anti-inflammatory properties in addition to their traditional antimicrobial effects, according to the results of several studies presented at the 12th European Congress of Clinical Microbiology and Infectious Diseases.
Reuters Health Information 2002
medscape.com/viewarticle/432712?srcmp=id-050302

-- GI TRACT --

BREATH TEST MAY REPLACE ENDOSCOPY TO DIAGNOSE H. PYLORI
The breath test is a more effective, safe, noninvasive, and cheaper test for dyspepsia.
MedscapeWire 2002
medscape.com/viewarticle/432684?srcmp=id-050302

ENDOSCOPY ADDS LITTLE TO BREATH TESTING FOR H. PYLORI INFECTION
The outcomes of patients found to have Helicobacter pylori infection are similar whether the bacteria is detected by a noninvasive breath test alone or in combination with endoscopy, according to a report published in the April 27th issue of the British Medical Journal.
Reuters Health Information 2002
medscape.com/viewarticle/432648?srcmp=id-050302

ONDANSETRON REDUCES VOMITING IN PEDIATRIC GASTROENTERITIS
The drug is safe, cost-effective, and reduces hospital admissions.
MedscapeWire 2002
medscape.com/viewarticle/432689?srcmp=id-050302

-- RESPIRATORY TRACT --

SINUSITIS LINKED TO AIRWAY INFLAMMATION IN SEVERE ASTHMATICS
The extent of sinus disease in patients with severe asthma is directly related to the degree of bronchial inflammation, according to a recent report by Dutch researchers.
Reuters Health Information 2002
medscape.com/viewarticle/433055?srcmp=id-050302

-- HEPATITIS --

HEPATITIS B VACCINE UPTAKE IN NEONATES LINKED TO GESTATIONAL AGE
Seroconversion rates following hepatitis B vaccination in neonates is linked with gestational age, with rates significantly lower in preterm infants, researchers from India report.
Reuters Health Information 2002
medscape.com/viewarticle/432776?srcmp=id-050302

PRIOR HCV INFECTION MAY PROVIDE SOME PROTECTION AGAINST REINFECTION
Results of a study of hepatitis C virus infection among users of injection drugs show that partial immunity against reinfection can develop, which supports the concept of anti-HCV vaccines to treat this high-risk population, researchers report in The Lancet for April 27.
Reuters Health Information 2002
medscape.com/viewarticle/432671?srcmp=id-050302

LIVER TRANSPLANT FEASIBLE FOR HIV-INFECTED PATIENTS WITH HCV
University of Pittsburgh researchers reported that a group of patients dually infected with HIV and hepatitis C virus who have received liver transplants have not experienced further progression of HIV infection following the procedure, which potentially strengthens the argument for offering transplantation to these patients.
Reuters Health Information 2002
medscape.com/viewarticle/432778?srcmp=id-050302

-- RABIES --

MOST CASES OF RABIES TRANSMISSION FROM BATS CAUSED BY UNRECOGNIZED BITES
Most transmission of rabies from bats to human occurs from bites that are often overlooked, rather than from aerosol transmission, which has never been well-documented in the natural environment, according to a report in the May issue of the Annals of Emergency Medicine.
Reuters Health Information 2002
medscape.com/viewarticle/432950?srcmp=id-050302

-- VACCINES & IMMUNIZATION --

VARICELLA VACCINE MAY INCREASE SHINGLES RISK IN ELDERLY
Scientists said on Thursday that immunising children against varicella could increase the risk of shingles in adults.
Reuters Health Information 2002
medscape.com/viewarticle/433038?srcmp=id-050302

MIXING DTaP VACCINES DOES NOT AFFECT SAFETY, IMMUNOGENICITY
One to two doses of Tripedia followed by Infanrix was found to be equivalent to 3 doses of Tripedia.
MedscapeWire 2002
medscape.com/viewarticle/432633?srcmp=id-050302

MULTIVALENT VACCINE EFFECTIVE AGAINST MANY STREPTOCOCCI IN PRECLINICAL TESTS
A vaccine containing surface M protein from 26 different serotypes of group A streptococci has shown considerable promise in animal studies, researchers report in the April issue of Infection and Immunity.
Reuters Health Information 2002
medscape.com/viewarticle/432831?srcmp=id-050302

-- HERPES VIRUSES --

SOCIAL STATUS DOES NOT EXPLAIN LYMPHOMA RISK LINKED TO INFECTIOUS MONONUCLEOSIS
The increased risk for Hodgkin's lymphoma associated with a history of Epstein-Barr virus-related infectious mononucleosis cannot be attributed to the fact that both conditions are associated with high socioeconomic status, Danish epidemiologists report.
Reuters Health Information 2002
medscape.com/viewarticle/433045?srcmp=id-050302

PREEMPTIVE GANCICLOVIR PREVENTS CMV INFECTION AFTER LIVER TRANSPLANT
Ganciclovir treatment beginning immediately upon detection of cytomegalovirus by PCR prevents CMV infection or disease after liver transplantation, according to a report in the April 1st issue of The Journal of Infectious Diseases.
Reuters Health Information 2002
medscape.com/viewarticle/433048?srcmp=id-050302

FOMIVIRSEN REASONABLY SAFE, EFFECTIVE FOR CMV RETINITIS
Ocular toxicity is 'nontrivial' and dose-dependent.
MedscapeWire 2002
medscape.com/viewarticle/432629?srcmp=id-050302

-- HIV/AIDS - EPIDEMIOLOGY -

HIGH PREVALENCE OF HIV INFECTION SEEN AMONG INCARCERATED WOMEN
HIV and AIDS risk behaviors are highly prevalent among urban women jailed for relatively minor infractions of the law, according to a report in the America Journal of Public Health for May.
Reuters Health Information 2002
medscape.com/viewarticle/432764?srcmp=id-050302

SEX DIFFERENCES IN HIV RISK FACTORS NOTED AMONG INJECTION DRUG USERS
Researchers in Vancouver have identified sex-specific risk factors that may explain a 40% higher incidence of HIV infection in women who use injection drugs compared with their male counterparts.
Reuters Health Information 2002
medscape.com/viewarticle/432659?srcmp=id-050302

-- HIV/AIDS - CLINICAL --

STUDY SUPPORTS VOLUNTARY INPATIENT HIV SCREENING
Adhering to the CDC recommendation for testing could double detection.
MedscapeWire 2002
medscape.com/viewarticle/432626?srcmp=id-050302

SHORT INTERRUPTIONS IN HAART MAY NOT EFFECT HIV DISEASE PROGRESSION
Occasional short treatment interruptions in highly active antiretroviral therapy (HAART) apparently do not worsen or improve disease outcome over a 3 to 4 year period, Swiss researchers report.
Reuters Health Information 2002
medscape.com/viewarticle/432777?srcmp=id-050302

DRUG-RESISTANT HIV-1 CAN BE SELECTED BY STRUCTURED TREATMENT INTERRUPTIONS
HIV-1-positive patients receiving antiretroviral therapy who undergo repeated structured treatment interruptions can exhibit increasing frequency of drug-resistant virus, researchers report.
Reuters Health Information 2002
medscape.com/viewarticle/433032?srcmp=id-050302

NEVIRAPINE MAY IMPAIR ORAL CONTRACEPTIVE EFFECTIVENESS
The nonnucleoside reverse transcriptase inhibitor nevirapine, when used to treat HIV-infected women, may reduce the effectiveness of oral contraceptives, according to a report in the April 15th Journal of Acquired Immune Deficiency Syndromes.
Reuters Health Information 2002
medscape.com/viewarticle/432841?srcmp=id-050302

HAART LIMITS NEED FOR ANTIFUNGAL THERAPY IN AIDS PATIENTS
A pilot study of certain AIDS patients responding to HAART suggests that prophylaxis against disseminated cryptococcal disease may be safely discontinued, researchers report in the April 15th issue of The Journal of Infectious Diseases.
Reuters Health Information 2002
medscape.com/viewarticle/432851?srcmp=id-050302

PI-CONTAINING HAART MAY INCREASE HEART DISEASE RISK
HIV-1 infected patients undergoing HAART containing a protease inhibitor appeared to be at increased risk of cardiovascular disease, Swedish researchers report in the April 15th issue of the Journal of Acquired Immune Deficiency Syndromes.
Reuters Health Information 2002
medscape.com/viewarticle/432786?srcmp=id-050302

-- HIV/AIDS - POLITICAL/GLOBAL --

UN SAYS INDIA MAY OVERTAKE SOUTH AFRICA IN AIDS CASES
India will have the largest number of people living with HIV/AIDS in a few years, overtaking South Africa, if steps are not taken to curb the deadly disease, UNAIDS chief Dr. Peter Piot said on Thursday.
Reuters Health Information 2002
medscape.com/viewarticle/433037?srcmp=id-050302

THOUSANDS MARCH FOR AIDS DRUG IN SOUTH AFRICA
Thousands of South African AIDS activists marched Thursday to demand access to nevirapine as the state appealed against a court ruling that it must offer the drug immediately.
Reuters Health Information 2002
medscape.com/viewarticle/433039?srcmp=id-050302

-- OTHER ID NEWS --

GENE THAT ALLOWS COLONIZATION OF FLEA GUT MAY HAVE INITIATED BLACK PLAGUE
Through a single gene change, Yersinia pestis appears to have undergone the crucial step that increased its virulence and led to its arthropod-borne transmission, a property unique among enteric bacteria.
Reuters Health Information 2002
medscape.com/viewarticle/432836?srcmp=id-050302

EARLY CHILDHOOD INFECTIONS DO NOT PROTECT AGAINST ATOPY
Results of a population-based study, reported in the May issue of Thorax, indicate that early childhood exposure to measles, rubella, varicella, or mumps does not confer protection against atopy.
Reuters Health Information 2002
medscape.com/viewarticle/432774?srcmp=id-050302

NEW CHIP ANALYZES DNA 'IN MINUTES'
A computer chip that can quickly analyse DNA in blood samples for a wide range of medical diagnostic tests, including HIV and other pathogens, was unveiled on Thursday by researchers in Britain.
Reuters Health Information 2002
medscape.com/viewarticle/433026?srcmp=id-050302

AMA DEVELOPING CASE STUDIES TO ILLUSTRATE ETHICAL DOCTOR-DRUG FIRM RELATIONSHIPS
The American Medical Association is attempting to define through case studies the ethical boundaries of drug company gift-giving to physicians.
Reuters Health Information 2002
medscape.com/viewarticle/432731?srcmp=id-050302

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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.