MEDSCAPE's Infectious Diseases MedPulse 11-18-01

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>>> MEDSCAPE's Infectious Diseases MedPulse(R) <<<

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Emerging Trends in CMV Infection from HAART to Heart

Saturday, December 16, 2001, 6:30 - 9:00 am,

supported by Roche Pharmaceuticals, at the Chicago

Marriott Downtown, at the 41st Interscience Conference

on Antimicrobial Agents and Chemotherapy (ICAAC)

For program description and registration, go to

http://www.cmv.icclink.com/register.html

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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 --

MEDSCAPE RESOURCE CENTER - ANTHRAX

Medscape's editors have collected the latest news, articles, and other

useful resources to keep you up to date on the detection, diagnosis, and

treatment of this organism.

http://id.medscape.com/44991.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/44991.rhtml?srcmp=id-111601"> Read it

Here</a>

TALKING ABOUT BIOTERRORISM - UNCOUPLING BIOTERRORISM: INFECTIOUS

DISEASES MEET PSYCHIATRY

Preparing for bioterrorism requires more than knowledge of the potential

bioweapons -- we must also prepare our communications and our

understanding of terror.

Medscape Infectious Diseases, 2001

http://id.medscape.com/45146.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45146.rhtml?srcmp=id-111601"> Read it

Here</a>

EXPERT COLUMN - CAN DERM WARFARE FIGHT GERM WARFARE?

Most bioterrorist-caused diseases have cutaneous manifestations, and

dermatologists are on the front lines.

Medscape Dermatology, 2001

http://id.medscape.com/45156.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45156.rhtml?srcmp=id-111601"> Read it

Here</a>

BOOK REVIEW - SCOURGE: THE ONCE AND FUTURE THREAT OF SMALLPOX

A book written before September 11 examines the history of this disease,

and the vulnerability of 'Fortress America.'

MedGenMed, November 13, 2001

http://id.medscape.com/45129.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45129.rhtml?srcmp=id-111601"> Read it

Here</a>

BOOK REVIEW - DARK REMEDY: THE IMPACT OF THALIDOMIDE AND ITS REVIVAL AS A VITAL MEDICINE

A new book looks at the rise and fall (and rise) of a 20th century drug.

MedGenMed, November 15, 2001

http://id.medscape.com/45157.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45157.rhtml?srcmp=id-111601"> Read it

Here</a>

CLINICAL ABSTRACTS - IMMUNE RECONSTITUTION DISEASES ASSOCIATED WITH

ANTIRETROVIRAL THERAPY

What's new concerning the inflammatory immune reconstitution diseases

observed in some patients soon after initiating potent antiretroviral

therapy? Find out in this easy-to-navigate compilation of MEDLINE and

conference abstracts compiled by Martyn French, MD, FRCP, Royal Perth

Hospital, Australia.

Medscape HIV/AIDS 7(6), 2001

http://id.medscape.com/45160.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45160.rhtml?srcmp=id-111601"> Read it

Here</a>

-- EMERGING INFECTIOUS DISEASES --

BIOTERRORISM-RELATED INHALATIONAL ANTHRAX: THE FIRST 10 CASES REPORTED IN THE UNITED STATES

From October 4 to November 2, 2001, the first 10 confirmed cases of

inhalational anthrax caused by intentional release of Bacillus anthracis

were identified in the United States.

Emerging Infectious Diseases 7(5):1-26, 2001

http://id.medscape.com/45170.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45170.rhtml?srcmp=id-111601"> Read it

Here</a>

IMPLEMENTING A NETWORK FOR ELECTRONIC SURVEILLANCE REPORTING FROM PUBLIC HEALTH REFERENCE LABORATORIES: AN INTERNATIONAL PERSPECTIVE

Electronic data reporting from public health laboratories to a central

site provides a mechanism for public health officials to rapidly

identify problems and take action to prevent further spread of disease.

Emerging Infectious Diseases 7(5), 2001

http://id.medscape.com/45161.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45161.rhtml?srcmp=id-111601"> Read it

Here</a>

-- MMWR --

UPDATE: INVESTIGATION OF BIOTERRORISM-RELATED ANTHRAX AND ADVERSE EVENTS FROM ANTIMICROBIAL PROPHYLAXIS

Since October 8, approximately 32,000 persons with potential exposure to

B. anthracis have initiated antimicrobial prophylaxis, and for

approximately 5,000 persons, a 60-day course of antibiotics has been

recommended.

MMWR 50(44):973-976, 2001. Centers for Disease Control

http://id.medscape.com/45071.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45071.rhtml?srcmp=id-111601"> Read it

Here</a>

NOTICE TO READERS: INTERIM GUIDELINES FOR INVESTIGATION OF AND RESPONSE

TO BACILLUS ANTHRACIS EXPOSURES

Nasal swab cultures should not be used to diagnose cases of anthrax or

to evaluate whether a person had been exposed.

MMWR 50(44):987-990, 2001. Centers for Disease Control

http://id.medscape.com/45075.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45075.rhtml?srcmp=id-111601"> Read it

Here</a>

NOTICE TO READERS: CONSIDERATIONS FOR DISTINGUISHING INFLUENZA-LIKE

ILLNESS FROM INHALATIONAL ANTHRAX

Nasal congestion and rhinorrhea are features of most influenza-like

cases not associated with anthrax, but was reported in only one of the

10 inhalational anthrax cases since September.

MMWR 50(44):984-986, 2001. Centers for Disease Control

http://id.medscape.com/45076.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45076.rhtml?srcmp=id-111601"> Read it

Here</a>

NATIONWIDE CAMPAIGN FOR VACCINATION OF ADULTS AGAINST RUBELLA AND

MEASLES --- COSTA RICA, 2001

Aspects of the design and implementation of this vaccination campaign

can serve as a model for other countries that want to eliminate CRS and

rubella.

MMWR 50(44):976-979, 2001. Centers for Disease Control

http://id.medscape.com/45072.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45072.rhtml?srcmp=id-111601"> Read it

Here</a>

WEEKLY UPDATE: WEST NILE VIRUS ACTIVITY ---UNITED STATES, OCTOBER

31--NOVEMBER 6, 2001

Five human cases of WNV encephalitis or meningitis were reported in New

York (four) and Connecticut (one)

MMWR 50(44):983, 2001. Centers for Disease Control

http://id.medscape.com/45074.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45074.rhtml?srcmp=id-111601"> Read it

Here</a>

-- IDSA 2001 COVERAGE --

CME summaries on HIV-related topics, from the 39th annual meeting of the

Infectious Diseases Society of America:

ANTIRETROVIRAL AGENTS AND RESPONSE TO THERAPY

http://id.medscape.com/44987.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/44987.rhtml?srcmp=id-111601"> Read it

Here</a>

OPTIMIZING LONG-TERM HIV TREATMENT STRATEGIES THROUGH A GREATER

UNDERSTANDING OF DISEASE PATHOGENESIS

http://id.medscape.com/44988.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/44988.rhtml?srcmp=id-111601"> Read it

Here</a>

METABOLIC COMPLICATIONS AND ADVERSE DRUG REACTIONS IN HIV

http://id.medscape.com/44989.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/44989.rhtml?srcmp=id-111601"> Read it

Here</a>

UPDATE: INCIDENCE, DIAGNOSIS, AND CLINICAL MANIFESTATIONS OF HIV-RELATED OPPORTUNISTIC INFECTIONS

http://id.medscape.com/44990.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/44990.rhtml?srcmp=id-111601"> Read it

Here</a>

-- OTHER JOURNALS --

USUAL INTERSTITIAL PNEUMONIA

Usual interstitial pneumonia (UIP) is a distinct histological lesion

that is observed in idiopathic pulmonary fibrosis (IPF), but can also be

observed in various etiologies (e.g., collagen vascular diseases,

asbestosis, diverse occupational, environmental, or drug exposures).

Sem Resp Crit Care Med 22(4):357-385, 2001.

http://id.medscape.com/45141.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45141.rhtml?srcmp=id-111601"> Read it

Here</a>

HIV TRANSMISSIONS FROM A WINDOW-PERIOD PLATELET DONATION

Recently, blood centers began investigational testing for HIV RNA by

pooled nucleic acid testing (NAT). A 35-year-old frequent platelet donor

tested HIV p24 antigen positive, antibody negative before implementation

of NAT.

Am J of Clin Pathology 116(4), 2001.

http://id.medscape.com/45142.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45142.rhtml?srcmp=id-111601"> Read it

Here</a>

_______________________________________________________________________

___________________________________ NEWS ______________________________

-- ANTHRAX: TREATMENT & PREVENTION --

DRUGS THAT MAY COMBAT ANTHRAX ARE BEING OVERLOOKED

Captopril and chloroquine are effective against the disease in vitro,

but they have yet to be adequately tested.

http://id.medscape.com/45116.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45116.rhtml?srcmp=id-111601"> Read it

Here</a>

CDC OUTLINES ANTHRAX PROPHYLAXIS FOR CHILDREN AND BREASTFEEDING WOMEN

For postexposure anthrax prophylaxis in children and breastfeeding

mothers, amoxicillin may be an alternative to ciprofloxacin or

doxycycline, according to the US Centers for Disease Control and

Prevention.

http://id.medscape.com/45201.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45201.rhtml?srcmp=id-111601"> Read it

Here</a>

ACOG ISSUES GUIDELINES ON ANTHRAX PROPHYLAXIS IN PREGNANT WOMEN

The American College of Obstetricians and Gynecologists (ACOG) advises

that pregnant or breastfeeding women being treated prophylactically for

anthrax exposure be switched to amoxicillin once the bacteria's

sensitivity to penicillin is confirmed.

http://id.medscape.com/44958.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/44958.rhtml?srcmp=id-111601"> Read it

Here</a>

-- ANTHRAX: US OUTBREAKS --

FOUR MORE US POST OFFICES TEST POSITIVE FOR ANTHRAX

Four more US postal facilities have tested positive for anthrax in New

Jersey, the US Postal Service said on Friday.

http://id.medscape.com/44961.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/44961.rhtml?srcmp=id-111601"> Read it

Here</a>

TRACES OF ANTHRAX FOUND IN MORE US SENATE OFFICES

Trace amounts of anthrax have been found in five more offices of the

Hart Senate Office Building, in what investigators say may be

cross-contamination from a letter sent to Senate Majority Leader Tom

Daschle, the US Capitol Police said on Sunday.

http://id.medscape.com/45020.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45020.rhtml?srcmp=id-111601"> Read it

Here</a>

-- BIOTERRORISM --

THOMPSON HOPES FOR SMALLPOX DEAL NEXT WEEK

Health and Human Services Secretary Tommy Thompson said Wednesday he

hoped to announce early next week which companies he selected to make

millions of smallpox vaccine doses for the government.

http://id.medscape.com/45102.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45102.rhtml?srcmp=id-111601"> Read it

Here</a>

SENATORS UNVEIL BIOTERROR BILL

Claiming backing from the Bush administration and Democratic and

Republican leaders, Sens. Edward Kennedy, D-Mass., and Bill Frist,

R-Tenn., Thursday introduced legislation that would authorize an

immediate $3.2 billion to help the nation address the potential for a

bioterrorist attack.

http://id.medscape.com/45198.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45198.rhtml?srcmp=id-111601"> Read it

Here</a>

ALTERNATIVE MEDICINE DOESN'T HOLD CURE FOR BIOTERROR AGENTS, LAWMAKERS HEAR

While alternative therapies to fight against potential bioterror agents

need more study and may be able to complement existing medical

treatments, they are not yet a viable alternative to more mainstream

modalities, experts told a House committee Wednesday.

http://id.medscape.com/45103.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45103.rhtml?srcmp=id-111601"> Read it

Here</a>

UK SCIENTISTS WARN OF LAST CHANCE TO ENFORCE BIOLOGICAL WEAPONS BAN

Next week's Biological Weapons Convention (BWC) may be the last chance

to reinforce the ban on the use of biological weapons, Britain's

national academy of science, the Royal Society, warned on Thursday.

http://id.medscape.com/45206.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45206.rhtml?srcmp=id-111601"> Read it

Here</a>

EU POLITICIANS SAY FUNDING PLAN FOCUSES TOO MUCH ON BIOTECH, GENOMICS

European Union plans for funding medical research risk neglecting major

diseases, according to a draft report to be voted on at the European

Parliament in Strasbourg on Wednesday.

http://id.medscape.com/45059.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45059.rhtml?srcmp=id-111601"> Read it

Here</a>

-- WEST NILE ENCEPHALITIS --

TWO CASES OF WEST NILE INFECTION REPORTED IN MASSACHUSETTS, ONE FATAL

One man died and another became seriously ill after contracting West

Nile virus, the Massachusetts Department of Health confirmed on

Wednesday.

http://id.medscape.com/45108.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45108.rhtml?srcmp=id-111601"> Read it

Here</a>

-- MALARIA --

ATOVAQUONE-PROGUANIL BETTER TOLERATED THAN MEFLOQUINE FOR MALARIA

PROPHYLAXIS

Although equally effective for malaria prophylaxis in nonimmune

travelers, atovaquone-proguanil is better tolerated than mefloquine,

according to a multinational study team.

http://id.medscape.com/45040.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45040.rhtml?srcmp=id-111601"> Read it

Here</a>

-- HEPATITIS --

GILEAD HEPATITIS B DRUG APPEARS SUCCESSFUL IN PHASE III

Gilead Sciences on Friday released preliminary data from a phase III

trial suggesting that its investigational nucleotide analogue adefovir

dipivoxil is able to lower levels of serum hepatitis B virus (HBV) DNA

in lamivudine-resistant chronic hepatitis B patients with compensated

liver disease.

http://id.medscape.com/44949.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/44949.rhtml?srcmp=id-111601"> Read it

Here</a>

HIGH-DOSE INTERFERON ALPHA-2B PREVENTS CHRONIC HEPATITIS C INFECTION

Early treatment of acute hepatitis C with a relatively short, high-dose

regimen of interferon alpha-2b prevents the development of chronic

infection in most patients, German investigators report in the New

England Journal of Medicine for November 15.

http://id.medscape.com/45084.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45084.rhtml?srcmp=id-111601"> Read it

Here</a>

ENTECAVIR MAY BROADEN HEPATITIS B ARMAMENTARIUM

The investigative antiviral agent entecavir (Bristol-Myers Squibb) has

the potential to broaden physicians' options for treating hepatitis B

virus (HBV) infection, according to study results presented at the 52nd

annual meeting of the American Association for the Study of Liver

Diseases (AASLD).

http://id.medscape.com/45090.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45090.rhtml?srcmp=id-111601"> Read it

Here</a>

-- HERPESVIRUSES --

MATERNAL HERPES VIRUS INFECTION RAISES RISK OF PSYCHOSIS IN OFFSPRING

Elevated maternal levels of IgG and IgM, as well as antibodies to herpes

simplex virus type 2 (HSV-2) prior to delivery, increase the risk of

psychotic illness in adult offspring, according to an analysis of data

from the prospective Collaborative Perinatal Project.

http://id.medscape.com/45056.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45056.rhtml?srcmp=id-111601"> Read it

Here</a>

-- NOSOCOMIAL INFECTIONS --

SOME UK HOSPITALS STILL REUSING SINGLE-USE SURGICAL INSTRUMENTS

Some UK hospitals persist in reusing surgical instruments designated for

single use, despite a government ban on the practice, a survey released

today shows.

http://id.medscape.com/45066.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45066.rhtml?srcmp=id-111601"> Read it

Here</a>

-- ANTIBIOTIC USE & MISUSE --

INAPPROPRIATE ANTIBIOTIC USE CAN MASK DIAGNOSIS, DELAY CARE

Indiscriminate use of antibiotics significantly increases the risk of

delayed hospital admission and missed diagnosis of infectious and

noninfectious diseases, according to a report in the October 22nd

Archives of Internal Medicine.

http://id.medscape.com/44935.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/44935.rhtml?srcmp=id-111601"> Read it

Here</a>

-- INFLUENZA --

INFLUENZA INFECTION LINKED TO INCREASED HISTAMINE PRODUCTION

The results of a new study provide what researchers say is the first

direct evidence that increased histamine release accompanies viral upper

respiratory infections.

http://id.medscape.com/45070.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45070.rhtml?srcmp=id-111601"> Read it

Here</a>

-- HIV/AIDS --

MOST ZAMBIAN WOMEN WOULD SUPPORT MASS DISTRIBUTION OF NEVIRAPINE

A majority of pregnant women in Zambia would support universal provision

of nevirapine to prevent HIV transmission, rather than targeting

treatment to HIV-infected women, if this would make the drug available

to a larger percentage of women at risk, according to the results of a

survey reported in The Lancet for November 10.

http://id.medscape.com/44945.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/44945.rhtml?srcmp=id-111601"> Read it

Here</a>

CDC ISSUES GUIDELINES DESIGNED TO EXPAND HIV TESTING

The Centers for Disease Control and Prevention (CDC) released two sets

of guidelines on Thursday that are intended to increase the number of

people tested for HIV infection.

http://id.medscape.com/44957.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/44957.rhtml?srcmp=id-111601"> Read it

Here</a>

-- CJD/BSE --

GENETIC SUSCEPTIBILITY FACTOR TO VCJD IDENTIFIED

Individuals who lack a particular gene in the human leukocyte antigen

complex appear to be more susceptible than others to develop variant

Creutzfeldt-Jakob disease (vCJD) after exposure to bovine spongiform

encephalopathy (BSE) prions, UK researchers report in the November 15th

issue of Nature.

http://id.medscape.com/45101.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45101.rhtml?srcmp=id-111601"> Read it

Here</a>

-- OTHER ID NEWS --

STATIN USE LOWERS RISK OF MORTALITY DURING BACTEREMIC INFECTION

Statins have a potential clinical role in bacteremic infection,

according to a review of cases at the VA Medical Center in Washington,

DC.

http://id.medscape.com/45050.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45050.rhtml?srcmp=id-111601"> Read it

Here</a>

DENDRITIC CELL-BASED VACCINE PROTECTS AGAINST PNEUMOCYSTIS CARINII

A new dendritic cell-based vaccine, that does not require CD4+ T-cell

participation, protects against Pneumocystis carinii challenge in mice,

according to a report in the November issue of the Journal of Clinical

Investigation.

http://id.medscape.com/45113.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45113.rhtml?srcmp=id-111601"> Read it

Here</a>

US AWAKENING TO IMPACT OF GLOBAL CLIMATE CHANGE ON PUBLIC HEALTH

A higher frequency of disease outbreaks, increasingly prolonged heat

waves, and escalating rates of asthma may break through the American

public's denial regarding the reality and extent of global climate

change.

http://id.medscape.com/45207.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45207.rhtml?srcmp=id-111601"> Read it

Here</a>

WTO CONCESSIONS PRODUCE CHINK IN DRUG COMPANIES' ARMOR

The drug industry put on a brave face on Wednesday as plans were made to

make it easier for poor countries to override patents on medicines, but

analysts said the move produces an important chink in drug companies'

armor.

http://id.medscape.com/45093.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45093.rhtml?srcmp=id-111601"> Read it

Here</a>

PEPTIDE ANTIBIOTICS FOUND IN FISH MAST CELLS

Peptide antibiotics, dubbed piscidins, reside in fish mast cells --

suggesting a role for mast cells in microbial killing, according to a

report in the November 15th issue of Nature.

http://id.medscape.com/45211.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45211.rhtml?srcmp=id-111601"> Read it

Here</a>

CHLAMYDIAL TOXIN GENE DISCOVERY MAY LEAD TO NEW THERAPIES

A gene that encodes for a toxin associated with Chlamydia trachomatis is

described in the November 20th online early edition of the Proceedings

of the National Academy of Sciences.

http://id.medscape.com/45212.rhtml?srcmp=id-111601

<a href="http://id.medscape.com/45212.rhtml?srcmp=id-111601"> Read it

Here</a>

______________________________________________________________________

_______________________________ MEMBER NEWS

___________________________

BIOTERRORISM RESOURCE CENTER: ARE WE PREPARED FOR A BIO-TERRORIST

ATTACK?

http://www.medscape.com/mp/rc/bioterrorism

ANTHRAX: WHAT EVERY CLINICIAN SHOULD KNOW

This recording of the live webcast from the CDC presents clinical

guidelines and procedures for the early recognition, diagnosis,

treatment, and reporting of anthrax exposure. A panel of experts from

the CDC provide an overview of clinical, laboratory and public health

preparedness for potential Bacillus anthracis incidence. Sponsored by

the American Hospital Assn., American Medical Assn., Public Health

Training Network, CDC, and the University of North Carolina School of

Public Health.

http://www.medscape.com/webcast/anthrax

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