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MedPulse is a weekly index of key news and features on
Medscape's
specialty sites compiled by Medscape's Editors.
_______________________________________________________________________
NOTE FROM THE EDITOR
Dear Readers,
Thank you for your support and kindness during this
difficult period. But as we react to
this tragedy, let us not lose sight of the heroism and humanity shown by each
of you every day. Your daily work
demonstrates that humane treatment has the upper hand, that in the balance, our
lives are enhanced knowing that you are involved in reducing the suffering of
the world. I applaud you for your work.
Harry Goldhagen
Managing Editor, Medscape ID
hgoldhagen@mny.medscapeinc.com
_______________________________________________________________________
___________________ NEW FEATURE ARTICLES THIS WEEK
____________________
-- MEDSCAPE ORIGINAL ARTICLES --
ANGELS IN OUR MIDST - TAKING HEALTHCARE TO SCHOOL
The best way to provide healthcare to adolescents may
be to bring it to them.
Medscape Infectious Disease, 2001
http://id.medscape.com/42905.rhtml?srcmp=id-092101
Other articles in this series:
TRAINING VILLAGERS TO BECOME HEALTHCARE WORKERS
http://www.medscape.com/41703.rhtml
SPECIAL DELIVERY
http://www.medscape.com/40604.rhtml
CONFERENCE REPORT - LIVER TRANSPLANTATION FOR
HEPATITIS B VIRUS
INFECTION: IMPROVING LONG-TERM OUTCOMES
What pharmacologic regimen is most efficacious in
preventing recurrence of hepatitis B virus infection after liver
transplantation?
Medscape Transplantation, 2001
http://id.medscape.com/42873.rhtml?srcmp=id-092101
WHEN DISASTER STRIKES: PERSPECTIVES ON PHYSICAL TRAUMA
AT THE WORLD
TRADE CENTER - AN INTERVIEW WITH LOUIS DEL GUERCIO, MD
A trauma expert discusses the physical injuries and
sequelae related to the World Trade Center disaster.
Medscape Neurology, 2001
http://id.medscape.com/42886.rhtml?srcmp=id-092101
-- EMERGING INFECTIOUS DISEASES --
RAPID DETERMINATION OF HLA B07 LIGANDS FROM THE WEST
NILE VIRUS NY99
GENOME
Defined T cell epitopes for West Nile virus may be
useful for developing subunit vaccines and diagnostic reagents.
Emerging Infectious Diseases (7)4, 2001
http://id.medscape.com/42896.rhtml?srcmp=id-092101
-- INFECTIONS in MEDICINE --
LYME DISEASE: CURRENT THERAPIES AND PREVENTION
Sound management of Lyme disease rests with accurate
identification of disease manifestations coupled with evidence-based approaches
to therapy.
Infect Med 18(8):388-395, 2001
http://id.medscape.com/42858.rhtml?srcmp=id-092101
-- THE AIDS READER --
THE CHANGING FACE OF MYCOSES IN PATIENTS WITH HIV/AIDS
Preliminary data from small studies suggest that it
may be possible to stop suppressive therapy in patients with a history of
mycosis whose CD4+ lymphocyte count rises with antiretroviral therapy.
The AIDS Reader 11(7):365-378, 2001
http://id.medscape.com/42913.rhtml?srcmp=id-092101
NEVIRAPINE-INDUCED HEPATITIS: A CASE SERIES AND REVIEW
OF THE LITERATURE
Elevated hepatic transaminase levels have been
reported in up to 4% of symptomatic HIV-infected persons.
The AIDS Reader 11(7):379-382, 2001
http://id.medscape.com/42919.rhtml?srcmp=id-092101
-- OTHER JOURNALS --
SWIMMER'S EAR: AN EAR CANAL INFECTION
Fortunately, swimmer's ear is a relatively minor otic
condition that can be prevented by following simple measures.
U.S. Pharmacist (26)8, 2001
http://id.medscape.com/42889.rhtml?srcmp=id-092101
FIRST REPORTS OF ADVERSE DRUG REACTIONS (ADRS) IN
RECENT WEEKS
ADRs related to erythromycin, interferon-beta, and
teicoplanin.
Drug & Ther Perspect 17(16):15, 2001
http://id.medscape.com/42894.rhtml?srcmp=id-092101
SEPSIS AND SEPTIC SHOCK: EARLY RECOGNITION AND
MULTIPRONGED APPROACH TO MANAGEMENT PARAMOUNT IN CHILDREN
Sepsis and septic shock present serious risk to
neonates and children, with high rates of mortality.
Drug & Ther Perspect 17(16):8-13, 2001
http://id.medscape.com/42856.rhtml?srcmp=id-092101
EFFECTS OF LIVING SKIN EQUIVALENT ON
CALCIPHYLAXIS-INDUCED SKIN NECROSIS WOUNDS -- CASE STUDIES
Systemic calciphylaxis is a rare but limb-threatening
and potentially lethal complication seen in patients with chronic renal
failure.
Wounds 13(4):65-170, 2001
http://id.medscape.com/42903.rhtml?srcmp=id-092101
CLINICAL QUIZ
A 27-year-old woman with a history of intravenous drug
use was admitted to the hospital with complaints of fever, fatigue, and
anorexia.
Applied Radiology 30(8):43-44, 2001
http://id.medscape.com/42908.rhtml?srcmp=id-092101
_______________________________________________________________________
___________________________INSTANT POLL
RESULTS________________________
Do you favor or oppose the decriminalization of
marijuana for medicinal purposes (palliative care in HIV/AIDS, cancer,
glaucoma, etc)?
Of 3976 respondents, 81% (3233) of you favor the
decriminalization of marijuana for medicinal purposes, and 19% (743) of you
oppose it.
This poll was posted on Medscape in all specialty
areas from August 1-8, 2001.
To see these and other instant poll results, click
here:
http://www.medscape.com/pollresults/medmarijuana
_______________________________________________________________________
___________________________________ NEWS
______________________________
-- MEETING NEWS --
ICAAC POSTPONED; OTHER MEDICAL MEETINGS SCHEDULED AS
PLANNED
The 41st Interscience Conference on Antimicrobial
Agents and Chemotherapy (ICAAC) in Chicago, Illinois has been postponed until
December 16 to 19, 2001, according to a statement released Saturday by the
American Society for Microbiology.
http://id.medscape.com/42769.rhtml?srcmp=id-092101
-- PREPARING FOR BIOTERRORISM --
EXPERTS DOUBT US IS READY FOR BIOWARFARE ATTACK
America is unprepared to handle an attack involving
biological or chemical weapons, experts said again on Monday.
http://id.medscape.com/42806.rhtml?srcmp=id-092101
UK REVIEWS BIOLOGICAL ATTACK RESPONSE PLANS
Government officials are reviewing contingency plans
for dealing with a potential biological attack by terrorists in the UK.
http://id.medscape.com/42808.rhtml?srcmp=id-092101
NEW SMALLPOX VACCINE NEARS CLINICAL TRIALS
Acambis Plc, the British biotechnology company charged
with developing a new smallpox vaccine for the US, announced on Thursday that
it expected to begin clinical trials on the drug early next year.
http://id.medscape.com/42939.rhtml?srcmp=id-092101
NEW SUPPLY OF ANTHRAX VACCINE UNLIKELY TO BE AVAILABLE
BEFORE 2002
The sole US manufacturer of the anthrax vaccine will
not be able to release new doses of the product until well into next year,
unless the US Food and Drug Administration speeds up its review of the
company's facilities, a spokeswoman for the firm said on Wednesday.
http://id.medscape.com/42945.rhtml?srcmp=id-092101
-- TUBERCULOSIS --
UK PHYSICIANS DEVELOP FAST TB DRUG-RESISTANCE TEST
Doctors in the UK have developed a test that could
transform the treatment of patients with tuberculosis by identifying the
drug-susceptibility of strains of the bacterium in hours instead of
days.
http://id.medscape.com/42753.rhtml?srcmp=id-092101
-- BSE/CJD --
SUSPECTED BSE COW IN JAPAN USED FOR FEED
The dairy cow suspected to be Japan's first case of
bovine Spongiform encephalopathy was used to produce feed intended for other
animals, an Agriculture Ministry official said on Saturday.
http://id.medscape.com/42756.rhtml?srcmp=id-092101
UK FAST-TRACKS QUINACRINE CJD TRIAL
The UK Department of Health has asked the Medical
Research Council to fast-track a clinical trial of the antimalarial drug
quinacrine after American research suggested it may slow down the onset of
Creutzfeldt Jakob disease (CJD), the ministry announced on Monday.
http://id.medscape.com/42792.rhtml?srcmp=id-092101
UK URGED TO MONITOR BSE RISK FROM EUROPE
Britain may be at risk of importing BSE from France
and Germany, where the number of cases seem ready to jump, a government adviser
said on Tuesday.
http://id.medscape.com/42805.rhtml?srcmp=id-092101
VARIANT CJD MAY BE MORE INFECTIOUS THAN SPORADIC CJD
Britain's Department of Health is greatly concerned
that variant Creutzfeldt Jakob disease may be more infectious than the prion
responsible for sporadic CJD, a leading expert said on Tuesday.
http://id.medscape.com/42807.rhtml?srcmp=id-092101
SWEDEN REPORTS STRONG CHANCE OF FIRST BSE CASE
Sweden said on Wednesday that there was a serious
chance that two sick dairy cows found on a farm in the northwest have the
country's first cases of BSE.
http://id.medscape.com/42847.rhtml?srcmp=id-092101
-- HIV/AIDS --
DIAPHRAGM PLUS MICROBICIDE MAY PROVIDE PROTECTION
AGAINST HIV
Because the diaphragm is a female-controlled modality
and protects the infection-susceptible cervix and upper reproductive tract,
researchers suggest that combining it with microbicide might be an effective
method of HIV prevention.
http://id.medscape.com/42770.rhtml?srcmp=id-092101
AIDS IS LEADING CAUSE OF DEATH IN SOUTH AFRICA
AIDS is now South Africa's leading cause of death; the
disease accounted for 40% of all deaths last year involving people between the
ages of 15 and 49 years, a local newspaper reported Sunday.
http://id.medscape.com/42771.rhtml?srcmp=id-092101
SOUTH AFRICA TO FIGHT AIDS LOBBY ON NEVIRAPINE
The South African government will oppose a court bid
by AIDS campaigners that would force it to provide nevirapine to HIV-infected
pregnant women, Health Minister Manto Tshabalala-Msimang said on Thursday.
http://id.medscape.com/42722.rhtml?srcmp=id-092101
QUALITY OF HIV SURVEILLANCE POOR IN MANY COUNTRIES
Some 40% of countries have HIV surveillance systems
categorized as 'poorly functioning' or 'nonexistent', according to an article
in the August 17th issue of AIDS.
http://id.medscape.com/42718.rhtml?srcmp=id-092101
ACCELERATION OF INCREASING PLASMA HIV RNA LOAD SIGNALS
INCIPIENT
PROGRESSION
Disease progression among HIV-1-infected patients who
are late progressors is accompanied by significant increases in HIV RNA load
approximately 1 year prior to the onset of decline in CD4+ cell counts,
according to results of a longitudinal study of participants in the
Multicenter AIDS Cohort Study (MACS).
http://id.medscape.com/42830.rhtml?srcmp=id-092101
This is only a selection of this week's HIV/AIDS NEWS.
Read all the latest news about advances in this field, from Reuters and
Medscape Wire.
http://www.medscape.com/hiv/news
And you can subscribe to the HIV/AIDS Medpulse, as
well as other specialty Medpulses, by updating your profile at the following
link:
http://www.medscape.com/profile
-- OTHER STDs --
ORAL FLUID NO BETTER THAN SERUM IN TESTING FOR
PAPILLOMAVIRUS ANTIBODIES
Oral IgA antibody testing in women with cervical
neoplasia appears no more sensitive than use of serum in detecting the presence
of human papillomavirus 16 (HPV-16) antibodies.
http://id.medscape.com/42706.rhtml?srcmp=id-092101
CHLAMYDIA MAY INFECT ONE IN TEN YOUNG WOMEN IN UK
Nearly one in ten young British women may be infected
with chlamydia, according to study findings presented by public health
specialists on Monday.
http://id.medscape.com/42759.rhtml?srcmp=id-092101
RATES OF PAP TESTING HIGH AMONG HIV-INFECTED WOMEN IN
US, BUT FOLLOWUP LACKING
Study results provide encouraging data on the rate of
initial screening for cervical cancer among HIV-infected women in the US, with
room for improvement in the area of repeat testing for abnormal findings.
http://id.medscape.com/42767.rhtml?srcmp=id-092101
STI RISE IN UK COULD HERALD HIV UPSURGE
A rise in sexually transmitted infections in the UK
could be an early warning sign of an imminent upsurge in new cases of HIV
infection and AIDS, experts warned on Tuesday.
http://id.medscape.com/42840.rhtml?srcmp=id-092101
HPV INFECTION, CERVICAL DISEASE PREVALENT IN
HIV-INFECTED WOMEN ON HAART
High-risk human papillomavirus infections and squamous
intraepithelial lesions persist in many HIV-infected women despite HAART,
Italian researchers report in The Journal of Infectious Diseases for September.
http://id.medscape.com/42929.rhtml?srcmp=id-092101
-- LEGIONAIRRE'S DISEASE --
EU MAY NAME HOTELS RESPONSIBLE FOR OUTBREAKS OF
LEGIONNAIRES' DISEASE
The names of European hotels implicated in outbreaks
of Legionnaires' disease could be officially published on the Web under new
guidelines drawn up by public health officials, a conference heard on Monday.
http://id.medscape.com/42757.rhtml?srcmp=id-092101
-- MENINGITIS --
MORE EU COUNTRIES WILL USE MENINGITIS C VACCINE
Vaccine manufacturers predict that more European Union
countries will start using Neisseria meningitidis type C vaccines following the
UK's success in reducing disease-related morbidity and mortality rates.
http://id.medscape.com/42760.rhtml?srcmp=id-092101
-- INFLUENZA --
WHO SETS CONTENT OF 2002 FLU VACCINE FOR SOUTHERN
HEMISPHERE
In a meeting held this week in Cannes, France, experts
convened by the World Health Organization agreed on the composition of the
vaccine for the 2002 influenza season in the Southern Hemisphere.
http://id.medscape.com/42804.rhtml?srcmp=id-092101
-- RABIES --
RABIES INFECTION MAY BE UNDETECTED BY UK PHYSICIANS
Doctors in the UK may be missing cases of rabies
infection, delegates at the Public Health Service Laboratory's annual
scientific conference were told here on Tuesday.
http://id.medscape.com/42809.rhtml?srcmp=id-092101
-- LYME DISEASE --
NEW RAPID TEST STREAMLINES DIAGNOSIS OF LYME DISEASE
Testing for Lyme disease can be time-consuming, since
current guidelines require performing a two-tier test before a diagnosis of
Borrelia burgdorferi infection can be made.
http://id.medscape.com/42820.rhtml?srcmp=id-092101
-- HEPATITIS --
GILEAD HEPATITIS B DRUG SUCCESSFUL IN SECOND PHASE III
TRIAL
Gilead Sciences Inc. said on Wednesday that according
to a preliminary analysis, its investigational precore mutant hepatitis B drug
adefovir dipivoxil has successfully achieved the primary endpoint of its second
pivotal phase III trial.
http://id.medscape.com/42837.rhtml?srcmp=id-092101
PEG-INTERFERON REGIMEN OUTPERFORMS STANDARD TREATMENT
FOR CHRONIC HEPATITIS C
Interferon alfa-2b plus ribavirin therapy is now the
standard initial treatment for patients with chronic hepatitis C, but a report
published in the September 22nd issue of The Lancet indicates that a
peg-interferon-based regimen achieves higher sustained virologic response
rates.
http://id.medscape.com/42934.rhtml?srcmp=id-092101
-- ANTIBIOTIC RESISTANCE --
FLUOROQUINOLONE RESISTANCE EMERGING IN US
Streptococcus pneumoniae resistance to
fluoroquinolones is an emerging problem in the US, according to the Centers for
Disease Control and Prevention, and physicians are being urged to use these
antibiotics appropriately.
http://id.medscape.com/42941.rhtml?srcmp=id-092101
-- OTHER ID NEWS --
UK STUDY REVEALS CAMPYLOBACTER SOURCES
People who travel to Asia and those who eat pre-packed
sandwiches and cold meat are among those at highest risk of infection with
Campylobacter, officials from the UK's Public Health Laboratory Service (PHLS)
said on Tuesday.
http://id.medscape.com/42832.rhtml?srcmp=id-092101
FLUCLOXACILLIN EFFECTIVE IN HOME THERAPY OF
STAPHYLOCOCCAL INFECTIONS
Continuous infusion of flucloxacillin is effective in
home treatment of serious Staphylococcus aureus infection and of cellulitis,
according to Australian researchers.
http://id.medscape.com/42819.rhtml?srcmp=id-092101
UK ZOONOTIC INFECTIONS DROP AFTER FOOT-AND-MOUTH
CRISIS
The UK's foot-and-mouth crisis has resulted in a sharp
drop in the number of infections being passed from animals to humans, according
to a presentation at the Public Health Laboratory Service's annual scientific conference
here on Tuesday.
http://id.medscape.com/42796.rhtml?srcmp=id-092101
VIRAL INFECTION MAY BE LINKED TO ASTHMA DEATHS
The high prevalence of cytotoxic CD8+ T lymphocytes in
lung tissue from victims of fatal asthma attacks suggests that an abnormal
response to viral infection might play a part in such events, according to
European researchers.
http://id.medscape.com/42780.rhtml?srcmp=id-092101
BLOOD TRANSFUSION A CONSISTENT RISK FACTOR FOR
INFECTION AFTER
COLORECTAL SURGERY
Numerous risk factors influence the likelihood that
patients will develop a surgical site infection after undergoing an elective colorectal
resection, according to a report by Taiwanese investigators.
http://id.medscape.com/42716.rhtml?srcmp=id-092101
IMMUNIZATION DAYS IN INDIA OFFER OPPORTUNITY TO
SCREEN, TREAT VITAMIN-A DEFICIENCY
A study from India reports that screening children
during the country's National Immunization Days is an effective strategy to
detect and treat vitamin-A deficiency.
http://id.medscape.com/42723.rhtml?srcmp=id-092101
______________________________________________________________________
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ORGASM INDUCED ASTHMA?
Believe it or not, it is possible. Listen to what CBS
Healthwatch's expert has to say on this and several other asthma-related
issues.
http://www.medscape.com/mp/AE/orgasmasthma
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