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MedPulse is a weekly index of key news and features on
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specialty sites compiled by Medscape's Editors.
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___________________ NEW FEATURE ARTICLES THIS WEEK
____________________
-- MEDSCAPE ORIGINAL ARTICLES --
FOCUSED CLINICAL REVIEW: THE MANAGEMENT OF INFECTIOUS
DIARRHEA
Scott D. Lee, MD, and Christina M. Surawicz, MD,
discuss the clinical evaluation and approach to management of acute diarrhea.
Medscape Gastroenterology 3(5), 2001
http://id.medscape.com/42450.rhtml?srcmp=id-090701
CLINICAL SIGNIFICANCE OF ANTIRETROVIRAL DRUG LEVELS
The present approach of administering a standard fixed
dose of an antiretroviral drug to all adults is not likely to ensure the
optimal anti-HIV response, and strategies that integrate pharmacologic
knowledge into the design of dosing regimens warrant careful evaluation
Medscape HIV/AIDS: Annual Update 2001. (C) 2001 by
iMedOptions, LLC.
http://id.medscape.com/42393.rhtml?srcmp=id-090701
THERAPEUTIC DRUG MONITORING: STEP BY STEP
A practical guide to analyzing and optimizing
antiretroviral drug levels in HIV-infected patients.
Medscape HIV/AIDS: Annual Update 2001. (C) 2001 by
iMedOptions, LLC.
http://id.medscape.com/42394.rhtml?srcmp=id-090701
MEDLINE ABSTRACTS - ANTIVENOM THERAPY
What's the latest in snakebite antivenom therapy? Find
out in thiseasy-to-navigate collection of recent MEDLINE abstracts compiled by
the editors at Medscape Pharmacotherapy.
Medscape Pharmacotherapy, 2001
http://id.medscape.com/42470.rhtml?srcmp=id-090701
-- EMERGING INFECTIOUS DISEASES --
WEST NILE VIRUS: A REEMERGING GLOBAL PATHOGEN
The recognition of West Nile virus in the Western
Hemisphere in the summer of 1999 marked the first introduction in recent
history of an Old World flavivirus into the New World.
Emerging Infectious Diseases (7)4, 2001
http://id.medscape.com/42466.rhtml?srcmp=id-090701
EMERGENCE OF METRONIDAZOLE-RESISTANT BACTEROIDES
FRAGILIS, INDIA
The authors report the first metronidazole-resistant
strain of B.fragilis from India.
Emerging Infectious Diseases 7(3), 2001
http://id.medscape.com/42389.rhtml?srcmp=id-090701
PROPER NOMENCLATURE FOR THE HGE AGENT
Until a cogent reclassification based on objective
criteria is firmly accepted, the creation and use of new scientific name
combinations for a single bacterium yield clinical and laboratory confusion and
should be avoided.
Emerging Infectious Diseases 7(3), 2001
http://id.medscape.com/42391.rhtml?srcmp=id-090701
SINGLE NUCLEOTIDE POLYMORPHISMS IN MYCOBACTERIUM
TUBERCULOSIS STRUCTURAL GENES
A recent article by Fraser et al. discussed the
frequency of single nucleotide polymorphisms (SNPs) in two genomes of M
tuberculosis. The article contains an inaccurate representation of the
published M. tuberculosis data on SNP frequency.
Emerging Infectious Diseases 7(3), 2001
http://id.medscape.com/42392.rhtml?srcmp=id-090701
-- INFECTIONS in MEDICINE --
NEW ORLEANS CITYWIDE ROUNDS: AN INGUINAL MASS
A 41-year-old homosexual man was referred by his
primary care physician with the chief complaint of a mass in his left groin
that had failed to respond to multiple courses of antibiotics.
Infect Med 18(8):375-377, 2001
http://id.medscape.com/42474.rhtml?srcmp=id-090701
-- SOUTHERN MEDICAL JOURNAL --
NONTUBERCULAR MYCOBACTERIAL PULMONARY INFECTION IN
IMMUNOCOMPETENT MEN
Nontubercular mycobacteria are increasingly recognized
to cause lung disease in immunocompetent patients.
South Med J 94(7):719-723, 2001
http://id.medscape.com/42456.rhtml?srcmp=id-090701
-- OTHER JOURNALS --
THE USE OF TANNIC ACID IN THE LOCAL TREATMENT OF BURN
WOUNDS: INTRIGUING OLD AND NEW PERSPECTIVES
A whole array of remedies has served in the local
treatment of burns through the ages.
Wounds 13(4):144-158, 2001
http://id.medscape.com/42459.rhtml?srcmp=id-090701
SUSPECTED ALLOPURINOL-INDUCED ASEPTIC MENINGITIS
Drug-induced aseptic meningitis is a syndrome with
symptoms similar to those of infectious meningitis.
Pharmacotherapy 21(8):1007-1009, 2001
http://id.medscape.com/42468.rhtml?srcmp=id-090701
_______________________________________________________________________
___________________________________ NEWS
______________________________
-- TUBERCULOSIS --
INTENSIVE CONTROL EFFORT PREVENTS TB CASES AND DEATHS
IN PERU
Peru's adoption a decade ago of DOTS (directly
observed treatmentshort course) as the treatment strategy for tuberculosis has
prevented a substantial number of cases and deaths.
http://id.medscape.com/42541.rhtml?srcmp=id-090701
-- INFLUENZA --
AVIRON SAYS NO NEW CLINICAL TRIALS NEEDED TO GET
FLUMIST BACK ON TRACK
The US Food and Drug Administration has requested
additional information from Aviron with regard to its biologics license
application for the influenza vaccine FluMist, the Mountain View,
California-based concern said on Monday evening.
http://id.medscape.com/42380.rhtml?srcmp=id-090701
NEW INTRANASAL INFLUENZA VACCINE SHOWS PROMISE IN
CHILDREN
A new inactivated, intranasal anti-influenza vaccine
prompts antibody responses in children, according to results of a small study
by Israeli researchers.
http://id.medscape.com/42525.rhtml?srcmp=id-090701
GENETIC TWEAK TURNED AVIAN INFLUENZA VIRUS INTO 1997
KILLER
Using new technology called plasmid-based reverse
genetics, investigators in Wisconsin have demonstrated that a single-base
alteration in the gene encoding hemagglutinin (HA) glycoprotein changes a
mildly infectious influenza virus into a killer.
http://id.medscape.com/42546.rhtml?srcmp=id-090701
-- HIV/AIDS --
GB VIRUS C MAY INHIBIT HIV REPLICATION
Two reports in the New England Journal of Medicine for
September 6 suggest that infection with the GB virus C -- also known as the hepatis
G virus -- improves survival in patients infected with HIV by directly
influencing HIV replication.
http://id.medscape.com/42404.rhtml?srcmp=id-090701
DRUG-RESISTANT HIV REACHING EPIDEMIC PROPORTIONS
By 2005, 42% of all HIV patients in San Francisco will
not respond to drugs currently used to treat the disease, according to UCLA
investigators.
http://id.medscape.com/42311.rhtml?srcmp=id-090701
MANY HIV-INFECTED PATIENTS RECEIVE MENTAL HEALTH CARE
FROM MEDICAL
PROVIDERS
Nearly half of a nationally representative cohort of
HIV-infected individuals had experienced a mood or anxiety disorder within a
1-year period, according to two reports in the Archives of General Psychiatry
for August.
http://id.medscape.com/42333.rhtml?srcmp=id-090701
RATE OF HIV TESTING DURING PREGNANCY INCREASING, BUT
STILL LOW
Since the US Public Health Service released guidelines
in 1995 recommending HIV testing for all pregnant women, the proportion of
women tested has increased.
http://id.medscape.com/42339.rhtml?srcmp=id-090701
UNAIDS STRESSES HARM CAUSED BY HIV STIGMA,
DISCRIMINATION
Only by removing the stigma surrounding HIV/AIDS and
discrimination against those infected can communities break the cycle that
links AIDS to poverty, racism, and gender inequality, representatives of the
Joint United Nations Programme on HIV/AIDS (UNAIDS) said today.
http://id.medscape.com/42425.rhtml?srcmp=id-090701
RWANDA REORGANIZING ITS EFFORTS TO FIGHT HIV/AIDS
The president of Rwanda, a sub-Saharan country with
one of the highest HIV infection rates, delivered the keynote address here at
AIDS Vaccine 2001, the first international scientific meeting devoted to
vaccine research and development.
http://id.medscape.com/42543.rhtml?srcmp=id-090701
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 --
FREE CONDOM DISTRIBUTION ENCOURAGES BOYS TO ACCESS
SEXUAL HEALTH
SERVICES
Distributing free condoms at a sexual health clinic
appears to help teenage boys overcome their reluctance to access sexual health
services, according to investigators in London.
http://id.medscape.com/42340.rhtml?srcmp=id-090701
HPV TESTING PLUS CERVICAL CANCER SCREEN IS COST
EFFECTIVE IN
HIV-INFECTED WOMEN
Adding molecular testing for human papillomavirus
(HPV) to a cervical cancer screening program for HIV-infected women improves
outcomes and is cost effective compared with annual cytological screening
alone, investigators report.
http://id.medscape.com/42299.rhtml?srcmp=id-090701
AGGRESSIVE HPV VARIANT COMMON AMONG MEXICAN WOMEN WITH
CERVICAL CANCER
An aggressive human papillomavirus 16 variant, known
as the Asian-American (AA) variant, is often found in Mexican women with
cervical cancer, a finding that may help explain the high incidence of cervical
cancer in Mexico.
http://id.medscape.com/42363.rhtml?srcmp=id-090701
TESTING FOR HIGH-RISK HPV FLAGS FALSE-NEGATIVE
CERVICAL SMEARS
Baseline cervical smears of women who go on to develop
cervical cancer usually contain high-risk human papillomavirus (HPV) DNA before
any cytologic abnormalities are identified, according to a report by Dutch
researchers.
http://id.medscape.com/42408.rhtml?srcmp=id-090701
-- HEPATITIS --
DAILY HIGH-DOSE INTERFERON INDUCTION THERAPY NOT
ADVANTAGEOUS IN
HEPATITIS C
Initial induction treatment with daily high-dose
lymphoblastoid interferon (IFN) alpha-n1 appears to be no better than the
standard interferon regimen for chronic hepatitis C, Spanish researchers report
in the August issue of the Journal of Medical Virology.
http://id.medscape.com/42320.rhtml?srcmp=id-090701
COMBINED HEPATITIS A/B VACCINE PROVIDES LONG-TERM
IMMUNITY
A combined vaccine against hepatitis A (HAV) and
hepatitis B (HBV) elicits long-term antibody persistence in adults and
children, according to a report in the September Journal of Medical Virology.
http://id.medscape.com/42401.rhtml?srcmp=id-090701
-- PEDIATRIC ID --
ALGORITHM IMPROVES DIFFERENTIAL DIAGNOSIS OF BREATHING
DIFFICULTIES IN CHILDREN
A modification to the WHO algorithm for the management
of childhood acute respiratory infections can help in differentiating infection
from wheeze-related disorders -- and in choosing appropriate empiric treatment
in the primary care setting -- according to a study from
India.
http://id.medscape.com/42398.rhtml?srcmp=id-090701
BEHAVIOUR AND COGNITIVE PROBLEMS CAN PERSIST FOR
CHILDREN WITH OTITIS MEDIA
Children with otitis media with effusion (OME) can
have behaviour and academic performance problems into at least their early
teens, according to a report in the August issue of the Archives of Disease in
Childhood.
http://id.medscape.com/42321.rhtml?srcmp=id-090701
ROUTINE ANTIBIOTIC PROPHYLAXIS OF BURN WOUNDS IN
CHILDREN NOT NECESSARY
Routine antibiotic prophylaxis against group A
beta-hemolytic streptococci (GAS) infection is not necessary in children with
burns, according to Dr. Robert L. Sheridan and others at the Shriners Burn Institute
in Boston.
-- GI TRACT --
FAMOTIDINE, OMEPRAZOLE COMPARABLE IN H. PYLORI
TREATMENT
Famotidine or omeprazole used in combination with
amoxicillin and tinidazole appear equally effective in eradicating Helicobacter
pylori infection, according to Taiwanese researchers.
http://id.medscape.com/42352.rhtml?srcmp=id-090701
-- CJD/BSE --
BRITAIN HAS NOT LEARNED 'MAD COW' LESSON, SCIENTIST
SAYS
Just as Britain confirmed its 2000th case of foot and
mouth disease, a leading scientist said Tuesday the government had not learned
the lessons of an earlier farming crisis -- mad cow disease.
http://id.medscape.com/42377.rhtml?srcmp=id-090701
-- AIDS VACCINES --
CAUTIOUS OPTIMISM SETS TONE OF FIRST INTERNATIONAL
AIDS VACCINE
CONFERENCE
The first international, abstract-driven AIDS vaccine
conference opened here Wednesday night with a note of cautious optimism.
http://id.medscape.com/42544.rhtml?srcmp=id-090701
NIH ACCELERATES AIDS VACCINE RESEARCH
Since 1990, the US National Institutes of Health has
increased HIV/AIDS vaccine research funding by more than six-fold, with a
projected budget of $356.6 million for fiscal year 2002, Dr. Anthony S. Fauci,
director of the National Institute of Allergy and Infectious Diseases (NIAID),
told conference participants here Wednesday night.
http://id.medscape.com/42536.rhtml?srcmp=id-090701
UGANDA AND IAVI ACCELERATE AIDS VACCINE RESEARCH
In a partnership agreement signed on August 30th, the
Government of the Republic of Uganda and the International AIDS Vaccine
Initiative (IAVI) have agreed to work together to accelerate the development
and testing of three AIDS vaccines.
http://id.medscape.com/42312.rhtml?srcmp=id-090701
-- CNS INFECTIONS --
POWASSAN VIRUS SHOULD BE CONSIDERED AS CAUSE OF
ENCEPHALITIS
Four cases of encephalitis attributed to Powassan
virus, a North American tick-borne flavivirus, arose in Maine and Vermont
between September 1999 and July 2001 -- the first cases in the United States since
1994.
http://id.medscape.com/42527.rhtml?srcmp=id-090701
MENINGITIS IN INFANCY CAN LEAD TO SEVERE, SUBTLE
DEFICITS
Five-year-old children who contracted meningitis
during their first year of life are at a 10-fold higher risk of severe or
moderate disability than children who never had meningitis, according to
prospective study results.
http://id.medscape.com/42519.rhtml?srcmp=id-090701
-- DRUG NEWS --
NEW APPROVAL - REBETOL
An archive of news announcement from the FDA's
HIV/AIDS email list.
http://id.medscape.com/42387.rhtml?srcmp=id-090701
FDA ADVISORY MTG, TENOFOVIR AND VORICONAZOLE
An archive of news announcement from the FDA's
HIV/AIDS email list.
http://id.medscape.com/42388.rhtml?srcmp=id-090701
-- OTHER ID NEWS --
SPREAD OF INFECTIOUS DISEASE MAY BE GLOBAL WARMING'S
GREATEST MEDICAL THREAT
Climate change associated with global warming is already
increasing the spread of infectious diseases, researchers at the New York
University School of Medicine maintain, and is likely to cause increasing
threats to public health if not reversed.
http://id.medscape.com/42336.rhtml?srcmp=id-090701
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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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