Medscape's Infectious Diseases MedPulse 9-1-01

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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 --

ANTIRETROVIRAL THERAPY: STARTING, CONTINUING, AND FIXING

The management of HIV-infected patients has become increasingly complex, not only because of expanding choices for therapy, but also because of the emergence of resistance testing and the growing recognition of the longer-term toxicity of antiretroviral agents.

http://id.medscape.com/42160.rhtml?srcmp=id-083101

MAKING SENSE OF RESISTANCE TESTING

This review describes some of the tools that are available for interpreting genotypic assays for HIV-1 drug resistance, as well as recent refinements in phenotypic assays.

http://id.medscape.com/42161.rhtml?srcmp=id-083101

MEDICAL ESSAY: OUT OF AFRICA

A US military physician reflects on a 3-week flood relief mission in Johannesburg and Mozambique.

MedGenMed, August 31, 2001

http://id.medscape.com/42253.rhtml?srcmp=id-083101

-- MMWR --

OUTBREAKS OF MULTIDRUG-RESISTANT SALMONELLA TYPHIMURIUM ASSOCIATED WITH VETERINARY FACILITIES ---IDAHO, MINNESOTA, AND WASHINGTON, 1999

Although most of the estimated 1.4 million Salmonella infections that occur each year in the US are transmitted through food, Salmonella also is transmitted through exposure to contaminated water, reptiles, farm animals, and pets.

MMWR 50(33):701-704, 2001. Centers for Disease Control

http://id.medscape.com/42156.rhtml?srcmp=id-083101

TULAREMIA --- OKLAHOMA, 2000

Physicians should consider tularemia in ill persons with fever who reside in or visit areas where the disease is endemic and who have been exposed to ticks or carcasses or tissue from rabbits or other animals.

MMWR 50(33):704-706, 2001. Centers for Disease Control

http://id.medscape.com/42157.rhtml?srcmp=id-083101

OUTBREAK OF PNEUMOCOCCAL PNEUMONIA AMONG UNVACCINATED RESIDENTS OF A NURSING HOME --- NEW JERSEY, APRIL 2001

This report underscore the importance of providing pneumococcal polysaccharide vaccine to elderly residents of long-term care facilities.

MMWR 50(33):707-710, 2001. Centers for Disease Control

http://id.medscape.com/42158.rhtml?srcmp=id-083101

PUBLIC HEALTH DISPATCH: ADVERSE EVENTS AND DEATHS ASSOCIATED WITH

LABORATORY ERRORS AT A HOSPITAL --- PENNSYLVANIA, 2001

For approximately 7 weeks, the reported INRs were falsely low. Some physicians who received these reports increased their patients' doses of warfarin.

MMWR 50(33):710-711, 2001. Centers for Disease Control

http://id.medscape.com/42159.rhtml?srcmp=id-083101

-- OTHER JOURNALS --

MEFLOQUINE VERSUS PROGUANIL IN SHORT-TERM MALARIA CHEMOPROPHYLAXIS IN SICKLE CELL ANAEMIA

Malaria chemoprophylaxis with a weekly dose of mefloquine in Nigerians with sickle cell anaemia appears to be as effective as a daily regimen with proguanil. The tolerability profile of mefloquine in this group of patients appears promising.

Clin Drug Invest 21(8):537-544, 2001

http://id.medscape.com/42222.rhtml?srcmp=id-083101

LOWER BACK WOUND COMPLICATING EPIDURAL ANESTHESIA

An 80-year-old man with ischemic heart disease, hypertension, gout, and maturity onset diabetes mellitus presented with an eight-month history of non-healing abdominal and lower back wounds.

Wounds 13(2):59-65, 2001

http://id.medscape.com/42204.rhtml?srcmp=id-083101

MED.PIX - AUGUST 2001

A 37-year-old woman has a 2-week history of a blistering lesion on her right hand.

Journal of West Med 175(2):84-85, 2001

http://id.medscape.com/42226.rhtml?srcmp=id-083101

FACIAL CELLULITIS BY PSEUDOMONAS AERUGINOSA IN A NEUTROPENIC PATIENT

Focal and generalized head and neck lesions may occur in severely neutropenic patients following chemotherapy.

Cancer Control; JMCC 8(4):364-367, 2001.

http://id.medscape.com/42239.rhtml?srcmp=id-083101

VASCULITIS

Physicians need to integrate clinical assessment with laboratory data in order to differentiate between the disorders where the vasculitic process represents a benign, self-limited disease from those that may be severe or even life threatening.

Wounds 13(3):99-110, 2001

http://id.medscape.com/42246.rhtml?srcmp=id-083101

EXTENDED-SPECTRUM BETA-LACTAMASES: EPIDEMIOLOGY, DETECTION, AND

TREATMENT

Extended-spectrum beta-lactamase-producing organisms are among the fastest growing problems in the area of infectious diseases.

Pharmacotherapy 21(8):920-928, 2001

http://id.medscape.com/42249.rhtml?srcmp=id-083101

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___________________________________ NEWS ______________________________

-- BSE/CJD --

HHS CHIEF ANNOUNCES 'MAD COW' BATTLE PLAN

The US will strengthen its efforts to prevent bovine Spongiform encephalopathy, or 'mad cow' disease, from entering the US, and will also boost funding for research into the illness, Health and Human Services Secretary Tommy Thompson announced Thursday.

http://id.medscape.com/42081.rhtml?srcmp=id-083101

FDA PROPOSES TIGHTER RESTRICTIONS ON BLOOD DONORS TO HALT SPREAD OF VCJD

In its latest effort to prevent variant Creutzfeldt-Jakob Disease (vCJD) from spreading to the US, the US Food and Drug Administration proposed tighter restrictions on the donation of blood by people who have lived in Europe.

http://id.medscape.com/42118.rhtml?srcmp=id-083101

-- HEPATITIS --

PATIENTS WARNED AFTER SURGEON LINKED TO HEPATITIS CASES

Hundreds of people in Scotland have been warned that they may be at risk of contracting hepatitis B after contact with a specific surgeon was linked to the death of one patient and the infection of another, health officials said on Thursday.

http://id.medscape.com/42083.rhtml?srcmp=id-083101

-- DEVICE-RELATED INFECTIONS --

IMPLANTED CARDIAC DEVICE INFECTIONS MAY BE UNDERESTIMATED

The incidence of infection of implanted pacemakers or cardioverter-defibrillators among patients with Staphylococcus aureus bacteremia may be higher than previously thought, according to a report in Circulation for August 28.

http://id.medscape.com/42091.rhtml?srcmp=id-083101

-- MALARIA --

GENETIC POLYMORPHISM OF MALARIA PARASITE POSES PROBLEM FOR VACCINE

DEVELOPMENT

The human malaria parasite Plasmodium falciparum is more genetically variable than previously thought, implying the need for more complex control strategies, according to a new report.

http://id.medscape.com/42107.rhtml?srcmp=id-083101

-- WEST NILE VIRUS --

COMPOUNDS DISPLAY ACTIVITY AGAINST WEST NILE VIRUS IN EARLY STUDIES

Investigators say that a group of synthesized compounds, D(-)-5-fluorocytosine analogs, show strong activity against the West Nile virus under laboratory conditions.

http://id.medscape.com/42140.rhtml?srcmp=id-083101

-- HIV/AIDS --

IUDS CAN BE SAFELY USED BY WOMEN WITH HIV-1 INFECTION

The results of a prospective study show that HIV-1-infected women may safely use the intrauterine device for contraception, provided they see a physician regularly.

http://id.medscape.com/42131.rhtml?srcmp=id-083101

SODIUM LAURYL SULFATE MAY PREVENT HIV TRANSMISSION

Sodium lauryl sulfate (SLS), as a vaginal microbicide, may prevent transmission of HIV and other sexually transmitted disease pathogens, according to a report published in the August issue of Antimicrobial

Agents and Chemotherapy.

http://id.medscape.com/42074.rhtml?srcmp=id-083101

VAGINAL MICROBICIDES MAY HELP PREVENT HETEROSEXUAL HIV TRANSMISSION

Animal studies indicate that two vaginal microbicides, dextrin-2-sulphate (D2S) and PRO-2000 (P2K), may provide a degree of protection again HIV infection, without undue toxicity.

http://id.medscape.com/42103.rhtml?srcmp=id-083101

VAGINAL INFLAMMATION INDUCED BY NONOXYNOL-9 INCREASES HIV RISK

Nonoxynol-9, a common component of vaginal spermicides and lubricant products, can increase the risk of HIV-1 transmission by causing inflammation of cervicovaginal epithelial cells, according to US researchers.

http://id.medscape.com/42153.rhtml?srcmp=id-083101

TRANSFUSION TRANSMISSION OF HIV REMAINS A PROBLEM IN KENYA

A large number of blood transfusions in Kenya transmit HIV due to faulty laboratory practices and other problems in maintaining a safe blood supply, according to a report in The Lancet for August 25.

http://id.medscape.com/42084.rhtml?srcmp=id-083101

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 --

HORMONAL CONTRACEPTION VARIABLY ALTERS RISK OF STD ACQUISITION

The use of oral contraception or depot medroxyprogesterone acetate (DMPA) is associated with a significantly increased risk of some sexually transmitted infections and a decreased risk of others,

according to results from a prospective study of Kenyan sex workers.

http://id.medscape.com/42174.rhtml?srcmp=id-083101

-- VACCINES --

DTP, MMR VACCINATION NOT ASSOCIATED WITH LONG-TERM ADVERSE OUTCOMES

Immunization with the diphtheria, tetanus, and pertussis (DTP) vaccine or the measles, mumps, and rubella (MMR) vaccine increases the risk of febrile seizures initially but does not appear to have any long-term adverse consequences.

http://id.medscape.com/42182.rhtml?srcmp=id-083101

-- DRUG APPROVALS --

TAP'S SPECTRACEF ANTI-INFECTIVE WINS FDA APPROVAL

The US Food and Drug Administration (FDA) has approved TAP Pharmaceuticals' oral anti-infective Spectracef (cefditoren pivoxil), the agency said on Wednesday.

http://id.medscape.com/42183.rhtml?srcmp=id-083101

-- OTHER ID NEWS --

VIRUS SELECTIVELY KILLS P53-DEFICIENT CANCER CELLS

The human adeno-associated virus (AAV) can selectively induce apoptosis in cancer cells that lack p53 tumor suppressor activity, according to a report published in the August 30th issue of Nature.

http://id.medscape.com/42188.rhtml?srcmp=id-083101

FIRST-TIME SIMPLE FEBRILE SEIZURES NOT LINKED WITH INCREASED RISK OF

SERIOUS BACTERIAL INFECTION

Children with first-time simple febrile seizures appear to be no more likely than febrile children without seizures to develop a serious bacterial illness, according to a report published in the August issue of Academic Emergency Medicine.

http://id.medscape.com/42062.rhtml?srcmp=id-083101

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