Infection

CHICAGO -- Americans are even less conscientious about washing up after visiting public washrooms than they were two years ago, according to a study released here.

WILMINGTON, Del. -- Tonsillectomy that leaves a layer of tissue covering the throat muscles may cause fewer complications than traditional tonsillectomy, but a small percentage of patients may need to go back to surgery to finish the job.

Congestive heart failure and cirrhosis are the most common causes of transudative pleural effusions, while pneumonia and malignancy are responsible for the majority of exudative effusions. Plain chest films are valuable in confirming the presence of an effusion, providing clues to the cause, and directing the method of pleural fluid sampling. Thoracentesis is safe and simple, and it is diagnostic in about 75% of cases. Pleural biopsy is indicated for unexplained exudative effusions, most of which are found to result from malignancy or tuberculosis. Medical thoracoscopy, if available, is the procedure of choice for patients with these effusions. Thoracoscopy permits visually directed pleural biopsies and allows for therapeutic intervention at the time of diagnosis, obviating the need for subsequent invasive procedures.

Methicillin-resistant Staphylococcus aureus (MRSA) infection may be significantly more widespread than previously thought. Investigators analyzed data from more than 1200 county, public, and private health care facilities across the country, including centers for acute care, cancer, cardiac care, pediatric care, rehabilitation, and long-term care.

My patient is a 39-year-old man who has had burning pain and lack of muscle endurance in his bilateral quadriceps and bilateral deltoids for 4 years.

DALLAS -- The natural habitat of the parasite that causes leishmaniasis, the so-called Baghdad boil, is creeping north, doctors here have warned.

LOMITA, Calif. -- Enterovirus, a common pathogen that can cause acute respiratory or gastrointestinal infections, may be a factor in chronic fatigue syndrome, according to researchers here.

NEW YORK -- Young gay men are having a sharp increase in new HIV infections here, city health officials said.

CLEVELAND -- Staphylococcus aureus in the contents of the bedpan increases the risk that the bacteria will contaminate hospital bedrails, as well as skin and other environmental surfaces, researchers here said.

AMSTERDAM -- Stopping natalizumab (Tysabri) may result in a rebound in multiple sclerosis activity, particularly after a short course of drug therapy, reported investigators in a small study.

MELBOURNE, Australia -- Cultures taken from contact lenses can be a useful clinical aid in cases of microbial keratitis, researchers here said.

SAN FRANCISCO -- Arm measurements alone may not identify clinically relevant lymphedema for breast cancer patients after axillary lymph node dissection or sentinel biopsy, researchers said.

SAN FRANCISCO -- Hepatitis C infection may impair breast cancer treatment and increase complications of chemotherapy, researchers found.

BOSTON -- Supplementing breast milk with long-chain polyunsaturated fatty acids might reduce the risk of mothers giving HIV to their infants, researchers here said.

WEST LAFAYETTE, Ind. -- A new approach to cardiopulmonary resuscitation may improve the poor results of the life-saving procedure, according to researchers here.

SEOUL, South Korea -- Aggressive induction therapy for locally advanced but operable non-small-cell lung cancer (NSCLC) appears safe and feasible, with hints of survival and surgical advantages.

abstract: While the risk factors for aspiration pneumonia are similar to those for aspiration pneumonitis, the 2 syndromes have different presentations. Aspiration pneumonia tends to occur in older patients or in those with neurological diseases, and the aspiration is not usually witnessed. Aspiration pneumonitis is more likely to occur in patients undergoing anesthesia or in those with acute drug and alcohol overdoses, and the aspiration is often witnessed. The workup may include bedside assessment of the cough and gag reflexes, chest radiography, videofluoroscopic imaging, or fiberoptic endoscopy. Empiric antibiotic therapy should be avoided in most patients with pneumonitis; however, antibiotics may be indicated for those at high risk for bacterial colonization of oropharyngeal and gastric contents who have fever, increasing sputum production, or new infiltrates or for those who fail to improve within 48 hours. (J Respir Dis. 2007;28(9):370-385)

A 43-year-old woman presented to the emergency department with complaints of severe dyspnea, wheezing, and cough productive of white sputum. She had received a diagnosis of asthma 3 years earlier, based on symptoms of wheezing and cough. Since then, her drug regimen has included intermittent use of albuterol.

Is it safe to use oseltamivir as prophylaxis against influenza in patients undergoing hematopoietic stem cell transplantation (HSCT)? Yes, according to this case-control study.

The patient described here was treated for pneumonia, but a chest wall mass and CT changes suggested that more was going on.

Petting zoos are highly popular: some estimates suggest that millions of human-animal contacts occur at state fairs, animal parks, and a host of other public events each year. A strong word of caution is in order, however.

A 52-year-old woman presented to her primary care physician complaining of a nonproductive cough and dyspnea on exertion. These symptoms had a subacute onset over 4 weeks before her initial visit. She denied fever, sputum production, hemoptysis, chest pain, palpitations, abdominal pain, nausea, vomiting, and diarrhea. She did not have any known sick contacts.

For several months, a 55-year-old white construction worker experienced intense burning of the skin when exposed to direct sunlight. In addition, multiple fragile blisters appeared on the dorsa of his hands and arms; these rapidly developed into crusted, superficial erosions.

A 47-year-old woman who recently completed adjuvant chemotherapy for colon cancer has painless cervical lymphadenopathy of 1 to 2 cm. She has no fever, sore throat, cough, or unexplained weight loss, and she denies exposure to ill persons or animals.

TUCSON, Ariz. -- For many adults with poor airway function or COPD, the genesis of the problem may have been in the womb, researchers reported.

HOUSTON -- For older patients on dialysis, the phosphate binder sevelamer (Renagel) may be associated with a lower death rate compared with calcium-based phosphate binders, investigators reported.

BETHESDA, Md. -- Emphasizing that asthma affects different patients in different ways, the National Asthma Education and Prevention Program has issued new evidence-based guidelines on the disease.

WASHINGTON -- A left-ventricular assist device that provides a steady rather than pulsed blood flow may serve as an effective bridge to transplant, found a multicenter team.

LOUISVILLE, Ky. -- Facial transplantation involves less immunosuppression-related risk than previously estimated, investigators here reported.

ROCKVILLE, Md. -- The FDA today allowed a human thrombin (Evithrom) on the market after the risk of transfusion-transmitted viral infection kept it on the sidelines for more than a half-century.