Infection

A 57-year-old woman presents with swelling of the hands that began several weeks earlier and is now worsening. She denies joint pain, and she has no history of trauma or significant vascular disease. She has had pneumonia several times; each episode was successfully treated with antibiotics. She has smoked 2 packs of cigarettes a day for the past 20 years

A recent study suggests a causal relationship between oral pathology-that is, gingivitis and periodontitis-and stroke. Periodontitis is the leading cause of tooth loss in the United States; the disease may affect nearly 50% of Americans older than 65 years. The pockets of infection that surround the teeth and penetrate into surrounding tissues function as chronic abscesses. The ongoing infection may seed the bloodstream with bacteria during flossing, toothbrushing, or professional cleaning.

The Advisory Committee on Immunization Practices recommendsthe zoster vaccine for persons aged 60 years and older, whether ornot they have had a previous episode of herpes zoster.

Urge incontinence, also referred to as overactive bladder (OAB)-wet, is the involuntary loss of urine accompanied by or immediately preceded by a sensation of urgency. It has a reported overall prevalence of 16.0% in men and 16.9% in women. Currently, the mainstay of management for symptomatic urgency and OAB-wet is medical therapy.

It is sometimes difficult for women with genital warts to visualize their lesions. Offer patients a hand-held mirror so that they can see what the lesions look like, and recommend that they use a similar mirror at home to monitor the lesions' size and number.

DURBAN. South Africa -- When women with HIV exclusively breastfeed their infants for the first six months, the chance of passing on the virus is only about 4%, researchers here said.

ANDOVER, Mass. -- Some radiofrequency (RF) denervation probes distributed from here by Smith & Nephew have been recalled because they were mistakenly labeled as sterile, the company announced.

NEW ORLEANS -- Tilarginine offers no benefit for heart attack patients suffering cardiogenic shock, researchers reported here. The finding rang the death knell for the agent.

NEW ORLEANS -- Artificially boosting high-density lipoprotein (HDL) levels does not reverse atherosclerosis, though it may have some vascular benefit, researchers said here.

NEW ORLEANS -- A burst of high-dose statins just before angioplasty and stenting for stable acute coronary syndrome appears to reduce cardiac complications, found an Italian trial.

MEMPHIS, Tenn. -- Clinicians may one day give children a nasal spray of viral enzymes to prevent acute otitis media, researchers said here.

LOS ANGELES -- Like a Pap smear, detection of abnormal anal cytology is clinically useful in HIV-positive gay men to predict the presence of anal dysplasia, according to researchers here.

LONDON -- The effects of bacterial meningitis in infancy persist as learning disabilities through young adulthood, suggested investigators here.

TAIPEI, Taiwan -- Enterovirus 71 infection in children associated with central nervous system involvement, and especially cardiopulmonary failure, may stall neurodevelopment and cognitive function, researchers here reported.

ROCKVILLE, Md. -- The FDA has issued a safety alert for linezolid (Zyvox) after clinical trial data suggested excess mortality when the drug was used to treat Gram-negative septicemia.

ROCKVILLE, Md. -- The FDA has approved eculizumab (Soliris), tbe first of a new class of natural immune system blockers, for paroxysmal nocturnal hemoglobinuria, a rare blood disorder that can lead to disability and death.

OMAHA, Neb. -- Antibiotics are prescribed for 70% to 80% of sinus infections even though most are caused by viruses, researchers here reported.

ROCKVILLE, Md. -- The FDA has approved a rapid test that will allow the diagnosis of viral meningitis within hours of symptoms rather than days.

LEIDEN, The Netherlands -- One fifth of temporary stomas created after surgery for rectal cancer became permanent, according to a Dutch study.

ATLANTA -- The Advisory Committee on Immunization Practices of the CDC, as expected, has recommended wide use of the vaccine against four major strains of human papillomavirus that cause cervical cancer.

HONG KONG -- Crowded hospital units were a key factor that led to "super-spreading" outbreaks of severe acute respiratory syndrome (SARS) in China, according to researchers here.

STONY BROOK, N.Y. -- The polio virus has been put to work at killing neuroblastoma cells in mice.

SEATTLE -- The metal gallium -- approved as a drug by the FDA to treat symptomatic hypercalcemia of malignancy -- may also be useful as an antimicrobial, according to researchers here.

UTRECHT, The Netherlands -- Tuberculosis tests based on interferon-gamma response, measured by a blood test, picked up exposure to a TB-infected store employee here, but a positive result on the standard tuberculin skin test was not associated with exposure to the infected employee.

MANCHESTER, England -- Failures of total hip replacements are significantly more likely to occur when patients carry variants in genes encoding for collagen breakdown and the vitamin D receptor, according to investigators here.

NEW YORK -- Men given thrombolysis for acute ischemic stroke were three times more likely than women to have a good functional outcome, despite elevated mortality, researchers here reported.

ROCKVILLE, Md. -- For the second time in two weeks, the FDA has informed physicians of an excess fracture risk in women taking an oral diabetes drug in the thiazolidinedione class. This time the drug is pioglitazone (Actos).

SEATTLE -- Percutaneous vertebroplasty reduces pain of collapsed vertebra without increasing risk of new fractures over the long term, Italian researchers said here.

SEATTLE -- Cardiac MRI used in tandem with echocardiography can enhance the likelihood of finding the cause of cardioembolic stroke, according to a small retrospective study.

ROCKVILLE, Md. -- The FDA has licensed an automated nucleic acid test to screen donor blood for West Nile virus.