Infection

LONDON -- A transfusion-linked case of variant Creutzfeldt-Jakob disease (vCJD) here has British health authorities increasingly worried about the possibility of a mini-epidemic of the incurable disease from tainted blood.

Primary care physicians' implementation of routine screening is crucial to reducing the incidence of and mortality from HIV. Here's how to implement routine testing in your practice.

GRAZ, Austria -- The cause of a form of hemorrhagic colitis associated with treatment with penicillin and its derivatives has been pinned down, according to researchers here. The culprit is Klebsiella oxytoca.

MINNETONKA, Minn. -- The healthiest state in the nation appears to be Minnesota, land of Wobegon and 10,000 other lakes, low cardiovascular death rates, and a well-insured population, according to the United Health Foundation here.

NEW HAVEN, Conn. -- All adults in the U.S. should be routinely given a rapid test for HIV unless there's evidence that the local prevalence of undiagnosed infection is less than 0.2%, suggest researchers here.

NEW YORK -- Even while HIV is well controlled in the bloodstream, the gut is suffering a fierce assault on immune cells, according to researchers here. While the attack isn't clinically obvious, it may have long-term effects, especially as people with HIV age.

The goals of therapy in chronic obstructive pulmonary disease are to ameliorate symptoms, improve daily function, preserve lung function, identify and reduce exacerbations and, if possible, decrease mortality. A comprehensiveapproach that includes prevention, early identification, and pharmacotherapy-and oxygen therapy, pulmonary rehabilitation, and/or surgery when appropriate-can optimize patient outcomes.

Cutaneous horn is a descriptive rather than diagnostic term that refers to horn projections of tissue that are caused by a variety of neoplasms, including actinic keratosis, warts, Bowen disease, granular cell tumors, Paget disease, sebaceous neoplasms, basal and squamous cell carcinoma, and seborrheic keratosis.

NEW YORK -- HIV patients should not take drug holidays. That's the unambiguous warning emerging from the randomized Strategies for Management of Antiretroviral Therapy (SMART) study.

A 71-year-old man presents with a2-week history of early satiety, decreasedappetite, postprandial nauseaand vomiting, jaundice, dark urine,acholic stools, and generalized pruritus.In addition, he reports a 4.5-kg(10-lb) weight loss within the past2 months.

I enjoyed Dr Henry Schneiderman’s “What’s Your Diagnosis?” case of an elderly woman with severe facial ecchymoses from a fall. Would Dr Schneiderman elaborate on several points about that case? This woman did not trip or complain of dizziness before she fell. What caused her to fall?

A 52-year-old man presented to his primary care physician with shortness of breath for 5 days, right-sided lower thoracic back pain, and dry cough. The patient was a 15-pack-year cigarette smoker who had emigrated from China to the United States in 1989. He had no significant history of occupational exposure or tuberculosis. He had no significant weight loss, and his past medical history was otherwise unremarkable.

Excessive sweating, or hyperhidrosis, can be primary or secondary. Cardiac disease can cause hyperhidrosis. If the results of his laboratory workup are normal and he does not show evidence of leukemia, lymphoma, infection, or diabetes, then I would try treating him for primary hyperhidrosis.

ABSTRACT: Painful recurrent ulceration of gingival tissue suggests a secondary intraoral presentation of herpes simplex virus (HSV) infection. Unlike the lesions of HSV, lesions associated with coxsackievirus do not erupt in the anterior mouth but rather on the soft palate and pharynx. Furthermore, unlike HSV infection, coxsackie infections may recur, because there is considerable viral variation. Patients with atrophic or erythematous candidiasis report burning pain and a metallic taste. The typical patient with benign mucous membrane pemphigoid is a woman older than 50 years; the condition usually involves the attached gingiva around the teeth. The lesions of erythema multiforme may erupt on any intraoral mucosa; biopsy may be required to rule out other conditions with similar presentations.

Is it appropriate to routinely order urinalysis for patients in a nursing home (both with and without dementia) when they exhibit behavioral changes but show no signs or symptoms of urinary tract infection (UTI)?

A 49-year-old man presents with recurring facial pain of 6 months' duration. The pain initially occurred several times per week; it now occurs as often as several times per day. The paroxysmal pain is intense and incapacitating but abates within several minutes. It occurs in the right maxillary region and lower jaw and is sharp and lancinating. Hard chewing and teeth cleaning are the usual precipitating events. Between episodes, the patient is asymptomatic, without numbness or deficit in the affected region.

A Photo Quiz to Hone Dermatologic Skills

The association between asthma and pneumococcal disease has been suspected by many clinicians; however, formal investigations confirming an increased risk of pneumococcal disease in patients with asthma are rare.

During a routine checkup, a middle-aged woman asks you whether she should stop wearing moisturizers and makeup that contain sunscreen. She has read that increased sunlight exposure enhances vitamin D production, which may prevent certain types of cancer. What would you tell her?

DALLAS - Women who develop chorioamnionitis during a first pregnancy have twice the risk for the amniotic infection in the next, suggesting a genetic component, researchers reported.

ROCHESTER, N.Y. -- The cyclooxygenase inhibitors -- including aspirin as well as Celebrex (celecoxib) -- may reduce the antibody-producing effect of vaccines, making them less useful in preventing disease, according to researchers here.

RENNES, France -- HIV can infect immune cells in the testis and produce infectious viral particles that, in turn, can re-infect cells in the blood, according to French researchers.

ATLANTA -- The seasonal flu season is here, but tell that to the viruses. The quixotic little pathogens haven't yet flexed their muscles in earnest, according to the CDC.

LOS ANGELES -- After an outpatient tonsillectomy, most patients can go home safely within a couple of hours, according to researchers here, although each case needs to be treated individually.

RIBEIRÃO PRETO, Brazil -- A single presurgical dose of antibiotics is as effective at preventing infection as is 24-hour coverage after surgery, researchers here said.

ATHENS, Greece -- For critical care patients, ultrasound-guided catheterization of the internal jugular vein proved quicker, easier, and safer than the traditional landmark-guided method, researchers here reported.

STOCKHOLM -- Smoking and human papillomavirus (HPV) may work together to increase the risk of cervical cancer in situ, according to researchers here.

WASHINGTON -- Vaccination against influenza or pneumococcal disease is safe and effective in people with rheumatoid arthritis who are taking Humira (adalimumab), a researcher said here.

PHILADELPHIA -- Seasonal asthma exacerbations among children requiring hospitalizations don't seem to correlate with seasonal allergen prevalence, suggesting that other factors may be at work.

TORONTO -- A flu shot appears to increase the relative risk of Guillain-Barré syndrome by 45%, according to researchers here.