Infection

PHILADELPHIA -- When a patient with an orthopedic implant develops a rash or inflammatory symptoms, think metal allergy, suggested researchers here.

ST. LOUIS -- High-risk kidney transplant recipients had a lower rate of acute rejection and severe rejection episodes when they received induction therapy with Thymoglobulin (rabbit antithymocyte globulin) compared with Simulect (basiliximab).

NEW YORK -- Veteran television journalist Ed Bradley has died of complications of chronic lymphocytic leukemia (CLL) at the age of 65.

PRAGUE -- For metastatic kidney cancer, neoadjuvant targeted therapy with Avastin (bevacizumab) and Tarceva (erlotinib) is apparently safe and may prolong progression-free survival, researchers said here.

Lung herniation was first describedin the 15th century. A systemto classify hernias as cervical,thoracic, or diaphragmatic and as eithercongenital or acquired was developedin 1847.

KIEL, Germany -- Bilateral pallidal neurostimulation to reduce movement symptoms outdid sham stimulation in patients with primary generalized or segmental dystonia, researchers reported.

CAMBRIDGE, Mass. -- Malaria prophylaxis may require the individualized guidance of a tropical-disease specialist for those embarking on lengthy trips to disease-endemic countries.

NEW YORK -- Uncomplicated diabetes does not affect 10-year heart transplant survival, but patients with diabetes-related renal disease or stroke do not do as well, reported surgeons here.

BOISE, Idaho -- Two more fatalities from the rarely encountered pathogen Clostridium sordellii have been reported, neither linked to the so-called morning-after pills, Mifeprex and Cytotec, according to investigators here.

TURKU, Finland -- Most children with acute otitis media have infections caused by both bacteria and viruses, suggesting that antibiotics may not be enough to control the infections, researchers here have found.

The false sensation of bugs crawling on or within the skin is a sensory hallucination commonly associated with psychostimulant drugs. It was first reported in chronic cocaine users in 1889. Patients with this disorder often have self-induced dermatosis caused by intense picking and scratching of the skin.

MAASTRICHT, The Netherlands -- Warts (verruca vulgaris), have proved too much for duct tape, the all-purpose fixer, researchers here reported.

SEATTLE -- Four donor-specific characteristics and nine recipient characteristics can help predict the odds for the success of a liver transplant, according to a surgeon here.

VANCOUVER, British Columbia -- Previous infection with hepatitis C virus and spontaneous clearance of the virus appear to confer protection against re-infection, reported researchers here.

ROCHESTER, Minn. -- Children with recurrent strep throat who keep their tonsils are three times more likely to develop a subsequent case as those who have tonsillectomies, according to researchers here.

MINNEAPOLIS -- Treating periodontal disease during pregnancy does not lessen the likelihood of preterm birth, according to researchers here.

BIRMINGHAM, England -- For early breast cancer, a fourth chemotherapy agent mixed in with a standard trio proved to make a superior adjuvant combination, researchers here reported.

COPENHAGEN -- Testing for the human papilloma virus -- particularly in older women -- can be a valuable tool for predicting future cervical abnormalities and cancer, found researchers here.

A 28-year-old man is hospitalized because of highfever with rigors and chills and rapid weight loss(5.4 kg [12 lb] in 2 weeks). During the past 48 hours,generalized throbbing headache, intermittent vomiting,blurry vision, and seizures have developed. The progressiveseizures started in the left hand and have becomegeneralized grand mal.

BOSTON -- Drug-resistant viral strains developed rapidly when exposed to telaprevir, the investigational protease inhibitor against hepatitis C virus (HCV), but both wild-type virus and mutants were controlled by follow-on therapy with interferon and Rebetol.

BOSTON -- An investigational immunomodulator has shown early antiviral activity in patients with difficult-to-treat chronic hepatitis C infections.

The NIH’s National Institute of Mental Health is fundinga $60 million effort to find treatments to counteract HIV’seffects on the human brain.

Although it has been evident since the early days of the HIV epidemic that a dementing illness often accompanies HIV infection and that the virus invades the nervous system soon after systemic infection, the clinical syndrome has evolved with the introduction of antiretroviral therapy.

Invasive aspergillosis is a common and often deadly infection in immunocompromised patients, such as neutropenic patients who are being treated for malignancies. Does it have similar features and outcomes in nonneutropenic patients? This study by Cornillet and colleagues provides some interesting answers.

Abstract: Our understanding of the pathobiology of pulmonary arterial hypertension (PAH) has evolved considerably over the past 2 decades, with increasing recognition of the important role that aberrant vasoproliferative responses play in conjunction with disordered vasoconstriction. Classification of the many forms of PAH into categories sharing a similar pathophysiology and clinical presentations help the practicing clinician approach a complex differential diagnosis. Noninvasive tests can be used to narrow this differential but must be applied with an appreciation for their limitations. Transthoracic echocardiography is the screening tool of choice; the workup should also include chest radiography and electrocardiography. However, right heart catheterization is ultimately required to establish the diagnosis. While PAH remains a progressive and generally fatal disease, existing therapies have a significant impact on survival and new therapeutic targets offer great hope for improving the prognosis. (J Respir Dis. 2006;27(11):487-493)

The 2006-2007 influenza season is upon us. Influenza epidemics have been associated with an average of about 36,000 deaths per year in the United States from 1990 to 1999.1 In July of this year, the Advisory Committee on Immunization Practices (ACIP) updated its recommendations for the prevention and control of influenza.2

Abstract: Allergic drug reactions are mediated by IgE. Other immunologic drug reactions are mediated by IgG and complement, T cells, systemic cytokine release, and mast cell activation. True drug allergies, which are IgE-mediated, account for less than 10% of all adverse drug reactions. IgE-mediated reactions are commonly seen with penicillins, but also occur with some other antibiotics, chemotherapeutic agents, therapeutic proteins, and neuromuscular blockers. They are often limited to urticaria but also include life-threatening anaphylaxis. Skin testing to identify patients who are allergic is available for many agents associated with IgE-mediated reactions. Protocols for desensitization permit the use of some culprit agents when indicated. (J Respir Dis. 2006;27(11):463-471)

A 38-year-old African American man with HIV infection presents with numerous dyspigmented macules and patches on the extremities, abdomen, and chest; the lesions are smooth, nontender, and minimally pruritic. He has been noncompliant with antiretroviral therapy since his diagnosis 3 years earlier.

A 26-year-old woman with dull left-sided chest pain, nausea, body aches, and low-grade fever is admitted to the hospital. She has been to other emergency departments (EDs) in the area recently with similar complaints and was sent home with diagnoses of anxiety and costochondritis.

When I repair facial lacerations on toddlers, I find that they are likely to start pulling at the bandage as soon as I put it on. This endangers the repair and increases the risk of infection. An effective solution is to put a colorful children's adhesive bandage on each of the patient's thumbs. This gives the child something new to focus on and distracts him or her from the facial bandage. The thumb bandages are more difficult to pull off, thus giving the face more time to heal.