BRIEFLY NOTED
Myopathy-related risk for arterial disease, low ambient UV and prevalence of immune disease, questioning the link between isotretinoin and IBD, and a severe combined immunodeficiency variant
H1N1 in Adults Can Be Severe
General Medicine
Summary and Comment
Free
In California, mortality was higher among hospitalized adults than among hospitalized children.
By Abigail Zuger, MD
November 19, 2009
Covering:
Louie JK et al., JAMA 2009 Nov 4; 302:1896
Assays for Invasive Fungal Disease
Infectious Diseases
Summary and Comment
Free
Two new antigen-based tests show promise and could prove useful for immunocompromised patients.
By Neil M. Ampel, MD
November 18, 2009
Covering:
Maertens J et al., Clin Infect Dis 2009 Dec 1; 49:1688
Koo S et al., Clin Infect Dis 2009 Dec 1; 49:1650
ECMO for Patients with 2009 H1N1 Influenza and ARDS
Emergency Medicine
Summary and Comment
In a study from New Zealand and Australia, ECMO was used largely in young adults, most of whom had good outcomes.
By John A. Marx, MD, FAAEM
November 13, 2009
Covering:
Davies A et al for the Australia and New Zealand Extracorporeal Membrane Oxygenation., JAMA 2009 Nov 4; 302:1888
Prevention of Flu Transmission in Households
General Medicine
Summary and Comment
Hand hygiene and face masks can help prevent the spread of influenza.
Background Events and Mass Vaccination
Infectious Diseases
Summary and Comment
Free
Knowledge about background rates of disease events is needed to assess events temporally related to vaccination.
By Mary E. Wilson, MD
November 10, 2009
Covering:
Black S et al., Lancet 2009 Oct 31
DeStefano F and Tokars J., Lancet 2009 Oct 31
Pneumococcal DNA Load in CAP
Infectious Diseases
Summary and Comment
The <$EMPH_O>Streptococcus pneumoniae<$EMPH_C> DNA load in blood may have both diagnostic and therapeutic implications.
By Larry M. Baddour, MD
November 10, 2009
Covering:
Peters RPH et al., J Clin Microbiol 2009 Oct; 47:3308
Long-Acting Bronchodilators With or Without Inhaled Steroids in COPD
General Medicine
Summary and Comment
Risk for moderate COPD exacerbations, but not severe exacerbations, was lower with combined therapy.
By Allan S. Brett, MD
November 5, 2009
Covering:
Rodrigo GJ et al., Chest 2009 Oct; 136:1029
Peramivir for Treatment of 2009 H1N1 Influenza
Responding to a CDC request, the FDA authorized the emergency use of this investigational agent in critically ill patients.
By Lynn Estes, PharmD
November 4, 2009
Covering:
Food and Drug Administration (FDA)., 2009 Oct 24
Centers for Disease Control and Prevention (CDC)., 2009 Oct 23
Birnkrant D and Cox E., N Engl J Med 2009 Nov 2
New CDC Interim Guidance on HIV and H1N1
HIV-infected individuals are a high-priority group for prevention and treatment of 2009 H1N1 influenza.
By Carlos del Rio, MD
November 2, 2009
Covering:
Centers for Disease Control and Prevention (CDC)., 2009 Oct 21
Zanamivir (Relenza) Must Not Be Given by Nebulization
Ventilator obstruction was blamed for the death of a woman who received zanamivir inhalation powder that was solubilized and administered by mechanical ventilation.
Surgical Masks or N95 Respirators for the Flu?
Infectious Diseases
Summary and Comment
Free
In a randomized trial, surgical masks and N95 respirators provided healthcare workers with comparable protection against influenza.
Immune Response from Bronchoalveolar Lavage Mononuclear Cells Diagnoses Active TB
Infectious Diseases
Summary and Comment
ELISpot performed on bronchoalveolar mononuclear cells had a sensitivity of 91% and a specificity of 79% in diagnosing active disease.
By Neil M. Ampel, MD
October 21, 2009
Covering:
Jafari C et al., Am J Respir Crit Care Med 2009 Oct 1; 180:666
Inflammatory Proteins: The Body–Brain Connection
Psychiatry
Summary and Comment
Inflammatory response to vaccination affected participants' sense of well-being and activated specific cortical regions but did not worsen cognitive performance.
By Steven Dubovsky, MD
October 19, 2009
Covering:
Harrison NA et al., Biol Psychiatry 2009 Sep 1; 66:415
Harrison NA et al., Biol Psychiatry 2009 Sep 1; 66:407
H1N1 Rapid Tests: Poor Sensitivity
Infectious Diseases
Summary and Comment
Free
Rapid tests for seasonal influenza generally have relatively low sensitivity; their sensitivity for detecting the 2009 H1N1 virus seems even worse.
By Stephen G. Baum, MD
October 14, 2009
Covering:
Drexler JF et al., Emerg Infect Dis 2009 Oct; 15:1662
2009 H1N1 Influenza in a Tour Group in China
Infectious Diseases
Summary and Comment
Free
Influenza developed in 30% of tour members who had talked with an H1N1-infected woman in the group but in none who had not.
By Mary E. Wilson, MD
October 14, 2009
Covering:
Han K et al., Emerg Infect Dis 2009 Oct; 15:1578
New Approach to Treating Tuberculosis
General Medicine
Summary and Comment
Targeting nonreplicative bacteria might avert long courses of therapy for TB patients.
Is Your Shower Like the Shower in the Bates Motel?
Dermatology
Summary and Comment
Researchers analyzed the microbial population living inside showerheads.
By Jan V. Hirschmann, MD
October 9, 2009
Covering:
Feazel LM et al., Proc Natl Acad Sci U S A 2009 Sep 22; 106:16393
Antibiotic Guideline Compliance and Outcomes for CAP
Emergency Medicine
Summary and Comment
Two large studies support guideline-based care.
By J. Stephen Bohan, MD, MS, FACP, FACEP
October 9, 2009
Covering:
McCabe C et al., Arch Intern Med 2009 Sep 14; 169:1525
Arnold FW et al., Arch Intern Med 2009 Sep 14; 169:1515
Sharpe BA., Arch Intern Med 2009 Sep 14; 169:1462
Strep Antibodies and PANDAS: An Animal Study
Psychiatry
Summary and Comment
Researchers tie behavioral abnormalities to strep-associated antibodies.
By Barbara Geller, MD
October 9, 2009
Covering:
Yaddanapudi K et al., Mol Psychiatry 2009 Aug 11
Pneumonia Severity and Bacterial Load
Infectious Diseases
Summary and Comment
Free
In patients with community-acquired pneumococcal pneumonia, high bacterial load at admission was associated with need for mechanical ventilation, development of shock, and in-hospital death.
By Thomas Glück, MD
October 7, 2009
Covering:
Rello J et al., Chest 2009 Sep; 136:832
CAP Treatment Recommendations: Guided in the Right Direction
Infectious Diseases
Summary and Comment
Results of two large cohort studies indicate that adherence to guidelines for treating community-acquired pneumonia is a good thing.
By Larry M. Baddour, MD
October 7, 2009
Covering:
Arnold FW et al., Arch Intern Med 2009 Sep 14; 169:1515
McCabe C et al., Arch Intern Med 2009 Sep 14; 169:1525
Sharpe BA., Arch Intern Med 2009 Sep 14; 169:1462
Procalcitonin Algorithm Reduces Antibiotic Use for Lower Respiratory Tract Infections
Emergency Medicine
Summary and Comment
Without increasing adverse outcomes of disease
By John A. Marx, MD, FAAEM
October 2, 2009
Covering:
Schuetz P et al., JAMA 2009 Sep 9; 302:1059
Yealy DM and Fine MJ., JAMA 2009 Sep 9; 302:1115
More on Blood β-Glucan to Diagnose PCP
In a study conducted in Japan, 96% of patients with HIV-related PCP had abnormal β-glucan levels.
By Paul E. Sax, MD
September 28, 2009
Covering:
Watanabe T et al., Clin Infect Dis 2009 Oct 1; 49:1128
Comparative Efficacy of Seasonal Influenza Vaccines
Infectious Diseases
Summary and Comment
Free
Inactivated vaccine was more efficacious than live-attenuated vaccine in healthy adults.
By Lynn L. Estes, PharmD
September 23, 2009
Covering:
Monto AS et al., N Engl J Med 2009 Sep 24; 361:1260