2009 H1N1 Influenza — The Pandemic Continues
Infectious Diseases Summary and Comment
Since the emergence of this virus in spring 2009, the number of infections has remained uncharacteristically high, presaging a bad winter for influenza.
By Stephen G. Baum, MD
September 23, 2009
Covering:
Centers for Disease Control and Prevention (CDC)., MMWR Morb Mortal Wkly Rep 2009 Sep 18; 58:1009
Candida Pneumonia in Critically Ill Patients?
Infectious Diseases Summary and Comment
Among ICU patients who died with evidence of pneumonia, autopsy revealed no cases of <$EMPH_O>Candida<$EMPH_C> pneumonia, even in those with positive <$EMPH_O>Candida<$EMPH_C> cultures before death.
By Thomas Glück, MD
September 23, 2009
Covering:
Meersseman W et al., Intensive Care Med 2009 Sep; 35:1526
Ricard J-D and Roux D., Intensive Care Med 2009 Sep; 35:1500
Neurological Impairments After H5N1 Viral Infection: An Animal Study
Psychiatry Summary and Comment
Long-term parkinsonian symptoms might follow acute H5N1 influenza.
By Barbara Geller, MD
September 21, 2009
Covering:
Jang H et al., Proc Natl Acad Sci U S A 2009 Aug 18; 106:14063
Good News and Bad News About 2009 H1N1 Influenza ("Swine Flu")
General Medicine Summary and Comment
Free
Only a minority of stored serum samples in the U.S. contained antibodies against H1N1, but a new vaccine easily elicited them.
By Abigail Zuger, MD
September 17, 2009
Covering:
Hancock K et al., N Engl J Med 2009 Sep 10
Clark TW et al., N Engl J Med 2009 Sep 10
Greenberg ME et al., N Engl J Med 2009 Sep 10
2009 H1N1 Vaccine: Will One Dose Be Enough?
Infectious Diseases Summary and Comment
Free
A single 15-µg dose of 2009 H1N1 vaccine, without an adjuvant, produced strong immune responses in 97% of healthy adults.
By Daniel J. Diekema, MD, MS
September 16, 2009
Covering:
Greenberg ME et al., N Engl J Med 2009 Sep 10
Neuzil KM., N Engl J Med 2009 Sep 10
Preexisting Immunity to the 2009 H1N1 Virus
Infectious Diseases Summary and Comment
Very few individuals younger than 30 have protective levels of cross-reactive neutralizing antibodies against this virus.
Which Pneumococcal Vaccine for Adults with COPD?
Infectious Diseases Summary and Comment
In a small study, serologic responses were generally better with the 7-valent protein-conjugate vaccine than with the currently approved 23-valent polysaccharide vaccine.
By Neil M. Ampel, MD
September 16, 2009
Covering:
Dransfield MT et al., Am J Respir Crit Care Med 2009 Sep 15; 180:499
Pandemic Influenza A (H1N1) Virus ("Swine Flu") Probably Is More Virulent Than Seasonal Flu Virus
General Medicine Summary and Comment
Free
In animal models, the pandemic virus replicates faster and damages lungs more.
Inhaled Steroids in COPD: Is Risk for Pneumonia Really Higher?
General Medicine Summary and Comment
Risk was not elevated in patients who received budesonide.
By Bruce Soloway, MD
September 8, 2009
Covering:
Sin DD et al., Lancet 2009 Aug 29; 374:712
Welte T., Lancet 2009 Aug 29; 374:668
Who Should Receive Flu Vaccine?
Infectious Diseases Summary and Comment
Free
A mathematical model incorporating transmission dynamics suggests that priority be given to immunizing schoolchildren and adults aged 30 to 39.
Upper-Airway Specimens at ICU Admission to Guide VAP Treatment?
Infectious Diseases Summary and Comment
Microorganisms identified in upper-airway specimens fairly accurately predicted the pathogens underlying early-onset ventilator-associated pneumonia.
By Thomas Glück, MD
September 2, 2009
Covering:
Pirracchio R et al., Crit Care Med 2009 Sep; 37:2559
What's New with the Flu?
New clinical information and updated preventive, diagnostic, and therapeutic recommendations geared for pediatricians
By Peggy Sue Weintrub, MD
August 21, 2009
Covering:
Centers for Disease Control and Prevention (CDC)., MMWR Morb Mortal Wkly Rep 2009 Jul 24; 58:773
Fiore AE et al., MMWR Recomm Rep 2009 Jul 31; 58:1
Centers for Disease Control and Prevention (CDC)., MMWR Morb Mortal Wkly Rep 2009 Aug 7; 58:826
Shun-Shin M et al., BMJ 2009 Aug 10; 339:b3172
Reducing Radiation Exposure in the ED
Careful history and physical exam can obviate the need for radiologic tests in children with headache or wheezing.
By Cornelius W. Van Niel, MD
August 19, 2009
Covering:
Lateef TM et al., Pediatrics 2009 Jul; 124:e12
Mathews B et al., Pediatrics 2009 Jul; 124:e29
Moxifloxacin Instead of Isoniazid for Pulmonary TB?
Infectious Diseases Summary and Comment
Free
In a multinational trial, rates of culture negativity after 2 months of therapy were similar between the two drugs.
By Neil M. Ampel, MD
August 19, 2009
Covering:
Dorman SE et al., Am J Respir Crit Care Med 2009 Aug 1; 180:273
Trends in Antibiotic Use in Acute Respiratory Tract Infections
General Medicine Summary and Comment
Overall use continues to decline, but broad-spectrum antibiotic use rose dramatically.
Pregnant Women Are at Elevated Risk for Complications from H1N1 Flu
General Medicine Summary and Comment
Free
Pregnant women were more than four times as likely to be hospitalized as people in the nonpregnant general population.
By Bruce Soloway, MD
August 13, 2009
Covering:
Jamieson DJ et al., Lancet 2009 Aug 8; 374:451
Delayed Viral Clearance Among Hospitalized Adults with Influenza
Infectious Diseases Summary and Comment
Viral replication and shedding may be more prolonged than expected and could warrant more-aggressive therapeutic and infection-control approaches.
By Larry M. Baddour, MD
August 12, 2009
Covering:
Lee N et al., J Infect Dis 2009 Aug 15; 200:492
Ison MG., J Infect Dis 2009 Aug 15; 200:485
More Evidence for the Role of Bocavirus in Asthma
Infectious Diseases Summary and Comment
Among children with asthma exacerbations, the virus most commonly detected was human bocavirus.
Improving the Efficacy of Flu Vaccine
General Medicine Summary and Comment
A stronger vaccine elicits more antibodies but has more side effects.
By Abigail Zuger, MD
August 11, 2009
Covering:
Falsey AR et al., J Infect Dis 2009 Jul 15; 200:172
Pregnancy and the Flu
Women's Health Summary and Comment
Pandemic H1N1 and seasonal influenza take their toll on pregnant women; vaccination is a top priority.
By Anna Wald, MD, MPH
August 6, 2009
Covering:
Jamieson DJ et al., Lancet 2009 Aug 8; 374:451
MacDonald NE et al., Obstet Gynecol 2009 Aug; 114:365
Phillippe M., Obstet Gynecol 2009 Aug; 114:206
Atlanta, GA: Centers for Disease Control and Prevention (CDC) 2009 Jul 29
Oseltamivir Prevents Complications of Influenza in High-Risk Children
Oseltamivir prescribed within 1 day of clinical diagnosis of influenza reduced risks for complications and hospitalization in children with chronic conditions.
H1N1 Influenza in Pregnant Women
Infectious Diseases Summary and Comment
Free
H1N1-infected pregnant women appear to be at increased risk for severe disease and death.
By Mary E. Wilson, MD
August 5, 2009
Covering:
Jamieson DJ et al., Lancet 2009 Aug 8; 374:451
AIDS-Associated PCP in the U.S.
Infectious Diseases Summary and Comment
Hospital discharge data indicate that hospitalizations for and mortality from AIDS-associated <$EMPH_O>Pneumocystis jirovecii<$EMPH_C> pneumonia have decreased significantly since 1986.
By Thomas Glück, MD
August 5, 2009
Covering:
Kelley CF et al., Chest 2009 Jul; 136:190
Treatment of Children with Sinusitis
Sinusitis in children with respiratory symptoms is uncommon, but, for those who have sinusitis, antibiotics improve clinical outcomes.
Antibiotic Prescribing and Respiratory Infection Outcomes
Infectious Diseases Summary and Comment
Among 3500 patients in 13 European countries, recovery from acute respiratory infections was not affected by whether — or which — antibiotics were given.
