Home Care for Severe Childhood Pneumonia in the Developing World
Infectious Diseases Summary and Comment
For young children with severe pneumonia diagnosed by a lay health worker, home treatment with amoxicillin yielded better results than TMP-SMX with referral to the nearest healthcare facility.
By Robert S. Baltimore, MD
November 23, 2011
Covering:
Bari A et al., Lancet 2011 Nov 19; 378:1796
Molyneux EM and Graham SM., Lancet 2011 Nov 19; 378:1762
Critical Illness in Children with Pandemic H1N1 Influenza
Infectious Diseases Summary and Comment
Children with pandemic H1N1 influenza were more likely to have severe illness or to die if they had a preexisting chronic medical condition or a methicillin-resistant staphylococcal lung coinfection.
Pneumonia Risk Increases After Therapeutic Hypothermia for Cardiac Arrest
Infectious Diseases Summary and Comment
Among 641 patients with out-of-hospital cardiac arrest, therapeutic hypothermia was the only independent risk factor for the development of early-onset pneumonia.
By Neil M. Ampel, MD
November 16, 2011
Covering:
Perbet S et al., Am J Respir Crit Care Med 2011 Nov 1; 184:1048
Does Anti–Tumor Necrosis Factor α Therapy Increase the Risk for Serious Infection?
Dermatology Summary and Comment
In this large cohort study, unlike in most of the previous studies, researchers found no increased risk for serious infections with TNF antagonists.
By Jeffrey P. Callen, MD
November 10, 2011
Covering:
Grijalva CG et al., JAMA 2011 Nov 6
Dixon W and Felson DT., JAMA 2011 Nov 6
Some H1N1 Patients with Respiratory Failure Benefit from ECMO
General Medicine Summary and Comment
Hospital mortality was lower among patients referred to extracorporeal membrane oxygenation centers.
By Patricia Kritek, MD
November 1, 2011
Covering:
Noah MA et al., JAMA 2011 Oct 19; 306:1659
Checkley W., JAMA 2011 Oct 19; 306:1703
Flu Vaccine–Associated Neurological and Immunologic Sequelae
Infectious Diseases Summary and Comment
The H1N1 influenza vaccine used in Sweden was associated with relatively few — and generally mild — neurological and autoimmune complications.
Say No to Adenoidectomy for Recurrent Upper Respiratory Infections
For children referred to surgeons because of frequent URIs, adenoidectomy conferred no clinical benefit over watchful waiting.
HIV/TB Coinfection + Low CD4-Cell Count = Start ART Sooner Rather Than Later
HIV/AIDS Clinical Care Summary and Comment
Free
The results of three randomized, controlled trials (SAPiT, STRIDE, and CAMELIA) demonstrate that, for coinfected patients with advanced immunosuppression, the survival benefit of starting ART within the first 2 weeks of TB therapy outweighs the risk for immune reconstitution inflammatory syndrome and other adverse events.
By Carlos del Rio, MD
October 19, 2011
Covering:
Abdool Karim SS et al., N Engl J Med 2011 Oct 20; 365:1492
Havlir DV et al., N Engl J Med 2011 Oct 20; 365:1482
Blanc F-X et al., N Engl J Med 2011 Oct 20; 365:1471
Török ME and Farrar JJ., N Engl J Med 2011 Oct 20; 365:1538
Adjunctive Steroids Are Not Beneficial in Non–HIV-Associated PCP
Infectious Diseases Summary and Comment
In HIV-uninfected patients with moderate-to-severe <$EMPH_O>Pneumocystis jirovecii<$EMPH_C> pneumonia, outcomes were similar between patients who received adjunctive corticosteroids and those who did not.
By Thomas Glück, MD
October 19, 2011
Covering:
Moon SM et al., Antimicrob Agents Chemother 2011 Oct; 55:4613
An Ultrashort Regimen for Latent TB Looks Promising — in Mice
Infectious Diseases Summary and Comment
In a mouse model of latent tuberculosis, 1 month of the diarylquinoline TMC207 alone was superior to isoniazid alone in reducing the lung burden of <$EMPH_O>Mycobacterium tuberculosis<$EMPH_C>.
By Neil M. Ampel, MD
October 19, 2011
Covering:
Zhang T et al., Am J Respir Crit Care Med 2011 Sep 15; 184:732
Adding Adjuvant Increases the Benefit of Influenza Vaccine in Young Children
Infectious Diseases Summary and Comment
Free
Vaccine efficacy and immunogenicity were both improved when trivalent inactivated influenza vaccine was adjuvanted with an oil-in-water emulsion.
Mortality Related to Stevens-Johnson Syndrome and TEN Is Lower in Children than in Adults
Dermatology Summary and Comment
Free
But long-term complications are common.
By Mary Wu Chang, MD
October 7, 2011
Covering:
Finkelstein Y et al., Pediatrics 2011 Oct; 128:723
Why Was the 1918 Influenza Pandemic So Lethal?
Infectious Diseases Summary and Comment
Free
In a case series of influenza-related deaths during and just before the pandemic, all 68 cases had histopathological evidence of severe bacterial pneumonia.
Oseltamivir in the Environment Can Induce Resistant Influenza Strains
Infectious Diseases Summary and Comment
Influenza virus–infected ducks exposed to oseltamivir levels similar to those in the environment rapidly developed resistant viral strains.
By Thomas Glück, MD
October 5, 2011
Covering:
Järhult JD et al., PLoS ONE 2011 Sep 12; 6:e24742
Long-Awaited Guidelines for Management of CAP in Kids
Pediatrics and Adolescent Medicine Clinical Practice Guideline Watch
Free
These comprehensive guidelines recommend a less aggressive approach that limits the use of lab tests, irradiation, and antibiotics in children who can be followed as outpatients.
A Vaccine and Treatment for All Strains of Flu Now Seems Possible
General Medicine Summary and Comment
Scientists envision a cocktail of broadly neutralizing antibodies.
By Anthony L. Komaroff, MD
September 27, 2011
Covering:
Ekiert DC et al., Science 2011 Aug 12; 333:843
Corti D et al., Science 2011 Aug 12; 333:850
Wang TT and Palese P., Science 2011 Aug 12; 333:834
Once-Daily Nevirapine Inferior to Efavirenz in HIV/TB-Coinfected Patients
HIV/AIDS Clinical Care Summary and Comment
Free
A nevirapine-based regimen was associated with higher rates of both virologic failure and death.
By Carlos del Rio, MD
September 26, 2011
Covering:
Swaminathan S et al., Clin Infect Dis 2011 Oct 1; 53:716
TB Is Uncommon After ART Initiation in the U.S. — but Not Unheard Of
Risk factors include a low CD4-cell count at ART initiation, a history of injection-drug use, and nonwhite race.
By Carlos del Rio, MD
September 26, 2011
Covering:
Sterling TR et al., J Infect Dis 2011 Sep 15; 204:893
Early Pseudomonas Infections in Children with CF: Four Regimens Compared
Infectious Diseases Summary and Comment
Although the regimens were equally efficacious in preventing exacerbations, culture-based therapy was most efficient; adding oral ciprofloxacin to inhaled tobramycin provided no benefit.
By Robert S. Baltimore, MD
September 14, 2011
Covering:
Treggiari MM et al., Arch Pediatr Adolesc Med 2011 Sep; 165:847
Swine-Origin Influenza Virus Is Among Us Again
Infectious Diseases Summary and Comment
Two epidemiologically independent cases of flu-like illness in young children were caused by a swine-origin influenza A (H3N2) virus with a novel genotype.
By Stephen G. Baum, MD
September 14, 2011
Covering:
Centers for Disease Control and Prevention (CDC)., MMWR Morb Mortal Wkly Rep 2011 Sep 9; 60:1213
Updated Guidelines for the Programmatic Management of Drug-Resistant TB
Infectious Diseases Clinical Practice Guideline Watch
This WHO document emphasizes the use of molecular diagnostics for rapid detection of drug resistance and provides treatment recommendations.
By Thomas Glück, MD
September 14, 2011
Covering:
Falzon D et al., Eur Respir J 2011 Sep; 38:516
Traditional Chinese Medicine for Treatment of H1N1 Influenza
General Medicine Summary and Comment
In a relatively young and healthy population, a combination of 12 herbs was as effective as oseltamivir.
Influenza Vaccination in the U.S., 2011–2012
Infectious Diseases Vaccine Watch
Free
The CDC recently released its recommendations for use of this year's vaccine.
Decision Rule Falls Short in Identifying Children at Low Risk for Pneumonia
Emergency Medicine Summary and Comment
Free
Even the lowest-risk group had a 7.6% pneumonia rate.
By Katherine Bakes, MD
August 26, 2011
Covering:
Neuman MI et al., Pediatrics 2011 Aug; 128:246
Follow-Up Chest X-Rays After Pneumonia?
General Medicine Summary and Comment
Free
Follow-up imaging probably can be limited to older patients.
By Allan S. Brett, MD
August 23, 2011
Covering:
Tang KL et al., Arch Intern Med 2011 Jul 11; 171:1193
