September 3rd 2024
The updated COVID-19 vaccine targets the currently circulating Omicron variant JN.1 strain of SARS-CoV-2.
Case In Point: Massive, fatal hemoptysis in a patientwith AIDS and B-cell lymphoma
July 1st 2006A 49-year-old man presented to theemergency department (ED) andcomplained of fever and cough thatproduced bloody sputum for 1 day.He had AIDS and recently receiveda diagnosis of large B-cell lymphoma.His most recent CD4+ cellcount was 24/µL. He had optedagainst receiving highly active antiretroviraltherapy and prophylaxisfor opportunistic infection.
Tuberculosis in the elderly: Keep a high index of suspicion
July 1st 2006Abstract: Elderly persons with active tuberculosis may present with the classic features, such as cough, hemoptysis, and fever, but some patients present with less typical signs, such as hepatosplenomegaly, liver function abnormalities, and anemia. A high index of suspicion is required when a patient presents with cough or pneumonia unresponsive to conventional therapy. Acid-fast smear and mycobacterial culture of a sputum specimen are recommended for diagnosis. For an elderly patient who tests positive with purified protein derivative, 9 months of isoniazid prophylaxis is recommended. For patients who are intolerant of isoniazid or have been exposed to or infected by an isoniazid-resistant strain, rifampin single-agent preventive therapy may be an effective alternative. (J Respir Dis. 2006;27(7):307-315)
Monitoring adolescents with cystic fibrosis
July 1st 2006abstract: There is increasing evidence that close monitoring and early intervention lead to better outcomes in patients with cystic fibrosis. At each office visit, spirometry should be performed and sputum culture specimens should be obtained; if the patient cannot produce sputum, a throat culture can be done instead. New respiratory symptoms or other evidence of worsening lung disease should prompt antibiotic therapy, increased airway clearance, and adjunctive anti-inflammatory medication as appropriate. Close attention should be paid to the patient's diet, appetite, stooling pattern, and growth measurements. Adolescents should be given additional information about their medications and adjunctive therapies to encourage them to take on a larger role in their own care. (J Respir Dis.2006;27(7):298-305)
Aspirin-exacerbated respiratory disease: An easy-to-overlook diagnosis
July 1st 2006Abstract: Patients who have aspirin-exacerbated respiratory disease (AERD) usually experience upper and lower respiratory tract symptoms about 1Z|x to 2 hours after taking aspirin or another NSAID that inhibits the enzyme cyclooxygenase-1. In addition to symptoms such as nasal congestion, rhinorrhea, paroxysmal sneezing, periorbital edema, laryngospasm, and intense flushing, patients may have severe--often life-threatening--exacerbations of asthma. AERD occurs in about 10% to 20% of patients with asthma and in about 30% of asthmatic patients with nasal polyposis. However, AERD also occurs in patients who do not have any of these predispos- ing conditions. In patients with AERD, aspirin desensitization can improve asthma control, reduce the need for corticosteroids, and reduce the need for sinus surgery. (J Respir Dis. 2006;27(7):282-290)
Erythema Multiforme on Hands of a 55-Year-Old Woman
July 1st 2006Painful, 1- to 1.5-cm macules and papules had developed on the palms and dorsal hands and wrists of a 60-year-old man 2 weeks earlier, after a deer-hunting trip. He had not seen any ticks on his skin or clothing. The lesions persisted despite self-treatment with over-the-counter topical corticosteroids. The patient had general malaise but denied fever, chills, and arthralgia. He was not taking any medications.
For Prion Diseases, It's Eat Now, Pay Later
June 22nd 2006LONDON - If the fates of former cannibals in New Guinea are an accurate indicator, British citizens may have a half-century to worry about whether they ate beef in the 1990s tainted with prion proteins that will lead one day to variant Creutzfeldt-Jakob disease.
Stem Cell Therapy Restores Walking Function to Paralyzed Rats
June 22nd 2006BALTIMORE - Reports of paralyzed rats made to walk come and go, all claiming to be new and different. That said, this one is based on coaxing mouse embryonic stem cells into forming functional motor neuron circuits that extend to skeletal muscle, and it may well be different.
Coffee Consumption May Protect Liver from Alcohol
June 12th 2006OAKLAND, Calif. ? Coffee may help protect the livers of heavy alcohol drinkers. In a cohort study of Kaiser Permanente members, drinking one to three cups of coffee a day was associated with a 40% decrease in the risk of alcoholic cirrhosis versus drinking less than one cup.
FDA Approves Cervical Cancer Vaccine
June 8th 2006ROCKVILLE, Md. - The FDA today approved Gardasil (quadrivalent human papillomavirus [Types 6, 11, 16, 18] recombinant vaccine) for prevention of cervical cancer and for prevention of cervical, vulvar and vaginal pre-cancers caused by HPV types 16 and 18.