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Archive for the ‘Infectious Disease’ Category

Nasopharyngeal Specimen Collection – A Guide for Medical Students

Posted by medliorator on June 8, 2010

The New York City Department of Health has prepared an excellent guide for nasopharyngeal specimen collection that describes both nasopharyngeal aspirate and nasopharyngeal swab methods.  This concise review will prove helpful for those medical students beginning outpatient medicine rotations or family medicine.

Nasopharyngeal Specimen Collection for Viral Respiratory Pathogens [NYC Dept of Health]

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The Association between Proton Pump Inhibitors and C. Difficile

Posted by medliorator on May 11, 2010

investigators conducted a secondary analysis of prospectively collected data from 101,796 patients who were discharged from a tertiary care medical center during a 5-year period. Acid suppression treatment was the primary exposure of interest, classified by intensity (no acid suppression, histamine2-receptor antagonist [H2RA] treatment, daily PPI use, and PPI use more often than daily).

The risk for nosocomial C difficile infection increased with increasing level of acid suppression. This risk was 0.3% (95% confidence interval [CI], 0.21% – 0.31%) in patients not receiving acid suppressive treatment, 0.6% (95% CI, 0.49% – 0.79%) in those receiving H2RA treatment, 0.9% (95% CI, 0.80% – 0.98%) in those using PPIs daily, and 1.4% (95% CI, 1.15% – 1.71%) in patients using PPIs more often than daily …The odds ratio was 1 for no acid suppression (reference), 1.53 for H2RA treatment (95% CI, 1.12 – 2.10), 1.74 for daily PPI use (95% CI, 1.39 – 2.18), and 2.36 for more frequent PPI use (95% CI, 1.79 – 3.11).

Proton Pump Inhibitor Use Linked to Clostridium Difficile Infection [Medscape]

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Influenza Review

Posted by medliorator on September 8, 2009

A plain language review of the influenza virus by Joseph Albietz:

The influenza season in the Northern hemisphere usually runs from October through May, with a peak mid-February.  Every season in the US between 5-20% of the US population is infected by influenza, and while the majority of people recover well from an influenza infection, not everyone will.  Annually 200,000 people are hospitalized, and on average 36,000 will die either from influenza or its complications.

Influenza is an RNA virus encoded by just 11 genes on 8 separate RNA segments  …One in every 1000-10,000 nucleotides is mis-transcribed by influenza, giving it one of the highest mutation rates known… Two genes encode influenza’s characteristic surface proteins hemagglutinin (HA) and neuraminidase (NA).  There are 16 types of HA, 9 of NA, and respectively these two proteins serve to bind the virus to a target cell and to release new viral particles from a host cell, and they also happen to be the parts of influenza the immune system recognizes.  Every so often a transcription error will change the conformation of either HA or NA just enough so that it cannot be recognized by the immune system.

the 2009 (H1N1) is distinct from the seasonal A (H1N1).  It appears to be a “triple recombination,” with characteristics derived from human, bird, and swine influenzas.  When our population was tested for antibodies against 2009 (H1N1) nearly no children, and less than 10% of those under the age of 65 had reactive antibodies, and of those over 65 only 33% showed any response.  It seems no one has seen a similar influenza in half a century.  This means that the vast majority of our population is susceptible to infection this season

An Influenza Primer [Science-Based Medicine]

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Case Study: New Strain of HIV

Posted by medliorator on August 3, 2009

060219_CinGorilla_vmed.widec

researchers have now discovered an HIV infection in a Cameroonian woman which is clearly linked to a gorilla strain, Nature Medicine reports.

HIV originated from a similar virus in chimpanzees called Simian Immunodeficiency Virus (SIV).

French doctors treating the 62-year-old Cameroonian woman who was living in Paris said they initially spotted some discrepancies in routine viral load tests.

Further analysis of the HIV strain she was infected with showed it was more closely related to SIV from gorillas than HIV from humans.

She is the only person known to be infected with the new strain but the researchers expect to find other cases.

Before moving to Paris, she had lived in a semi-urban area of Cameroon and had no contact with gorillas or bush meat, suggesting she caught the virus from someone else who was carrying the gorilla strain.

Scientists find new strain of HIV [BBC News]

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