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November 6, 2006, 7:53 PM CT

Most Ear Infections Host Both Bacteria And Viruses

Most Ear Infections Host Both Bacteria And Viruses
Ear infections are among the most common diseases seen in pediatric practice. They have generally been considered bacterial diseases and are therefore commonly treated with antibiotics. New research, reported in the December 15 issue of Clinical Infectious Diseases and currently available online, provides evidence that viruses are found in a great a number of ear infection cases and may complicate therapy.

The scientists used a variety of laboratory techniques to identify the pathogen that caused ear infections, known clinically as acute otitis media (AOM), in 79 young children. They found bacteria in 92 percent of the cases, viruses in 70 percent, and both bacteria and viruses in 66 percent.

As per Aino Ruohola, MD, PhD, from the Turku University Hospital in Finland and lead author of the study, "the major finding of the study is that acute otitis media is a coinfection of bacteria and viruses in the great majority of children. This is actually logical since acute otitis media is virtually always connected to viral respiratory infection".

Antibiotics, which are effective against the bacteria that cause AOM, have no effect on the viruses found in AOM infections. Therefore, the standard therapy for AOM--antibiotics--can be, at best, partially effective in the majority of cases. "Based on this and prior research," said Dr. Ruohola, "it is possible that viruses cause a considerable proportion of clinical therapy failures. Thus, in these cases a new antibiotic is not necessarily the best choice eventhough bacteria resistant to common antibiotics are wide-spread."........

Posted by: Sue      Permalink         Source


November 6, 2006, 4:51 AM CT

Hospital Costs For Children With Flu

Hospital Costs For Children With Flu
Going into another flu season, a new study reports that hospitalizing children for influenza may cost up to three or four times the previously accepted estimates. Pediatric scientists from The Children's Hospital of Philadelphia say their finding strengthens the economic justification for broadly vaccinating children against flu.

"We found the cost of influenza-related hospitalizations in children was about $13,000 each--in comparison to most previous studies that estimated the cost at three to four thousand dollars," said study leader Ron Keren, M.D., M.P.H., a pediatrician at The Children's Hospital of Philadelphia. "This suggests that annual influenza vaccinations for children, particularly for those with certain high-risk conditions, may be more cost-effective than previously thought".

The study appears in the recent issue of Pediatrics.

The scientists analyzed billing data for 727 patients up to age 21 who were admitted to Children's Hospital with laboratory-confirmed influenza over four consecutive flu seasons, from 2000 to 2004. The study team statistically adjusted the direct medical costs to account for geographic variations in those costs.

"We found a broad range of hospital costs in the study, from approximately $7,000 each for patients treated only on the ward, to nearly $40,000 each for children cared for in the intensive care unit," said Dr. Keren. Children with low-risk conditions had hospital costs averaging $9,000 each, in comparison to those with high-risk conditions, whose costs averaged $15,000 each.........

Posted by: Mark      Permalink         Source


November 2, 2006, 5:29 PM CT

Smoking Related Cancers

Smoking Related Cancers
There are currently about fifty million smokers in the U.S. and there are another fifty million ex-smokers. Cigarette smoking has been linked to several human malignancies. Some of these links like the relationship between smoking and lung cancer are well established. In some other cases the relationship between smoking and cancer is not very well established. However several studies have clearly shown the malignant potential of chemical substances in cigarette smoke. This article is an attempt to summarize some of the known links between cigarette smoking and caner.

Lung cancer

Lung cancer has a strong association with smoking. On average, smokers increase their risk of lung cancer between 5 and 10-fold compared to never smokers. Even though lung cancer can occur in non-smokers, it should be appreciated that more than 90 percent of all lung cancer patients are current or past smokers. Some sub types of lung cancer like small cell lung cancer is more strongly associated with smoking than others. There is plenty of research evidence in the literature linking lung cancer to smoking. A recent study published in the British Journal Of Medicine (Ref: BMJ 1997) concluded that the accumulated evidence support the fact secondhand exposure to cigarette smoke could lead to lung cancer. ........

Posted by: Agarwaal MD      Permalink


November 2, 2006, 4:59 AM CT

Intact Tonsils Triple Risk Of Recurrent Strep Throat

Intact Tonsils Triple Risk Of Recurrent Strep Throat
Children with recurrent strep throat whose tonsils have not been removed are over three times more likely to develop subsequent episodes of strep throat than children who undergo tonsillectomy, as per a Mayo Clinic study reported in the Nov. 2 issue of Laryngoscope.

"These results suggest that tonsillectomy is a useful treatment for treating children with recurrent strep throat infections," says Laura Orvidas, M.D., Mayo Clinic ear, nose and throat surgeon and senior study investigator. "It should decrease the amount of infections experienced by this subset of children and therefore diminish the number of missed school days and hopefully improve overall quality of life".

Dr. Orvidas and his colleagues conducted a population-based retrospective cohort study of children between ages 4 and 16 who received three or more diagnoses of strep-correlation tonsillitis or pharyngitis at least one month apart, within 12 months. Within this group, children who subsequently underwent a tonsillectomy were compared with an age- and sex-matched sample of children who had not had a tonsillectomy. The date of the tonsillectomy for the matched pair was defined as the index date. All strep infections were recorded for each of these two groups of children.

The study population comprised 290 children (145 who received a tonsillectomy and 145 who did not). In the tonsillectomy group, 74 children experienced at least one strep infection after the index date and before age 16. Among those who did not receive a tonsillectomy, 122 experienced at least one strep infection during the follow-up. The time before first subsequent strep infection was much longer for those who had a tonsillectomy, a median of 1.1 years as in comparison to 0.6 years for children whose tonsils had not been removed. By one year after the index date, the cumulative occurence rate of a strep infection was 23.1 percent among the children who had a tonsillectomy in comparison to 58.5 percent among the children who had not.........

Posted by: JoAnn      Permalink         Source


November 1, 2006, 4:51 AM CT

HPV Test Is A Better Long-term Predictor

HPV Test Is A Better Long-term Predictor HPV Virus
The best initial cervical cancer screening tool for younger women is still the traditional Pap smear. However, a large Danish study has observed that for older women (age 40 and older), a test for human papillomavirus (HPV) is a much more effective way to screen for potential cancer.

The reason, report scientists in the November 1 issue of Cancer Research, is that HPV infection is both frequent and transient in younger women, and they would often test positive for HPV when no actual risk of cervical cancer existed. But, in older women, HPV infection is rarer and more persistent, putting a woman at substantial risk for the disease before changes in cervical cells, detected by Pap smears, are obvious.

"We have documented that a single HPV test can actually predict older women at risk for cervical cancer better than a single Pap smear can," said the study's senior author, Susanne Kr├╝ger Kjaer, M.D., professor and head of the Department of Virus, Hormones and Cancer at the Danish Cancer Society.

The scientists specifically observed that the absolute risk of developing cervical cancer in an older woman who tests positive for HPV is greater than 20 percent within a 10-year period. They also note that most women who test positive for HPV also test negative on a Pap smear given at the same time.........

Posted by: Emily      Permalink         Source


October 30, 2006, 8:34 PM CT

Staph Vaccine Shows Promise

Staph Vaccine Shows Promise Staphylococcus aureus
By combining four proteins of Staphylococcus aureus that individually generated the strongest immune response in mice, researchers have created a vaccine that significantly protects the animals from diverse strains of the bacterium that cause disease in humans. A report describing the University of Chicago study, funded by the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health, appears online this week in the Proceedings of the National Academy of Sciences.

"This finding represents a promising step toward identifying potential components to combine into a vaccine designed for people at high risk of invasive S. aureus infection," notes Anthony S. Fauci, M.D., NIAID director.

S. aureus, the most common agent of hospital-acquired infection, is the leading cause of bloodstream, lower respiratory tract and skin infections. These infections can result in a variety of illnesses, including endocarditis (inflammation of the heart), toxic-shock syndrome and food poisoning.

Research in S. aureus has taken on new urgency: In the past few decades, the bacterium has developed resistance to traditional antibiotics, thus allowing infections to spread throughout the body of the infected individual despite therapy. More recently, healthy people with no apparent risk factors have been infected by novel and extremely virulent strains of S. aureus acquired from community rather than hospital sources.........

Posted by: Mark      Permalink         Source


October 26, 2006, 4:59 AM CT

HIV-positive individuals with inadequate care

HIV-positive individuals with inadequate care
In a first-of-its-kind study, UCLA scientists have shown that segments of the HIV-infected population who have little to no consistent outpatient medical care -- and yet are most in need of such services -- are overwhelmingly minorities, the poor and substance abusers.

Prior studies had shown minorities, the poor and substance users who were receiving routine medical care for the HIV infection, and whose data could therefore be easily captured in healthcare studies, were likelier to be medically underserved and to die more quickly. But Dr. William Cunningham, and the study's lead author, said UCLA scientists tracked HIV-infected people who were not receiving regular care -- and thus more difficult to find. Often this segment showed up in the medical system in emergency situations.

"As we expected, they are much less likely to get routine outpatient care but more likely to get acute care, when they are at their sickest," said Cunningham, who is professor of medicine in the Division of General Internal Medicine and Health Services Research at the David Geffen School of Medicine at UCLA. "This is just the group that needs to get grassroots outreach service".

For this study, would be reported in the recent issue of the journal Medical Care, the scientists compared socio-demographic, clinical and health care utilization characteristics of HIV-infected adults from two samples: 1,286 people from the 2001-02 Targeted HIV Outreach and Intervention Initiative (Outreach) and 2,267 who were interviewed in 1998 for the HIV Costs and Services Utilization Study (HCSUS).........

Posted by: Mark      Permalink         Source


October 19, 2006, 9:51 PM CT

Malaria in the Middle East

Malaria in the Middle East
Malaria is not commonly thought of as a major disease in the Middle East, but a study from Yemen in this week's BMJ reveals worryingly high levels of severe malaria in children.

In fact, the figures show that as a number of as 4 out of 10 children attending hospital with severe illness could be affected during the peak season. This is comparable to a number of areas of Africa.

Scientists identified over 2,000 children aged 6 months to 10 years who were admitted to two public hospitals with suspected severe malaria. Malaria was confirmed in 1,332 children, 808 of whom had severe malaria.

The proportion of admissions varied as per the season, from 1% between July and September to 40% in February and March. Twenty six children died in hospital. Most deaths were in children with a neurological presentation, and more girls died than boys.

Severe malaria puts a high burden on health services in Yemen, say the authors. Malaria control should be a priority and lesson should be learnt from other areas of highly seasonal malaria.........

Posted by: Mark      Permalink         Source


October 19, 2006, 9:43 PM CT

Beliefs Could Have Adverse Effect On HIV Rates

Beliefs Could Have Adverse Effect On HIV Rates
A review of research on the prevalence of HIV in the Middle East and North Africa has observed that whilst cultural and religious practices may be behind a low prevalence of HIV in the region, they could potentially contribute to increasing the spread of HIV.

Research from the World Health Organisation, published in this week's BMJ, argues it is possible that some practices which are common among Muslim populations may contribute to decreasing the risk of HIV transmission. One is low alcohol consumption, which reduces 'risky' behaviours and another is potentially male circumcision which was shown in a recent clinical trial to have a protective effect but application of these results to other epidemiological, cultural and social settings still needs to be confirmed.

At the same time other population trends, beliefs and practices in the region may have an adverse effect. Most countries in the region have young populations with a rapidly increasing age at marriage, but young people may be ill-equipped to protect themselves against sexually transmitted infections. Traditional Muslim approaches have tended to be very conservative, and it is difficult to break the silence around issues of sexual behaviour particularly those which deviate from religious norms.

A detailed analysis of religious publications and doctrinal pronouncements revealed that strong moralising views were common HIV was seen as divine retribution and religion was presented as a protection. This can mean that those with HIV/AIDS are stigmatised.........

Posted by: Mark      Permalink         Source


October 19, 2006, 9:35 PM CT

Immune System And Fight Against TB

Immune System And  Fight Against TB
A key aspect of how the body kicks the immune system into action against tuberculosis is revealed in research published recently. The authors, writing in Science, hope that their research could aid the development of novel vaccines and immunotherapies to combat TB, which is responsible for two million deaths each year.

The cause of TB is a slow-growing bacterium known as Mycobacterium tuberculosis. Researchers have known for some time that when host cells are invaded by this bacterium, the host cells are able to call up additional immune cells such as lymphocytes to fight them and try to limit the damage which the bacteria can cause.

The new research, by researchers from Imperial College London, the Universities of Cambridge and Oxford, and other international institutions, identifies a receptor on the host cells which triggers the immune cells' response to tuberculosis. The researchers demonstrated that without this receptor, known as CCR5, mycobacteria were able to thrive inside host cells, as the immune cells did not receive the signal from CCR5 to attack them.

The researchers hope that their findings could enable a novel vaccine or immunotherapy to be developed which could artificially kick the immune cells into action in the same way as CCR5. This could boost the immune response to TB.........

Posted by: Mark      Permalink         Source



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Did you know?
Scientists at Baylor College of Medicine in Houston have found a genetic marker that may identify individuals at greater risk for life-threatening infection from the West Nile virus. Results of the study are reported in the Nov. 15 print edition of Journal of Infectious Diseases.

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