Author Interviews, Herpes Viruses, Infections, Nature, Pulmonary Disease / 21.11.2013

Gerard Nuovo MD Professor College of Medicine, The Ohio State University Satellite Laboratory, Ohio State Univ Comprehensive Cancer Center Phylogeny Inc, Powell, OhioMedicalResearch.com Interview with: Gerard Nuovo MD Professor College of Medicine, The Ohio State University Satellite Laboratory, Ohio State Univ Comprehensive Cancer Center Phylogeny Inc, Powell, Ohio MedicalResearch.com: What are the main findings of the study? Dr. Nuovo: The main finding of the study was that idiopathic pulmonary fibrosis was strongly associated with an infection by a herpesvirus.  The data that supported this main finding included:
  • 1) detection of the viral DNA by in situ hybridization in each case of idiopathic pulmonary fibrosis (IPF) and in none of the controls;
  • 2) the localization of the viral DNA to the nucleus of the cell that orchestrates IPF, the regenerating epithelial cell (herpes viruses localize to the nucleus of the target cell);
  • 3) the demonstration that the viral DNA co-localized with "pirated proteins" that the virus makes during productive infection (these were IL-17. cyclin D, dihydrofolate reductase, and thymidylate synthase); this combination of proteins are rarely if ever co-expressed in lung disease and  their co-expression per se was highly suggestive of a viral infection;
  • 4) the demonstration by RTPCR that the cyclin D RNA in IPF comes from the virus and not the human cells;
  • 5) the recognition that this family of herpesviruses (called gammaherpesvirus) causes IPF in other animals including horses, mice, and donkeys;
  • 6) the cloning of part of the gene of the virus from a clinical IPF sample that showed 100% homology to the published sequence of the likely viral pathogen - herpesvirus saimiri. (more…)
Author Interviews, NEJM, Urinary Tract Infections / 14.11.2013

Thomas M. Hooton M.D. Associate Chief of Staff, Medical Service, Miami VA Healthcare System Professor of Clinical Medicine and Vice Chair for VA Affairs, Department of Medicine, UMSOM Clinical Director, Division of Infectious Diseases, UMSOMMedicalResearch.com Interview with: Thomas M. Hooton M.D. Professor of Medicine and Vice Chair for VA Affairs, University of Miami Miller School of Medicine Associate Chief of Staff, Medical Service, Miami VA Healthcare System Clinical Director, Division of Infectious Diseases MedicalResearch.com: What are the main findings of the study? Dr. Hooten: The main findings from this study are: ·        Voided urine colony counts of E. coli as low as 101 to 102 cfu/mL are highly sensitive and specific for their presence in bladder urine in symptomatic women (growth of bacteria in bladder urine is the gold standard for the etiology of UTI). Moreover, even when E. coli is found along with other mixed flora in voided urine, it should not be considered a contaminant since it likely represents true bladder infection. ·        On the other hand, enterococci and Group B streptococci, which are frequently isolated from voided urine, are rarely isolated from paired catheter specimens, suggesting that these organisms only rarely cause acute uncomplicated cystitis. In our study, E. coli frequently grew from the urines of these women and is the likely cause for UTI symptoms in such episodes. ·        Organisms usually considered contaminants, such as lactobacilli, occasionally grow from catheter urines, but they are rarely found alone with pyuria, suggesting that these bacteria rarely cause acute uncomplicated cystitis. ·        The etiology of a quarter of acute uncomplicated cystitis episodes is unknown.  It is possible that some of these women have E. coli urethritis, which has been documented in some women with UTI symptoms, but we did not do further studies to evaluate this. It is possible also that enterococci and Group B streptococci may also cause urethritis, but there is no published evidence of this in young women with UTI symptoms. ·        Although voided urine cultures growing mixed flora are common in women with acute cystitis, true polymicrobic cystitis, as determined by sampling bladder urine, appears to be rare in this population. (more…)
Author Interviews, Flu - Influenza / 12.11.2013

MedicalResearch.com with: Dr Kate Mandeville MD MPH Clinical Research Fellow, London School of Hygiene and Tropical MedicineDr Kate Mandeville MD MPH Clinical Research Fellow, London School of Hygiene and Tropical Medicine   MedicalResearch.com: What is the background for your study? Dr. Mandeville: The UK spent nearly one billion pounds on pharmaceutical drugs during the swine flu pandemic, including vaccine and antiviral drugs. After the swine flu pandemic, it was revealed that some scientists on the World Health Organization’s advisory committee had links with the pharmaceutical industry. Scientists often provide commentary for journalists on emerging health risks and we set out to see whether scientists commentating on swine flu were also more likely to have links to pharmaceutical companies. We analysed UK newspaper coverage of the swine flu pandemic between April and July 2009. This was the period in which the UK government was making decisions on how best to respond to the emerging pandemic, including providing the public with vaccine and antiviral drugs. We looked for how often scientists were quoted in articles on the pandemic from a wide range of newspapers. We then examined these comments in more detail to see if scientists made an assessment of the risk to the public from swine flu, and compared these against assessments made by official agencies like the Department of Health. We also judged whether the scientists promoted or rejected the use of vaccines or antiviral drugs. For each scientist, we then looked for links with the pharmaceutical industry – or what we formally call competing interests - from a variety of sources, including scientific papers and the internet. (more…)
Author Interviews, Flu - Influenza, Pediatrics, Vaccine Studies / 29.10.2013

MedicalResearch.com Interview with: Karen K. Wong, MD MPH Community Interventions for Infection Control Unit Division of Global Migration & Quarantine Centers for Disease Control and Prevention MedicalResearch.com: What are the main findings of the study? Dr. Wong: There were 830 pediatric influenza-associated deaths reported to CDC during the 2004–2005 through 2011–2012 seasons; deaths occurred in children of all ages, and 43% had no high-risk medical conditions. Of children 6 months of age or older whose vaccination status was known, only 16% had been fully vaccinated with seasonal influenza vaccine. (more…)
Author Interviews, HPV, Vaccine Studies / 12.10.2013

Lisen Arnheim Dahlström, Associate Professor (Docent) Institutionen för medicinsk epidemiologi och biostatistik Department of Medical Epidemiology and Biostatistics Karolinska Institutet 171 77 Stockholm, SwedenMedicalResearch.com Interview with: Lisen Arnheim Dahlström, Associate Professor (Docent) Institutionen för medicinsk epidemiologi och biostatistik Department of Medical Epidemiology and Biostatistics Karolinska Institutet 171 77 Stockholm, Sweden   MedicalResearch.com: What are the main findings of the study? Answer: This is a Swedish/Danish population-based study comparing serious disease outcomes in girls immunized with the quadrivalent HPV vaccine against the unvaccinated population. The main finding of this study was that none of the 53 outcomes included in the study were more common in the vaccinated population compared to the non-vaccinated population. (more…)
Author Interviews, Infections / 07.10.2013

George Alangaden MD Senior Staff Physician, Transplant Infectious Diseases Medical Director of Infection Prevention Henry Ford Hospital Professor of Medicine, Wayne State University Infectious Diseases, CFP-316 Detroit, MI 48202MedicalResearch.com Interview with: George Alangaden MD Senior Staff Physician, Transplant Infectious Diseases Medical Director of Infection Prevention Henry Ford Hospital Professor of Medicine, Wayne State University Infectious Diseases, CFP-316 Detroit, MI  48202 MedicalResearch.com: What are the main findings of the study? Dr. Alangaden:
  • Infections caused by Mycobacterium marinum infections are rare. A total of 5 patients were identified in our hospital over a 10 year period.
  • In all instances the infection affected the skin and soft tissues of the hand and arm and presented as sores or bumps on the skin that did not improve after usual antibiotic therapy.
  • All patients had an history of some trauma to the hand and subsequent exposure to water  from home aquariums
  • The time to onset of infection after exposure ranged from 11 days to 56 days.
  • The median time from infection to diagnosis and appropriate therapy was 161 days (range 33-379 days).
  • In all cases the diagnosis was made by doing a skin biopsy.
  • All patients were cured after several weeks of treatment with appropriate antibiotics. (more…)
Author Interviews, Hand Washing, JAMA, MRSA / 07.10.2013

Anthony Harris, MD, MPH Department of Epidemiology and Public Health Professor University of Maryland School of Medicine Acting Medical Director of Infection Control University of Maryland Medical CenterMedicalResearch.com Interview with: Anthony Harris, MD, MPH Department of Epidemiology and Public Health Professor University of Maryland School of Medicine Acting Medical Director of Infection Control University of Maryland Medical Center     MedicalResearch.com: What are the main findings of the study? Dr. Harris: The aim of the study was to understand if wearing disposable gowns and gloves for all patient contact in the ICU could help prevent the spread of MRSA and similar antibiotic-resistant bacteria. Secondarily we wanted to make sure this type of patient isolation did not result in any harm to patients. The results of the study were that gowns and gloves worn by healthcare workers for contact with all patients in the ICU did not decrease the number of patients who acquired VRE but did decrease MRSA about 40 percent.  Also, wearing gloves and gowns did not adversely impact patient care.  For our goal of studying all types of infection, we did not find a benefit to universal gown and glove use. However, for transmission of MRSA alone, the intervention decreased transmission by about 40 percent. Although previous studies have showed isolation is associated with falls, bed sores and other adverse events, we found gowns and gloves did not produce more of these negative events. (more…)
Hospital Acquired, Infections, Outcomes & Safety, Pediatrics / 07.10.2013

MedicalResearch.com Interview with: Elias Iosifidis, MD, PhD Pediatric Infectious Disease Fellow Aristotle University of Thessaloniki Hippokration Hospital Thessaloniki, Greece MedicalResearch.com: What are the main findings of the study? Dr. Iosifidis: A large outbreak of VRE colonization was found in neonates hospitalized in an intensive care unit (Neonatal Intensive Care Unit, NICU) after the implementation of an active surveillance program. Both high incidence of VRE colonization (or “colonization pressure”) and antibiotic use promoted VRE spread according to the results of the case control study. No proven sources of VRE were found (in local hospital or even in local livestock). A multifaceted management was implemented and included enhanced infection control measures, active surveillance cultures, cohorting of colonized patients, daily audits and optimization of antibiotic therapy. Although the outbreak had a biphasic pattern (monoclonal first wave followed by a polyclonal second wave) strict adherence to the aforementioned bundle of actions was proved essential for reducing VRE colonized cases. During the study period no new VRE infection occurred in neonates. (more…)
Author Interviews, Global Health, Infections, Lancet / 01.10.2013

Prof Didier Pittet, MD, MS Director of the Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals, Geneva, SwitzerlandMedicalResearch.com Interview with : Prof Didier Pittet, MD, MS Director of the Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals, Geneva, Switzerland   MedicalResearch.com : What are the main findings of the study? Prof. Pittet: The main finding is that the WHO hand hygiene promotion strategy is feasible and sustainable across healthcare settings worldwide. For the first time, we have evidence of its feasibility and successful effects to improve hand hygiene in a variety of different geographical and income settings, with an even greater impact in low-/middle-income countries than in high-income countries. (more…)
Author Interviews, C. difficile, Infections, NEJM / 26.09.2013

MedicalResearch.com Interview with: David W. Eyre, B.M., B.Ch. Nuffield Department of Clinical Medicine University of Oxford National Institute for Health Research (NIHR) Oxford Biomedical Research Centre John Radcliffe Hospital MedicalResearch.com: What are the main findings of this study? Dr. Eyre: All cases of Clostridium difficile in Oxfordshire were studied over 3 years. Isolates were characterized by whole genome sequencing and the data was linked to hospital databases allowing epidemiological relationships between patients at the level of the hospital ward, hospital specialty, and post code to be identified. For comparison, similar information was also available for all other patients with and without diarrhea.  Preliminary work on the genetic diversity of Clostridium difficile within individuals and between individuals within discrete outbreaks allowed reliable interpretation of transmission events using genomic data. This allowed a complete reconstruction of the pattern of transmission between affected cases in Oxfordshire to be made. The findings were: 1. Unexpectedly few cases (13%) appear to be acquired from direct ward based contact with other symptomatic cases (these have previously been thought to be the main source of infections, and the focus of prevention efforts). Another 6% were associated with other hospital contact and 3% had plausible community contacts. 2. In 13% of cases potential donors were identified gnomically but no contact, within hospitals or the community, were identified. This suggests that the existence of other modes of transmission of Clostridium difficile. 3. The sources of Clostridium difficile infections were highly genetically diverse, with 45% of cases having a genetically distinct origin - suggesting a diverse reservoir of disease, not previously appreciated 4. During the 3 years of the study the rate of Clostridium difficile in Oxfordshire fell.  Any improvement in infection control techniques would be expected to reduce the incidence of cases caused by within hospital transmission. Surprisingly, similar rates of fall occurred in both in secondary cases (considered to be acquired from hospital associated symptomatic cases) and for primary cases (cases not associated with transmission from symptomatic cases). (more…)
Author Interviews, MRSA, Pediatrics / 23.09.2013

MedicalResearch.com Interview with: Dr. Martha Iwamoto, MD, MPH Centers for Disease Control and Prevention, Atlanta, Georgia; MedicalResearch.com: What are the main findings of the study? Dr. Iwamoto: We have been successful in decreasing invasive MRSA infections among infants younger than 3 months, mostly due to declines in hospital –onset infections in NICUs. However, more needs to be done among pediatric patients older than 3 months, especially those in the community settings and without recent healthcare exposures. (more…)
Author Interviews, CMAJ, Infections, Outcomes & Safety, Urinary Tract Infections / 18.09.2013

MedicalResearch.com Interview with: Mohamad Fakih, MD, MPH Medical Director, Infection Prevention and Control St John Hospital and Medical Center MedicalResearch.com: What are the main findings of the study? Dr. Fakih: Urinary catheters are commonly used in the hospital.  Although they help in the management of the sickest patients, they also present a risk for infection and other harms to the patient. The Centers for Medicaid and Medicare Services (CMS) have made catheter associated urinary tract infections (CAUTI) publicly reportable, and no longer reimburse hospitals for these infections if they occur in hospital setting. The definition of CAUTI is based on the surveillance definition of the National Healthcare Safety Network (NHSN) by the Centers for Disease Control and Prevention (CDC). We looked at clinician practice, including the Infectious Diseases specialist’s impression and compared them to the NHSN definition. We found a significant difference between what clinicians think is a urinary catheter infection and give antibiotics for it compared to the NHSN definition. The NHSN definition predicted clinical infection by the Infectious Diseases specialist in only about a third of the cases. We also found that Infectious Disease specialists considered patients to have true CAUTI in only half of what clinicians treated as CAUTI. (more…)
Author Interviews, Case Western, Cleveland Clinic, Respiratory / 13.09.2013

Pranab K. Mukherjee, Ph.D. Assistant Professor Center for Medical Mycology Department of Dermatology University Hospitals Case Medical Center Case Western Reserve University Cleveland, OH 44106-5028MedicalResearch.com Interview with: Pranab K. Mukherjee, Ph.D. Assistant Professor Center for Medical Mycology Department of Dermatology University Hospitals Case Medical Center Case Western Reserve University Cleveland, OH 44106-5028 MedicalResearch.com: What are the main findings of the study? Answer: We performed a randomized double-blinded placebo-controlled pilot clinical trial to assess the safety, tolerability and effectiveness of a cetylpyridinium chloride (CPC)-based oral spray in the prevention of acute upper respiratory tract infections (URIs).
  • The tested CPC spray (ARMS-I, developed by Arms Pharmaceutical LLC, Cleveland, OH) was safe and exhibited high tolerability and acceptability among study participants
  • The product exhibited a trend to protect against URIs (55% relative reduction compared to the placebo), based on confirmed URIs, post-medication exit interviews, and daily electronic diaries completed by study participants
  • There was statistically significant reduction in frequency of cough and sore throat in the active group
  • The number of days (duration) of cough was significantly reduced in the active group compared to placebo arm
  • URI-associated viruses (influenza, rhinovirus and coronavirus) were detected in three individuals, all in the placebo arm. No virus was detected in the active arm/
  • No drug-related adverse events or oral lesions were observed
  • Previous vaccination status of the study participants did not affect the study outcome.
(more…)
Author Interviews, HIV, Kidney Disease / 11.09.2013

MedicalResearch.com Interview with: Magnus G. Rasch MD Faculty of Health Sciences, University of Copenhagen 1455 København K, Denmark Department of Infectious Diseases Copenhagen University Hospital, Rigshospitalet, Denmark MedicalResearch.com: What are the main findings of the study? Dr. Rasch: In the study “Increased risk of dialysis and end-stage renal disease among HIV patients in Denmark compared with the background population” we found that the risk of acute renal replacement therapy (aRRT) and the risk of chronic renal replacement therapy (cRRT) was increased substantially in HIV patients compared with the background population. The risk of aRRT was highest the first year after HIV diagnosis. Factors associated with increased risk of aRRT were intravenous drug use, hypertension and an AIDS-defining illness. Risk factors for cRRT were hypertension and baseline estimated glomerular filtration rate. (more…)
Author Interviews, HIV, Social Issues, UCLA / 03.09.2013

Sean D. Young, PhD, MS Assistant Professor In-Residence Center for Behavioral and Addiction Medicine Department of Family Medicine University of California, Los AngelesMedicalResearch.com Interview with: Sean D. Young, PhD, MS Assistant Professor In-Residence Center for Behavioral and Addiction Medicine Department of Family Medicine University of California, Los Angeles Dr. Young: Here's the main take-home point: There is a lot of excitement about the possibility of using technologies, big data, and mHealth to improve health outcomes and change behavior. However, 1) little work has been done on this topic using sound research methods (for example, studies have asked people to report whether a technology changed behavior rather than objectively measuring whether it actually changed behavior. (more…)
Author Interviews, Heart Disease, Infections, JACC, Yale / 31.08.2013

Behnood Bikdeli, MD Yale/YNHH Center for Outcomes Research and Evaluation One Church St, Suite 200 New Haven CT 0651MedicalResearch.com Interview with: Behnood Bikdeli, MD Yale/YNHH Center for Outcomes Research and Evaluation One Church St, Suite 200 New Haven CT 0651 MedicalResearch.com: What are the main findings of the study?
 Dr. Bikdeli: We determined the trends in hospitalizations and mortality from endocarditis among US older adults from 1999 to 2010. Endocarditis is the most serious cardiovascular infection and our study that had a very large sample, signified the high burden of endocarditis in this time period. (more…)
Author Interviews, Hepatitis - Liver Disease, HIV, McGill / 16.08.2013

Marina Klein, MD, MSc, FRCP(C) Associate Professor of Medicine McGill University Health Centre Division of Infectious Diseases and Chronic Viral Illness Service 3650 Saint Urbain Montreal, Quebec H2X 2P4MedicalResearch.com Interview with: Marina Klein, MD, MSc, FRCP(C) Associate Professor of Medicine McGill University Health Centre Division of Infectious Diseases and Chronic Viral Illness Service 3650 Saint Urbain Montreal, Quebec H2X 2P4 Disease in HIV–Hepatitis C Coinfection: A Longitudinal Cohort Analysis                MedicalResearch.com: What are the main findings of the study? Dr. Klein: We showed that people with HIV and hepatitis C infection who smoked marijuana did not tend to progress more rapidly to liver fibrosis, liver cirrhosis or end-stage liver disease, even with increasing numbers of joints smoked per week. Previous studies that reported that marijuana was harmful to the liver were likely biased because they did not ensure that marijuana smoking occurred before the development of liver problems. (more…)
Author Interviews, Gastrointestinal Disease, Infections, Lancet, Probiotics / 15.08.2013

Prof. Steve Allen Professor of Paediatrics and International Health; RCPCH International Officer and David Baum Fellow Room 314, The College of Medicine, Swansea University, Swansea, SA2 8PP, UK.Prof. Steve Allen Professor of Paediatrics and International Health; RCPCH International Officer and David Baum Fellow Room 314, The College of Medicine, Swansea University, Swansea, SA2 8PP, UK. MedicalResearch.com: What are the main findings of the study? Answer: Overall, diarrhoea occurred in just over 10% participants and diarrhoea caused by C. difficile in about 1%. These outcomes were equally common in those taking the microbial preparation and those taking placebo. Other outcomes (e.g. common GI symptoms, length of hospital stay, quality of life) were also much the same in the two groups. So, there was no evidence that the microbial preparation had prevented diarrhoea or had led to any other health benefit. In agreement with previous research, serious adverse events were also similar in the two groups – so we found no evidence that the microbial preparation caused any harm. (more…)
Author Interviews, HIV, Infections, JNCI, Lymphoma / 08.08.2013

MedicalResearch.com Interview with: Satish Gopal, MD, MPH Program in Global Oncology, Lineberger Comprehensive Cancer Center UNC Project-Malawi, Tidziwe Center, Private Bag A-104, Lilongwe, Malawi MedicalResearch.com: What is the primary message our physician readers should take away from the piece?” Answer: Lymphoma is one of the leading causes of HIV-associated death in the modern ART era. In our analyses of a large multicenter US cohort, survival for HIV-associated lymphoma patients receiving routine care has not clearly improved since the modern ART era began, and remains significantly worse than SEER outcomes for the same lymphoma subtypes in the general population. This was somewhat surprising in an era of normalizing life expectancy for HIV-infected patients on ART, and quite different from the outstanding results achieved for this population in recent clinical trials conducted by AMC and NCI. (more…)
Author Interviews, HPV, Infections, Race/Ethnic Diversity / 02.08.2013

MedicalResearch.com interview with: Matthew B. Schabath, Ph.D Assistant Member, Department of Cancer Epidemiology H. Lee Moffitt Cancer Center, 12902 Magnolia Drive MRC-CANCONT, Tampa, Florida MedicalResearch.com: What are the main findings of the study? Dr. Schabath: In this study we found that Asian/Pacific Islander men had the lowest incidence of human papillomavirus (HPV) infection and that they exhibited a lower probability of acquiring new HPV infections.   Furthermore, men of multiple and mixed race had the second lowest incidence of HPV infection and however, while they had a lower probability of acquiring HPV, they also had a lower probability of clearing an HPV infection once acquired. (more…)
CDC, Infections / 01.08.2013

CDC Highlights from 7/31/2013 From http://www.cdc.gov/parasites/cyclosporiasis/outbreaks/investigation-2013.html

Epidemiologic Investigation

  • As of July 30, 2013 (5pm EDT), CDC has been notified of 378 cases of Cyclospora infection from the following 16 health departments: Iowa, Texas, Nebraska, Florida, Wisconsin, Illinois, New York City, Georgia, Missouri, Arkansas, Connecticut, Kansas, Minnesota, New Jersey, New York, and Ohio.
  • Most of the illness onset dates have ranged from mid-June through early July.
  • At least 21 persons reportedly have been hospitalized in three states.
  • Nebraska and Iowa have performed investigations within their states and have shared the results of those investigations with CDC. Based on their analysis, Cyclospora infections in their states are linked to a salad mix. CDC will continue to work with federal, state, and local partners in the investigation to determine whether this conclusion applies to the increase in cases of cyclosporiasis in other states.
  • It is not yet clear whether the cases from all of the states are part of the same outbreak. (more…)
Author Interviews, Hospital Acquired, Johns Hopkins / 31.07.2013

MedicalResearch.com Interview with: Bruce Y. Lee, MD MBA Associate Professor of International Health Director of Operations Research International Vaccine Access Center (IVAC) Johns Hopkins Bloomberg School of Public Health 855 N. Wolfe Street Suite 600 Baltimore, MD 21205Bruce Y. Lee, MD MBA Associate Professor of International Health Director of Operations Research International Vaccine Access Center (IVAC) Johns Hopkins Bloomberg School of Public Health 855 N. Wolfe Street Suite 600 Baltimore, MD 21205 MedicalResearch.com: What are the main findings of the study? Dr. Lee: Vancomycin resistant enterococci (VRE) is every hospital’s problem.  A VRE outbreak in one hospital, even if the hospital is relatively small or distant, can readily spread to other hospitals in a region because patients leaving one hospital often will go to other hospitals either directly or after an intervening stay at home.  These patients can then carry VRE with them to other hospitals.  Therefore, as long a single hospital has a problem with VRE or any other healthcare associated infection, all other hospitals are at risk.  Conquering VRE then requires cooperation among hospitals. (more…)
Author Interviews, Diabetes, Infections, JAMA, Respiratory / 15.07.2013

Andreas Beyerlein, PhD Institute of Diabetes Research, Helmholtz Zentrum München and Forschergruppe Diabetes der Technischen Universität München, Munich, GermanyMedicalResearch.com Interview with: Andreas Beyerlein, PhD Institute of Diabetes Research, Helmholtz Zentrum München and Forschergruppe Diabetes der Technischen Universität München, Munich, Germany MedicalResearch.com What are the main findings of the study? Dr. Beyerlein: We identified respiratory infections in early childhood, especially in the first year of life, as a risk factor for islet autoimmunity, which is known as a precursor of type 1 diabetes (T1D). We also found some evidence for short term effects of infectious events on development of autoimmunity. (more…)
Author Interviews, Infections, Lyme, NEJM / 02.07.2013

MedicalResearch.com Interview with: Sam R. Telford III, ScD Department of Infectious Disease and Global Health, Tufts University, Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, MA Borrelia miyamotoi Infection Presenting as Human Granulocytic Anaplasmosis: A Case Report MedicalResearch.com: What are the main findings of the study? Answer: The study presents two additional cases of BMD (Borrelia miyamotoi disease) that add to our knowledge of the spectrum of illness of this recently recognized zoonosis.  Our report of the North American index case in NEJM in January 2013 described a case-patient who was elderly and immunocompromised and it was not clear whether that case was just very unusual.  With our Annals report, we describe cases in immune-intact individuals and suggest that cases of BMD may have been under our noses all along, just presumptively diagnosed as HGA and successfully treated with doxycycline with no followup (e.g., lab confirmation of diagnosis of HGA Human Granulocytic Anaplasmosis).  Hence, individuals presenting with fever, headache, myalgia, and show leukopenia and elevated LFTs may have either HGA or BMD and confirmatory testing should be done accordingly.  It should be noted that all tick borne diseases are clinical diagnoses and treatment of an acute case should not depend on "lab tests".  Both these infections are effectively managed by oral doxycycline, hence those with these signs and symptoms might be empirically treated with doxycyline, which would be important in areas where RMSF and tularemia (which also produce leukopenia and elevated LFTs) co-occur with deer tick -transmitted infections such as Lyme disease; waiting for "lab tests" to confirm RMSF or tularemia might lead to a negative outcome.  RMSF and tularemia are the most dangerous of the tick American tick borne diseases, although I would certainly place the very rare deer tick virus and Powassan virus in the same category. (more…)
Author Interviews, Infections, Lyme / 27.06.2013

MedicalResearch.com Interview with: Xin Li, Ph.D. Assistant Professor Department of Veterinary Biosciences The Ohio State University 344 Veterinary Medicine Academic Building Columbus, OH 43210 MedicalResearch.com: What are the main findings of the study? Dr. Xin Li : Antibody responses to borrelial antigens that are primarily expressed during the tick phase the spirochetes’ life cycle are common in American patients with Lyme arthritis, a late-stage manifestation of Lyme borreliosis, but are rare in American patients with early-stage infection or European patients with early- or late-stage infection. (more…)
HIV, Infections, JAMA, Race/Ethnic Diversity / 21.06.2013

MedicalResearch.com Interview with Dr. H. Irene Hall, PhD Division of HIV/AIDS Prevention National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC 1600 Clifton Road, MS E-47, Atlanta, GA 30333 MedicalResearch.com: What are the main findings of the study? Dr. Hall: Our research finds that, across all populations, far too few Americans with HIV receive the care they need to stay healthy and reduce risk of transmission. According to our research, gaps in care are the largest among African Americans and young people. Moving forward, improving care for all HIV-infected people will be critical to achieving the goal of an AIDS-free generation in America. More specifically, some of the key findings of the study include:
  • Overall, only a quarter of all Americans with HIV have a suppressed viral load – meaning the level of HIV in their bodies is low enough to stay healthy and dramatically reduce the chance of transmitting to others.
  • By race/ethnicity, African-Americans and Hispanics or Latinos are less likely to be aware of their infection compared to whites.
  •  By age, younger Americans are less likely to be in ongoing care and have a suppressed viral load; HIV care and viral suppression generally improved with age. For example:
  • Fifteen percent of those aged 25-34 were virally suppressed, compared to 36 percent of those aged 55-64.
  • In terms of ongoing care, 28 percent of those 25-34 years old were retained in care, compared to 46 percent of those aged 55-64. (more…)
Author Interviews, BMJ, Hospital Acquired, Infections, Outcomes & Safety / 19.06.2013

Marin L. Schweizer Ph.D. Assistant Professor University of Iowa Carver College of Medicine, Iowa City, IA, USAMedicalResearch.com Interview with: Marin L. Schweizer Ph.D. Assistant Professor University of Iowa Carver College of Medicine Iowa City, IA, USA MedicalResearch.com: What are the main findings of the study? Dr. Schweizer: A clinical bundle that includes nasally screening cardiac and orthopedic surgery patients for S. aureus (both methicillin-resistant S. aureus and methicillin-susceptible S. aureus), decolonizing carriers, and changing antibiotic prophylaxis for MRSA carriers, can significantly reduce the number of gram-positive surgical site infections, S. aureus surgical site infections and MRSA surgical site infections. (more…)
Author Interviews, C. difficile, Infections, Nutrition, Probiotics / 07.06.2013

MedicalResearch.com eInterview with: Dr. Reena Pattani MD Department of Medicine St. Michael’s Hospital 30 Bond Street, Toronto ON M5B 1W8 MedicalResearch.com: What are the main findings of the study? Dr. Pattani: We performed a meta-analysis of 16 studies that assessed the effectiveness of probiotics administered concurrently with antibiotics compared to the use of antibiotics alone. The use of probiotics among patients in these trials reduced the risk of antibiotic-associated diarrhea by almost 40% and decreased the rate of Clostridium difficile infection by 63%. On subgroup analysis, the reduction remained statistically significant for the subgroups of good quality trials, trials in which a primarily Lactobacillus-based regimen was used, and those studies which had a follow-up period of less than 4 weeks. (more…)