MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'The Lancet Infectious Diseases' source. Sat, 20 Mar 2010 14:28:04 +0100 http://www.medworm.com/index.php?rid=3296204&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700074%2Ffulltext%3Frss%3Dyes Ophthalmological examination of a 55-year-old white woman with longstanding ocular histoplasmosis syndrome (OHS) and recently diagnosed multiple sclerosis revealed poor central vision, peripapillary atrophy, extensive subretinal pigment deposition (), old choroidal neovascularisation (CNV; ), and punched-out chorioretinal scars in the absence of any anterior segment and vitreous inflammation. Cirrus HD retinal optical coherence tomography (OCT) scan revealed markedly disrupted topography of the internal limiting membrane and retinal pigment epithelium layers resulting from extensive chorioretinal scarring (). The so-called peaks and valleys seen on retinal OCT in this patient are in stark contrast to the smooth contours of these layers in eyes of healthy individuals. (Source: The Lancet In... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296204 Mon, 22 Feb 2010 00:00:00 +0100 3296204 http://www.medworm.com/index.php?rid=3296203&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703299%2Fabstract%3Frss%3Dyes Gains in the control of malaria and the promising progress of a malaria vaccine that is partly efficacious do not reduce the need for a high-efficacy vaccine in the longer term. Evidence supports the feasibility of developing a highly efficacious malaria vaccine. However, design of candidate malaria vaccines remains empirical and is necessarily based on many unproven assumptions because much of the knowledge needed to design vaccines and to predict efficacy is not available. Data to inform key questions of vaccine science might allow the design of vaccines to progress to a less empirical stage, for example through availability of assay results associated with vaccine efficacy. We discuss six strategic gaps in knowledge that contribute to empiricism in the design of vaccines. Comparative ev... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296203 Mon, 22 Feb 2010 00:00:00 +0100 3296203 http://www.medworm.com/index.php?rid=3296202&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700128%2Fabstract%3Frss%3Dyes An international group of multidisciplinary experts on middle-ear and paediatric infections met to explore where consensus exists on the management of acute otitis media. After informal discussions among several specialists of paediatric infectious disease, the group was expanded to include a larger spectrum of professionals with complementary expertise in middle-ear disease. Acute otitis media is a very common bacterial infection in children worldwide, leading to excessive antibiotic consumption in children in most countries and to a substantial burden of deafness and suppurative complications in developing countries. The group attempted to move beyond the existing controversies surrounding guidelines on acute otitis media, and to propose to clinicians and public health officials their vi... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296202 Mon, 22 Feb 2010 00:00:00 +0100 3296202 http://www.medworm.com/index.php?rid=3296201&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700116%2Fabstract%3Frss%3Dyes Combination therapy for the treatment of visceral leishmaniasis has increasingly been advocated as a way to increase treatment efficacy and tolerance, reduce treatment duration and cost, and limit the emergence of drug resistance. We reviewed the evidence and potential for combination therapy, and the criteria for the choice of drugs in such regimens. The first phase 2 results of combination regimens are promising, and have identified effective and safe regimens as short as 8 days. Several phase 3 trials are underway or planned in the Indian subcontinent and east Africa. The limited data available suggest that combination therapy is more cost-effective and reduces indirect costs for patients. Additional advantages are reduced treatment duration (8–17 days), with potentially better patien... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296201 Mon, 22 Feb 2010 00:00:00 +0100 3296201 http://www.medworm.com/index.php?rid=3296200&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700281%2Fabstract%3Frss%3Dyes WHO international guidelines for the control of tuberculosis in relation to air travel require—after a risk assessment—tracing of passengers who sat for longer than 8 h in rows adjacent to people with pulmonary tuberculosis who are smear positive or smear negative. A further recommendation is that all commercial air travel should be prohibited until the person has two consecutive negative sputum smears for drug-susceptible tuberculosis or two consecutive cultures for multidrug-resistant tuberculosis. In this Review I examine the evidence put forward to support these recommendations and assess whether such an approach is justifiable. A systematic review identified 39 studies of which 13 were included. The majority of studies found no evidence of transmission. Only two studies reported r... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296200 Mon, 22 Feb 2010 00:00:00 +0100 3296200 http://www.medworm.com/index.php?rid=3296199&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS147330991070027X%2Fabstract%3Frss%3Dyes Antibiotics have dramatically changed the prognoses of patients with severe infectious diseases over the past 50 years. However, the emergence and dissemination of resistant organisms has endangered the effectiveness of antibiotics. One possible approach to the resistance problem is the appropriate use of antibiotic drugs for preventing and treating infections. This Review describes how the volume and appropriateness of antibiotic use in hospitals vary between countries, hospitals, and physicians. At each specific level—cultural, contextual, and behavioural—we discuss the determinants that influence hospital antibiotic use and the possible improvement strategies to make it more appropriate. Changing hospital antibiotic use is a challenge of formidable complexity. On each level, many de... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296199 Mon, 22 Feb 2010 00:00:00 +0100 3296199 http://www.medworm.com/index.php?rid=3296198&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703287%2Fabstract%3Frss%3Dyes Following large-scale roll-out of antiretroviral therapy in sub-Saharan Africa, the non-clinical efficacy of antiretroviral therapy has received little attention. We aimed to systematically review virological efficacy and drug-resistance outcomes of programmes of antiretroviral therapy in sub-Saharan Africa. 89 studies with heterogeneous design, definitions, and methods were identified. Overall, in on-treatment analysis, 10 351 (78%) of 13 288 patients showed virological suppression after 6 months of antiretroviral therapy, 7413 (76%) of 9794 after 12 months, and 3840 (67%) of 5690 after 24 months. Long-term virological data are scarce. Genotyping results were available for patients with virological failure (HIV-1 RNA greater than 1000 copies per mL). Most patients (839 of 849; 99%) were... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296198 Mon, 22 Feb 2010 00:00:00 +0100 3296198 http://www.medworm.com/index.php?rid=3296197&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS147330991070044X%2Ffulltext%3Frss%3Dyes The Red Book of the American Academy of Pediatrics has grown in size and scope from the first edition in 1938 to the twenty-eighth edition in 2009. It is an impressive reference text, with 984 pages and a list of contributors comparable to a North American Who's Who in the specialty of paediatric infectious diseases. In addition to the presentation, diagnosis, treatment, and control of specific infections, the book also has sections on antimicrobial treatment, prophylaxis, vaccination, and recommendations for care of children under special circumstances. This last section is among the most useful and interesting, because it condenses a host of issues that infrequently arise in paediatric practice, ranging from discarded needle stick injuries in the community, through evaluating children ad... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296197 Mon, 22 Feb 2010 00:00:00 +0100 3296197 http://www.medworm.com/index.php?rid=3296196&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700438%2Ffulltext%3Frss%3Dyes The spread of disease throughout cities, countries, and the world relies on the spatial nature of transmission. Urban cities might face very different effects to rural communities, depending on the nature of the disease. Infections might cluster or they might move rapidly through modern transportation networks. At a smaller scale, an individual's social and travel networks might cause them to encounter infected individuals in a variety of ways. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296196 Mon, 22 Feb 2010 00:00:00 +0100 3296196 http://www.medworm.com/index.php?rid=3296195&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700426%2Ffulltext%3Frss%3Dyes The Tropical Health and Education Trust's International Health Links Manual is a well written and detailed guide on how to establish collaborative development partnerships between health-sector organisations in the UK and counterparts in developing countries. Although the focus is on partnerships with UK-based organisations, the general principles are valid for organisations in other parts of the world who wish to embark on similar partnerships. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296195 Mon, 22 Feb 2010 00:00:00 +0100 3296195 http://www.medworm.com/index.php?rid=3296194&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700414%2Ffulltext%3Frss%3Dyes Infection with hepatitis C virus (HCV) puts individuals at risk of cirrhosis and hepatocellular cancer. Standard interferon-based therapy for HCV infection is costly, time-consuming, and fails in about 50% of patients, but the lack of good assay systems has hampered the development of new HCV antivirals. Two recent studies may help to remedy this situation. In the first, researchers describe a cell-based fluorescent reporter system that allows real-time imaging of HCV infection. The system consists of human hepatoma cells (Huh-7.5) stably transduced with fluorescently labelled interferon-β promoter stimulator protein 1, a substrate of the HCV-encoded protease HCV NS3-4A. Productive infection of these cells with HCV causes fluorescence relocalisation, which can be used to study HCV biology... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296194 Mon, 22 Feb 2010 00:00:00 +0100 3296194 http://www.medworm.com/index.php?rid=3296193&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700402%2Ffulltext%3Frss%3Dyes Outbreaks of salmonella caused by tainted food products in the USA continue to shine a light on the need for improved food safety. In 2008–09 outbreak more than 700 people were infected after exposure to peanut products produced by Peanut Corporation of America (PCA), and in 2009–10 over 200 people have been infected after exposure to tainted salami products produced by Daniele International. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296193 Mon, 22 Feb 2010 00:00:00 +0100 3296193 http://www.medworm.com/index.php?rid=3296192&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700396%2Ffulltext%3Frss%3Dyes As of Jan 31, 2010, confirmed cases of pandemic H1N1 influenza have been reported in more than 209 countries and overseas territories worldwide, including at least 15 174 deaths. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296192 Mon, 22 Feb 2010 00:00:00 +0100 3296192 http://www.medworm.com/index.php?rid=3296191&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700384%2Ffulltext%3Frss%3Dyes At the recent annual meeting of the World Economic Forum in Davos, Switzerland, Bill and Melinda Gates pledged US$10 billion to aid vaccine efforts in the world's poorest countries. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296191 Mon, 22 Feb 2010 00:00:00 +0100 3296191 http://www.medworm.com/index.php?rid=3296190&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700372%2Ffulltext%3Frss%3Dyes Although the general rate of new infections with HIV and deaths from AIDS has been falling in Africa because of improvements in awareness and use of antiretroviral medicines, reports that people age 15–24 years are at higher risk of contracting the virus are causing concern among HIV/AIDS campaigners and governments. African countries might be facing a new chapter in the HIV/AIDS crisis originating in unsafe sexual practices among younger age groups. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296190 Mon, 22 Feb 2010 00:00:00 +0100 3296190 http://www.medworm.com/index.php?rid=3296189&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700360%2Ffulltext%3Frss%3Dyes Last year was a significant one for polio eradication. Real progress was made simultaneously in northern Nigeria, on the Afghanistan–Pakistan border, and in the remaining pockets in Bihar and Uttar Pradesh in India, cutting the number of cases worldwide to 1597 (correct as of Feb 2, 2010). The new bivalent oral polio vaccine (bOPV), which targets type 1 and type 3 polioviruses, was licensed in late 2009 and has been in use since December. Starting in February, March, and April, 2010, multiple mass immunisations are planned in all four remaining countries where polio is endemic, at the start of a 3-year intensive effort to finally halt polio transmission worldwide. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296189 Mon, 22 Feb 2010 00:00:00 +0100 3296189 http://www.medworm.com/index.php?rid=3296188&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700359%2Ffulltext%3Frss%3Dyes When Giuseppe Cornaglia, associate professor of microbiology at Verona University, Italy, was a young boy living in Sardinia, he would dream of travelling beyond the limits of the island. When he started to do so, he kept a travel journal. After spending almost a decade in “the top floors” of the European Society for Clinical Microbiology and Infectious Diseases (ESCMID), he reflects that his version of Gulliver's Travels would run to volumes if he had continued. His work with the society continues as ESCMID immediate past-president, and Cornaglia told TLID about this ideal combination of his passions for microbiology, travel, history, culture, and for people. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296188 Mon, 22 Feb 2010 00:00:00 +0100 3296188 http://www.medworm.com/index.php?rid=3296187&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700347%2Ffulltext%3Frss%3Dyes In September 1969, while in Exeter attending the annual meeting of the British Association for the Advancement of Science, the immunologist Sir Peter Medawar suffered a near-fatal stroke. Then aged 54, he was at the height of his powers. A professor at 32, a Fellow of the Royal Society at 34, and a Nobel laureate at 45, he was later the Director of the National Institute for Medical Research in London. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296187 Mon, 22 Feb 2010 00:00:00 +0100 3296187 http://www.medworm.com/index.php?rid=3296186&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700104%2Ffulltext%3Frss%3Dyes Concern about the antivaccination movement is clearly warranted. It is also correct that most concerns about vaccine safety can, in theory, be allayed by logic and reason, and that the role of vaccines in improving public health should never be understated. The accumulation of more evidence and clearer communication about the differences between causation and correlation, would also help. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296186 Mon, 22 Feb 2010 00:00:00 +0100 3296186 http://www.medworm.com/index.php?rid=3296185&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS147330991070030X%2Ffulltext%3Frss%3Dyes In their Review, Drosos E Karageorgopoulos and Matthew E Falagas discussed in depth the emerging role of Acinetobacter baumannii in multidrug-resistant infection and the many therapeutic problems it poses. Although they also emphasised the risk factors and characteristics of patients who are susceptible to colonisation and infection, there was no mention of A baumannii infection in children. Over the past few years, we have noted that A baumannii has been the cause of severe infections of the CNS in children with postsurgical meningitis or mechanical ventilation. The majority of children were unsuccessfully treated with broad-spectrum antibiotics. Our personal experience was recently confirmed by others. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296185 Mon, 22 Feb 2010 00:00:00 +0100 3296185 http://www.medworm.com/index.php?rid=3296184&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700293%2Ffulltext%3Frss%3Dyes It was with great satisfaction that I saw, published in The Lancet Infectious Diseases, a Review by Charlotte Warren-Gash and colleagues on influenza as a trigger for acute myocardial infarction and cardiovascular diseases deaths. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296184 Mon, 22 Feb 2010 00:00:00 +0100 3296184 http://www.medworm.com/index.php?rid=3296183&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700098%2Ffulltext%3Frss%3Dyes Adoke Yeka and colleagues question the use of quinine monotherapy as a second-line treatment in Africa in the era of artemisinin-based combination therapy. We discuss the rationale for continuing to treat malaria in Africa with quinine. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296183 Mon, 22 Feb 2010 00:00:00 +0100 3296183 http://www.medworm.com/index.php?rid=3296182&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700086%2Ffulltext%3Frss%3Dyes Adoke Yeka and colleagues rightly call for the discontinuation of quinine monotherapy in sub-Saharan Africa. However, combination therapies using quinine for the treatment of uncomplicated malaria in pregnancy were discounted. We agree that artemether with lumefantrine, azithromycin, artesunate with mefloquine, or dihydroartemisinin with piperaquine should be investigated for their potential use in the treatment of pregnant women with uncomplicated malaria. However, with the exception of azithromycin, all of these compounds are contraindicated in the first trimester. Priority should be given to investigating treatment regimens including azithromycin with quinine and azithromycin with chloroquine that are safe for use throughout pregnancy. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296182 Mon, 22 Feb 2010 00:00:00 +0100 3296182 http://www.medworm.com/index.php?rid=3296181&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700335%2Ffulltext%3Frss%3Dyes The GAVI Alliance celebrated the tenth anniversary of its foundation on Jan 29 this year. During its 10 years GAVI has overseen the delivery of vaccines to around 250 million children in the world's poorest countries, a programme that has probably averted around 5 million deaths. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3296181 Mon, 22 Feb 2010 00:00:00 +0100 3296181 http://www.medworm.com/index.php?rid=3202694&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700050%2Ffulltext%3Frss%3Dyes A 42-year-old woman presented to our hospital after 2 months of pain in her left hip. She had received a cadaveric-kidney transplant 9 months earlier at our hospital because of end-stage renal disease. After transplantation, the patient received maintenance immunosuppressants with oral tacrolimus (3 mg twice a day) and prednisolone (5 mg per day). On admission, she was afebrile. Her white-blood-cell count was 9150 cells per μL, with neutrophils of 62%, lymphocytes of 31%, and monocytes of 5%. Radiography showed an osteolytic lesion on her left pelvic brim adjacent to the acetabulum (). The osteolytic lesion was biopsied using an echoguided needle. Staining with gomori methenamine silver revealed yeast-like fungi with transverse septa (). At 25°C, this fungus grew as mold on sabouraud dex... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202694 Mon, 25 Jan 2010 00:00:00 +0100 3202694 http://www.medworm.com/index.php?rid=3202693&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700049%2Fabstract%3Frss%3Dyes We present a simple mathematical model of vaccination, screening, and disease incidence, including an analysis of the effect of data uncertainties. For a population with opportunistic screening and 30% vaccine coverage, screening rates in vaccinated women would have to decline by at least 80% (median value of probabilistic uncertainty analysis) before the incidence of cervical cancer would increase in the era since the introduction of the vaccine. By comparison, the decline needed is at least 49% in a population with organised screening and 70% vaccine coverage. In populations that have highly effective cervical screening programmes, incidence of cervical cancer starts to increase after smaller, but still substantial, decreases in screening. Introduction of vaccine is unlikely to lead to a... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202693 Mon, 25 Jan 2010 00:00:00 +0100 3202693 http://www.medworm.com/index.php?rid=3202692&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703275%2Fabstract%3Frss%3Dyes Paediatric formulations of artemisinin combination therapies (ACTs) have recently been developed for the treatment of children with falciparum malaria. Compared with conventional tablet formulations, the new non-tablet preparations have shown equivalent efficacy, safety, and tolerability in individual trials. We aimed to investigate whether objective evidence supports the development and use of paediatric ACTs. A systematic review identified seven studies involving 2515 children that were eligible for meta-analysis. Similar efficacy and safety were seen in pooled analyses of paediatric and conventional formulations. 23 (2·0%) of 1154 patients in the paediatric formulation groups and 19 (1·7%) of 1137 in the tablet formulation groups were not cured (RR 1·27, 95% CI 0·66–2·44). Despit... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202692 Mon, 25 Jan 2010 00:00:00 +0100 3202692 http://www.medworm.com/index.php?rid=3202691&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS147330990970324X%2Fabstract%3Frss%3Dyes Most invasive meningococcal disease in developed countries is caused by Neisseria meningitidis with a serogroup B capsule. However, despite availability of vaccines for other serogroups since the 1960s, no serogroup B vaccine exists. In this Review we look at the development of serogroup B vaccines over the past 40 years. Outer membrane vesicle vaccines have been successfully used to control geographically isolated epidemics, but most have not been highly immunogenic in young children or provided broad cross-protection from infections with other strains. Vaccines based on subcapsular antigens have recently produced promising results in early clinical trials, and the disease burden might be substantially reduced over the next few years. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202691 Mon, 25 Jan 2010 00:00:00 +0100 3202691 http://www.medworm.com/index.php?rid=3202690&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703305%2Fabstract%3Frss%3Dyes The wide geographic distribution of one clade of Mycobacterium tuberculosis, the Beijing genotype family, and its genetic homogeneity, suggests that strains belonging to this grouping might have a selective advantage over other M tuberculosis strains. This hypothesis was addressed by reviewing molecular-epidemiological, experimental, and clinical studies. Beijing strains represent about 50% of strains in east Asia and at least 13% of strains worldwide. Their emergence might be linked to escape from BCG vaccination, and to multidrug resistance, which is associated with the Beijing genotype in many areas. Different animal models have shown Beijing strains to be more virulent, and to cause more histopathological changes, higher outgrowth, and increased mortality. At a molecular level, Beijing... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202690 Mon, 25 Jan 2010 00:00:00 +0100 3202690 http://www.medworm.com/index.php?rid=3202689&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703263%2Fabstract%3Frss%3Dyes Intensified case finding is the regular screening for evidence of tuberculosis in people infected with HIV, at high risk of HIV, or living in congregate settings. We systematically reviewed studies of intensified case finding published between January, 1994, and April, 2009. In 78 eligible studies, the number of people with tuberculosis detected during intensified case finding varied substantially between countries and target groups of patients. Median prevalence of newly diagnosed tuberculosis was 0·7% in population-based surveys, 2·2% in contact-tracing studies, 2·3% in mines, 2·3% in programmes preventing mother-to-child transmission of HIV, 2·5% in prisons, 8·2% in medical and antiretroviral treatment clinics, and 8·5% in voluntary counselling and testing services. Metaregressio... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202689 Mon, 25 Jan 2010 00:00:00 +0100 3202689 http://www.medworm.com/index.php?rid=3202688&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703317%2Fabstract%3Frss%3Dyes Acute coronary syndromes are a leading cause of morbidity and mortality worldwide. The mechanisms underlying the triggering of these events are diverse and include increased coronary and systemic inflammatory activity, dominant prothrombotic conditions, increased biomechanical stress on coronary arteries, variations in the coronary arterial tone, disturbed haemodynamic homoeostasis, and altered myocardial metabolic balance. There is experimental evidence that acute infections can promote the development of acute coronary syndromes, and clinical data strongly support a role for acute infections in triggering these events. In our Review, we summarise the pathogenesis of coronary artery disease and present the evidence linking acute infections with the development of acute coronary syndromes.... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202688 Mon, 25 Jan 2010 00:00:00 +0100 3202688 http://www.medworm.com/index.php?rid=3202687&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700256%2Ffulltext%3Frss%3Dyes Guy R, Gold J, Calleja JM, et al. Accuracy of serological assays for detection of recent infection with HIV and estimation of population incidence: a systematic review. Lancet Infect Dis 2009; 9: 747–59. In this Review reference 38 should have been Bärnighausen T, Wallrauch C, Welte A, et al. HIV incidence in rural South Africa: comparison of estimates from longitudinal surveillance and cross-sectional cBED assay testing. PLoS One 2008; 3: e3640. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202687 Mon, 25 Jan 2010 00:00:00 +0100 3202687 http://www.medworm.com/index.php?rid=3202686&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700244%2Ffulltext%3Frss%3Dyes The author of The Elusive Malaria Vaccine: Miracle or Mirage? has spent several decades engaged in malaria research. Given the start in May, 2009, of the Phase 3 trial of RTS,S/AS01, the first malaria vaccine that might be registered and that could potentially be available for use in sub-Saharan Africa, this book is timely and provides a very good overview of the prehistory and history of microbiology, parasitology, and vaccinology. Its strengths include illuminating details into the life of figures such as Robert Koch and Louis Pasteur, the seminal malaria work of some of the doyens of the 1960s, 1970s, and 1980s, and outlining preclinical research on the blood stages of non-human plasmodia. More recent research is enlivened by descriptions that appear to be based on interviews with some ... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202686 Mon, 25 Jan 2010 00:00:00 +0100 3202686 http://www.medworm.com/index.php?rid=3202685&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700232%2Ffulltext%3Frss%3Dyes Edited by H Simon Schaaf and Alimuddin Zumla, Tuberculosis: A Comprehensive Clinical Reference addresses the increasingly complex medical and social face of tuberculosis in a thorough, well structured, and easy to access reference work. The 107 chapters are grouped into sections about history and epidemiology, basic science, natural history, clinical features and diagnosis, challenges to tuberculosis control, treatment and management, prevention, illustrative case histories, and social and structural issues related to tuberculosis. Concise appendices provide information on tuberculosis drugs, web resources, and information about tuberculosis research funding. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202685 Mon, 25 Jan 2010 00:00:00 +0100 3202685 http://www.medworm.com/index.php?rid=3202684&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700220%2Ffulltext%3Frss%3Dyes This book is, as the subtitle states, a book about ethics and infectious disease and has as such become even more relevant in recent months where we have been threatened by an influenza pandemic. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202684 Mon, 25 Jan 2010 00:00:00 +0100 3202684 http://www.medworm.com/index.php?rid=3202683&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700219%2Ffulltext%3Frss%3Dyes Epidemics of emerging infectious diseases pose logistical problems for public health officials. How can the effects of vaccination, social distancing, and other control measures be optimised when knowledge about an emerging infection is limited? A new modelling study suggests that targeting disease interventions at the group with the highest risk of infection per individual will achieve the largest reduction in the transmission potential of an emerging infectious disease. More specifically, vaccination should be targeted at groups with the highest product of incidence and force of infection, and social distancing should be instigated in groups with the highest incidence of infection. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202683 Mon, 25 Jan 2010 00:00:00 +0100 3202683 http://www.medworm.com/index.php?rid=3202682&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700207%2Ffulltext%3Frss%3Dyes In November, the US Food and Drug Administration approved a capsaicin skin patch for the treatment of postherpetic neuralgia (PHN), the chronic pain that affects many people in the months after shingles. Great news; however, developments like this make it all the more puzzling that a vaccine that could prevent shingles, is still little used despite having been licensed in the USA and Europe since 2006. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202682 Mon, 25 Jan 2010 00:00:00 +0100 3202682 http://www.medworm.com/index.php?rid=3202681&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700190%2Ffulltext%3Frss%3Dyes Heroin contaminated with anthrax is thought to have caused several cases of the infection in Scotland, although the source has not yet been identified. So far 14 people have been confirmed to have had the infection and seven of these have died. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202681 Mon, 25 Jan 2010 00:00:00 +0100 3202681 http://www.medworm.com/index.php?rid=3202680&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700189%2Ffulltext%3Frss%3Dyes Walter Stamm, the infectious disease expert who revolutionised management of urinary tract infections and pelvic inflammatory disease, died on Dec 14 from malignant melanoma, aged 64 years. Worldwide, the specialty is mourning the notable professor of medicine and former head of the division of allergy and infectious disease at the University of Washington (Seattle, WA, USA). (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202680 Mon, 25 Jan 2010 00:00:00 +0100 3202680 http://www.medworm.com/index.php?rid=3202679&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700177%2Ffulltext%3Frss%3Dyes On World AIDS Day, Dec 1, 2009, attention was again focused on the many people who have died of this disease and the multiple challenges that remain in treating and preventing it. Among the challenges is the need to target prevention efforts and treatment strategies at specific populations that are disproportionately burdened by the disease. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202679 Mon, 25 Jan 2010 00:00:00 +0100 3202679 http://www.medworm.com/index.php?rid=3202678&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700165%2Ffulltext%3Frss%3Dyes Mongolia became the first developing nation to receive the pandemic influenza H1N1 vaccine under WHO's plan to deploy the vaccine to 95 poor nations worldwide. As TLID went to press on Jan 13, Azerbaijan and Afghanistan were expected to receive the vaccine within a few days. Some developing countries have been working on their own vaccine. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202678 Mon, 25 Jan 2010 00:00:00 +0100 3202678 http://www.medworm.com/index.php?rid=3202677&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700153%2Ffulltext%3Frss%3Dyes World Leprosy Day on Jan 31 marked the start of the final year of the current WHO Global Strategy for Further Reducing the Leprosy Burden. The period 2011–15 will be covered by a strategy that introduces a new target—the reduction of grade 2 disability by 35%, taking the end of 2010 as the baseline—and eschews the rhetoric of elimination that characterised previous campaigns. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202677 Mon, 25 Jan 2010 00:00:00 +0100 3202677 http://www.medworm.com/index.php?rid=3202676&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700141%2Ffulltext%3Frss%3Dyes Every year since 1980 investigators have described about three new pathogens in human beings, with most of them being causes of zoonoses. Estimates vary, but it seems that about three quarters of all emerging infectious diseases are zoonotic, coming principally from wildlife. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202676 Mon, 25 Jan 2010 00:00:00 +0100 3202676 http://www.medworm.com/index.php?rid=3202675&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700013%2Ffulltext%3Frss%3Dyes Lymphadenopathy was identified as an essential feature of AIDS soon after its appearance and before the identification of HIV as its cause. However, lymphadenopathy has not subsequently received much attention. Recently, two studies have allowed lymph nodes to regain centre stage. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202675 Mon, 25 Jan 2010 00:00:00 +0100 3202675 http://www.medworm.com/index.php?rid=3202674&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700025%2Ffulltext%3Frss%3Dyes We thank Patrick Phillips and colleagues for their comments. As they suggest, the distinction between surrogacy as an endpoint for clinical trials and a predictor for the outcomes in individual patients is an important one. Federal regulations in the USA (subpart H of 21CFR314) permit accelerated approval of new drugs for serious or life-threatening illnesses on the basis of a surrogate endpoint that is “reasonably likely, based on epidemiologic, therapeutic, pathophysiologic, or other evidence, to predict clinical benefit”. We strongly agree with Phillips and colleagues that 2-month culture conversion meets this standard, on the basis of the highly significant inverse relation between effects on rates of conversion and relapse that is evident in randomised trials of tuberculosis chemo... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202674 Mon, 25 Jan 2010 00:00:00 +0100 3202674 http://www.medworm.com/index.php?rid=3202673&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702567%2Ffulltext%3Frss%3Dyes Robert S Wallis and colleagues present a timely and useful overview of the development of biomarkers and surrogate endpoints for the assessment of treatment success in tuberculosis. They make the important distinction between the use of biomarkers in clinical trials evaluating new treatments and predicting the individual patient's response to treatment. However, the implications of these two connected but different applications of biomarkers are not fully discussed. Furthermore, the presentation of existing data on bacteriological biomarkers seems incomplete and potentially misleading. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202673 Mon, 25 Jan 2010 00:00:00 +0100 3202673 http://www.medworm.com/index.php?rid=3202672&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309910700037%2Ffulltext%3Frss%3Dyes Our Review published in The Lancet Infectious Diseases last year contained an analysis of the relation between rates of 2-month sputum-culture conversion and relapse in a small number of published trials on the treatment of tuberculosis. The findings supported a potential role for 2-month conversion in accelerating the approval process of new drugs for the treatment of tuberculosis. Assessment of that material during recent regulatory meetings revealed that one study should not have been included, because it contained an arm in which a new drug (thiacetazone) was added only in the continuation phase. We regret this error, as it called into question the validity of our conclusion because of the relatively small number of cited studies. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202672 Mon, 25 Jan 2010 00:00:00 +0100 3202672 http://www.medworm.com/index.php?rid=3202671&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS147330991070013X%2Ffulltext%3Frss%3Dyes Since the identification of Pneumocystis (carinii) jirovecii pneumonia in five homosexual men in San Francisco in 1981, which led to the first description of what has become known as AIDS, our understanding of the syndrome has come a long way. Although the disease briefly acquired the somewhat divisive monikers gay-related immune deficiency (GRID) and 4H (after the populations affected: Haitians, homosexuals, haemophiliacs, and heroin users), the story in the past three decades has been one of a pandemic that has touched most social groups in every country. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3202671 Mon, 25 Jan 2010 00:00:00 +0100 3202671 http://www.medworm.com/index.php?rid=3107517&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703470%2Ffulltext%3Frss%3Dyes A 27-year-old woman presented to a tertiary centre for mycology in Mexico City, Mexico, with an 11-year history of progressive swelling and deformity of her right foot, and was no longer able to weight-bear. Clinically, there were draining sinuses and giant, white grains with a seropurulent discharge (). A radiograph of her foot showed marked soft tissue enlargement and bony lytic lesions (). Direct microscopy of the grains showed characteristic features of nocardia (). Histopathology of a skin biopsy showed grains together with a granulomatous inflammatory reaction (). Culture confirmed the presence of Nocardia brasiliensis. The patient had previously been treated unsuccessfully with oral penicillin, which is not a recommended treatment for actinomycetomas. Given the incapacitating nature... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107517 Mon, 21 Dec 2009 00:00:00 +0100 3107517 http://www.medworm.com/index.php?rid=3107516&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703214%2Fabstract%3Frss%3Dyes Despite the enormous progress made in scaling up antiretroviral therapy (ART) in sub-Saharan Africa, many challenges remain, not least of which are the identification and management of patients who have failed first-line therapy. Less than 3% of patients are receiving second-line treatment at present, whereas 15–25% of patients have detectable viral loads 12 months or more into treatment, of whom a substantial proportion might have virological failure. We discuss the reasons why virological ART failure is likely to be under-diagnosed in the routine health system, and address the current difficulties with standard recommended second-line ART regimens. The development of new diagnostic tools for ART failure, in particular a point-of-care HIV viral-load test, combined with simple and inexpe... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107516 Mon, 21 Dec 2009 00:00:00 +0100 3107516 http://www.medworm.com/index.php?rid=3107515&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703226%2Fabstract%3Frss%3Dyes Host immunity is an important but poorly understood determinant of antimalarial efficacy, influencing the outcome of prevention and treatment trials. Variations in host immunity might explain why factors such as host genetics, age, pregnancy, infection with HIV, parasite density, and malaria transmission intensity, can raise or lower apparent cure rates. Recently, attempts have been made to characterise immunological correlates of treatment outcome in Plasmodium falciparum malaria, but not yet for Plasmodium vivax. A better understanding of such correlates might improve trials of antimalarial drugs and provide leads for vaccine development. Greater understanding of the relation between host immunity and treatment outcome is crucial to making informed choices about the use of safe but partl... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107515 Mon, 21 Dec 2009 00:00:00 +0100 3107515 http://www.medworm.com/index.php?rid=3107514&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703251%2Fabstract%3Frss%3Dyes Rising rates of resistance to antimicrobial drugs among Enterobacteriaceae limit the choice of reliably active forms of these drugs. We evaluated the evidence on fosfomycin as a treatment option for infections caused by members of the family Enterobacteriaceae with advanced resistance to antimicrobial drugs, including producers of extended-spectrum β-lactamase (ESBL). We systematically reviewed studies evaluating the antimicrobial activity, or the clinical effectiveness of fosfomycin. 17 antimicrobial-susceptibility studies were found and included in our Review, accounting for 5057 clinical isolates of Enterobacteriaceae with advanced resistance to antimicrobial drugs (4448 were producers of ESBL); 11 of the 17 studies reported that at least 90% of the isolates were susceptible to fosfomy... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107514 Mon, 21 Dec 2009 00:00:00 +0100 3107514 http://www.medworm.com/index.php?rid=3107513&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703068%2Fabstract%3Frss%3Dyes Bacterial meningitis continues to be an important cause of mortality and morbidity in neonates and children throughout the world. The introduction of the protein conjugate vaccines against Haemophilus influenzae type b, Streptococcus pneumoniae, and Neisseria meningitidis has changed the epidemiology of bacterial meningitis. Suspected bacterial meningitis is a medical emergency and needs empirical antimicrobial treatment without delay, but recognition of pathogens with increasing resistance to antimicrobial drugs is an important factor in the selection of empirical antimicrobial regimens. At present, strategies to prevent and treat bacterial meningitis are compromised by incomplete understanding of the pathogenesis. Further research on meningitis pathogenesis is thus needed. This Review su... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107513 Mon, 21 Dec 2009 00:00:00 +0100 3107513 http://www.medworm.com/index.php?rid=3107512&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703056%2Fabstract%3Frss%3Dyes The worldwide increase in resistance to antimicrobial drugs has made reducing the unnecessary use of antibiotics a public health priority. There have been campaigns in many countries to educate the public about appropriate use of antibiotics in outpatients. By use of a comprehensive search strategy and structured interviews, we were able to identify and review the characteristics and outcomes of 22 campaigns done at a national or regional level in high-income countries between 1990 and 2007. The intensity of the campaigns varied widely, from simple internet to expensive mass-media campaigns. All but one campaign targeted the public and physicians simultaneously. Most campaigns that were formally evaluated seemed to reduce antibiotic use. The effect on resistance to antimicrobial drugs cann... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107512 Mon, 21 Dec 2009 00:00:00 +0100 3107512 http://www.medworm.com/index.php?rid=3107511&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703469%2Ffulltext%3Frss%3Dyes Mermel LA. Preventing the spread of influenza A H1N1 2009 to health-care workers. Lancet Infect Dis 2009; 9: 723–24. It was stated that N95 respirators were found to be more effective than surgical masks in the prevention of infection with influenza. A subsequent update of the cited study has since concluded that there is no difference. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107511 Mon, 21 Dec 2009 00:00:00 +0100 3107511 http://www.medworm.com/index.php?rid=3107510&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703457%2Ffulltext%3Frss%3Dyes Substantial reduction in malaria mortality worldwide is a major goal for public-health officials. As the authors of this book rightly point out, this can only be achieved by having a well prepared and responsive health-care system. This is something that Yazoumé Yé and colleagues feel could be improved by having an early warning system for malaria, and they propose that the model presented contributes to the development of such a system. The specific aims of the book were to investigate the relation between malaria transmission in children and local weather in a holoendemic region with seasonal transmission, and to predict malaria primarily by use of weather indices. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107510 Mon, 21 Dec 2009 00:00:00 +0100 3107510 http://www.medworm.com/index.php?rid=3107509&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703445%2Ffulltext%3Frss%3Dyes In Sequelae and Long-Term Consequences of Infectious Diseases, the authors focus not only on a selection of infections that are known to be associated with chronic illness, but also on possible links—such as Mycobacterium avium paratuberculosis with Crohn's disease or some strains of Porphyromonas gingivitis and atherosclerosis. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107509 Mon, 21 Dec 2009 00:00:00 +0100 3107509 http://www.medworm.com/index.php?rid=3107508&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703433%2Ffulltext%3Frss%3Dyes The current standard treatment for hepatitis C virus (HCV) infections—pegylated interferon-alfa and ribavirin—clears HCV in only 50% of patients and has serious side-effects. Now, two papers offer hope that a more effective treatment for HCV infections might be found in the near future. In the first paper, researchers report that treatment of chronically infected chimpanzees with a locked nucleic-acid-modified oligonucleotide (SPC3649) complementary to miR-122—a liver-expressed microRNA that HCV needs for replication in human liver cells—leads to long-lasting suppression of HCV viraemia and improvement of HCV-induced liver pathology with no evidence of viral resistance or side-effects. In the second paper, researchers describe an unbiased screening system for the identification of ... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107508 Mon, 21 Dec 2009 00:00:00 +0100 3107508 http://www.medworm.com/index.php?rid=3107507&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703421%2Ffulltext%3Frss%3Dyes Last month's summit between the European Union (EU) and the USA, in Washington, DC, saw US President Barack Obama and Swedish Prime Minister Fredrik Reinfeldt—on behalf of the EU Presidency—agree to establish a transatlantic taskforce to tackle antibiotic resistance. The Infectious Disease Society of America (IDSA) subsequently wrote to the respective leaders commending them on their undertaking and advising that the prospective taskforce include an antibacterial drug pipeline work group. The letter called for global commitment to the development of new antibacterial drugs. “The immediate goal”, wrote the authors, “should be the development of ten novel drugs by 2020.” (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107507 Mon, 21 Dec 2009 00:00:00 +0100 3107507 http://www.medworm.com/index.php?rid=3107506&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS147330990970341X%2Ffulltext%3Frss%3Dyes As the latest figures indicate that new HIV infections and AIDS deaths are starting to fall globally, WHO has released guidelines that recommend earlier initiation of antiretroviral treatment and prolonged use of antiretrovirals to prevent mother-to-child (vertical) transmission. These measures are intended to further reduce the epidemic in high-burden countries, says WHO. Now, the challenge is encouraging more people to come earlier for HIV testing, says Teguest Guerma, acting director of WHO's HIV/AIDS division. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107506 Mon, 21 Dec 2009 00:00:00 +0100 3107506 http://www.medworm.com/index.php?rid=3107505&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703408%2Ffulltext%3Frss%3Dyes Although 90% of malaria deaths occur in Africa, the fight against the disease has never looked as hopeful, according to speakers at the fifth pan-African Multilateral Initiative on Malaria (MIM) conference in Nairobi, Kenya on Nov 1–6. Increased funding for malaria research has enabled a remarkable rise in the number of new medicines being developed, more people have access to insecticide-treated bednets (ITNs), and bringing malaria under control and even elimination of the disease seem to be in sight. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107505 Mon, 21 Dec 2009 00:00:00 +0100 3107505 http://www.medworm.com/index.php?rid=3107504&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703391%2Ffulltext%3Frss%3Dyes Pandemic influenza H1N1 vaccination campaigns are at last underway across the world. Public health officials are finding, however, that a major barrier to vaccination is not the availability of the vaccine but a lack of enthusiasm from the general public and some health professionals. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107504 Mon, 21 Dec 2009 00:00:00 +0100 3107504 http://www.medworm.com/index.php?rid=3107503&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS147330990970338X%2Ffulltext%3Frss%3Dyes We report some of the major advances in hepatitis B (HBV) and hepatitis C (HCV). (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107503 Mon, 21 Dec 2009 00:00:00 +0100 3107503 http://www.medworm.com/index.php?rid=3107502&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703378%2Ffulltext%3Frss%3Dyes “Many clusters of diarrhoea are not investigated using laboratory methods that could lead to the identification of an aetiological agent. Thus cholera may be under-recognized.” (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107502 Mon, 21 Dec 2009 00:00:00 +0100 3107502 http://www.medworm.com/index.php?rid=3107501&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703366%2Ffulltext%3Frss%3Dyes The new cover illustrators for The Lancet Infectious Diseases for 2010 are Ross Crawford and David Souch, working under the pseudonym of Ahoythere, who replace Nigel Owen. We thank Nigel for his imaginative cover illustrations during 2009, which have received much praise. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107501 Mon, 21 Dec 2009 00:00:00 +0100 3107501 http://www.medworm.com/index.php?rid=3107500&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703354%2Ffulltext%3Frss%3Dyes Paul Johnson, a former American Peace Corps volunteer and present US medical student, claims that there is corruption in the use of funds allocated to Mozambique through the US President's Emergency Plan for AIDS Relief (PEPFAR). As PEPFAR-implementing partners in Mozambique, working specifically in the rural district in which Johnson lived and worked as a Peace Corps volunteer (in education and not health), we wish to offer what we believe is a more balanced perspective. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107500 Mon, 21 Dec 2009 00:00:00 +0100 3107500 http://www.medworm.com/index.php?rid=3107499&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703342%2Ffulltext%3Frss%3Dyes Seasonal influenza imposes an enormous but poorly defined burden of excess deaths, hospital admissions, and health-care costs, and often spreads within health-care facilities. Hospital patients with influenza are a potential source of infection for health-care workers that are not immunised, with attack rates among health-care workers of 18–24%. Unfortunately, health-care workers infected with influenza often continue to work, despite symptoms, with potentially devastating consequences for high-risk patients, including those who are very young, elderly, or immunocompromised—for example, patients receiving bone-marrow transplants have a high risk of pneumonia and death from influenza. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107499 Mon, 21 Dec 2009 00:00:00 +0100 3107499 http://www.medworm.com/index.php?rid=3107498&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703330%2Ffulltext%3Frss%3Dyes The 49th Interscience Conference on Antimicrobial Agents and Chemotherapy further emphasised the need for new antibiotics to combat the escalating problem of bacterial resistance. In addition to previous microbial problems such as meticillin-resistant Staphylococcus aureus, the continued emergence of pan-resistant Gram-negative organisms provides further clinical difficulties. These organisms are now ubiquitous worldwide, so perhaps it is time to address this matter from an international perspective? (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107498 Mon, 21 Dec 2009 00:00:00 +0100 3107498 http://www.medworm.com/index.php?rid=3107497&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703329%2Ffulltext%3Frss%3Dyes This month sees publication by our parent journal of a series of four reviews on neglected tropical diseases. According to the first paper in The Lancet series by Bernhard Liese and colleagues, “neglected tropical diseases represent the most common diseases for the 2·7 billion people living on less than US$2 per day”. Given that neglected tropical diseases are caused by a great range of bacteria, viruses, and parasites, can there possibly be a unified approach to tackling the burden of disease they cause? (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=3107497 Mon, 21 Dec 2009 00:00:00 +0100 3107497 http://www.medworm.com/index.php?rid=2994532&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909700854%2Ffulltext%3Frss%3Dyes A 24-year-old Caribbean man, with no previous medical history, presented with cough, dyspnoea, and weight loss of 6 kg over the previous month. He reported a 2-month history of night sweats without fever. Physical examination revealed breath frequency of 40 breaths per min and a tachycardia of 121 beats per min, with soft heart sounds and ankle oedema. Laboratory findings showed a normal complete blood count and C-reactive protein of 107 mg/L. HIV serology was negative. Echocardiography found a tamponade with a thickened pericardium (6 mm), confirmed by a contrast-enhanced thoracic CT scan (). (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994532 Mon, 16 Nov 2009 00:00:00 +0100 2994532 http://www.medworm.com/index.php?rid=2994531&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702658%2Fabstract%3Frss%3Dyes Invasive aspergillosis due to multi-azole-resistant Aspergillus fumigatus has emerged in the Netherlands since 1999, with 6·0–12·8% of patients harbouring resistant isolates. The presence of a single resistance mechanism (denoted by TR/L98H), which consists of a substitution at codon 98 of cyp51A and a 34-bp tandem repeat in the gene-promoter region, was found in over 90% of clinical A fumigatus isolates. This is consistent with a route of resistance development through exposure to azole compounds in the environment. Indeed, TR/L98H A fumigatus isolates were cultured from soil and compost, were shown to be cross-resistant to azole fungicides, and genetically related to clinical resistant isolates. Azoles are abundantly used in the environment and the presence of A fumigatus resistant t... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994531 Mon, 16 Nov 2009 00:00:00 +0100 2994531 http://www.medworm.com/index.php?rid=2994530&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702634%2Fabstract%3Frss%3Dyes Yearly vaccination against seasonal influenza viruses is recommended for certain individuals at high risk of complications associated with influenza. It has been recommended in some countries, including the USA, that all children aged 6–59 months are vaccinated against seasonal influenza. However, it has been shown—mainly in animals—that infection with influenza A viruses can induce protective immunity to influenza A viruses of other unrelated subtypes. This so-called heterosubtypic immunity does not provide full protection, but can limit virus replication and reduce morbidity and mortality of the host. This type of immunity might be relevant to human beings when a new subtype of influenza A virus is introduced into the population, such as the new influenza A H1N1 virus responsible f... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994530 Mon, 16 Nov 2009 00:00:00 +0100 2994530 http://www.medworm.com/index.php?rid=2994529&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702646%2Fabstract%3Frss%3Dyes We present a case of a man infected with HIV with sexually acquired acute hepatitis C and discuss the immunology, natural history, and epidemiology of acute hepatitis C and coinfection with HIV. Several recent reports have documented acute hepatitis C among men who have sex with men who engage in high risk sexual practices and often have concomitant genital ulcer disease. We review treatment options for the medical management of acute hepatitis C and coinfection with HIV. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994529 Mon, 16 Nov 2009 00:00:00 +0100 2994529 http://www.medworm.com/index.php?rid=2994528&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703202%2Fabstract%3Frss%3Dyes The prevention and management of malaria is primarily based on the use of drugs. Clinical trials have however revealed that between individuals there is large variability in the pharmacokinetic profiles of many antimalarial drugs. The resulting variations in concentrations of the drug within plasma might lead to either suboptimum effectiveness or drug toxicity in some patients. The evidence is increasing that polymorphically expressed drug-metabolising enzymes, predominantly various cytochrome P450 isozymes but also drug transporters, might contribute to the variability in drug response (incomplete cure, relapse, or resistance) or toxicity experienced with antimalarial drugs. For example, there is a clear association between concentrations of proguanil within plasma and certain genetic pol... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994528 Mon, 16 Nov 2009 00:00:00 +0100 2994528 http://www.medworm.com/index.php?rid=2994527&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703007%2Fabstract%3Frss%3Dyes We systematically reviewed the accuracy of serological tests for recent infections with HIV that have become widely used for measuring population patterns incidence of HIV. Across 13 different assays, sensitivity to detect recent infections ranged from 42–100% (median 89%). Specificity for detecting established infections was between 49·5% and 100% (median 86·8%) and was higher for infections of durations longer than 1 year (median 98%, range 31·5–100·0). For four different assays, comparisons were made between assay-derived population incidence estimates and a reference incidence estimate. The median percentage difference between the assay-derived incidence and reference incidence was 26·0%. Serological assays have reasonable sensitivity for the detection of recent infection with... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994527 Mon, 16 Nov 2009 00:00:00 +0100 2994527 http://www.medworm.com/index.php?rid=2994526&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702828%2Fabstract%3Frss%3Dyes The link between diabetes mellitus and tuberculosis has been recognised for centuries. In recent decades, tuberculosis incidence has declined in high-income countries, but incidence remains high in countries that have high rates of infection with HIV, high prevalence of malnutrition and crowded living conditions, or poor tuberculosis control infrastructure. At the same time, diabetes mellitus prevalence is soaring globally, fuelled by obesity. There is growing evidence that diabetes mellitus is an important risk factor for tuberculosis and might affect disease presentation and treatment response. Furthermore, tuberculosis might induce glucose intolerance and worsen glycaemic control in people with diabetes. We review the epidemiology of the tuberculosis and diabetes epidemics, and provide ... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994526 Mon, 16 Nov 2009 00:00:00 +0100 2994526 http://www.medworm.com/index.php?rid=2994525&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703196%2Ffulltext%3Frss%3Dyes Mebis J, Goossens H, Berneman ZN. Cefepime and mortality. Lancet Infect Dis 2009; 9: 585–86. Whereas the authors had no personal conflicts of interest to declare, for clarity they declare that Antwerp University Hospital was in receipt of a research grant from Bristol-Myers Squibb until 2008. Virga Jesse Hospital received a research grant and sponsorship for scientific symposia until 2007 and in 2008–09 received partial sponsorship for symposia from Bristol-Myers Squibb. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994525 Mon, 16 Nov 2009 00:00:00 +0100 2994525 http://www.medworm.com/index.php?rid=2994524&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703184%2Ffulltext%3Frss%3Dyes Sutcliffe CG, van Dijk JH, Bolton C, Persaud D, Moss WJ. Effectiveness of antiretroviral therapy among HIV-infected children in sub-Saharan Africa. Lancet Infect Dis 2008; 8: 477–89. Under the heading “Mortality and loss to follow-up” (page 484), “HIV-positive caregiver” was incorrectly listed as a risk factor for death. The cited research actually shows that HIV-positive caregivers are protective against paediatric mortality compared with caregivers who were untested or not infected with HIV. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994524 Mon, 16 Nov 2009 00:00:00 +0100 2994524 http://www.medworm.com/index.php?rid=2994523&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703172%2Ffulltext%3Frss%3Dyes Despite the availability of cheap and effective treatments, tuberculosis continues to be a major global health problem, causing an estimated 8·8 million new cases and 1·6 million deaths every year. Efforts to control tuberculosis by the consistent use of existing interventions have met with only limited success over the past decade, slowing its rate of increase but failing to make substantial progress towards the goal of tuberculosis elimination. Several advances in clinical management, molecular biology, biochemistry, immunology, and cell biology have led to accumulation of a large body of knowledge on host–pathogen interactions of tuberculosis over the past two decades. These have yet to be disseminated to scientists and clinicians around the world through updated reference textbooks... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994523 Mon, 16 Nov 2009 00:00:00 +0100 2994523 http://www.medworm.com/index.php?rid=2994522&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703160%2Ffulltext%3Frss%3Dyes Released June 21, 2009. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994522 Mon, 16 Nov 2009 00:00:00 +0100 2994522 http://www.medworm.com/index.php?rid=2994521&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703159%2Ffulltext%3Frss%3Dyes Influenza virus causes seasonal epidemics because it evades existing natural and vaccine-induced immunity by accumulating aminoacid changes in its attachment protein, haemagglutinin. Two studies provide new insights into this antigenic drift. In one study, researchers passage virus between naive and immunised mice and examine the changes that accumulate. In response to variations in neutralising antibody pressure between individuals, influenza virus evolves by accumulating aminoacid substitutions that adjust the avidity with which haemagglutinin binds to host cell receptors. Results suggest that an increase in paediatric influenza vaccination rates (which would decrease the naive population size) should slow antigenic drift and extend the effectiveness of influenza vaccines. In the second ... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994521 Mon, 16 Nov 2009 00:00:00 +0100 2994521 http://www.medworm.com/index.php?rid=2994520&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703147%2Ffulltext%3Frss%3Dyes Limited resources and limited access to regions torn by current or recent conflict pose a challenge to neglected tropical disease (NTD) control programmes in many developing countries. As a result, many organisations have been searching for ways to maximise the efficiency of those programmes. A new study from Southern Sudan has shown feasibility of integrated field surveys to assess community needs for mass drug administration. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994520 Mon, 16 Nov 2009 00:00:00 +0100 2994520 http://www.medworm.com/index.php?rid=2994519&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703135%2Ffulltext%3Frss%3Dyes A major advance in the treatment of sleeping sickness is still awaiting implementation 13 months after data from a successful trial was presented. Kits of the combination treatment nifurtimox–eflornithine (NECT) are sitting in a Médecins Sans Frontières (MSF) warehouse pending the resolution of legal barriers to their use. Experts are optimistic that NECT will be a major advance in the fight against sleeping sickness but are warning against complacency over the disease—in particular, the belief that sleeping sickness might be soon eradicated. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994519 Mon, 16 Nov 2009 00:00:00 +0100 2994519 http://www.medworm.com/index.php?rid=2994518&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703123%2Ffulltext%3Frss%3Dyes European Union member states are not adequately financing research and development for tuberculosis, according to a new report by Médicins Sans Frontières (MSF). Given current shortcomings in diagnostics and treatment, as well as the inadequate nature of the BCG vaccine, these funds are urgently required. “Governments don't recognise the potential dire consequences if the resources aren't made available”, says Mel Spigelman (TB Alliance, New York, USA). (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994518 Mon, 16 Nov 2009 00:00:00 +0100 2994518 http://www.medworm.com/index.php?rid=2994517&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703111%2Ffulltext%3Frss%3Dyes Agencies and individuals worldwide are continuing their efforts to vaccinate the world's children and their achievements are highlighted by State of the World's Vaccines and Immunization, a major report published recently by WHO, UNICEF, and The World Bank. “We have good news…”, announced Daisy Mafubelu, Assistant Director General of Family and Community Health at WHO (Geneva, Switzerland). “The number of children being vaccinated is now at an all time high—and we have the numbers to prove this.” In 2008, 106 million children received routine vaccinations for childhood killer infectious diseases including measles, whooping cough, tetanus, and polio, more children than have ever been vaccinated in a single year. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994517 Mon, 16 Nov 2009 00:00:00 +0100 2994517 http://www.medworm.com/index.php?rid=2994516&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS147330990970310X%2Ffulltext%3Frss%3Dyes The end of influenza season in the southern hemisphere has provided some insight into what effect pandemic influenza A H1N1 2009 might have during the northern hemisphere influenza season. The high proportion of deaths among pregnant women and people infected with HIV was notable, with severe illness also associated with pregnancy and a range of comorbidities (eg, chronic lower respiratory and metabolic diseases and obesity). (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994516 Mon, 16 Nov 2009 00:00:00 +0100 2994516 http://www.medworm.com/index.php?rid=2994515&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703093%2Ffulltext%3Frss%3Dyes Although the meeting is divided loosely into four official tracks—investigative, adult, paediatric, and HIV—and the programme contains a diverse set of symposia, teaching, and research presentation sessions, a few topics dominate the 47th meeting of the Infectious Diseases Society of America. Inevitably influenza features heavily, but many sessions on health-care acquired infections, antimicrobial resistance, and vaccine development mark this out as a very American conference. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994515 Mon, 16 Nov 2009 00:00:00 +0100 2994515 http://www.medworm.com/index.php?rid=2994514&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703081%2Ffulltext%3Frss%3Dyes Microbiologists and dentists alike tend to scoff at the idea that we can lower the risk of dental caries by rinsing our mouths with antiseptics to destroy the bacteria, principally Streptococcus mutans, which promote decay. A final year BSc project done by a fellow student decades ago persuaded me of the absurdity of trying to sterilise the oral cavity in this way. 20 min after even the most vigorous swilling and gargling, the bacterial flora had returned to its original composition. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994514 Mon, 16 Nov 2009 00:00:00 +0100 2994514 http://www.medworm.com/index.php?rid=2994513&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703032%2Ffulltext%3Frss%3Dyes In their recent Review, Emma Lappin and Andrew J Ferguson provide a thorough and interesting update on the pathophysiology and management of two major toxic shock syndromes caused by the Gram-positive pathogens Staphylococcus aureus and Streptococcus pyogenes. As the most common cause of Gram-positive toxic shock syndromes, it is important for health-care providers to familiarise themselves with these pathogens. However, by contrast with the broad scope implied by the title of their paper, the authors did not mention toxic shock syndrome caused by the Gram-positive bacterium Clostridium sordellii. This oversight is surprising given the marked increase in the number of reported cases of toxic shock syndrome caused by C sordellii. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994513 Mon, 16 Nov 2009 00:00:00 +0100 2994513 http://www.medworm.com/index.php?rid=2994512&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703020%2Ffulltext%3Frss%3Dyes In the May issue of The Lancet Infectious Diseases, Justin Stebbing and Angus Dalgleish noted that 79 of the 85 deaths (93%) in the SMART study happened in the USA, whereas 45% of the participants were enrolled outside the USA. They concluded that it was “apparently safer to be off highly active antiretroviral therapy (HAART) outside the USA rather than on HAART within the USA”, and contemplated possible reasons for this difference. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994512 Mon, 16 Nov 2009 00:00:00 +0100 2994512 http://www.medworm.com/index.php?rid=2994511&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702993%2Ffulltext%3Frss%3Dyes There is ongoing debate about influenza transmission and how best to reduce the risk of infection among health-care workers. For no other common infectious disease is there such varied opinion, reflecting gaps in our knowledge about a common human pathogen. This debate is based on five variables (). (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994511 Mon, 16 Nov 2009 00:00:00 +0100 2994511 http://www.medworm.com/index.php?rid=2994510&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909703019%2Ffulltext%3Frss%3Dyes The recent emergence of pandemic influenza A H1N1 demands prompt development of well-optimised and well-evaluated diagnostic methods, permitting rapid risk assessment and measures for counteracting the spread of infection and allowing epidemiological surveillance. The perfect diagnostic method is highly specific to A H1N1 and yet robust enough to cope with small genetic changes, it should also be rapid and yet suited to high throughput analyses in case substantial demands are placed on laboratories during a pandemic. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994510 Mon, 16 Nov 2009 00:00:00 +0100 2994510 http://www.medworm.com/index.php?rid=2994509&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS147330990970266X%2Ffulltext%3Frss%3Dyes In this issue of The Lancet Infectious Diseases, Rogier Bodewes and colleagues state that influenza vaccination is beneficial for infants and young children, but at the same time they urge re-evaluation of vaccine recommendations because the inactivated vaccine available at present does not induce heterosubtypic immunity and might make infants more susceptible to pandemic influenza. Although there are numerous immunological mechanisms related to infection with influenza to be discovered, we feel that the conclusions should be put into perspective. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994509 Mon, 16 Nov 2009 00:00:00 +0100 2994509 http://www.medworm.com/index.php?rid=2994508&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS147330990970307X%2Ffulltext%3Frss%3Dyes At the time of going to press, the first major vaccination campaigns to prevent pandemic H1N1 are getting underway. The vaccine might not have been ready in quite the volume hoped; nonetheless, for the production of vaccine in any substantial quantity in such a short time while still providing seasonal vaccine, those involved—the scientist, the pharmaceutical companies, and the chickens that laid the millions of eggs used—should be applauded. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2994508 Mon, 16 Nov 2009 00:00:00 +0100 2994508 http://www.medworm.com/index.php?rid=2906521&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909701136%2Ffulltext%3Frss%3Dyes A 60-year-old man was admitted to hospital with a 2-week history of fever, rigors, and headache. Apart from hypertension, his past medical history was unremarkable. He travelled abroad frequently, and had visited China where he had been exposed to a herd of goats 2 months before the current illness. On examination, he was pyrexial (38·5°C) and his liver was enlarged. His full blood count was normal, but his C-reactive protein was raised. Serum transaminases and alkaline phosphatase were mildly raised. Preliminary screening for auto-antibodies was negative. Initial parasitic and virological screening was also negative. Cerebrospinal fluid showed a mild increase in protein and a reduced glucose. MRI of his head was normal as was CT of his chest, abdomen, and pelvis. Indium-111-labelled leu... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906521 Sun, 18 Oct 2009 23:00:00 +0100 2906521 http://www.medworm.com/index.php?rid=2906520&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702294%2Fabstract%3Frss%3Dyes Operational research is increasingly being discussed at institutional meetings, donor forums, and scientific conferences, but limited published information exists on its role from a disease-control and programme perspective. We suggest a definition of operational research, clarify its relevance to infectious-disease control programmes, and describe some of the enabling factors and challenges for its integration into programme settings. Particularly in areas where the disease burden is high and resources and time are limited, investment in operational research and promotion of a culture of inquiry are needed so that health care can become more efficient. Thus, research capacity needs to be developed, specific resources allocated, and different stakeholders (academic institutions, national p... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906520 Sun, 18 Oct 2009 23:00:00 +0100 2906520 http://www.medworm.com/index.php?rid=2906519&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702348%2Fabstract%3Frss%3Dyes The necrotising skin infection Buruli ulcer is at present the third most common human mycobacteriosis worldwide, after tuberculosis and leprosy. Buruli ulcer is an emergent disease that is predominantly found in humid tropical regions. There is no vaccine against Buruli ulcer and its treatment is difficult. In addition to the huge social effect, Buruli ulcer is of great scientific interest because of the unique characteristics of its causative organism, Mycobacterium ulcerans. This pathogen is genetically very close to the typical intracellular parasites Mycobacterium marinum and Mycobacterium tuberculosis. We review data supporting the interpretation that M ulcerans has the essential hallmarks of an intracellular parasite, producing infections associated with immunologically relevant infl... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906519 Sun, 18 Oct 2009 23:00:00 +0100 2906519 http://www.medworm.com/index.php?rid=2906518&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702555%2Fabstract%3Frss%3Dyes The type-1 cytokine (interleukin 12, interleukin 23, interferon γ, interleukin 17) signalling pathway is triggered during infection by activation of phagocyte-expressed pattern-recognition receptors that recognise specific pathogen-associated molecular patterns. Triggering of this pathway results, among other things, in activation of microbicidal mechanisms in phagocytic cells. Individuals with a deficiency in one of the proteins in the pathway are unusually susceptible to otherwise poorly pathogenic, mostly environmental, mycobacteria and salmonellae. Individuals with deficiencies in other innate immune signalling proteins show unusual susceptibility to pathogens other than mycobacteria or salmonellae. We discuss recent insights into key molecules involved in type-1 cytokine signalling p... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906518 Sun, 18 Oct 2009 23:00:00 +0100 2906518 http://www.medworm.com/index.php?rid=2906517&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702543%2Fabstract%3Frss%3Dyes The spread of dengue virus throughout the tropics represents a major, rapidly growing public health problem with an estimated 2·5 billion people at risk of dengue fever and the life-threatening disease, severe dengue. A safe and effective vaccine for dengue is urgently needed. The pathogenesis of severe dengue results from a complex interaction between the virus, the host, and, at least in part, immune-mediated mechanisms. Vaccine development has been slowed by fears that immunisation might predispose individuals to the severe form of dengue infection. A pipeline of candidate vaccines now exists, including live attenuated, inactivated, chimeric, DNA, and viral-vector vaccines, some of which are at the stage of clinical testing. In this Review, we present what is understood about dengue pa... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906517 Sun, 18 Oct 2009 23:00:00 +0100 2906517 http://www.medworm.com/index.php?rid=2906516&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS147330990970235X%2Fabstract%3Frss%3Dyes Male circumcision provides long-term indirect protection to women by reducing the risk of heterosexual men becoming infected with HIV. In this Review, we summarise the evidence for a direct effect of male circumcision on the risk of women becoming infected with HIV. We identified 19 epidemiological analyses, from 11 study populations, of the association of male circumcision and HIV risk in women. A random-effects meta-analysis of data from the one randomised controlled trial and six longitudinal analyses showed little evidence that male circumcision directly reduces risk of HIV in women (summary relative risk 0·80, 95% CI 0·53–1·36). Definitive data would come from a further randomised controlled trial of circumcision among men infected with HIV in serodiscordant heterosexual relation... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906516 Sun, 18 Oct 2009 23:00:00 +0100 2906516 http://www.medworm.com/index.php?rid=2906515&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702816%2Ffulltext%3Frss%3Dyes Bartlett JA, Shao JF. Success, challenges, and limitations of current antiretroviral therapy in low-income and middle-income countries. Lancet Infect Dis 2009; 9: 637–49. Page 640, reference 31 should cite Zhou J, Li PC, Kumarasamy N, Boyd MA, Pujari S, on behalf of The TREAT Asia HIV Observational Database. Deferred modification of antiretroviral regimen following treatment failure in Asia: results from the TREAT Asia HIV Observational Database (TAHOD). 17th International AIDS Conference; Mexico City, Mexico; Aug 3–8, 2008. Abstract TUPE0116. Page 641, reference 84 should cite Losina E, Chang Y, Campbell E, Walensky R, Freedberg KA, Wood R. Immunologic benefits of complete vs partial virologic suppression in patients initiating ART in Gugulethu, South Africa. 15th Conference on Retrov... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906515 Sun, 18 Oct 2009 23:00:00 +0100 2906515 http://www.medworm.com/index.php?rid=2906514&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702804%2Ffulltext%3Frss%3Dyes Colourful images of the pandemic influenza H1N1 virus have recently abounded in the media. However, none have quite looked like the translucent glass sculpture that has been on display at the Smithfield Gallery in London, UK. The exhibition has showcased a cluster of clear-glass sculptures of different viruses and the bacterium Escherichia coli. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906514 Sun, 18 Oct 2009 23:00:00 +0100 2906514 http://www.medworm.com/index.php?rid=2906513&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702798%2Ffulltext%3Frss%3Dyes In the 1800s—when the British Government started recording such matters—infectious diseases accounted for almost half of the country's mortality. Thousands of death certificates carried inscriptions such as scarlet fever, diphtheria, cholera, typhus, and smallpox. But one disease dominated. In 1815—the year Napoleon was finally defeated—a quarter of the deaths in the UK were due to consumption, so-called because sufferers would emaciate and weaken, coughing up blood, and losing their colour. The ancient Greek physician Aretaeus of Cappadocia described such patients as “having shoulder blades like the wings of birds”. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906513 Sun, 18 Oct 2009 23:00:00 +0100 2906513 http://www.medworm.com/index.php?rid=2906512&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702786%2Ffulltext%3Frss%3Dyes Serious fungal infections arise less commonly than bacterial, viral, and parasitic diseases in the clinic, but they are diverse, difficult to diagnose, and often associated with severe morbidity or mortality. A comprehensive and scholarly reference work, covering all aspects of fungal disease, is therefore an obviously desirable addition to hospital libraries and the bookshelves of infectious disease and clinical microbiology specialists. Two competitors for this role were published in 2003, both entitled Clinical Mycology. One was edited by Dismukes, Pappas, and Sobel, the other by Anaissie, McGinnis, and Pfaller. The second edition of the latter has now been published and is the subject of this review. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906512 Sun, 18 Oct 2009 23:00:00 +0100 2906512 http://www.medworm.com/index.php?rid=2906511&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702774%2Ffulltext%3Frss%3Dyes Influenza pandemics often start when avian influenza viruses evolve to recognise human cells. Avian and human influenza viruses enter host cells by binding to species-specific cell-surface receptors by use of their haemagglutinins, so how do avian viruses make the transition to people? An examination of the structure of receptor complexes formed by haemagglutinins from the 1957 pandemic influenza virus and from its potential avian precursors suggests that some avian haemagglutinins can bind to human receptors even though they lack the human-specific haemagglutinin mutations of the pandemic virus. This ability might have given avian viruses a foothold in people from which to evolve into pandemic viruses. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906511 Sun, 18 Oct 2009 23:00:00 +0100 2906511 http://www.medworm.com/index.php?rid=2906510&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702762%2Ffulltext%3Frss%3Dyes International standards for deporting migrants infected with HIV should be reassessed, concludes a new report commissioned by Human Rights Watch (HRW). The report notes that, before deportation, migrants found to be infected with HIV in the Persian Gulf are often detained in overcrowded conditions where they are denied drugs, and that the South African authorities sometimes drop migrant workers infected with multidrug-resistant (MDR) tuberculosis or HIV at the border of their home country with neither treatment nor referral. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906510 Sun, 18 Oct 2009 23:00:00 +0100 2906510 http://www.medworm.com/index.php?rid=2906509&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702750%2Ffulltext%3Frss%3Dyes As of December, 2008, about 4 030 000 people were receiving antiretroviral therapy for HIV/AIDS, according to the report Towards Global Access released on Sept 30. Although this represents an increase of 36% in coverage from the 3 million people receiving treatment at the end of 2007, the new estimate suggests that just 42% of people in need of antiretroviral coverage are receiving the treatment they need. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906509 Sun, 18 Oct 2009 23:00:00 +0100 2906509 http://www.medworm.com/index.php?rid=2906508&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702749%2Ffulltext%3Frss%3Dyes Six decades of effort to develop a dengue vaccine are finally coming to fruition with the first full-scale efficacy trial to test the Sanofi Pasteur live-attenuated vaccine candidate based on the ChimeriVax technology. “This pivotal efficacy trial will run in Ratchaburi, Thailand, where full enrolment of about 4000 4–11-year-old children has been approved by the Thai Ministry of Public Health”, reported Jean Lang (Sanofi Pasteur, Lyon, France). The first findings are expected in 2012, but the exact timing will depend on the enrolment rate and the incidence of dengue in the region. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906508 Sun, 18 Oct 2009 23:00:00 +0100 2906508 http://www.medworm.com/index.php?rid=2906507&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702737%2Ffulltext%3Frss%3Dyes Given the rising tide of drug resistance, a new business model for the development of antibiotics is urgently needed, an expert conference hosted by the Swedish Presidency of the European Union heard on Sept 17. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906507 Sun, 18 Oct 2009 23:00:00 +0100 2906507 http://www.medworm.com/index.php?rid=2906506&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702725%2Ffulltext%3Frss%3Dyes Access to HIV medicines has been highlighted recently, with advocates applauding decisions by India and Brazil to reject the patenting of key antiretroviral drugs. Although companies are increasingly instituting their own initiatives to increase access, calls for the pharmaceutical industry to join the UNITAID patent pool have grown louder. On Sept 30, Médecins Sans Frontières (MSF) launched a campaign calling on companies to join the UNITAID patent pool and asking the public to make the same call. As the December goal for the UNITAID implementation plan grows nearer, all parties are debating the role of patents in access to HIV drugs and the advantages and challenges presented by a patent pool. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906506 Sun, 18 Oct 2009 23:00:00 +0100 2906506 http://www.medworm.com/index.php?rid=2906505&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702713%2Ffulltext%3Frss%3Dyes October saw the launch of a massive H1N1 vaccination campaign in the USA, just in time for the influenza season. Pandemic influenza cases have been on the rise on the USA, especially now that children are back at school; however, closing schools no longer seems a viable option. Health experts also fear that the US health-care system will not stand up to the strain of a renewed H1N1 pandemic. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906505 Sun, 18 Oct 2009 23:00:00 +0100 2906505 http://www.medworm.com/index.php?rid=2906504&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702701%2Ffulltext%3Frss%3Dyes The 49th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC; San Francisco, CA, USA; Sept 12–15, 2009) gave due prominence in the programme of this year's event to the evolving pandemic of influenza A H1N1. Here we report some of the influenza-related highlights of the meeting. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906504 Sun, 18 Oct 2009 23:00:00 +0100 2906504 http://www.medworm.com/index.php?rid=2906503&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702695%2Ffulltext%3Frss%3Dyes Publication of the latest book by Richard Dawkins, The Greatest Show on Earth (London: Transworld, 2009), has triggered more angry attacks on his atheism, including curious defences of a religious attitude by commentators without any discernible supernatural convictions themselves. Some true believers have insisted that they can accept evolution as a divinely creative process. Others have asserted that Dawkins is simply wrong because science and religion are categorically different views of the world. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906503 Sun, 18 Oct 2009 23:00:00 +0100 2906503 http://www.medworm.com/index.php?rid=2906502&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702683%2Ffulltext%3Frss%3Dyes The broad picture of immunisation in Africa is one of excellent progress and enthusiastic energy, with amazing advances having been made since the turn of the century. There has been a large drop in mortality due to measles, and about a third of countries now use a three dose regimen of diphtheria-tetanus-pertussis triple vaccine (DTP3), which provides coverage of at least 80% in all districts. However, a review of immunisation in Africa found that all is not well. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906502 Sun, 18 Oct 2009 23:00:00 +0100 2906502 http://www.medworm.com/index.php?rid=2906501&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702592%2Ffulltext%3Frss%3Dyes Since 2003, the US National Institutes of Health (NIH) funding for scientific and medical research has decreased steadily (after adjusting for inflation), which has created plenty of criticism and scorn within academic and scientific communities across the USA. Competition for scarce grant funding has sky-rocketed, graduate interest in investigative research has decreased, and thousands of researchers have lost their jobs. This has slowed scientific progress and has introduced numerous challenges to US medical research. For most developing countries, though, the effects seem to be drastically different. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906501 Sun, 18 Oct 2009 23:00:00 +0100 2906501 http://www.medworm.com/index.php?rid=2906500&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702580%2Ffulltext%3Frss%3Dyes We read with great interest Daniel P Webster and colleagues' Review of the development of new treatments for hepatitis C. The authors emphasised the promise of new selective inhibitors of hepatitis C virus (HCV) and their acceptable side-effect profiles. However, the clinical trial of specifically targeted antiviral therapy for HCV showed that it often leads to new mutant viruses and it is unclear whether the response can be sustained off-therapy. Therefore, more effective and tolerable treatments, such as new immune-based treatments, are being actively developed to complement or replace standard treatments of HCV. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906500 Sun, 18 Oct 2009 23:00:00 +0100 2906500 http://www.medworm.com/index.php?rid=2906499&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702579%2Ffulltext%3Frss%3Dyes Martin Schmidt commented on a Review by Stefan Baral and colleagues on vaccine immunogenicity in injecting drug users; however, Schmidt's criticism was actually directed at our paper. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906499 Sun, 18 Oct 2009 23:00:00 +0100 2906499 http://www.medworm.com/index.php?rid=2906498&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702671%2Ffulltext%3Frss%3Dyes The results released on Sept 24 of the RV144 trial of a vaccine against HIV offer a glimmer of hope in a field that has experienced many disappointments. The reported vaccine efficacy of 31% for prevention of HIV infection seems promising, but still leaves the prospect of immunisation as a practical public health intervention against HIV tantalisingly out of reach. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2906498 Sun, 18 Oct 2009 23:00:00 +0100 2906498 http://www.medworm.com/index.php?rid=2816582&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909701148%2Ffulltext%3Frss%3Dyes A 78-year-old man with a history of hypertension, advanced dilated cardiomyopathy, and longstanding type 2 diabetes mellitus was admitted to hospital because of heart failure. Besides clinical signs of ventricular dysfunction, physical examination showed multiple asymptomatic reddish-purple macular, papular, and nodular skin lesions with surrounding lymphoedema in the man's hands, arms (), and legs, which had been present for the past 6 months. Exploration was otherwise unremarkable. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816582 Mon, 21 Sep 2009 23:00:00 +0100 2816582 http://www.medworm.com/index.php?rid=2816581&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702270%2Fabstract%3Frss%3Dyes As a result of the scale-up of antiretroviral treatment (ART) programmes and substantial financial support worldwide, an increasing number of HIV-infected individuals in low-income and middle-income countries (LIMCs) now have access to ART. Despite this progress, important questions remain on the best use of ART and how patients should be maintained on a successful regimen. This Review addresses some of the issues faced by those managing the epidemic in LMICs, including when to start treatment, choice of first-line ART, and when to switch regimens. Although the first priority must be continued expansion of access to ART, there should be a move towards starting ART earlier to treat individuals before they reach advanced stages of disease, to reduce early mortality, and to build support for ... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816581 Mon, 21 Sep 2009 23:00:00 +0100 2816581 http://www.medworm.com/index.php?rid=2816580&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702269%2Fabstract%3Frss%3Dyes Progressive multifocal leukoencephalopathy is caused by the JC polyomavirus (JCV) and is one of the most feared complications of HIV-1 infection. Unlike other opportunistic infections, this disease can present when CD4 counts are higher than those associated with AIDS and when patients are receiving combined antiretroviral therapy, either shortly after starting or, more rarely, during long term successful treatment. Clinical suspicion of the disease is typically when MRI shows focal neurological deficits and associated demyelinating lesions; however, the identification of JCV in cerebrospinal fluid or brain tissue is needed for a definitive diagnosis. Although no specific treatment exists, the reversal of immunosuppression by combined antiretroviral therapy leads to clinical and MRI stabil... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816580 Mon, 21 Sep 2009 23:00:00 +0100 2816580 http://www.medworm.com/index.php?rid=2816579&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702002%2Fabstract%3Frss%3Dyes The decrease in vancomycin treatment efficacy that is accompanying increases in vancomycin minimum inhibitory concentration (MIC) within the susceptible range (so-called MIC creep) has led to the suggestion that vancomycin is losing its potency in treating serious Staphylococcus aureus infections. Understanding the clinical importance of the microbiological effects of glycopeptides on bacterial lipopeptides and lipoglycopeptides will be crucial in treating serious meticillin-resistant S aureus infections. We review the observed effects of reduced glycopeptide susceptibility on the activities of daptomycin in S aureus in vitro and in vivo. Factors associated with loss of susceptibility and ways to reduce the risk of resistance to daptomycin are reviewed, including the importance of prompt m... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816579 Mon, 21 Sep 2009 23:00:00 +0100 2816579 http://www.medworm.com/index.php?rid=2816578&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909701781%2Fabstract%3Frss%3Dyes emm sequence typing is the most widely used method for defining group A streptococcal (GAS) strains, and has been applied to isolates in all regions of the world. We did a systematic review of the global distribution of GAS emm types. 102 articles and reports were included (38 081 isolates). Epidemiological data from high-income countries were predominant, with sparse data from low-income countries. The epidemiology of GAS disease in Africa and the Pacific region seems to be different from that in other regions, particularly high-income countries. In Africa and the Pacific, there were no dominant emm types, a higher diversity of emm types, and many of the common emm types in other parts of the world were less common (including emm 1, 4, 6, and 12). Our data have implications for the devel... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816578 Mon, 21 Sep 2009 23:00:00 +0100 2816578 http://www.medworm.com/index.php?rid=2816577&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702336%2Fabstract%3Frss%3Dyes We examined the effectiveness of influenza vaccines at protecting against cardiac events and did a meta-analysis of data from randomised controlled trials. 42 publications describing 39 studies were identified. Many observational studies in different settings with a range of methods reported consistent associations between influenza and acute myocardial infarction. There was weaker evidence of an association with cardiovascular death. Two small randomised trials assessed the protection provided by influenza vaccine against cardiac events in people with existing cardiovascular disease. Whereas one trial found that influenza vaccination gave significant protection against cardiovascular death, the other trial was inconclusive. A pooled estimate from a random-effects model suggests a protecti... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816577 Mon, 21 Sep 2009 23:00:00 +0100 2816577 http://www.medworm.com/index.php?rid=2816576&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702531%2Ffulltext%3Frss%3Dyes Written by a score of experts from sociology through medical humanities to geography, this book discusses how the interconnected fluid network formed by the flow of cash, commodities, people, and vectors helps spread infectious diseases among cities worldwide, and what the social and political reactions are to disease spread. Although the book primarily focuses on the role of this worldwide network on the spread of severe acute respiratory syndrome (SARS), a few other diseases such as avian influenza, AIDS, and tuberculosis are discussed. A meticulous social autopsy was done on SARS in the context of the Hong Kong, Singapore, and Toronto outbreaks to explore the vulnerability of cities worldwide, and to examine the effect of the epidemic on the social and cultural aspects of urban life. Th... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816576 Mon, 21 Sep 2009 23:00:00 +0100 2816576 http://www.medworm.com/index.php?rid=2816575&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS147330990970252X%2Ffulltext%3Frss%3Dyes Incredible though it may sound, “AIDS rethinkers really, truly believe that HIV does not cause AIDS”, explains Seth Kalichman in the preface to Denying AIDS. Instead, they argue that “the propagation of the HIV equals AIDS myth is the product of a government conspiracy in cahoots with a multibillion dollar pharmaceutical scam…that antiretroviral medications are toxic poison”. “In their minds”, the author concludes, “they have not been duped like everyone else…and one day the AIDS orthodoxy will crumble on its own lies.” (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816575 Mon, 21 Sep 2009 23:00:00 +0100 2816575 http://www.medworm.com/index.php?rid=2816574&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702518%2Ffulltext%3Frss%3Dyes An intriguing exhibition at Wellcome Collection in London, UK—subtitled “the curious and grotesque story of the anatomical model”—not only shows how anatomical models were used as aids in teaching structural anatomy in the 19th century, but also provides an insight into how contemporary medical students were taught to recognise the signs of infectious diseases. More sensationally, the exhibition highlights how particularly graphic models were used to warn the general public about the dangers of diseases. This overlap between science and circus persists today, in freakish but hugely popular displays of plasticised corpses in cities around the world. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816574 Mon, 21 Sep 2009 23:00:00 +0100 2816574 http://www.medworm.com/index.php?rid=2816573&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702506%2Ffulltext%3Frss%3Dyes Researchers have made a new type of HIV-1 entry inhibitor that has strong antiviral activity and neutralises CCR5-tropic and CXCR4-tropic HIV-1 strains. The inhibitor—mCD4-HS12—contains a CD4-mimetic peptide linked to a heparan sulphate dodecasaccharide. The CD4-mimetic peptide binds to the HIV-1 envelope glycoprotein gp120, the crucial viral protein for cell entry, and induces the exposure of a cryptic coreceptor binding domain. This domain is then blocked by the heparan sulphate part of the inhibitor. Thus, mCD4-HS12 targets two conserved regions of gp120 that are needed for cell entry by HIV-1. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816573 Mon, 21 Sep 2009 23:00:00 +0100 2816573 http://www.medworm.com/index.php?rid=2816572&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS147330990970249X%2Ffulltext%3Frss%3Dyes In 2009, 210 people in Uttar Pradesh have died as a result of Japanese encephalitis (JE) virus infection. A total of 960 patients have been admitted to hospitals in the region with JE virus infection or acute encephalitis syndrome. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816572 Mon, 21 Sep 2009 23:00:00 +0100 2816572 http://www.medworm.com/index.php?rid=2816571&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702488%2Ffulltext%3Frss%3Dyes In late August, the Gambian Ministry of Health launched the first national pneumococcal vaccination programme in west Africa, following a similar immunisation initiative in Rwanda launched in April. The two countries are sharing 3·1 million doses of seven-valent pneumococcal conjugate vaccine (PCV7) donated by Wyeth Pharmaceuticals and made available through an agreement with the GAVI alliance. According to WHO, one in six deaths in children under 5 years of age in The Gambia is caused by pneumonia. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816571 Mon, 21 Sep 2009 23:00:00 +0100 2816571 http://www.medworm.com/index.php?rid=2816570&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702476%2Ffulltext%3Frss%3Dyes At the recent London International Development Centre meeting on the influences of the behaviours of patients and health-care workers on clinical outcome, researchers highlighted the possibility that prescribing behaviour in developing countries means that many people without malaria receive antimalarials, raising the risk of resistance and side-effects. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816570 Mon, 21 Sep 2009 23:00:00 +0100 2816570 http://www.medworm.com/index.php?rid=2816569&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702464%2Ffulltext%3Frss%3Dyes Reports at the International Scientific Council for Trypanosomiasis Research and Control (ISCTRC) biennial scientific conference (Kampala, Uganda, September 21–25, 2009) will indicate that Africa is winning its battle against sleeping sickness. Aerial spraying and localised use of insecticides has eradicated the tsetse fly that carries Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense from 36 000 km2 of land across Botswana, Namibia, Angola, and Zambia. “Plans are in place to progressively tackle further areas, and we expect tsetse eradication to be achieved in the entire Kwando-Zambezi tsetse belt by 2012”, says Peter Sinyangwe (Ministry of Agriculture and Cooperatives, Lusaka, Zambia). (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816569 Mon, 21 Sep 2009 23:00:00 +0100 2816569 http://www.medworm.com/index.php?rid=2816568&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702452%2Ffulltext%3Frss%3Dyes A rising epidemic of multidrug-resistant (MDR) tuberculosis in Russia is being fuelled in part by infection among inmates in Russia's crowded jail system, and also by what one public health expert called a major bottleneck of second-line antituberculosis drugs. However, approaches to the treatment of tuberculosis in Russia have their critics, with some observers calling imprisonment to enforce treatment an abuse of human rights. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816568 Mon, 21 Sep 2009 23:00:00 +0100 2816568 http://www.medworm.com/index.php?rid=2816567&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702440%2Ffulltext%3Frss%3Dyes 1 year before the G8 target of universal access to antiretrovirals (ARVs), only a third of those in need are receiving medication. With the HIV pandemic continuing to spread dramatically, an inquiry by the UK all-party parliamentary group on AIDS “shows that we are sitting on a treatment timebomb”. Action is needed now, to avert crisis later, says the report, which predicts that over 50 million people worldwide could need ARVs by 2030. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816567 Mon, 21 Sep 2009 23:00:00 +0100 2816567 http://www.medworm.com/index.php?rid=2816566&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702439%2Ffulltext%3Frss%3Dyes H1N1 vaccination efforts are on track for the start of the influenza season in October, say public health officials. The good news is that a one-shot H1N1 vaccine works. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816566 Mon, 21 Sep 2009 23:00:00 +0100 2816566 http://www.medworm.com/index.php?rid=2816565&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702427%2Ffulltext%3Frss%3Dyes More than 900 delegates and representatives from 20 governments attended the international conference on influenza that took place in Beijing, China, between Aug 21 and 23. The focus of the meeting, organised jointly by The Lancet and the Chinese Ministry of Health, was on pandemic influenza A H1N1 in the Asia–Pacific region. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816565 Mon, 21 Sep 2009 23:00:00 +0100 2816565 http://www.medworm.com/index.php?rid=2816564&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702415%2Ffulltext%3Frss%3Dyes I once knew an intelligent dog that regularly enjoyed evening meals of the finest fillet steak, cooked to perfection—actually beyond perfection. The dog's owner would not dream of giving the animal anything less, and was especially disdainful of offering it raw meat. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816564 Mon, 21 Sep 2009 23:00:00 +0100 2816564 http://www.medworm.com/index.php?rid=2816563&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702403%2Ffulltext%3Frss%3Dyes All I wanted to do was to wash my hands. Hunched over the sink in quiet solace after a hard day in the cholera ward, I was at peace. And then it happened, “Eric, there's a baby I want you to see.” (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816563 Mon, 21 Sep 2009 23:00:00 +0100 2816563 http://www.medworm.com/index.php?rid=2816562&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702397%2Ffulltext%3Frss%3Dyes Raffaella M Ravinetto and colleagues stressed the need to overcome the situation of disparate qualities of drugs in rich and poor developing countries. Interagency collaboration, the enforcement of international regulation, and the use of appropriate procurement policies and practices were therefore proposed to supply countries with the best quality drugs. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816562 Mon, 21 Sep 2009 23:00:00 +0100 2816562 http://www.medworm.com/index.php?rid=2816561&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702385%2Ffulltext%3Frss%3Dyes In May 2007, Dafna Yahav and colleagues published a meta-analysis about a high rate of all-cause mortality in patients treated with cefepime, especially in neutropenic patients, compared with those treated with other β-lactams. They could, however, not find the reasons for this occurrence. A response by Trent G Towne and colleagues, reviewed the 19 studies with neutropenia in this meta-analysis and found no difference between infectious causes as cause of death, and also no cases of non-convulsive status epilepticus as a possible explanation for this mortality. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816561 Mon, 21 Sep 2009 23:00:00 +0100 2816561 http://www.medworm.com/index.php?rid=2816560&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702373%2Ffulltext%3Frss%3Dyes I read with great interest the Reflection and Reaction in which Sally Hargreaves and colleagues tackled the issue of immigrant tuberculosis in Europe. My own research focuses on the problem of immigrant tuberculosis in Canada, where immigrants carry the highest burden. Althouth I agree that there are great benefits in systematic community-based screening and surveillance that go beyond “a one-stop-shop at arrival” (as the authors aptly remarked), these are definitely not the only answers to the question of how to control immigrant tuberculosis in developed countries, as can be illustrated with a Canadian example. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816560 Mon, 21 Sep 2009 23:00:00 +0100 2816560 http://www.medworm.com/index.php?rid=2816559&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702361%2Ffulltext%3Frss%3Dyes If the predictions of some experts come to pass, by the time you read this the next wave of pandemic influenza A H1N1 in the northern hemisphere will have begun. Indeed, Ira Longini (University of Washington, Seattle, WA, USA), speaking at the recent Lancet conference on influenza (Beijing, China, August 21–23, 2009) suggested that the peak in cases of H1N1 influenza may have passed by the time that sufficient vaccine is available to reduce the number of people who become ill. Such a scenario rather begs the question of the value of an immunisation programme. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2816559 Mon, 21 Sep 2009 23:00:00 +0100 2816559 http://www.medworm.com/index.php?rid=2706671&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909701355%2Fabstract%3Frss%3Dyes Sepsis is a disorder characterised by systemic inflammation secondary to infection. Despite recent progress in the understanding and treatment of sepsis, no data or recommendations exist that detail effective approaches to sepsis care in resource-limited low-income and middle-income countries (LMICs). Although few data exist on the burden of sepsis in LMICs, the prevalence of HIV and other comorbid conditions in some LMICs suggest that sepsis is a substantial contributor to mortality in these regions. In well-resourced countries, sepsis management relies on protocols and complex invasive technologies not widely available in most LMICs. However, the key concepts and components of sepsis management are potentially translatable to resource-limited environments. Health personnel in LMICs shoul... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2706671 Sun, 16 Aug 2009 23:00:00 +0100 2706671 http://www.medworm.com/index.php?rid=2706670&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909701793%2Fabstract%3Frss%3Dyes Two new rotavirus vaccines have recently been licensed in many countries. However, their efficacy has only been shown against certain serotypes commonly circulating in Europe, North America, and Latin America, but thought to be globally important. To assess the potential impact of these vaccines in sub-Saharan Africa, where rotavirus mortality is high, knowledge of prevalent types is essential because an effective rotavirus vaccine is needed to protect against prevailing serotypes in the community. We did two systematic reviews and two meta-analyses of the most recent published data on the burden of rotavirus disease in children aged under 5 years and rotavirus serotypes circulating in countries in sub-Saharan Africa. Eligible studies were selected from PubMed/Medline, Cochrane Library, Em... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2706670 Sun, 16 Aug 2009 23:00:00 +0100 2706670 http://www.medworm.com/index.php?rid=2706669&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS147330990970177X%2Fabstract%3Frss%3Dyes Plasmodium vivax is geographically the most widely distributed cause of malaria in people, with up to 2·5 billion people at risk and an estimated 80 million to 300 million clinical cases every year—including severe disease and death. Despite this large burden of disease, P vivax is overlooked and left in the shadow of the enormous problem caused by Plasmodium falciparum in sub-Saharan Africa. The technological advances enabling the sequencing of the P vivax genome and a recent call for worldwide malaria eradication have together placed new emphasis on the importance of addressing P vivax as a major public health problem. However, because of this parasite's biology, it is especially difficult to interrupt the transmission of P vivax, and experts agree that the available methods for preve... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2706669 Sun, 16 Aug 2009 23:00:00 +0100 2706669 http://www.medworm.com/index.php?rid=2706668&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909701501%2Fabstract%3Frss%3Dyes Detection and eradication of meticillin-resistant Staphylococcus aureus (MRSA) represents a public health priority worldwide. Our aim was to do a systematic review and meta-analysis of randomised, non-randomised, and observational studies to summarise the available evidence on the effect of MRSA detection by rapid screening tests on hospital-acquired MRSA infections and acquisition rate. Eligible studies were retrieved from Medline, EmBase, Science Citation Index, and the Cochrane database. We judged as eligible those studies that compared hospitals and wards in which active screening for the detection of MRSA carriers was done at hospital admission by use of a rapid molecular test to those in which active screening was done with culture alone or not at all. To account for statistical hete... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2706668 Sun, 16 Aug 2009 23:00:00 +0100 2706668 http://www.medworm.com/index.php?rid=2706667&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909701999%2Fabstract%3Frss%3Dyes We present the results for healthy adults (ie, adults without known comorbidities) and people at-risk of influenza-related complications. There was an overall reduction in the median time to symptom alleviation in healthy adults by 0·57 days (95% CI −1·07 to −0·08; p=0·02; 2701 individuals) with zanamivir, and 0·55 days (95% CI −0·96 to −0·14; p=0·008; 1410 individuals) with oseltamivir. In those at risk, the median time to symptom alleviation was reduced by 0·98 days (95% CI −1·84 to −0·11; p=0·03; 1252 individuals) with zanamivir, and 0·74 days (95% CI −1·51 to 0·02; p=0·06; 1472 individuals) with oseltamivir. Little information was available on the incidence of complications. In view of the advantages and disadvantages of different management strategies for... The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2706667 Sun, 16 Aug 2009 23:00:00 +0100 2706667 http://www.medworm.com/index.php?rid=2706666&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702257%2Ffulltext%3Frss%3Dyes Oehler RL, Velez AP, Mizrachi M, Lamarche J, Gompf S. Bite-related and septic syndromes caused by cats and dogs. Lancet Infect Dis 2009; 9: 439–47. In figure 3 (page 443) and the accompanying text Pasteurella spp should be described as Gram negative. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2706666 Sun, 16 Aug 2009 23:00:00 +0100 2706666 http://www.medworm.com/index.php?rid=2706665&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702245%2Ffulltext%3Frss%3Dyes Green C, Huggett JF, Talbot E, Mwaba P, Reither K, Zumla AI. Rapid diagnosis of tuberculosis through the detection of mycobacterial DNA in urine by nucleic acid amplification methods. Lancet Infect Dis 2009; 9: 505–11. The affiliations of Klaus Reither (page 505) should have been NIMR-Mbeya Medical Research Programme, Mbeya, Tanzania, and Department of Infectious Diseases and the Tropical Medicine, Klinikum of the Ludwig-Maximilians-University of Munich, Munich, Germany. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2706665 Sun, 16 Aug 2009 23:00:00 +0100 2706665 http://www.medworm.com/index.php?rid=2706664&cid=s_36846_20_f&fid=36846&url=http%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flaninf%2Farticle%2FPIIS1473309909702233%2Ffulltext%3Frss%3Dyes McConnell J. Influenza at the 26th ICC. Lancet Infect Dis 2009; 9: 464. The outbreak of influenza that happened in the second week of March in Mexico's Tlaxcala was not caused by swine-origin influenza A H1N1, and the outbreak in Las Gloria, Veracruz only had six confirmed cases of the new virus, with other strains of influenza also identified. (Source: The Lancet Infectious Diseases) The Lancet Infectious Diseases journals http://www.medworm.com/rss/comments.php?id=2706664 Sun, 16 Aug 2009 23:00:00 +0100 2706664