REFERENCE: Abstract H-1059
Jose Miro, Hospital Clinic, Barcelona
When is the best time to start antiretroviral therapy for HIV/AIDS? A study from Spain confirms that doctors should wait until the CD4 cell count drops below 350. Jose Miro of the Hospital Clinic in Barcelona gave the data to Derek Thorne in San Francisco.

REFERENCE: Abstract K-786
Julia Dombrowski, University of California, San Francisco
Methicillin resistant Staphylococcus aureus is sometimes difficult to treat – and now, a study presented at ICAAC suggests that infection of the bone may predict a worse outcome. Julia Dombrowski, of the University of California San Francisco, discussed the possible implications of her data with Derek Thorne.

REFERENCE: Abstract M-908
Graeme Forrest, University of Maryland School of Medicine, Baltimore
The lipid-lowering drugs statins have an anti-inflammatory effect that could help control infections. Graeme Forrest of the University of Maryland told Derek Thorne about his results in patients with candidemia who were already on a statin.

REFERENCE: Abstract C2-605
Henry Fraimow, Cooper University Hospital, Camden, New Jersey
Methicillin resistant Staphylococcus aureus is most often looked for in the nose, but could it be hiding elsewhere? According to Henry Fraimow, of Cooper University Hospital in Camden, New Jersey, vaginal and rectal cavities may also be an important reservoirs for this bacterium. Derek Thorne asked him about his findings.

REFERENCE: Abstract G-346
Michael Jacobs, Case Western Reserve University, Cleveland
The conjugated pneumococcal vaccine did initially reduce the incidence of invasive Streptococcus pneumoniae infection in children; however, six years after its introduction, a particular multidrug resistant serotype has replaced the types that were covered by the vaccine. Michael Jacobs of the Case Western Reserve University, Cleveland, revealed his findings to the ICAAC conference and talked about them in San Francisco with Derek Thorne.

REFERENCE: Abstract G-345
Ron Dagan, Soroka University Medical Center, Beer-Sheva, Israel
If antibiotic use drops markedly, will resistant strains become less common? Have they paid a ‘fitness cost’ in becoming resistant? A group led by Ron Dagan, of the Soroka University Medical Center in Beer-Sheva, Israel, tested this hypothesis by tracking Streptococcus pneumoniae strains throughout the year, to see whether a decrease in antibiotics – which is seen in the summer months – led to a decrease in resistant strains. During the ICAAC meeting he told Derek Thorne about their findings.

REFERENCE: Abstract K-0349
Roger Baxter, Kaiser Permanente, Oakland
In the presence of certain antibiotics, it seems Clostridium difficile can flourish. Roger Baxter, from Kaiser Permanente in Northern California, presented data suggesting that imipenem and clindamycin are among the drugs that give patients a greater risk of C. difficile infection.

REFERENCE: Abstract K-0352
Jaap van Dissel, Leiden University Medical Center
Clostridium difficile relapse is sometimes difficult to prevent with antibiotics – so could a rather different approach, involving a protein powder obtained from immunised cows, give a greater and more durable benefit? Jaap van Dissel of the Leiden University Medical Center had the details at ICAAC.

REFERENCE: European Society of Cardiology Meeting with the World Congress of Cardiology, Barcelona, September 2-6, 2006
Andrew Pipe, University of Ottawa
Bryan Williams, Leicester University
A global survey of nearly 3 000 physicians called, STOP (Smoking The Opinions of Physicians), highlighted the importance of helping patients to quit smoking above all other interventions cardiologists and primary care physicians can make for their patients. The study investigated doctors’ attitudes and perceptions towards smoking. Andrew Pipe of Ottawa University told Sarah Maxwell why he thinks the matter is so urgent.

REFERENCE: 4825 “Clinical Trial Update I” Session
Christoph Kaiser, University of Basel
Bare metal stents may be just as effective, and in some lesions even more effective, than drug eluting stents, according to the findings of the BASKET trial from the University of Basel in which patients receiving drug eluting stents were compared with others having bare metal stents. Christoph Kaiser told a “Clinical Trial Update” session in Barcelona, that it is important to define sub-groups of patients who will do better on bare metal stents rather than simply giving drug eluting stents to all. He discussed the study with Peter Goodwin.

REFERENCE: Abstract 984
John Cleland, University of Hull
A new way of relieving symptoms and reducing morbidity in older patients with diastolic heart failure was announced at the cardiology congress in Barcelona. John Cleland from Hull University in the UK presented his results on the PEP-CHF (Perindopril in Elderly People with Chronic Heart Failure) study looking at the use of the ACE-inhibitor perindopril in comparison with placebo. He explained to Sarah Maxwell that although the investigators found an unexpectedly low rate of mortality and morbidity in both arms of the study, the ACE inhibitor brought worthwhile benefits.

REFERENCE: Abstract 3413, “Hot Line II” Session, Abstract 649
Gilles Montalescot, Pitié-Salpêtriere Hospital, Paris
Angioplasty outcomes can be improved by modifying factors identified by the 8000-patient, 23-country, prospective, observational “RIVIERA” study presented at a “Hot Line” session of the cardiology congress in Barcelona. Gilles Montalescot discussed the rôle of pre-treatment with clopidogrel, the use of statins, radial rather than femoral access, and the choice of anticoagulation. Peter Goodwin asked him about his findings.

REFERENCE: “Hot Line II” Session
Freek Verheugt, Nijmegen University, Netherlands
Amid controversy in Barcelona about the choice of anticoagulation for patients receiving angioplasty Freek Verheugt commented on the relative merits of low-molecular weight heparin and the factor 10a inhibitor fondaparinux. He gave Peter Goodwin his reactions to recommendations emerging from the RIVIERA study of angioplasty outcome determinants.