Monthly Archives: September 2006

Reporting from the 2006 Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), September 27 – 30, San Francisco

By admin | Published: September 30, 2006

Jose Miro

Julia Dombrowski

Graeme Forrest

HIV/AIDS Antiretroviral Therapy: Good to Start when CD4 Count Drops Below 350

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.

Higher Failure with MRSA and Bone Infection

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.

Could Statins Help Treat Candida Infections?

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.

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Posted in Global Health | Tagged aids, antiretroviral, bone, candidemia, hiv, lipid-lowering, therapy | Leave a comment

Audio Journal of Global Health Issues: Smoking Inequalities Explain Half the Mortality Differences Between Men of Different Socioeconomic Groups

By admin | Published: September 30, 2006

michael marmot Audio Journal of Global Health Issues: Smoking Inequalities Explain Half the Mortality Differences Between Men of Different Socioeconomic Groups

MICHAEL MARMOT, University College, London

REFERENCE: Lancet, 2006; 364:367 and 341
A study published in the Lancet from the University of Toronto concludes that half of the mortality differences between social and economic groups can be explained by differences in smoking. Because poorer people are more likely to smoke they are also more likely to die, the study suggests, with smoking emerging as the biggest single factor explaining such inequalities. Michael Marmot of University College London wrote the accompanying editorial in the Lancet and answered questions from Peter Goodwin.

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Posted in Global Health | Tagged smoking | Leave a comment

Audio Journal of Infectious Disease: Reporting from the 2006 Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), September 27 – 30, San Francisco

By admin | Published: September 29, 2006

Henry Fraimow

Michael Jacobs

Ron Dagan

MRSA: Not Only Carried in the Nose

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.

Pneumococcal Vaccine Selects for Multidrug Resistant S. Pneumoniae Serotype

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.

Decrease in Antibiotic Use Leads to Decrease in Resistant S. pneumoniae

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.

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Posted in Global Health | Tagged antibiotic, bacterium, disease, infectious, MRSA, pneumococcal, pneumoniae, serotype, Streptococcus, vaccine | Leave a comment

Audio Journal of Global Health Issues: Tipranavir Brings Hope for HIV-1 Patients Resistant to Standard Antiretorviral Therapy

By admin | Published: September 29, 2006

CHARLES HICKS, Associate Professor Medicine, Duke University, Durham

REFERENCE: Lancet 2006; 368: 466-75
Results with a new antiretroviral agent, tipranavir, tested among patients who were resistant to standard therapies have been published in The Lancet. Charles Hicks of Duke University in North Carolina told Sarah Maxwell about the treatment responses they’ve reported and the potential role of this agent for treating late stages of HIV infection.

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Posted in Global Health | Tagged antiretroviral, disease, hiv, infectious, therapy | Leave a comment

Audio Journal of Infectious Disease: Reporting from the 2006 Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), September 27 – 30, San Francisco

By admin | Published: September 28, 2006

Roger Baxter

Jaap van Dissel

Which Antibiotics Pose Greatest Risk of C. difficile infection?

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.

Prevent C. difficile relapse – with a Protein Concentrate from Cows

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.

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Posted in Global Health, ICAAC 2005 | Tagged antibiotic, c.difficile, infection, protein | Leave a comment

Audio Journal of Global Health Issues: Counterfeit Anti-Infective Drugs: A Huge Problem, Often Overlooked

By admin | Published: September 19, 2006

PAUL NEWTON, Centre for Clinical Vaccinology and Tropical Medicine, Oxford

REFERENCE: Lancet Infect Dis 2006; 6:602-13
No one knows the exact proportion of anti-infective drugs in the developing world which are not genuine, but even a conservative estimate tells us that counterfeit drugs affect millions of people. A review in the Lancet Infectious Diseases has tried to bring together the available data and propose some solutions to the problem, and Derek Thorne found out more from Paul Newton, of the Centre for Clinical Vaccinology and Tropical Medicine in Oxford.

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Posted in Global Health | Tagged anti-infective, drugs | Leave a comment

ASCO Audio Journal of Oncology – September 15th, 2006

By admin | Published: September 14, 2006

Robert Ozols

William See

Ruth Lupu

Improving on Standard Treatment in Ovarian Cancer: Have We Hit a Wall?

REFERENCE: Abstract 5002, 2006 ASCO Annual Meeting; N Engl J Med 2006, 354:34-43
ROBERT OZOLS, Fox Chase Cancer Center, Philadelphia
The combination of paclitaxel and carboplatin has become the standard treatment for ovarian cancer, but it is not entirely satisfactory. Is it possible to find an improvement, either by using another chemotherapeutic agent, or by employing intraperitoneal therapy? Robert Ozols of the Fox Chase Cancer Center in Philadelphia tells Derek Thorne about the recent evidence and looks ahead to the future.

Bicalutamide Alternative to Castration for Radiation-Treated Patients with Locally Advanced Prostate Cancer?

REFERENCE: J Cancer Res Clin Oncol 132, Supplement 13:7
WILLIAM SEE, Medical College of Wisconsin, Milwaukee
COMMENT: Robert Ozols
A new option has emerged for patients with locally advanced prostate cancer that may avoid the need for castration. According to a study just published in the Journal of Cancer Research and Clinical Oncology the nonsteroidal antiandrogen bicalutamide may provide a similar benefit to that of castration, but with more acceptable side effects. William See of the Medical College of Wisconsin discussed his team’s findings with Derek Thorne.

Breast Tumors with High Heregulin, Low Her-2, Could Benefit from Trastuzumab

REFERENCE: J Clin Oncol, 24:3735-3746
RUTH LUPU, Evanston Northwestern Healthcare Research Institute
COMMENT: Robert Ozols
Despite promising results for the breast cancer agent trastuzumab, only a minority of breast tumors have the appropriate genetic profile for treatment – which includes overexpressed Her-2. However, a new paper in the Journal of Clinical Oncology might lead to an increase in the number of eligible patients. Ruth Lupu described her team’s study, which looked at tumorigenic cells that overexpress heregulin, an activator of Her-2.

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Posted in AJO, Oncology | Tagged bicalutamide, breast, cancer, heregulin, ovarian, paclitaxel, prostate, trastuzumab, tumour | Leave a comment

Audio Journal of Global Health Issues: Audio Journal of Global Health Issues, September 13th, 2006

By admin | Published: September 13, 2006

Andrew Pipe

Bryan Williams

STOP – Smoking The Opinions of Physicians, A Global Survey

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.

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Posted in Global Health | Tagged smoking, survey | Leave a comment

Audio Journal of Global Health Issues: Heart Disease Prevention in the Developing World Can Be Cost Effective

By admin | Published: September 11, 2006

Thomas Gaziano, Brigham & Womens’ Hospital, Boston

REFERENCE: Lancet 2006; 368: 679-86
Heart disease is currently the leading cause of death in less developed nations but it can be prevented cost effectively, according to a study published in the Lancet. A team from the US and South Africa developed a model to test the use of multi-drug regimens (which could be combined in so called “polypills”) to see whether they would be effective and cheap enough, and fulfill World Health Organisation guidelines. Thomas Gaziano told Derek Thorne about their findings.

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Posted in Global Health | Tagged disease, heart, multi-drug, polypills | Leave a comment

Audio Journal of Cardiovascular Medicine: September 8th 2006

By admin | Published: September 8, 2006

Christoph Kaiser

John Cleland

BASKET Study Shows Bare Metal Stents Can Be Better

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.

Perindopril Benefits Older Patients with Diastolic Heart Failure

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.

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Posted in Cardiovascular | Tagged diastolic, heart-failure, perindopril, stents | Leave a comment

Audio Journal of Cardiovascular Medicine: September 7th 2006

By admin | Published: September 7, 2006

Gilles Montalescot

Freek Verheugt

Angioplasty: Four-Continent RIVIERA Study Identifies “Real World” Modifiable Factors Which Affect Outcome

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.

Coagulation Choices in Elective and Primary PCI

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.

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Posted in Cardiovascular | Tagged angioplasty, audio, clopidogrel, coagulation, conference, doctor, heparin, interview, medical, News, PCI, podcast, statins | Leave a comment

Audio Journal of Cardiovascular Medicine: September 6th 2006

By admin | Published: September 6, 2006

REFERENCE: Abstract 1011 to 1016
Tony Gershlick, Leicester University

A session entitled: “Stent Thrombosis in the Drug-Eluting Stents Era” at the Barcelona congress identified important mechanism, markers and strategies for avoiding stent thrombosis which can occur despite the use of drug-eluting stents, especially when dual anti-platelet therapy is discontinued. Tony Gershlick chaired the session, and afterwards discussed the findings with Peter Goodwin.

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Posted in Cardiovascular | Tagged drug-eluting, stent, thrombosis | Leave a comment