Acute invasive fungal rhinosinus- itis occurs predominantly in immunocompromised patients, such as those with neutropenia and transplant recipients. The diagnosis requires biopsy, but permanent section can be time-consuming and result in a delay in treatment. Ghadiali and colleagues conducted a study to evaluate the accuracy of frozen-section biopsy in this setting.
Your Observations About the Man With the Tripod Sign
The diagnostic criteria for major depression are anhedonia, depressed mood, feelings of worthlessness or inappropriate guilt, inability to concentrate, fatigue, insomnia or hypersomnia, psychomotor agitation or retardation, significant weight loss or gain, and recurrent thoughts of death or suicide. Five or more of these symptoms must be present for at least 2 weeks, and one of them must be anhedonia or depressed mood. Conditions that can present with depression include dysthymia, bipolar disorder, cyclothymia, and adjustment disorder. Depression may also result from substance abuse or from the physiological conditions associated with a medical disorder, such as spinal or head injury, AIDS, or cancer.
BALTIMORE -- A needle stick injures more than four of every five surgical residents during their training, researchers here said, and about half of the incidents go unreported.
ATLANTA -- Rapid HIV testing with on-the-spot results during emergency room visits or at community events appears to be a feasible way to identify people who are infected with the virus and don't know it.
INDIANAPOLIS -- More than a third of U.S. adults report problems falling asleep or daytime sleepiness, and lack of sleep is linked to one in five serious motor vehicle accidents.
SEATTLE -- A hand-held echocardiography device can bring cardiac imaging to the outpatient setting, said investigators here.
ATLANTA -- Varicella vaccine should be administered in a two-dose regimen with the first dose at 12 to 15 months and the second dose at age four to six.
BALTIMORE -- When treating hepatitis B and HIV co-infection, physicians should use caution with the antiviral drug entecavir (Baraclude), researchers here said.
TORONTO -- The tests used to evaluate influenza vaccines are so unreliable they can vary up to 700-fold from one lab to another, according to a British researcher.
BALTIMORE -- The old system of targeting high-risk persons for HIV testing is more efficient than screening all patients routinely, according to a researcher here.
SAN FRANCISCO -- A standard six-month course of treatment for tuberculosis may not be sufficient to cure patients co-infected with HIV, researchers here say.
We present a case of a 35-year-old man with fever and pancytopenia, who had rapid progression to acute respiratory distress syndrome (ARDS), multiorgan failure, and disseminated intravascular coagulopathy secondary to disseminated tuberculosis (TB). Although both sputum and bronchoalveolar lavage (BAL) fluid smears were negative for acid-fast bacilli, the polymerase chain reaction (PCR) assay on the BAL fluid was positive for Mycobacterium tuberculosis. This case emphasizes the need to include TB in the differential for ARDS and the value of PCR testing of BAL fluid, especially in high-risk patients.
abstract: The use of fiberoptic bronchoscopy (FOB) in HIV- infected patients has sharply declined since the availability of highly active antiretroviral therapy and the resulting decrease in the incidence of opportunistic infections. Nevertheless, FOB continues to be an important diagnostic tool in this patient population. For example, FOB is useful in evaluating for Pneumocystis jiroveci (formerly carinii) pneumonia (PCP) in patients with CD4+ cell counts of less than 200/µL who have diffuse pulmonary infiltrates and in whom sputum induction has not been performed or is nondiagnostic. It is also useful for evaluating patients who have not responded adequately to empiric therapy for bacterial pneumonia or PCP. Other applications include the visual diagnosis of endobronchial Kaposi sarcoma or the assessment of suspected lung cancer. (J Respir Dis. 2007;28(6): 244-252)
SAN DIEGO -- When talking about antipsychotic agents for schizophrenia, it's important to distinguish efficacy from effectiveness.
WASHINGTON -- The FDA should be given the authority to regulate tobacco as an addictive drug, including marketing, advertising, and, eventually, the right to regulate nicotine content, said an Institute of Medicine report issued today.
BETHESDA, Md. -- The bumpy road to an HIV vaccine is leading researchers to try non-traditional avenues and to consider vaccines that -- unlike the classic paradigm -- would offer only partial protection.
LOS ANGELES -- A peptide that protects rhesus monkeys from HIV-1 infection does just the opposite when its structure is reversed, researchers here say.
SILVER SPRING, Md. -- Although the FDA advised physicians in March to use erythropoiesis-stimulating agents at the lowest possible dose to preclude a transfusion, an advisory committee has urged the agency to develop still stricter standards.
OXFORD, England -- A moderately high daily dose of aspirin taken long term may reduce colorectal cancer risk, but gastroenterologists should be cautious about recommending it, researchers said.
HOUSTON -- Patients with hepatitis C virus infection may have a 20% to 30% increased risk of developing non-Hodgkin's lymphoma, researchers here reported.
SEATTLE -- Only 16% of sedating antihistamine use among older patients at VA medical centers was for an appropriate indication, researchers reported here.
SEATTLE -- Light, physical activity and other non-drug therapies may be as effective against insomnia in the elderly as pharmacologic interventions, researchers said here.
