Infectious Disease

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SEATTLE -- The metal gallium -- approved as a drug by the FDA to treat symptomatic hypercalcemia of malignancy -- may also be useful as an antimicrobial, according to researchers here.

UTRECHT, The Netherlands -- Tuberculosis tests based on interferon-gamma response, measured by a blood test, picked up exposure to a TB-infected store employee here, but a positive result on the standard tuberculin skin test was not associated with exposure to the infected employee.

MANCHESTER, England -- Failures of total hip replacements are significantly more likely to occur when patients carry variants in genes encoding for collagen breakdown and the vitamin D receptor, according to investigators here.

LOS ANGELES -- A drug for patients infected with hepatitis B virus, an agent that was thought to be inactive against HIV for those co-infected with that virus, may not be so innocuous with HIV after all, investigators suggested here.

abstract: The mainstay of therapy for acute severe asthma includes ß2-agonists, anticholinergics, and corticosteroids. Other agents, such as leukotriene modifiers and magnesium sulfate, can be used in patients who have responded poorly to conventional therapy. Noninvasive positive pressure ventilation (NPPV) should be tried before intubation in alert, cooperative patients who have not improved with aggressive medical therapy. However, NPPV should not be attempted in patients who are rapidly deteriorating or in those who are somnolent or confused. Endotracheal intubation is recommended for airway protection or for patients who present with altered mental status or circulatory shock. Patients should be admitted to the ICU if they have difficulty in talking because of breathlessness, altered mental status, a forced expiratory volume in 1 second or peak expiratory flow rate of less than 25% of predicted, or a PaCO2 greater than 40 mm Hg after aggressive treatment in the emergency department. (J Respir Dis. 2007;28(3):113-117)

The influenza vaccine not only reduces the morbidity and mortality of influenza, it also reduces the risk of death in adults hospitalized with community-acquired pneumonia (CAP). Spaude and colleagues found that this protective effect covered in-hospital all-cause mortality, even after adjustment for pneumococcal vaccination status and the presence of comorbidities.