EL BIRUNI (CIENCIAS MÉDICAS NEWS) DIRECTORIO DE DOCUMENTOS EDITADOS EN AGOSTO de 2010

EL BIRUNI (CIENCIAS MÉDICAS NEWS)
un culto a las ciencias médicas fundadas en la filosofía de las ciencias (no en el negocio de ellas)
DIRECTORIO DE DOCUMENTOS EDITADOS EN AGOSTO 2010

CIENCIAS MÉDICAS NEWS
CIENCIAS MÉDICAS APLICADAS
RESEARCH & CLINICAL DEVELOPMENT

► http://elbiruniblogspotcom.blogspot.com
un aporte al conocimiento médico-científico actualizado al segundo

► http://saludequitativa.blogspot.com
un aporte a la salud pública y su sostenimiento racional

► http://herenciageneticayenfermedad.blogspot.com
herencia, genética y enfermedades en idioma español

Consultas acumuladas desde enero 2009 a la fecha: 223.673
Consultas totales conjuntas (todos los blogs): 857.200

Discriminadas como sigue:
1. Argentina 35.012 15,7 %
2. España 33.915 15,2 %
3. México 30.675 13,7 %
4. Estados Unidos 24.181 10,8 %
5. Colombia 13.327 6,0 %
6. Perú 12.898 5,8 %
7. Venezuela 12.539 5,6 %
8. Chile 8.002 3,6 %
9. Ecuador 5.499 2,5 %
10. Bolivia 4.038 1,8 %
El resto 43.587 19,5 %
Total 223.673 100,0 %


Documentos del mes de AGOSTO: 467
Documentos acumulados en 2010: 3.903
Documentos editados desde el inicio del blog: 8.410


Archivo del blog

* ▼ 2010 (3903)
o ▼ agosto (467)
+ Access : Complement-mediated regulation of the IL-...
+ Austrian Syndrome Associated with Pandemic (H1N1) ...
+ Avian Hepatitis E Virus from Chickens, China | CDC...
+ Guillain-Barre Syndrome and Influenza A (H1N1) Vac...
+ Polyomaviruses in HIV-infected Patients | CDC EID
+ Human Herpesvirus 8 Genotype E, Peru | CDC EID
+ Increasing Incidence of Mucormycosis, Belgium | CD...
+ Contact Lens Solution–associated Acanthamoeba and ...
+ Antimicrobial Resistance: Beyond the Breakpoint | ...
+ Typhoid Fever and Nontyphoid Salmonellosis | CDC E...
+ Hospitalizations for Peptic Ulcer Disease | CDC EI...
+ Co-infections with Plasmodium spp., Myanmar | CDC ...
+ Treatment for S. aureus skin infection works in mo...
+ Research Activities, September 2010: Chronic Disea...
+ Pediatric Group Issues New Flu Shot Guidelines: Me...
+ RICKETTSIOSIS, HUMANA, MUERTES - MÉXICO (SONORA)
+ DENGUE HEMORRÁGICO, MUERTES - HONDURAS
+ RABIA HUMANA, MUERTES: OPS, ALERTA EPIDEMIOLÓGICA ...
+ SALMONELLA, HUEVOS CONTAMINADOS, PRODUCCIÓN IRREGU...
+ CDC Commentary: Testing for Clostridium difficile ...
+ Atrazine causes prostate inflammation in male rats...
+ Consumer Updates > Registries Help Moms Measure Me...
+ National Guideline Clearinghouse | ACR Appropriate...
+ National Guideline Clearinghouse | Lipid managemen...
+ National Guideline Clearinghouse | Diagnosis of br...
+ National Guideline Clearinghouse | Outpatient mana...
+ National Guideline Clearinghouse | Urinary inconti...
+ National Guideline Clearinghouse | Incontinence in...
+ National Guideline Clearinghouse | (1) Pharmacothe...
+ National Guideline Clearinghouse | (1) Incontinenc...
+ NCTR Publications > NCTR Research Highlights
+ Viruses Found in Chronic Fatigue Syndrome Patients...
+ Both Real and “Sham” Acupuncture Relieve Knee Pain...
+ Array of Childhood Brain Disorders Linked
+ Intrinsic biophysical diversity decorrelates neuro...
+ Arch Ophthalmol -- Abstract: Attenuation of Iodine...
+ Genome-wide association study of migraine implicat...
+ Widely Used Plastics Chemical Linked to Testostero...
+ Salmonella Enteritidis // CDC Features - Tips to R...
+ Announcement: Epidemic Intelligence Service Applic...
+ Estimates of Deaths Associated with Seasonal Influ...
+ Changes in Measurement of Haemophilus influenzae s...
+ Notes from the Field: Measles Transmission Associa...
+ Alzheimer's Disease Signature Seen in Spinal Fluid...
+ Kabuki Syndrome Gene Identified
+ Pulsed Light Paces the Heart
+ Rectal Cancer Rates on the Rise in Younger Adults:...
+ Meta-Analysis of Genome-Wide Association Studies o...
+ Family-Based Genome-Wide Association Scan of Atten...
+ Host genetic basis for hepatitis C virus clearance...
+ Familial thyroid neoplasia: impact of technologica...
+ Genome-wide association study of esophageal squamo...
+ A shared susceptibility locus in PLCE1 at 10q23 fo...
+ Endocrine autoimmune disease: genetics become comp...
+ A towards-multidimensional screening approach to p...
+ Brothers of prostate cancer patients undergo more ...
+ Experts find gene variants for stomach, gullet can...
+ HealthDay Articles: Inner Workings of Gene Tied to...
+ Scientists to discuss research on XMRV in blood, c...
+ PHG Foundation | Genetic transcriptional signature...
+ PHG Foundation | New study points the way to muscu...
+ Scientists develop the first atomic view of key ge...
+ Road Signs And Traffic Signals On DNA
+ How Well Do You Know Your Genes?
+ Personalized Genome Sequencing In Cancer Treatment...
+ Link Across Array Of Childhood Brain Disorders Rev...
+ Physical Model Describes The Distribution Of Nucle...
+ Over 200 Genes Influenced By Vitamin D, Highlighti...
+ Gene Involved In Fuchs Corneal Dystrophy Is Found
+ Study Identifies Genetic Variation Linked To Lupus...
+ Genome Study Finds 13 New Celiac Disease-associate...
+ Chronic fatigue syndrome - Study: Presence of muri...
+ Hiperbilirrubinemia neonatal
+ What are seasonal influenza-related deaths?
+ INFLUENZA H1N1, VACUNA PANDÉMICA Y NARCOLEPSIA: PO...
+ National Guideline Clearinghouse | Reducing the ri...
+ National Guideline Clearinghouse | Long-term conse...
+ National Guideline Clearinghouse | Estrogen and pr...
+ AIDSinfo - HIV Guidelines - Pediatric
+ National Guideline Clearinghouse | Guideline Synth...
+ National Guideline Clearinghouse | Expert Commenta...
+ NIH Director's Response to Stem Cell Injunction
+ Studies on combat related substance use and abuse ...
+ In Some Patients, Hypertension Meds Raise Blood Pr...
+ Alerts and Notices (Medical Devices) > FDA Safety ...
+ Link Between Diabetes, Alzheimer's Disease Strengt...
+ Workshops, Meetings & Conferences (Biologics) > Pu...
+ Regulador europeo revisa seguridad vacuna de Glaxo...
+ Systemic lupus erythematosus: From mouse models to...
+ AUSENTE hasta el 29 de AGOSTO de 2010
+ Rickettsia sibirica mongolitimonae in Traveler fro...
+ Scientists Move Closer To Blood Test That Predicts...
+ Studies Confirm Genetic Link To Advanced Fatty Liv...
+ DNA Repair Genes Help Predict Impact Of Chemo For ...
+ Disturbances in certain genes play a role in autis...
+ Tuberculosis (Biographies of Disease) | CDC EID
+ Antimicrobial Resistance: Beyond the Breakpoint | ...
+ Increase in Neisseria meningitidis Serogroup W135,...
+ Invasive Klebsiella pneumoniae Infections, Califor...
+ Acute Cervical Lymphadenitis Caused by Mycobacteri...
+ Dentists and M. tuberculosis, Nigeria | CDC EID
+ XDR TB, Pakistan | CDC EID
+ Sarampión: detectan dos casos en Brasil
+ Typhoid Fever and Nontyphoid Salmonellosis | CDC E...
+ Long–Term Health Risks after Gastroenteritis | CDC...
+ Pneumococcal Serotypes in 4 European Countries | C...
+ Illicit Drug Use and USA300 MRSA | CDC EID
+ Hospitalizations for Peptic Ulcer Disease | CDC EI...
+ MDR TB, California, USA, 2004–2007 | CDC EID
+ Legionellosis and Paving Machine | CDC EID
+ Influenza in Refugees on the Thailand–Myanmar Bord...
+ Diversity of K. pneumoniae That Produce KPC | CDC ...
+ Recurrent Granulibacter bethesdensis Infections | ...
+ Vol. 16, No. 9 Cover: Cover Title | CDC EID - NEXT...
+ Safety Alerts for Human Medical Products Stalevo(...
+ A Unifying Genetic Model for Facioscapulohumeral M...
+ American Journal of Hypertension - Abstract of art...
+ American Journal of Hypertension - Abstract of art...
+ American Journal of Hypertension - Abstract of art...
+ PLoS ONE: Examination of Apoptosis Signaling in Pa...
+ PLoS ONE: The Tuberculin Skin Test (TST) Is Affect...
+ PLoS ONE: Human Neural Stem Cells Differentiate an...
+ Immunity - Development and Migration of Plasma Cel...
+ Immunity - The Phosphatase PTP-PEST Promotes Secon...
+ Articles of Significant Interest Selected from Thi...
+ European Medicines Agency - Calendar - First joint...
+ ARGENTINA: Alerta nacional por casos de sarampión
+ Early Palliative Care for Patients with Metastatic...
+ Racial Variation in Medical Outcomes among Living ...
+ Preparing for a Consumer-Driven Genomic Age | Heal...
+ An interferon-inducible neutrophil-driven blood tr...
+ Microenvironmental reprogramming of thymic epithel...
+ Yellow Fever Mosquito Shows Up in Northern Europe ...
+ The Path to Personalized Medicine — NEJM
+ Discovery opens door to therapeutic development fo...
+ NIH renews major research program to develop medic...
+ Notice to Readers: Final 2009 Reports of Nationall...
+ National, State, and Local Area Vaccination Covera...
+ Notes from the Field: Acute Hemorrhagic Conjunctiv...
+ Development Resources > Pediatric Exclusivity Gran...
+ Development Resources > Medical, Statistical, and ...
+ Long-Term Type 1 Diabetes 'Survivors' Give Clues t...
+ Poultry Litter Leaches Arsenic Into Streams, River...
+ Progeria Research Foundation - Find the Other 150 ...
+ Ruptured Intracranial Aneurysms: Factors Affecting...
+ Value of Cerebral Microhemorrhages Detected with S...
+ Atherosclerotic Plaque Composition: Analysis with ...
+ PLoS ONE: Extreme Evolutionary Disparities Seen in...
+ Guided Cardiopoiesis Enhances Therapeutic Benefit ...
+ Detienen el desarrollo de un fármaco para paliar e...
+ Combinatorial homophilic interaction between γ-pro...
+ In vitro and in vivo reconstitution of the cadheri...
+ miR-204 is required for lens and retinal developme...
+ Mesenchymal and haematopoietic stem cells form a u...
+ Guided Cardiopoiesis Enhances Therapeutic Benefit ...
+ The maternal body mass index: a strong association...
+ Alerts and Notices (Medical Devices) FDA Safety N...
+ Antibiotic Sponges Don't Benefit Heart Surgery Pat...
+ Vaccines: Pubs/PinkBook/Changes 12th edition 2011
+ Preventing Chronic Disease: September 2010: 09_019...
+ Preventing Chronic Disease: September 2010: 09_020...
+ Preventing Chronic Disease: September 2010: 09_020...
+ Linfangioma zosteriforme circunscripto
+ Heart Failure Practice Guideline - HEART FAILURE S...
+ National Guideline Clearinghouse | Stroke and tran...
+ National Guideline Clearinghouse | Prevention of c...
+ National Guideline Clearinghouse | Nursing managem...
+ National Guideline Clearinghouse | Diagnosis and t...
+ National Guideline Clearinghouse | Assessment and ...
+ CDRH/FDA Public Webinar: FDA Discussion on the Dra...
+ Blog.AIDS.gov: Data Academy: Providing Training an...
+ U.S. Preventive Services Task Force: Opportunity f...
+ IntraMed - Artículos - Metformina en pacientes con...
+ RCP - IntraMed - Artículos - RCP: ¿Con o sin venti...
+ National Guideline Clearinghouse | ACR Appropriate...
+ National Guideline Clearinghouse | ACR Appropriate...
+ How does an individual become a member of an FDA a...
+ What is a financial conflict of interest waiver?
+ How is a potential advisory committee member scree...
+ What is a conflict of interest?
+ What is an FDA Advisory Committee?
+ What are the qualifications of a scientific member...
+ National Guideline Clearinghouse | Evidence-based ...
+ Lung Cancer Among Postmenopausal Women Treated Wit...
+ Common genetic variation in the HLA region is asso...
+ Expansion of cancer care and control in countries ...
+ New breast cancer committee to establish federal r...
+ Outward knee alignment increases arthritis risk, f...
+ Medication Quickly Lifts Bipolar Depression Sympto...
+ Coaxing the Body’s Cells to Repair Damaged Joints
+ Dozens of Genetic Variants Linked to Blood Lipid L...
+ IntraMed - Artículos - Tratamiento inicial de la i...
+ FDA Proposes Withdrawal of Low Blood Pressure Drug...
+ Children's Oncology Group: Long-term follow-up gui...
+ NIDA and Federal Partners to Launch National Drug ...
+ MeCP2 controls BDNF expression and cocaine intake ...
+ MeCP2 in the nucleus accumbens contributes to neur...
+ Rod photoreceptors drive circadian photoentrainmen...
+ In NIH-funded study, researchers uncover early ste...
+ Discovered gene causes Kabuki syndrome, August 15,...
+ FDA approves ella™ tablets for prescription emerge...
+ CDC - Outbreak of Typhoid Fever Infections - Augus...
+ European Medicines Agency - News and press release...
+ Blood Products Advisory Committee > July 26-27, 20...
+ Collateral vessels on CT angiography predict outco...
+ AHRQ in the Professional Literature
+ Oregon Evidence-based Practice Center
+ Search for Guides, Reviews, and Reports - AHRQ Eff...
+ Search for Guides, Reviews, and Reports - AHRQ Eff...
+ Until monday 16th
+ GT | Initial Trials on New Ovarian Cancer Tests Ex...
+ Rapid Mass Spectrometric Metabolic Profiling of Bl...
+ PLoS Genetics: Conserved Role of unc-79 in Ethanol...
+ Equity in access to total joint replacement of the...
+ Disparities in breast cancer mortality trends betw...
+ Understanding the population structure of North Am...
+ PHG Foundation | Common genetic variants associate...
+ Team From Pitt, Helicos BioSciences Say Human Cell...
+ Large Risk Schizophrenia Marker Revealed
+ Genetic Variant Linked To TB Susceptibility In Afr...
+ Genes For Meningitis Susceptibility And Resistance...
+ Genome Scanning Finds Genes For Cholesterol And He...
+ How does the FDA use Advisory Committees to make d...
+ Research Into Suspicious Gene Tied To Breast Cance...
+ Gene Target May Block Breast Cancer Recurrence And...
+ K-State Research Team Investigates Mutated Gene's ...
+ Familial Link In Rare Childhood Leukemia
+ Personalized Genome Sequencing In Cancer Treatment...
+ NCTR Publications > NCTR Research Highlights
+ Safety Alerts for Human Medical Products > Lamicta...
+ Alerts and Notices (Medical Devices) > Positive Di...
+ IntraMed - Artículos - Incidencia de la pesquisa d...
+ British Journal of Cancer - Detection of lung, bre...
+ TheLancet.com: CRASH-2: tranexamic acid and trauma...
+ Emergence of a new antibiotic resistance mechanism...
+ New NIH website offers easy access to information ...
+ Announcement: Interactive CDC DengueMap Available ...
+ Update: Recommendations of the Advisory Committee ...
+ Completion of National Laboratory Inventories for ...
+ CDC Grand Rounds: Additional Opportunities to Prev...
+ SALMONELLA, BROTE HUMANO, ALIMENTOS SECOS DE MASCO...
+ DENGUE, EPIDEMIA EN PROGRESO - VENEZUELA (02)
+ Postmarket Drug Safety Information for Patients an...
+ FDA: Aseptic Meningitis Risk with Use of Seizure D...
+ CDC - Blogs - Safe Healthcare - Decline In Most Se...
+ IntraMed - Artículos - En niños alérgicos al huevo...
+ Prevention and Control of Influenza with Vaccines
+ Guideline on Diagnosis of Periprosthetic Joint Inf...
+ National Guideline Clearinghouse | ACR Appropriate...
+ National Guideline Clearinghouse | ACR Appropriate...
+ National Guideline Clearinghouse | ACR Appropriate...
+ National Guideline Clearinghouse | ACR Appropriate...
+ National Guideline Clearinghouse | ACR Appropriate...
+ National Guideline Clearinghouse | ACR Appropriate...
+ National Guideline Clearinghouse | ACR Appropriate...
+ NIH launches effort to define markers of human imm...
+ NIHSeniorHealth site offers information about olde...
+ NIH study indicates stress may delay women getting...
+ JAMA -- Abstract: Exposure to Oral Bisphosphonates...
+ Arch Neurol -- Meta-analysis Confirms CR1, CLU, an...
+ Arch Neurol -- Abstract: Diagnosis-Independent Alz...
+ Prevalence and Complications of Single-Gene and Ch...
+ TRIQUINOSIS, BROTE EXTENSO, EMBUTIDOS - ARGENTINA ...
+ HEPATITIS C, EPIDEMIA EXTENSA - EGIPTO
+ alerta epidemiológico por sarampión
+ Relieving Eye Pressure May Slow Glaucoma: MedlineP...
+ WHO | H1N1 in post-pandemic period
+ WHO | WHO recommendations for the post-pandemic pe...
+ WHO Declares End to 2009 H1N1 Influenza Pandemic
+ CDC - Injury - Poisoning in the United States - Is...
+ NIH Launches Effort to Define Markers of Human Imm...
+ Registration Open for FDA Clinical Investigator Tr...
+ cystic fibrosis. - European Medicines Agency - Rar...
+ ovarian cancer - European Medicines Agency - Rare ...
+ chronic myeloid leukaemia - European Medicines Age...
+ non-infectious uveitis - European Medicines Agency...
+ mastocytosis - European Medicines Agency - Rare di...
+ ovarian cancer - European Medicines Agency - Rare ...
+ tuberous sclerosis - European Medicines Agency - R...
+ Guideline on quality, non-clinical and clinical as...
+ National Guideline Clearinghouse | Atopic eczema i...
+ National Guideline Clearinghouse | Screening and m...
+ National Guideline Clearinghouse | Primary care di...
+ National Guideline Clearinghouse | Office-based su...
+ National Guideline Clearinghouse | Management and ...
+ National Guideline Clearinghouse | Clinical practi...
+ Women's cholesterol levels vary with phase of mens...
+ ENTEROBACTERIAS, GEN NDM-1, DISEMINACIÓN, VIAJES I...
+ Síndrome del ovario poliquístico (SOP) // IntraMed...
+ Guidances (Drugs) > Questions and Answers on Curre...
+ Information for Healthcare Professionals (Drugs) >...
+ Consideration of Evidence on Antiemetic Drugs for ...
+ CDC - Seasonal Influenza (Flu) - Preventing Season...
+ CDC - Seasonal Influenza (Flu) - Q & A: CSL Season...
+ SARAMPIÓN, CASO AUCTÓCTONO CONFIRMADO - BRASIL (P...
+ European Medicines Agency - Rare disease designati...
+ European Medicines Agency - Rare disease designati...
+ Human clinical trial of NIH-developed dengue vacci...
+ Epigenetic silencing of engineered L1 retrotranspo...
+ Hepatitis B virus infection and risk of non-Hodgki...
+ Tattooing and the risk of transmission of hepatiti...
+ GABAergic circuits control stimulus-instructed rec...
+ Hindbrain interneurons and axon guidance signaling...
+ Es posible regenerar conexiones nerviosas tras una...
+ Cell Stem Cell - Chromatin Structure and Gene Expr...
+ CELÍACOS // IntraMed - Artículos - Enfermedad celí...
+ CDC - Blogs - Safe Healthcare - CMS Rule: Shining ...
+ National Guideline Clearinghouse | Chronic pain.
+ ¿Qué causó la pandemia de H1N1 en 2009?: MedlinePl...
+ Dengue: MedlinePlus en español
+ NCRR Reporter - Winter 2010 - Research Brief
+ SARAMPIÓN, CASOS SOSPECHOSOS: ALERTA - ARGENTINA (...
+ Overview of comments received on 'Guideline on the...
+ Guideline on the clinical investigation of medicin...
+ Positions on specific questions addressed to the E...
+ Overview of comments received on the guideline on ...
+ Guideline on the clinical investigation of human n...
+ Guideline on setting specifications for related im...
+ guidance on quality of modified release oral dosag...
+ European Medicines Agency - Rare disease designati...
+ late-onset sepsis in premature infants of less tha...
+ traumatic spinal cord injury - European Medicines ...
+ primary biliary cirrhosis - European Medicines Age...
+ primary myelofibrosis- European Medicines Agency -...
+ post-polycythaemia vera myelofibrosis.- European M...
+ post-essential thrombocythaemia myelofibrosis - Eu...
+ glaucoma filtration surgery - European Medicines A...
+ Guidance Documents (Medical Devices and Radiation-...
+ HEPATITIS C, INCIDENCIA EN RELACIÓN CON NÚMERO DE ...
+ SNB, RÁPIDA PROPAGACIÓN, MUERTE MASIVA DE MURCIÉLA...
+ Possible Recurrent Pandemic (H1N1) 2009 Infection ...
+ Pandemic (H1N1) 2009 Viral Load and Shedding | CDC...
+ FDA Approves Vaccines for the 2010-2011 Influenza ...
+ UCSD Researcher Leads Schizophrenia Genetics Conso...
+ Genomics|Genetic Testing|EGAPP Recommendations|UGT...
+ CDC Expert Commentary directory
+ Gene variant may increase severity of multiple scl...
+ NIH Genomic Mapping Study Finds Largest Set of Gen...
+ Mental Retardation Research Published In Nature
+ Bay Area Researchers Will Try To Turn Off Genes To...
+ PHG Foundation | Common susceptibility locus assoc...
+ PHG Foundation | Genetic factors in breast cancer ...
+ Male breast cancer in family leads to high percept...
+ 'Linc-ing' a noncoding RNA to a central cellular p...
+ Biologics Procedures (SOPPs) > SOPP 8401.3: Filing...
+ Fractionated Plasma Products > Flebogamma DIF 10%
+ Untitled Letters (Biologics) > PROVENGE (sipuleuce...
+ Mycobacterium avium subsp. hominissuis Infection i...
+ Lethal Necrotizing Pneumonia caused by an ST398 St...
+ Not-So-Novel Michigan Rabbit Calicivirus | CDC EID...
+ Leptospira Serovar as Prognostic Factor | CDC EID
+ Crimean-Congo Hemorrhagic Fever in Man, Republic o...
+ West Nile Virus Knowledge among Hispanics, San Die...
+ Eye-Opening Norovirus Surveillance | CDC EID
+ Blog.AIDS.gov: Interview with Ernest Hopkins and B...
+ WHO | Pandemic (H1N1) 2009 - update 112
+ Nonoptimal Lipids Commonly Present in Young Adults...
+ A Shift in the Clinical Spectrum of Eosinophilic G...
+ Reinduction With Certolizumab Pegol in Patients Wi...
+ High Risk Ulcer Bleeding: When Is Second-Look Endo...
+ Low-Dose Maintenance Therapy With Infliximab Preve...
+ Image of new antibiotic in action opens up new opp...
+ PLoS Pathogens: Biological and Structural Characte...
+ Cell - Dendritic Function of Tau Mediates Amyloid-...
+ Cell - PNPASE Regulates RNA Import into Mitochondr...
+ Cell - A Large Intergenic Noncoding RNA Induced by...
+ Cell - Direct Reprogramming of Fibroblasts into Fu...
+ AUMENTO DE ENFERMEDADES TRANSMITIDAS POR VECTORES ...
+ RABIA, MURCIÉLAGOS, TASAS DE TRANSMISIÓN POR ESPEC...
+ Biological Approvals by Year > 2010 Biological Dev...
+ Biological Approvals by Year > 2010 Biological Lic...
+ Biological Approvals by Year > 2010 Biological Lic...
+ ArrayTrackTM > ArrayTrack™ News
+ CDRHNew: FR Doc 2010-19339 and Draft Guidance for...
+ Postmarket Drug Safety Information for Patients an...
+ HIV and AIDS Activities > Guidance: Fixed Dose Com...
+ American College of Radiology - ACR Appropriatenes...
+ Prevention and Control of Influenza with Vaccines:...
+ Vaccine Shows Some Promise Against Advanced Cancer...
+ CMS Rule: A Bold Step, But Just One Step Toward El...
+ CMS Rule: Infection Preventionists Key to Reportin...
+ LIBRO INÉDITO DE UNA ENFERMERA SIN FRONTERAS
+ Lack of Food Puts Kids at Risk for Asthma, Other C...
+ Impact of diet in shaping gut microbiota revealed ...
+ Pathway-Based Identification of Biomarkers for Tar...
+ Ferroportin and Iron Regulation in Breast Cancer P...
+ Oral Contraceptive Use and Estrogen/Progesterone R...
+ Xenografting of human fetal testis tissue: a new a...
+ Sanidad alerta de casos graves de sobredosis por u...
+ Clostridium difficile Bacteremia, Taiwan1
+ Lethal Necrotizing Pneumonia Caused by an ST398 St...
+ Human Rickettsia heilongjiangensis Infection, Japa...
+ Picornavirus Salivirus/Klassevirus in Children wit...
+ Novel Mycobacterium tuberculosis Complex Pathogen,...
+ Lyme Borreliosis, Po River Valley, Italy
+ Bat Rabies in Massachusetts, USA, 1985–2009
+ Amblyomma imitator Ticks as Vectors of Rickettsia ...
+ Duck Hunters' Perceptions of Risk for Avian Influe...
+ NIH Genomic Mapping Study Finds Largest Set of Gen...
+ NIH-Funded Researchers Generate Mature Egg Cells F...
+ CMS Rule: A Monumental Step Forward for Patient Sa...
+ Design of an HA2-based Escherichia coli expressed ...
+ Reconstitution of RPA-covered single-stranded DNA-...
+ Deep phenotyping to predict live birth outcomes in...
+ Synaptic input organization of the melanocortin sy...
+ Genome-wide association study identifies five new ...
+ The transmembrane activator TACI triggers immunogl...
+ Review Suggests Bias in Drug Study Reporting -Medl...
+ FDA Issues Assessments of the 510(k) Program and U...
+ Management of obesity. Scottish Intercollegiate Gu...
+ Society of Thoracic Surgeons practice guideline se...
+ DMD Care Considerations Working Group: Duchenne mu...
+ American Thyroid Association
+ American Society of Anesthesiologists
+ critical issues in the evaluation and management o...
+ Características clínicas de pacientes con enfermed...
+ e- Boletín DROGAS Y MEDICAMENTOS / Año Nº I - Nº 7...
+ Vital Signs: State-Specific Obesity Prevalence Amo...
+ Cardiac Index Is Associated With Brain Aging. The ...
+ Primary deficiency of microsomal triglyceride tran...
+ An alphavirus vector overcomes the presence of neu...
+ Regulation of cell motile behavior by crosstalk be...
+ Biological role of noise encoded in a genetic netw...
+ Nicotinic pharmacophore: The pyridine N of nicotin...
+ 3D visualization of HIV transfer at the virologica...
+ A tumor-suppressing mechanism in Drosophila involv...
+ Risks, Benefits of Emerging Heart Valve Replacemen...
+ Multiyear Surveillance for Avian Influenza Virus i...
+ Bat Coronaviruses and Experimental Infection of Ba...
+ Outbreak of Corynebacterium pseudodiphtheriticum I...
+ White-Nose Syndrome Fungus (Geomyces destructans) ...
+ Scavenging Ducks and Transmission of Highly Pathog...
+ West Nile Virus Range Expansion into British Colum...
+ Diagnosis and Evaluation of Chronic Heart Failure ...
+ e- Boletín DROGAS Y MEDICAMENTOS - Año Nº I - Nº 7...
+ New Data Supports Link Between Diabetes Drugs, Fra...
+ Cigarette Smoking as a Risk Factor for Uveitis
+ Effect of calcium supplements on risk of myocardia...
+ Regeneration of the articular surface of the rabbi...
+ Safety Alerts for Human Medical Products Nimodipi...
+ Gene Tied to Kidney Disease, Sleeping Sickness in ...
+ Brain Circuits Start and Stop the Action
+ Some Stem Cells Find it Hard to Forget
+ Genomewide Association Studies and Assessment of t...
+ Pharmacogenetics of asthma. [Curr Opin Pharmacol. ...
+ Genetic ancestry in lung-function predictions. [N ...
+ Genetic aspects of the Paget's disease of bone: co...
+ Personalized Tamoxifen: A Step Closer But Miles To...
+ Common variants conferring risk of schizophrenia: ...
+ Excess of rare variants in genes identified by gen...
+ A history of stressful life events, prolonged ment...
+ JAMA -- Abstract: Incidence of Breast Cancer and I...
+ Research Activities, August 2010: Feature Story: A...
+ Pandemic (H1N1) 2009 in Marginalized Populations |...
+ Quarantine Methods and Secondary Outbreak Preventi...
+ The Dictionary of Virology, 4th Edition | CDC EID
+ One Health Approach to Influenza: Assessment of Cr...
+ School Closure during Pandemic (H1N1) 2009 | CDC E...
+ Pandemic (H1N1) 2009 and Down Syndrome | CDC EID
+ Pandemic (H1N1) 2009, Taiwan | CDC EID
+ Pandemic (H1N1) 2009, Australia | CDC EID
+ Pandemic (H1N1) 2009 Surveillance in New York City...
+ Pandemic (H1N1) 2009 Viral Load and Shedding | CDC...
+ Pertussis Vaccine | CDC EID
+ Clostridium difficile Bacteremia, Taiwan | CDC EID...
+ Clostridium difficile Bacteremia, Taiwan | CDC EID...
+ Hantavirus Infections, China | CDC EID
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Access : Complement-mediated regulation of the IL-17A axis is a central genetic determinant of the severity of experimental allergic asthma : Nature Immunology

Nature Immunology
Published online: 29 August 2010 | doi:10.1038/ni.1926
Complement-mediated regulation of the IL-17A axis is a central genetic determinant of the severity of experimental allergic asthma
Stephane Lajoie1,3, Ian P Lewkowich1,3, Yusuke Suzuki1, Jennifer R Clark1, Alyssa A Sproles1, Krista Dienger1, Alison L Budelsky2 & Marsha Wills-Karp1



-------------------
Abstract
Severe asthma is associated with the production of interleukin 17A (IL-17A). The exact role of IL-17A in severe asthma and the factors that drive its production are unknown. Here we demonstrate that IL-17A mediated severe airway hyperresponsiveness (AHR) in susceptible strains of mice by enhancing IL-13-driven responses. Mechanistically, we demonstrate that IL-17A and AHR were regulated by allergen-driven production of anaphylatoxins, as mouse strains deficient in complement factor 5 (C5) or the complement receptor C5aR mounted robust IL-17A responses, whereas mice deficient in C3aR had fewer IL-17-producing helper T cells (TH17 cells) and less AHR after allergen challenge. The opposing effects of C3a and C5a were mediated through their reciprocal regulation of IL-23 production. These data demonstrate a critical role for complement-mediated regulation of the IL-23–TH17 axis in severe asthma.

Access : Complement-mediated regulation of the IL-17A axis is a central genetic determinant of the severity of experimental allergic asthma : Nature Immunology




GENÉTICA
Actualidad Ultimas noticias - JANOes -
Identifican una base genética clave en el asma severa
JANO.es · 31 Agosto 2010 11:24

El avance podría ayudar a desarrollar tratamientos terapéuticos para esta variante de la enfermedad.

Investigadores del Hospital Pediátrico de Cincinnati, en Estados Unidos, han identificado una base genética cuya presencia puede determinar la gravedad del asma, según los resultados de un estudio en ratones, cuyos resultados se han publicado en la revista Nature Immunology.

La prevalencia del asma ha aumentado en los últimos años y, pese a que existen numerosos factores ambientales que favorecen su aparición, como el humo del tabaco, algunos alérgenos o la contaminación atmosférica, este estudio ha fijado un posible "punto de inflexión molecular" entre la variante más suave y la más agresiva.

De este modo, los autores de este estudio han descubierto que una proteína preinflamatoria, la interleukina-17 (IL-17A), puede ser la principal culpable de los síntomas más graves de esta enfermedad respiratoria.

Error en la regulación de un gen
Según describe la autora del estudio, Marsha Wills-Karps, el proceso de la enfermedad parece comenzar cuando las vías respiratorias se exponen a los alérgenos ambientales, lo que provoca una mala regulación de un gen llamado factor 3 del complemento (C3), que activa una parte del sistema inmune denominada "cascada de activación del complemento".

Esto conduce a la producción exagerada de IL-17A por las células de las vías respiratorias y pone en marcha lo que los científicos describen como un bucle de amplificación, ya que la IL-17A a su vez induce la producción de más C3 en la superficie de las vías respiratorias.

Al continuar el bucle de amplificación por la exposición constante a estos alérgenos, se aumenta la respuesta inflamatoria, involucrando ya a las células T auxiliares y a otras proteínas interleuquinas (IL-13 e IL-23), lo que provoca en último lugar, la obstrucción del flujo nasal.

"Este hallazgo puede ser clave en la búsqueda de futuros tratamientos terapéuticas para combatir esta variante, aunque para ello será necesario precisar si es necesario actuar inhibiendo la producción del IL-17A i sobre las C3", asegura Wills-Karp.


Nature Immunology; Published online: 29 August 2010; doi:10.1038/ni.1926
Access : Complement-mediated regulation of the IL-17A axis is a central genetic determinant of the severity of experimental allergic asthma : Nature Immunology

Hospital Pediátrico de Cincinnati
Cincinnati Children's Hospital Medical Center

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Austrian Syndrome Associated with Pandemic (H1N1) 2009 in Child | CDC EID

EID Journal Home > Volume 16, Number 9–September 2010

Volume 16, Number 9–September 2010
Letter
Austrian Syndrome Associated with Pandemic (H1N1) 2009 in Child
Waseem Alhushki and Chokechai Rongkavilit
Author affiliation: Wayne State University, Detroit, Michigan, USA

To the Editor: In 1957, an American internist reported the preference of Streptococcus pneumoniae for the aortic valve and its frequent association with meningitis and pneumonia (1), an association now known as Austrian syndrome. This syndrome mainly occurs in middle-age men who have predisposing factors, such as chronic alcoholism, altered immune state, dural fistula, and ear or sinus infections.

One case of Austrian syndrome has been reported in the pediatric age group, in a 7-year-old girl in whom aortic valve endocarditis developed after pneumococcal meningitis infection (2). In pneumococcal endocarditis, the native aortic valve is the most frequent location of vegetation. Valve replacement must be considered to avoid development of cardiogenic shock, whereas medical treatment alone may be adequate in some cases of mitral endocarditis (3,4).

We report a previously healthy adolescent with Austrian syndrome associated with pandemic (H1N1) 2009 infection. Cardiac involvement resulted in extensive mitral valve destruction requiring surgical valve replacement.

A 13-year-old boy had cough, nasal congestion, and a fever ≥103°F for 2 weeks before being seen at a hospital. On the day he was admitted to hospital, he became unarousable, and weakness was noted on his left side. His medical history included mild asthma requiring no therapy over the past 3 years. His immunizations were up to date except for seasonal influenza and pandemic (H1N1) 2009 vaccination.

When admitted to hospital, his temperature was 38.7°C, blood pressure 97/47 mm Hg, respiratory rate 77 breaths/min, and heart rate 150 beats/min. Pupils were 3 mm in diameter and reactive to light and accommodation. Weakness and hypertonia of the left upper and lower extremities were noted. He had neck stiffness without Kernig sign or Brudzinski sign. Complete blood count showed a leukocyte count of 26,400 cells/mm3 and differential of 92.1% neutrophils, 5.3% lymphocytes, 2.6% monocytes, and 0.1% eosinophils; hemoglobin level of 12.9 g/dL; hematocrit 38.6%; and a thrombocyte count of 102,000 cells/mm3. A plain chest radiograph showed a left lower lobe infiltrate. Computed tomography of the head showed a large infarction involving the right frontal lobe at the distribution of the right middle cerebral artery; small infarcts involved the left frontal lobe and the right parietal lobe.

Lumbar puncture showed a leukocyte count of 100 cells/mm3, 71% neutrophils, 8% bands, 15% lymphocytes, 5% monocytes, and 1% eosinophils; protein 195 mg/dL, and glucose 6 mg/dL, with a blood glucose level of 140 mg/dL. Gram stain of the cerebrospinal fluid showed gram-positive cocci in pairs. The patient was treated with intravenous ceftriaxone, vancomycin, and dexamethasone. He subsequently became unconscious and hypotensive and required intubation with mechanical ventilation and intravenous dopamine. His nasal wash sample was positive for pandemic (H1N1) 2009 RNA by real-time reverse transcription–PCR; oseltamivir (75 mg) through a nasogastric tube every 12 h for 5 days was administered. Because of heart murmur, a 2-dimensional echocardiography was conducted; it showed a large mitral valve vegetation 1.6 cm ´ 2.1 cm attached to the posterior mitral leaflet and mild to moderate mitral insufficiency. Because of this finding, he was transferred to Children’s Hospital of Michigan for surgical intervention.


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Austrian Syndrome Associated with Pandemic (H1N1) 2009 in Child | CDC EID

Suggested Citation for this Article
Alhushki W, Rongkavilit C. Austrian syndrome associated with pandemic (H1N1) 2009 in child [letter]. Emerg Infect Dis [serial on the Internet]. 2010 Sep [date cited]. http://www.cdc.gov/EID/content/16/9/1493.htm


DOI: 10.3201/eid1609.091779

Avian Hepatitis E Virus from Chickens, China | CDC EID

EID Journal Home > Volume 16, Number 9–September-2010/2010

Volume 16, Number 9–September 2010
Dispatch
Analysis of Avian Hepatitis E Virus from Chickens, China
Qin Zhao, En Min Zhou ,1 Shi Wei Dong, Hong Kai Qiu, Lu Zhang, Shou Bin Hu, Fei Fei Zhao, Shi Jin Jiang, and Ya Ni Sun
Author affiliation: Shandong Agricultural University, Shandong, People’s Republic of China

Suggested citation for this article

Abstract
Avian hepatitis E virus (HEV) has been identified in chickens; however, only 4 complete or near-complete genomic sequences have been reported. We found that the near-complete genomic sequence of avian HEV in chickens from China shared the highest identity (98.3%) with avian HEV from Europe and belonged to avian HEV genotype 3.
Hepatitis E virus (HEV) is a nonenveloped, positive-sense, single-stranded RNA virus. It has 3 open reading frames (ORFs) and a genome size of 7.2 kb (1). So far, HEV strains are classified into 4 major genotypes, and genotypes 3 and 4 are probably zoonotic.

Avian HEVs have been identified from chickens with big liver syndrome and hepatitis–splenomegaly syndrome. Each syndrome mainly causes increased deaths, reduced egg production, and enlarged liver and spleen (2); hepatitis–splenomegaly syndrome also causes accumulation of bloody fluid in the abdomen and vasculitis and amyloidosis in the liver (3,4). Molecular epidemiologic investigations have shown that avian HEV infection in chickens is endemic to the United States and Spain (5,6). Because propagating avian HEV in cell culture or embryonated eggs is difficult (2,3), avian HEV is primarily detected by reverse transcription–PCR (RT-PCR). However, only 4 complete or near-complete genomic sequences have been reported to GenBank (7–9). We identified and analyzed the near-complete genomic sequence of avian HEV in a chicken flock from the People’s Republic of China.

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Avian Hepatitis E Virus from Chickens, China | CDC EID


Suggested Citation for this Article
Zhao Q, Zhou EM, Dong SW, Qiu HK, Zhang L, Hu SB, et al. Analysis of avian hepatitis E virus from chickens, China. Emerg Infect Dis [serial on the Internet]. 2010 Sep [date cited]. http://www.cdc.gov/EID/content/16/9/1469.htm

DOI: 10.3201/eid1609.100626

Current affiliation: Northwest A&F University, Yangling, People’s Republic of China.

Guillain-Barre Syndrome and Influenza A (H1N1) Vaccine Adverse Events | CDC EID

EID Journal Home > Volume 16, Number 9–September 2010

Volume 16, Number 9–September 2010
Letter
Hospital Discharge Data for Guillain-Barre Syndrome and Influenza A (H1N1) Vaccine Adverse Events
Timothy F. Jones, Marcy McMillian, Effie Boothe, Samir Hanna, and L. Amanda Ingram
Author affiliation: Tennessee Department of Health, Nashville, Tennessee, USA
To the Editor: As part of the public health response to the current pandemic (H1N1) 2009, surveillance for adverse events following vaccination for influenza A (H1N1) is a high priority (1). Surveillance for Guillain-Barre syndrome (GBS) has been of particular interest, because the syndrome was associated with the 1976–1977 swine influenza vaccine (1,2). To study this association, reliable ascertainment of recent incident cases of GBS is necessary.

GBS is an acute, immune-mediated paralytic disorder of the peripheral nervous system (3–5) with an estimated annual incidence of 0.8–1.9/100,000 (6). Most cases are associated with an antecedent infection (6). Several surveillance systems are in place to monitor rates of postvaccination GBS (1–3), most of which include a component of electronic administrative record review for case detection. Analysis of computerized medical databases is a well-established method of monitoring for vaccine adverse events (7). Although the validity of such data varies, depending on the diagnosis and region, few studies have evaluated the use of hospital discharge data for GBS specifically (8,9).

We reviewed the Tennessee Department of Health Uniform Hospital Discharge Dataset for all hospital discharge diagnoses in 4 major metropolitan regions of Tennessee in 2002–2003 with codes from the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), that might indicate acute GBS. Records with ICD-9-CM code 357.0 (acute infective polyneuritis) or other combinations suggestive of GBS within the top 10 diagnoses were requested. These data were compared with information on cases identified by directly requesting lists of patients with discharge diagnoses of GBS from hospital medical record departments. Charts of all reported cases were validated by chart review. Patients were classified as having acute GBS if they met Brighton Criteria Levels 1, 2, or 3 (10).

A total of 344 records of possible cases of acute GBS were identified. Of these cases, 215 (63%) were identified through the state hospital discharge database, 315 (92%) were reported directly by hospitals, and 186 (54%) were identified by both systems. Among all suspected cases identified, only 103 (30%) met criteria for acute GBS (annual rate 2.1/100,000 population), 14 (4%) were out-of-state residents, 114 (33%) were nonacute cases that occurred before the study period and patients were readmitted for other reasons, 90 (26%) had no documentation of GBS in the medical record, 17 (5%) were duplicate reports, and 6 (2%) had insufficient information for further investigation. The predictive-value positive of a GBS diagnostic code from the statewide hospital discharge database representing acute GBS was only 30%. Of the 103 confirmed cases, 26 (25%) would have been missed if only the state hospital discharge database was used to identify potential cases.

Of 103 cases, all were identified with ICD-9-CM diagnosis code 357.0; in 91 (88%) cases, this was the primary diagnosis. Other combinations of codes did not identify additional cases. Of cases of acute GBS identified, 32 (30%) met only clinical criteria (Brighton Level 1), 40 (39%) had either laboratory or electrophysiologic evidence (Brighton Level 2), and 32 (31%) had both (Brighton Level 3).

Because the 2 surveillance systems we compared both relied on medical record discharge diagnoses, they were not independent, and we could not perform a capture/recapture analysis. Because GBS is a diagnosis for which the great majority of patients are hospitalized, and our overall incidence rate is within the range identified in other studies, it is likely that the combination of these methods is reasonably sensitive. The administrative hospital discharge database could not be relied on to confirm that all coded GBS cases were acute. Even if the 114 nonacute cases could easily have been identified and excluded from the initial list of 344 records, only 103 (45%) of the remaining 230 reports were identified as confirmed acute cases.

Although the use of large hospital discharge databases may be useful as an adjunct for identification of GBS cases as part of public health surveillance, they lack sufficient sensitivity or specificity to be relied upon exclusively. The poor specificity of the system is particularly problematic for public health surveillance. A large investment of time and resources was necessary to perform manual chart reviews to confirm possible cases, two-thirds of which were ultimately found not to be cases at all. Statewide administrative hospital discharge diagnosis databases should not be solely relied on for GBS surveillance. Additional methods of reliable and efficient ascertainment and verification of cases are crucial to ensure valid data. Obtaining reliable methods is particularly important for urgent situations such as current surveillance for adverse events after pandemic (H1N1) 2009 virus vaccination, in which the detection of problems will have immediate public health effects.

References
1.Centers for Disease Control and Prevention. Safety of influenza A (H1N1) 2009 monovalent vaccines—United States, October 1–November 24, 2009. MMWR Morb Mortal Wkly Rep. 2009;58:1–6.
2.Iskander J, Broder K. Monitoring the safety of annual and pandemic influenza vaccines: lessons from the US experience. Expert Rev Vaccines. 2008;7:75–82. DOI
3.Iskander J, Haber P, Herrera G. Monitoring vaccine safety during an influenza pandemic. Yale J Biol Med. 2005;78:265–75.
4.Haber P, DeStefano F, Angulo FJ, Iskander J, Shadomy SV, Weintraub E, et al. Guillain-Barre syndrome following influenza vaccination. JAMA. 2004;292:2478–81. DOI
5.van Doorn PA, Ruts L, Jacobs BC. Clinical features, pathogenesis, and treatment of Guillain-Barre syndrome. Lancet Neurol. 2008;7:939–50. DOI
6.McGrogan A, Madle GC, Seaman HE, de Vries CS. The epidemiology of Guillain-Barre; syndrome worldwide. A systematic literature review. Neuroepidemiology. 2009;32:150–63. DOI
7.Mullooly JP, Donahue JG, DeStefano F, Baggs J, Eriksen E. Predictive value of ICD-9-CM codes used in vaccine safety research. Methods Inf Med. 2008;47:328–35.
8.France EK, Glanz JM, Xu S, Davis RL, Black SB, Shinefield HR, et al. Safety of the trivalent inactivated influenza vaccine among children: a population-based study. Arch Pediatr Adolesc Med. 2004;158:1031–6. DOI
9.Bogliun G, Beghi E. Validity of hospital discharge diagnoses for public health surveillance of the Guillain-Barre syndrome. Neurol Sci. 2002;23:113–7. DOI
10.Sejvar J, Kohl KS, Gidudu J, Amato A, Bakshi N, Baxter N, et al. Guillain-Barre syndrome and Fisher syndrome: case definition and guidelines for collection, analysis and presentation of immunization safety data. Atlanta: Centers for Disease Control and Prevention; 2009 [cited 2010 Apr 26]. http://www.brightoncollaboration.org

Suggested Citation for this Article
Jones TF, McMillian M, Boothe E, Hanna S, Ingram LA. Hospital discharge data for Guillain-Barrβ syndrome and influenza A (H1N1) vaccine adverse events. Emerg Infect Dis [serial on the Internet]. 2010 Sep [date cited]. Available from http://www.cdc.gov/EID/content/16/9/1500.htm


DOI: 10.3201/eid1609.091837

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Guillain-Barre Syndrome and Influenza A (H1N1) Vaccine Adverse Events | CDC EID

Polyomaviruses in HIV-infected Patients | CDC EID

EID Journal Home > Volume 16, Number 9–September 2010

Volume 16, Number 9–September 2010
Dispatch
KI and WU Polyomaviruses and CD4+ Cell Counts in HIV-1–infected Patients, Italy
Muhammed Babakir-Mina, Massimo Ciccozzi, Francesca Farchi, Massimiliano Bergallo, Rossana Cavallo, Gaspare Adorno, Carlo Federico Perno, and Marco Ciotti
Author affiliations: Foundation University Hospital Tor Vergata, Rome, Italy (M. Babakir-Mina, G. Adorno, C.F. Perno, M. Ciotti); Istituto Superiore di Sanita’, Rome (M. Ciccozzi, F. Farchi); and University of Turin, Turin, Italy (M. Bergallo, R. Cavallo)

Suggested citation for this article

Abstract
To investigate an association between KI and WU polyomavirus (KIPyV and WUPyV) infections and CD4+ cell counts, we tested HIV-1–positive patients and blood donors. No association was found between cell counts and virus infections in HIV-1–positive patients. Frequency of KIPyV infection was similar for both groups. WUPyV was more frequent in HIV-1–positive patients.
BK and JC polyomaviruses are known to infect humans (1,2). Recently, the novel KI polyomavirus (KIPyV) and WU polyomavirus (WUPyV) have been identified in respiratory secretions of children with signs of acute respiratory disease (3,4). However, there is little evidence that these viruses are the causative agents of respiratory disease. The pathogenic role of these viruses in immunocompromised patients is also unclear.

In a study that investigated human polyomaviruses in autopsy lymphoid tissue samples from patients who were positive for HIV, KIPyV was detected in 7.1% of immunocompromised patients with AIDS and in 1.8% of nonimmunocompromised controls; WUPyV was detected in 9.5% of patients with AIDS but not in controls (5). We detected KIPyV and WUPyV in 3.2% and 1.6%, respectively, of plasma samples from HIV-1–infected patients (6). To determine an association between infection with KIPyV and WUPyV and CD4+ cell counts, we obtained plasma samples from HIV-1–positive patients having high and low CD4+ cell counts and a group of healthy controls and tested them for these 2 polyomaviruses.


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Polyomaviruses in HIV-infected Patients | CDC EID

Suggested Citation for this Article
Babakir-Mina M, Ciccozzi M, Farchi F, Bergallo M, Cavallo R, Adorno G, et al. KI and WU polyomaviruses and CD4+ cell counts in HIV-1–infected patients, Italy. Emerg Infect Dis [serial on the Internet]. 2010 Sep [date cited]. http://www.cdc.gov/EID/content/16/9/1482.htm

DOI: 10.3201/eid1609.100211

Human Herpesvirus 8 Genotype E, Peru | CDC EID

EID Journal Home > Volume 16, Number 9–September 2010

Volume 16, Number 9–September 2010
Dispatch
Human Herpesvirus 8 Genotype E in Patients with Kaposi Sarcoma, Peru
Olivier Cassar,1 Marie-Lise Blondot,1 Salim Mohanna, Gregory Jouvion, Francisco Bravo, Vicente Maco, Renan Duprez, Michel Huerre, Eduardo Gotuzzo, and Antoine Gessain
Author affiliations: Institut Pasteur, Paris, France (O. Cassar, M.-L. Blondot, G. Jouvion, R. Duprez, M. Huerre, A. Gessain); Centre National de la Recherche Scientifique, Paris (O. Cassar, M.-L. Blondot, R. Duprez, A. Gessain); and Universidad Peruana Cayetano Heredia, Lima, Peru (S. Mohanna, F. Bravo, V. Maco, E. Gotuzzo)

Suggested citation for this article

Abstract
To determine human herpesvirus 8 (HHV-8) K1 genotypes in patients with Kaposi sarcoma (KS) from Peru, we characterized HHV-8 in 25 KS biopsy samples. Our findings of 8 A, 1 B, 14 C, and 2 E subtypes showed high HHV-8 diversity in these patients and association between E genotype and KS development.
Human herpesvirus 8 (HHV-8; also known as Kaposi sarcoma–associated herpesvirus) is the etiologic agent of all forms of Kaposi sarcoma (KS) (1,2). In 2002, the number of KS cases worldwide was »65,000, nearly 1% of all diagnosed cancer cases (3). KS occurs commonly during HIV-1 infection (AIDS-KS); in transplant recipients; and in persons not infected with HIV, predominantly elderly men of Mediterranean and Middle Eastern origin (classic KS) or in children and adult men from eastern and Central Africa (endemic KS).

Sequence analysis of the highly variable open reading frame (ORF) K1 of HHV-8 has enabled the identification of 5 main HHV-8 molecular subtypes, A–E (4). A and C subtypes are prevalent in Europe, Mediterranean countries, the United States, northwestern People’s Republic of China, and southern Siberia; subtype B, in sub-Saharan Africa; and subtype D, in Japan and Oceania. Subtype E is found among Native Americans (5–9). To our knowledge, KS has been reported in patients infected by all HHV-8 subtypes, except E.

Recent studies demonstrated that classic KS is common in Peru and that AIDS-KS incidence is increasing because of the spread of HIV infection (10,11). Classic and epidemic KS occurred in patients of Amerindian origin (Quechuas) and in mestizos, reflecting the multiethnic origin of the Peruvian population.

A goal of our study was to determine the HHV-8 genotypes for a series of classic KS or AIDS-KS cases in Peru. We also aimed to report KS in patients infected by an E subtype.

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Human Herpesvirus 8 Genotype E, Peru | CDC EID


Suggested Citation for this Article
Cassar O, Blondot M-L, Mohanna S, Jouvion G, Bravo F, Maco V, et al. Human herpesvirus 8 genotype E in patients with Kaposi sarcoma, Peru. Emerg Infect Dis [serial on the Internet]. 2010 Sep [date cited].
http://www.cdc.gov/EID/content/16/9/1459.htm

Human Herpesvirus 8 Genotype E in Patients with Kaposi Sarcoma, Peru

DOI: 10.3201/eid1609.100381

1These authors contributed equally to this article.

Increasing Incidence of Mucormycosis, Belgium | CDC EID

EID Journal Home > Volume 16, Number 9–September 2010

Volume 16, Number 9–September 2010
Dispatch
Increasing Incidence of Mucormycosis in University Hospital, Belgium
Veroniek Saegeman, Johan Maertens, Wouter Meersseman, Isabel Spriet, Eric Verbeken, and Katrien Lagrou
Author affiliation: Leuven University Hospitals, Leuven, Belgium

Suggested citation for this article

Abstract
To determine why incidence of mucormycosis infections was increasing in a large university hospital in Belgium, we examined case data from 2000–2009. We found the increase was not related to voriconazole use but most probably to an increase in high-risk patients, particularly those with underlying hematologic malignancies.
In September 2009, Bitar et al. reported an increasing incidence of mucormycosis in France from 1997 through 2006 (1). Their epidemiologic study was based on International Classification of Diseases, 10th Revision (ICD-10), codes extracted from hospital information systems from an estimated 95% of public and private hospitals in France. This study is particularly interesting because population-based estimates of the incidence of mucormycosis are scarce (2). However, as the authors state, ICD code–based evaluations have limitations; such limitations are mainly related to difficulties encountered with the diagnosis of mucormycosis in clinical practice. Conventional diagnostic tools lack sensitivity. Moreover, distinction between colonization and infection is problematic in the absence of invasive procedures or autopsy data. Thus, epidemiologic studies on mucormycosis are often hampered by the limited number of documented cases.

Several surveys have been conducted in large US transplant centers. Based on these studies, the increasing incidence of mucormycosis has been linked to the widespread use of voriconazole prophylaxis in high-risk patients (3,4). In contrast with the study in France, these surveys have the limitation of focusing on particular risk groups, mainly cancer patients, and do not provide a general estimate on the incidence of mucormycosis. In our study, we determined the incidence rate of invasive mucormycosis in a large university hospital in Belgium over a 10-year period and reviewed the clinical data of the patients with proven or probable disease.


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Increasing Incidence of Mucormycosis, Belgium | CDC EID

Suggested Citation for this Article
Saegeman V, Maertens J, Meersseman W, Spriet I, Verbeken E, Lagrou K. Increasing incidence of mucormycosis in university hospital, Belgium. Emerg Infect Dis [serial on the Internet]. 2010 Sept [date cited]. http://www.cdc.gov/EID/content/16/9/1456.htm

DOI: 10.3201/eid1609.100276

Contact Lens Solution–associated Acanthamoeba and Fusarium Keratitis | CDC EID

EID Journal Home > Volume 16, Number 9–September 2010

Volume 16, Number 9–September 2010
Letter
Contact Lens Solution–associated Acanthamoeba and Fusarium Keratitis
To the Editor: Verani et al. (1) detailed the 2004–2007 outbreak of Acanthamoeba keratitis (AK) in persons wearing soft contact lenses who used Complete MoisturePlus (CMP) multipurpose contact lens solution (Advanced Medical Optics, Santa Ana, CA, USA). They noted similarities between the AK outbreak and the Fusarium keratitis (FK) outbreak of 2004–2006, including the concomitant time frame and association with a particular solution, ReNu with MoistureLoc (Bausch & Lomb, Rochester, NY, USA). Both solutions were new products introduced within 1 year before the respective outbreaks.

In neither outbreak was the solution contaminated; in both outbreaks, implicated bottles were from multiple lots, suggesting that each outbreak resulted from insufficient antimicrobial activity. However, in the FK outbreak, all reported cases involved bottles produced at 1 (Greenville, SC, USA) of 4 multinational Bausch & Lomb manufacturing plants (2). After a Food and Drug Administration inspection of the Greenville facility, Bausch & Lomb was cited for inadequacies in temperature control during production, storage, and transport of its products in and beyond the plant (3).

We experimentally demonstrated that, when exposed to prolonged temperature elevation, ReNu with MoistureLoc loses more in vitro fungistatic activity than do other contact lens solutions. We concluded that improper temperature control of ReNu with MoistureLoc may have contributed to the FK outbreak (4). We are aware of no other theory that adequately explains why only ReNu with MoistureLoc from only 1 plant was implicated.

CMP was manufactured and used internationally; AK has a much higher incidence in Europe and Hong Kong than in the United States (5), and CMP–associated AK has been reported internationally (6). Therefore, it would seem critical to know, and we would like the authors to comment on, whether the geographic pattern of the AK coincided with distribution of CMP solution from ≥1 Advanced Medical Optics manufacturing plants and, if so, the relevance of that information.

John D. Bullock and Ronald E. Warwar
Author affiliations: Wright State University Boonshoft School of Medicine, Dayton, Ohio, USA

Suggested citation for this article:
Bullock JD, Warwar RE. Contact lens solution–associated Acanthamoeba and Fusarium keratitis [letter]. Emerg Infect Dis [serial on the Internet]. 2010 Sep [date cited]. http://www.cdc.gov/EID/content/16/9/1501.htm
DOI: 10.3201/eid1609.091381

References
1.Verani JR, Lorick SA, Yoder JS, Beach MJ, Braden CR, Roberts JM, et al. National outbreak of Acanthamoeba keratitis associated with use of a contact lens solution, United States. Emerg Infect Dis. 2009;15:1236–42. DOI
2.Levy B, Heiler D, Norton S. Report on testing from an investigation of Fusarium keratitis in contact lens wearers. Eye Contact Lens. 2006;32:256–61. DOI
3.US Food and Drug Administration. FDA Form-483 [cited 2007 Jul 28]. http://www.fda.gov/downloads/AboutFDA/CentersOffices/ORA/ORAElectronicReadingRoom/UCM059206.pdf
4.Bullock JD, Warwar RE, Elder BL, Northern WI. Temperature instability of ReNu with MoistureLoc: a new theory to explain the worldwide Fusarium keratitis epidemic of 2004–2006. Arch Ophthalmol. 2008;126:1493–8. DOI
5.Lam DS, Houang E, Fan DS, Lyon D, Seal D, Wong E, et al. Incidence and risk factors for microbial keratitis in Hong Kong: comparison with Europe and North America. Eye (Lond). 2002;16:608–18. DOI
6.Por YM, Mehta JS, Chua JL, Koh TH, Khor WB, Fong AC, et al. Acanthamoeba keratitis associated with contact lens wear in Singapore. Am J Ophthalmol. 2009;148:7–12.e2. DOI


-----------
In Response: We thank Bullock and Warwar for offering their theory of potential consequences of manufacturing inadequacies in temperature control during production of ReNu with MoistureLoc (Bausch & Lomb, Rochester, NY, USA) associated with the Fusarium keratitis (FK) outbreak during 2004–2006 (1). They note the substantial similarities between the FK outbreak and the Ancanthamoeba keratitis (AK) outbreak that we reported (2). They inquire whether the geographic pattern of AK outbreak–associated cases coincides with distribution of ≥1 manufacturing plants for the associated product, Complete MoisturePlus (CMP) multipurpose contact lens solution (Advanced Medical Optics [AMO], Santa Ana, CA, USA).

We obtained lot numbers for 22 bottles of CMP that AK case-patients used before symptom onset. Because no lot number was repeated, intrinsic contamination was unlikely as the source of the AK outbreak; the geographic and temporal distribution of cases further argued against a point-source outbreak. All 17 lot numbers for which AMO plant of origin was determined were manufactured in Spain (Food and Drug Administration, pers. comm.). According to a press release from AMO in November 2006, the “vast majority of AMO's contact lens solution products distributed in the U.S.” were manufactured in the company’s production facility in Spain, 1 of its 2 international manufacturing plants (3).

CMP was produced and used internationally at the time of the US multistate outbreak (4). Por and colleagues (5) reported an increase in the number of AK cases among contact lens users in Singapore that temporally coincided with the US outbreak. However, their retrospective case series did not include a control group; therefore, measuring associations between particular contact lens products and AK was not possible for those case-patients. The authors reported that a case–control study was underway, and we look forward to seeing the results of that investigation to better understand the magnitude of AK cases associated with CMP use.

Jennifer R. Verani, Jonathan S. Yoder, and Sharon L. Roy
Author affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA

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Citation 2

References
1.Bullock JD, Warwar RE. Contact lens solution–associated Acanthamoeba and Fusarium keratitis [letter]. Emerg Infect Dis. 2010;16:1501–2.
2.Verani JR, Lorick SA, Yoder JS, Beach MJ, Braden CR, Roberts JM, et al. National outbreak of Acanthamoeba keratitis associated with use of a contact lens solution, United States. Emerg Infect Dis. 2009;15:1236–42. DOI
3.US Food and Drug Administration. Advanced Medical Optics announces voluntary recall of 18 lots of Complete(R) MoisturePLUS(TM) contact lens care products distributed and sold in the U.S. Includes certain lots of 12-ounce bottles and active packs [cited 2010 Jun 11]. http://www.fda.gov/Safety/Recalls/ArchiveRecalls/2006/ucm112073.htm
4.US Food and Drug Administration. Advanced Medical Optics, Inc. COMPLETE® MoisturePLUS™ multi-purpose contact lens solution [2010 Jun 11]. http://www.fda.gov/MedicalDevices/Safety/RecallsCorrectionsRemovals/ListofRecalls/ucm062478.htm
5.Por YM, Mehta JS, Chua JL, Koh TH, Khor WB, Fong AC, et al. Acanthamoeba keratitis associated with contact lens wear in Singapore. Am J Ophthalmol. 2009;148:7–12.e2. DOI

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Contact Lens Solution–associated Acanthamoeba and Fusarium Keratitis | CDC EID

Antimicrobial Resistance: Beyond the Breakpoint | CDC EID

EID Journal Home > Volume 16, Number 9–September 2010

Volume 16, Number 9–September 2010
Book Review
Antimicrobial Resistance: Beyond the Breakpoint
J. Todd Weber, editor
S. Karger AG, Basel, Switzerland
IBSN: 3805593236
Pages: 174; Price: US $189.00

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The Fifth Decennial International Conference on Healthcare-Associated Infections, held March 2010 in Atlanta, Georgia, USA, brought the issue of antimicrobial drug resistance to the forefront. Results of a survey that polled members of the Society for Healthcare Epidemiology of America regarding critical knowledge gaps and research priorities were presented. Respondents reported that 3 of the 5 most important issues they face are directly associated with antimicrobial drug resistance: multidrug–resistant gram-negative bacteria, antimicrobial stewardship, and methicillin-resistant Staphylococcus aureus (MRSA)

The publication of this collection of authoritative reviews of these issues is therefore timely. This concise volume draws on the knowledge of 23 authors, many of whom are either current or past staff members of the Centers for Disease Control and Prevention. In 10 chapters and 174 pages, these authors address contemporary issues in bacterial, fungal, parasitic, and viral (HIV) resistance, as well as some aspects of the effects of antimicrobial drug resistance on healthcare facilities. The main emphasis of the book is on the epidemiology and mechanisms and public health implications of resistant pathogens, not on details of treatment. Chapters on MRSA, extended-spectrum b-lactamase–producing gram-negative bacteria, and fluoroquinolone resistance cover the epidemiology and mechanisms of resistance, laboratory detection, and treatment considerations. A historical review of the contribution of bacterial pneumonia to the death rate of previous influenza pandemics clearly discusses the likelihood and consequences of resistance in strains of Streptococcus pneumoniae and S. aureus. Questions raised here about how these antimicrobial drug–resistant bacteria affect a modern pandemic, such as the impact of antiviral drugs and diagnostic testing on antibiotic use, can now be investigated in light of the subsequent pandemic (H1N1) 2009.

Three chapters address resistance in healthcare settings and the promotion of appropriate antimicrobial drug use. The first describes interventions to reduce the inappropriate use of antimicrobial agents for respiratory conditions and quality initiatives that can improve prescribing. The chapter that reviewed effective strategies for controlling resistant pathogens in hospitals is the only chapter that was not well referenced on some of the more controversial issues, such as silver coating of devices. However, the chapter on estimating costs attributable to infections caused by antimicrobial drug–resistant bacteria is comprehensive.

Three final chapters expand the scope of this volume into issues of parasitic, fungal, and viral resistance. Resistance in helminths is presented in the context of mass treatment during eradication programs and the need for enhanced surveillance programs. The chapter on antifungal resistance reviews available drugs and laboratory detection of resistance. The final chapter on HIV drug resistance in the developing world reviews initial concerns and current encouraging data on antiretroviral drug–resistance in sub-Saharan Africa and southern Asia. Current public health strategies for detecting and controlling drug–resistant HIV are given, along with a clear account of the biological and pharmacologic factors that affect HIV resistance and a review of areas needing continued attention and resources.

The strength of this book is the wide scope of its coverage of antimicrobial drug resistance. Most chapters are well written in a succinct style and format easily accessible to the general reader. The text has supportive references from primary sources, and contains a good index. This book is a valuable resource for those beginning their careers or who are looking for a research focus, or for anyone already an expert in an aspect of antimicrobial resistance who is seeking a broader perspective.

David J. Pombo
Author affiliation: Latter Day Saints Hospital, Salt Lake City, Utah, USA

Suggested Citation for this Article
Pombo D. Antimicrobial resistance: beyond the breakpoint [book review]. Emerg Infect Dis [serial on the Internet]. 2010 Sep [date cited].
http://www.cdc.gov/EID/content/16/9/1505a.htm

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Antimicrobial Resistance: Beyond the Breakpoint | CDC EID

Typhoid Fever and Nontyphoid Salmonellosis | CDC EID

EID Journal Home > Volume 16, Number 9–September 2010

Volume 16, Number 9–September 2010
Dispatch
Typhoid Fever and Invasive Nontyphoid Salmonellosis, Malawi and South Africa
Nicholas A. Feasey, Brett N. Archer, Robert S. Heyderman, Arvinda Sooka, Brigitte Dennis, Melita A. Gordon, and Karen H. Keddy
Author affiliations: Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi (N.A. Feasey, R.S. Heyderman, B. Dennis); National Institute for Communicable Diseases, Johannesburg, South Africa (B.N. Archer, A. Sooka, K.H. Keddy); University of the Witwatersrand, Johannesburg (K.H. Keddy); and University of Liverpool, Liverpool, UK (M.A. Gordon)

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Abstract
To determine the prevalence of invasive nontyphoid salmonellosis and typhoid fever in Malawi and South Africa, we compared case frequency and patient age distribution. Invasive nontyphoid salmonellosis showed a clear bimodal age distribution; the infection developed in women at a younger age than in men. Case frequency for typhoid fever was lower than for salmonellosis.
Invasive nontyphoid salmonellosis (iNTS) was first described as an AIDS-related illness in Africa and the United States in the 1980s. Although incidence in industrialized countries declined, nontyphoid Salmonella (NTS) spp. serovars (predominantly S. enterica serovars Typhimurium and Enteritidis) remain a common cause of bloodstream and focal infection in sub-Saharan Africa for adults with HIV infection and children with HIV, malaria, and malnutrition. iNTS has a strong seasonal pattern in adults and children. In addition, epidemics of iNTS have been described as associated with the emergence of multidrug resistance in Malawi (1). Similarly, multidrug resistance is well recognized in iNTS in South Africa (www.nicd.ac.za/pubs/survbull/2010/CommDisBullMay10_Vol0802.pdf). Death rates are 20%–25% among adults and children (1). In sub-Saharan Africa, transmission is thought most likely to be between humans, and no food or animal source has been found, although epidemiologic data remain sparse (2).

In comparison to iNTS, S. enterica serovar Typhi is a highly adapted, invasive, human-restricted pathogen that in the 19th century caused considerable illness and death in the United States and Europe but now has the greatest impact in developing countries. In sub-Saharan Africa, perhaps surprisingly, typhoid fever is not associated with HIV among adults (3).

Regional data on the demography and prevalence of both iNTS and S. Typhi for sub-Saharan Africa are incomplete (4). Estimates of incidence of iNTS among children, 175–388/100,000 (5–7), and among adult HIV-prevalent cohorts, 2,000–8,500/100,000 (8–10), have been made separately, in different locations, giving no overall demographic picture. Estimates of the incidence of typhoid fever have relied on limited available data from sub-Saharan Africa (11). Although typhoid is usually regarded as an illness of school-age (>5 years of age) children and young adults, there is considerable heterogeneity; some sites in Asia report high incidences of typhoid fever among children <5 years of age (12). We compared case frequency and patient age distribution for the predominant types of invasive salmonellosis among febrile patients of all ages treated at our 2 centers in 2 regions in sub-Saharan Africa, Malawi and South Africa, before 2004.

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Typhoid Fever and Nontyphoid Salmonellosis | CDC EID

Suggested Citation for this Article
Feasey NA, Archer BN, Heyderman RS, Sooka A, Dennis B, Gordon MA, et al. Typhoid fever and invasive nontyphoid Salmonellosis, Malawi and South Africa. Emerg Infect Dis [serial on the Internet]. 2010 Sep [date cited]. http://www.cdc.gov/EID/content/16/9/1448.htm

DOI: 10.3201/eid1609.100125

Hospitalizations for Peptic Ulcer Disease | CDC EID

EID Journal Home > Volume 16, Number 9–September 2010

Volume 16, Number 9–September 2010
Research
Trends in Hospitalizations for Peptic Ulcer Disease, United States, 1998–2005
Lydia B. Feinstein,2 Robert C. Holman, Krista L. Yorita Christensen, Claudia A. Steiner, and David L. Swerdlow
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (L.B. Feinstein, R.C. Holman, K.L. Yorita Christensen, D.L. Swerdlow); and Agency for Healthcare Research and Quality, Rockville, Maryland, USA (C.A. Steiner)
in part at the Annual Interscience Conference on Antimicrobial Agents and Chemotherapy and Infectious Diseases Society of America; 2008 Oct 28; Washington, DC (abstract number L-4129).
University of North Carolina, Chapel Hill, North Carolina, USA.

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Abstract
Infection with Helicobacter pylori increases the risk for peptic ulcer disease (PUD) and its complications. To determine whether hospitalization rates for PUD have declined since antimicrobial drugs to eradicate H. pylori became available, we examined 1998–2005 hospitalization records (using the Nationwide Inpatient Sample) in which the primary discharge diagnosis was PUD. Hospitalizations for which the diagnosis was H. pylori infection were also considered. The age-adjusted hospitalization rate for PUD decreased 21% from 71.1/100,000 population (95% confidence interval [CI] 68.9–73.4) in 1998 to 56.5/100,000 in 2005 (95% CI 54.6–58.3). The hospitalization rate for PUD was highest for adults ≥65 years of age and was higher for men than for women. The age-adjusted rate was lowest for whites and declined for all racial/ethnic groups, except Hispanics. The age-adjusted H. pylori hospitalization rate also decreased. The decrease in PUD hospitalization rates suggests that the incidence of complications caused by H. pylori infection has declined.
Peptic ulcer disease (PUD) is a common illness that affects >6 million persons in the United States each year, causing considerable illness and a large economic cost to the healthcare system (1). Infection with Helicobacter pylori substantially increases the risk for PUD and its complications (2). Appropriate antimicrobial drug regimens to eradicate the infection and cure ulcers have been available since Marshall and Warren discovered H. pylori as an etiologic agent of ulcers in the early 1980s (3). Eradicating these infections prevents recurrence and ulcer complications such as bleeding or perforation (4–6). Therefore, a decline in hospitalizations for PUD and its complications could be expected since treatment for H. pylori infection became available.

Although rates of hospitalization for PUD declined in the United States during the 1980s and 1990s, rates remained high (7,8). One reason was the lack of knowledge among the general public and clinicians about the link between H. pylori and PUD (9–11). The Centers for Disease Control and Prevention, in collaboration with partners from other federal agencies, academic institutions, and private industry, initiated an educational campaign in 1997 to increase awareness of the relationship (9). The goals of the campaign were to promote the increased use of appropriate antimicrobial drug treatment to eradicate H. pylori, which would thus lead to a further decline in rates of hospitalization for PUD and its complications. Accordingly, reducing hospitalizations for PUD 35% from the 1998 baseline rate of 71/100,000 population to 46/100,000 population by the year 2010 was included in the Healthy People 2010 objectives that were developed in 1998 by the US Department of Health and Human Services (12).

The prevalence of H. pylori infections and their associated conditions can vary considerably among population groups within the same country. Racial and ethnic differences have been noted, with blacks more affected than whites and Mexican-Americans more affected than non-Hispanic whites and non-Hispanic blacks (12,13). A recent meta-analysis in which researchers adjusted for age and socioeconomic status, showed that H. pylori infection was significantly associated with male sex in 18 adult populations (14). In addition, male patients were hospitalized more often for duodenal ulcers than were female patients (15,16). The prevalence of H. pylori infection and PUD can also vary by geographic location, socioeconomic status, and age (13,17).

Although recent studies have suggested that rates of PUD have declined in European countries and in non-European countries outside the United States (16,18–20), the overall recent national trends of PUD in the United States have not been described. To determine whether rates of hospitalization due to PUD and its complications have decreased and to describe the demographic characteristics of hospitalized persons with PUD, we conducted a retrospective analysis of hospital discharge data for PUD in the United States from 1998 through 2005.

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Hospitalizations for Peptic Ulcer Disease | CDC EID

Suggested Citation for this Article
Feinstein LB, Holman RC, Yorita Christensen KL, Steiner CA, Swerdlow DL. Trends in hospitalizations for peptic ulcer disease, United States, 1998–2005. Emerg Infect Dis [serial on the Internet]. 2010 Sep [date cited]. Available from
http://www.cdc.gov/EID/content/16/9/1410.htm

DOI: 10.3201/eid1609.091126

Co-infections with Plasmodium spp., Myanmar | CDC EID

EID Journal Home > Volume 16, Number 9–September 2010

Volume 16, Number 9–September 2010
Dispatch
Co-infections with Plasmodium knowlesi and Other Malaria Parasites, Myanmar
Ning Jiang,1 Qiaocheng Chang,1 Xiaodong Sun,1 Huijun Lu, Jigang Yin, Zaixing Zhang, Mats Wahlgren, and Qijun Chen
Author affiliations: Jilin University, Changchun, People’s Republic of China (N. Jiang, Q. Chang, H. Lu, J. Yin, Q. Chen); Chinese Academy of Medical Sciences, Beijing, People’s Republic of China (X. Sun, Z. Zhang, Q. Chen); Institute for Parasitic Disease Control, Puer City, People’s Republic of China (X. Sun, Z. Zhang); and Karolinska Institutet, Stockholm, Sweden (M. Wahlgren, Q. Chen)

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Abstract
To determine the frequency of co-infections with Plasmodium species in southern Myanmar, we investigated the prevalence of P. knowlesi. More than 20% of patients with malaria had P. knowlesi infection, which occurred predominantly as a co-infection with either P. falciparum or P. vivax.
Plasmodium species are co-endemic to regions of Southeast Asia (1,2). This finding is believed to be underestimated because of insufficient sensitivity of microscopic detection of parasites. The prevalence of mixed infections with malaria parasites in the border regions between Thailand and Myanmar was recently found to be <24% (3). Identification of P. knowlesi as the fifth human malaria pathogen, which is prevalent in countries in Southeast Asia, has complicated this situation. P. knowlesi is a parasite that infects mainly long-tailed macaques (Macaca fascicularis) and pig-tailed macaques (M. nemestrina) in Southeast Asia (4). The parasite has developed the capacity to naturally infect humans, and infections in some persons have been life-threatening (5,6). Furthermore, infections with P. knowlesi in travelers to this region have been increasing (7,8).

P. knowlesi isolates obtained from humans have been frequently misidentified as P. falciparum or P. malariae because of the morphologic similarities of these parasites (2). Use of PCRs specific for 18S small subunit (SSU) rRNA genes of malaria parasites has identified suspected cases (2,9). P. knowlesi infection in humans in the border area between the People’s Republic of China and Myanmar has been reported (10), but the prevalence is unknown. We investigated the frequency of co-infections with P. knowlesi and other Plasmodium spp. in this region.

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Co-infections with Plasmodium spp., Myanmar | CDC EID


Suggested Citation for this Article
Jiang N, Chang Q, Sun X, Lu H, Yin J, Zhang Z, et al. Co-infections with Plasmodium knowlesi and other malaria parasites, Myanmar. Emerg Infect Dis [serial on the Internet]. 2010 Sep [date cited]. http://www.cdc.gov/EID/content/16/9/1476.htm

DOI: 10.3201/eid1609.100339

These authors contributed equally to this article.