MIDS Annual Meeting Announcement March 10, 2012
Dear Colleague:
The Annual Business and Scientific meetings of the Michigan Infectious Disease Society (MIDS) will be held on Saturday, March 10, 2012, hosted by Division of Infectious Diseases, Beaumont Hospital, Royal Oak. The meeting will be held in the Auditorium located on the first floor of [...]
Wayne State University School of Medicine Presents:
Antimicrobial Resistance: Management, Prevention and Therapeutic Strategies
Saturday October 15, 2011
Wayne State University School of Medicine presents a one day conference to be held in the Auditorium of Wayne State University’s Eugene Applebaum College of Pharmacy and Health Sciences.
Continue reading…
MIDS 2011 Spring Scientific Conference
POSTER PRESENTATIONS
Hepatic Schistosomiasis
Subhashis Mitra MD, Milagros Reyes MD. Detroit Medical Center/ Wayne State University
Case report. A 74- year- old female, who emigrated from Yemen 20yrs ago, presented with 2- weeks history of progressively worsening jaundice associated with nausea, vomiting, itching, loss of appetite and weight loss of about 5lbs. Continue reading…
MIDS 2011 Spring Scientific Conference
ORAL PRESENTATIONS
Atypical Presentation of Listeria Brainstem Encephalitis with Cervical Myelitis in a Patient on Anti-TNF-α Therapy
Rowena Medina, MD and Mary Ann Tran, MD
Division of Infectious Diseases, Department of Medicine, Michigan State University, Lansing, MI
Brainstem encephalitis and myelitis are rare central nervous system manifestations of neurolisteriosis. We describe an atypical case of neurolisteriosis in a patient on infliximab for ulcerative colitis who developed brainstem encephalitis and cervical myelitis. Continue reading…
The Michigan Infectious Disease Society agrees with the CDC and IDSA statements regarding the Influenza A (H1N1) outbreak these last several days. Please go to their links found on this web page for the most up to date guidelines and information.
From Dr. Keystone’s talk at U of M, March 24, 2001, I recorded the following:
- What is the risk of malaria in persons who do not take chemoprophylaxis in visiting certain areas of the world for > 1 month — Mexico and Central America 1:10,000; S.E. Asia 1:1,000; Africa 1:50, and Oceania 1:5;
- 3% of persons taking mefloquine discontinue the drug; 1:200-500 have neuropsychiatric problems; seizures and psychosis occur in 1:10,000-13,000 persons on the medication.
- Mefloquine is the only drug used as chemoprophylaxis for the pregnant woman; there are some data to suggest pregnancy increases attraction of mosquitoes;
- There is a self diagnostic test for malaria available outside of the U.S.; the sensitivity and specificity in trials were > 90%, however, clinical experience suggests travelers don’t use the test correctly;
- MalaroneÒ is a relatively new anti-malarial with a cure rate of ³ 98% in non-immune persons with malaria; the dose is 4 tabs/day x 3 days in adults and 1-3 tabs/day x 3 days in children; the medication may induce vomiting so an antiemetic may be needed as well.
Clinical and laboratory guidelines have been recently published for use of HIV—1 drug resistance testing as part of treatment management; AIDS 2001; 15: 309-320.
From the 3rd Surgeon Symposium on Clinical Implications of HIV Drug Resistance — Frankfurt, Germany, February, 2001
From Clifford Lane, NIH: HIV infection is characterized by the development of immunodeficiency occurring simultaneously with an increase in immune activation. Use of IL-2 may expand T-cell pool and extend half-life of CD4 cells. The clinical benefit of this strategy remains to be demonstrated.
From C. Craig of Roche Discovery, England: The level of unbound protease inhibitor (PI) is associated with antiretroviral activity, and because most PIs are highly protein bound, the level of protein in serum may have a significant effect on the efficiency of PIs in vivo. Alpha-acid glycoprotein provides the greatest contribution to PI protein binding. Use of serum in drug testing to assay antiretroviral activity of PIs may underestimate the role of serum proteins in vivo.
Treatment options for persons who have failed all 3 currently available classes of antiretroviral agents are extremely limited. A trial of amprenavir and lopinavir/r as part of lopinavir/r Easy Access Program showed moderate viral suppression and immunologic recovery for patients with documented treatment failure with all 3 classes of available agents.
Data from Wayne State/Detroit Medical Center (R. MacArthur) were presented which examined use of ritonovir-boosted indinavir in highly experienced HIV-infected patients. Using retrospective chart review of 17 patients, at 24 weeks after initiating the combination therapy, 5 patients achieved full virologic response and 6 patients had a partial response. However, 4/17 patients had confirmed or probable episodes of nephrolithiasis, with 2 of 4 discontinuing the regimen.
In terms of defining resistance, the final analysis of the HAVANA trial was presented by B. Clotet of Spain. These data, using 326 patients with first, second or third drug failure, demonstrated that, at week 24, individuals who had genotypic testing and access to expert opinion had a significant difference in viral load below detection and HIV-1 RNA reduction compared with those who did not receive genotypic testing and/or expert opinion.
Discussing transmission of resistant virus, R. Comacho of Portugal demonstrated a prevalence of 16.7% (9/54) primary resistance mutations in newly HIV-infected patients. Similarly, O. Donoso of Spain showed resistant genotypes in 14/130 (10.8%) therapy-naïve HIV-infected persons in 18 outpatient clinics in Spain.
In March, Dr. John Bennet of NIAID, Bethesda sent a query to EIN re: reports of negative EIA tests for cryptococcal antigen from serum and CSF of known cryptococcosis patients. Latex agglutination tests on the same specimens gave positive results with titers up to 1:1024. Positive controls in the EIA test kits were checked and found to be functional. Has anyone else had a similar experience?
Apparently, meningococcal group B polysaccharide is chemically very similar/identical to some sialic acid polymers in mammalian heart valves, CNS tissues and kidney. This resemblance to host antigen may help explain why B polysaccharide is poorly immunogenic compared with serogroups A, C, Y, and W-135 polysaccharides.
[Ed. note: Group B disease continues to be problematic in the U.S.; @ 30% of meningococcal disease in college students is serogroup B. Group B vaccines based on the outer membrane vesicle of the organism, which contains minimal to no group B polysaccharide, are in research trials. Unfortunately, antibody titers wane quickly and are not as efficacious as once was thought. Protein conjugation of Group B polysaccharide (similar to that already used with Hib and S. pneumoniae) may be an issue because of concern about cross-reacting antibodies to polysialic acid and epitopes on vital human organs.]
Earlier this year there was a tremendous outbreak of foot-and-mouth disease (FMD) in England and Northern Ireland. This is a very serious, easily transmissible viral disease (related to enteroviruses in humans) in cloven-hoofed ruminants [cattle, pigs, sheep, goats, deer, etc.]. The disease causes loss of meat and milk production. Humans rarely contract FMD but can unknowingly transmit FMD by coming into contact (including clothing or footwear) with FMD virus contaminated material.
To contain the outbreak, diseased and suspect animals were slaughtered and burned (Science had a very graphic picture). Travel to rural areas was significantly restricted and roads closed. Zoos and rural tourist sites were also closed.
[Ed. note: Per two non-medical colleagues, I’m happy to report that some restrictions have been lifted and that some tourist sites recently reopened. Please check with the CDC for further updates on this tragic situation and its effect on the upcoming tourist season.]
According to Keith Sabin at CDC, billions of unsafe and unnecessary injections each year cause serious illness and millions of premature deaths. Using WHO data, Sabin claims 75% of the estimated 12 billion injections each year are unnecessary. Because of unsanitary conditions in parts of the world, these injections may be responsible for 8-16 million cases of hepatitis B virus infection, 2-5 million cases of hepatitis C virus infection, and 80,000-160,000 cases of HIV.