Malignant Mesothelioma

Malignant mesothelioma, or is often simply shortened to just mesothelioma, is a cancer of the mesothelium, the tissue that lines our lungs, stomach, heart and other organs. It is fairly rare, especially for people under age 55, however, a serious cancer.

Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Also mesothelioma is very hard to control. Treatment for mesothelioma depends on the location of the cancer, the stage of the disease, and the patient's age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined.

Working with asbestos is the major risk factor for mesothelioma. About 70 percent to 80 percent of all cases have been linked to asbestos exposure in the workplace. There is also some evidence that family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers.

If you got mesothelioma because of your workplace is "an asbestos environment," you can go to mesothelioma law firm and work together with the mesothelioma lawyer to make a claim. You need an experienced mesothelioma attorney not just an ordinary law firm or lawyer since it could mean the difference between success and failure.

Hepatitis C and Cardiovascular Risk

Conflicting results have been produced regarding the association between chronic hepatitis C virus (HCV) infection and coronary artery disease, including heart attacks and strokes. It was found in a study about the relationship between HCV infection and risk for incident (newly emerging) coronary artery disease. HCV-positive patients were less likely to have arterial hypertension, dyslipidemias, and diabetes than persons without HCV. HCV-positive patients were more likely to smoke cigarettes and abuse alcohol or drugs. Compared with participants without HCV, patients with HCV had lower mean plasma levels of total cholesterol , low-density lipoprotein (LDL) cholesterol, and triglycerides .

In a multivariate analysis, HCV infection was associated with a 25% higher risk for coronary artery disease. Classic risk factors (older age, hypertension, smoking, diabetes, dyslipidemias) were associated with a higher risk for coronary artery disease. In contrast, nonwhite ethnicity and female sex were associated with a lower risk. It was concluded that people infected with HCV are at increased risk for coronary artery disease despite having fewer other cardiovascular risk factors.

(Butt A, Xiaoqiang W, Budoff M, et al. Hepatitis C virus infection and the risk of coronary disease. Program and abstracts of the 48th ICAAC/46th IDSA; October 25-28, 2008; Washington, DC. Abstract V-4219)

Sleep Quality Is An Important Predictor Of Immunity And Susceptibility To The Common Cold

Poorer sleep efficiency and shorter sleep duration in the weeks before exposure to a rhinovirus are linked to greater susceptibility to the common cold. Sleep quality is an important predictor of immunity and susceptibility to the common cold. Sleep deprivation has been shown to result in poorer immune function and to attenuate antibody response to virus infections. Shorter sleep duration and lower efficiency were associated with an increased risk for development of a common cold. People who less than 7 hours of sleep were 2.94 times more likely to get a cold than those with 8 hours or more of sleep. Longer sleep duration is associated with a reduced risk for infection with the common cold. People with less than 92% sleep efficiency were 5.50 times more likely to get a cold than those with 98% or more efficiency. Higher sleep efficiency is associated with a reduced risk for infection with the common cold, and sleep efficiency lower than 85% is associated with an increased risk.
So, if you don't want to get cold, please just sleep tight... :)
(Arch Intern Med. 2009;169:62-67)

HIV and Methicillin-resistant Staphylococcus Aureus (MRSA)

HIV-infected patients could increase the risk for Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection, including bloodstream infection. A study reported that the incidence of methicillin resistant Staphylococcus aureus (MRSA) bacteraemia increased significantly in HIV-infected patients from 2000 to 2004. Injection drug use (IDU), end-stage renal disease (ESRD) and CD4 count <200 cells/μL were independent predictors for incident MRSA bacteraemia, while ESRD was more common in patients with MRSA bacteraemia than methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia. IDU, ESRD and CD4 count <200 cells/μL factors may serve as important clinical markers of MRSA likelihood in decisions regarding initial antimicrobial management.

Initial antimicrobial therapy for presumed sepsis in HIV-infected patients may require agents active against MRSA, including vancomycin, linezolid and, in nonpulmonary infections, daptomycin, particularly in patients with risk factors for MRSA bacteraemia.

(HIV Med. 2008;9(10):858-862)

The Role of Viral Infections in Type 1 Diabetes

A number of epidemiological studies support the hypothesis that viral infections play a causative role in type 1 diabetes. However, systematic review of control studies published between 1966 and 2002 has shown no convincing evidence for or against an association between type 1 diabetes and the prime candidate for infectious cause, Coxsackievirus B　(CVB). In animal models for type 1 diabetes, solid evidence supporting an inductive role for viruses is faced with just as solid evidence supporting a protective effect of viral infections. For example, based on mouse studies alone, there is no doubt that association between viruses and type 1 diabetes is extremely complex: while belonging to the same enteroviral group, CVB3 and CVB4 have opposing effects on type 1 diabetes in the same mouse model. Thus, the reason for current failure to associate a particular virus with induction of autoimmune diabetes likely is that such an association might be impossible to make. Certain viruses might be capable of inducing diabetes and others of preventing diabetes, and type 1 diabetes inducers might be capable of preventing disease under certain conditions. This will depend of course on the nature of the considered virus, but also on the state of advancement of autoimmunity at the time of infection. A given viral infection could thus be an essential disease precipitator once required predisposing events have occurred, but could on the other hand disrupt accumulation of these events.

Most important is the indication from animal studies that modulation of autoimmunity during viral infection does not depend merely on inherent properties of the virus, but also significantly on intrinsic factors of the host. The close interplay between the two will dictate whether enhancement or abrogation of autoimmune diabetes occurs. While molecular mimicry might activate autoreactive T-cells, it could also segregate these cells away from the islets and/or induce the activation of protective Tregs. While inflammatory cytokines might promote bystander activation of APCs and autoreactive T-cells, infection could occur at a time where inflammation will induce the relocation or demise of these cells. Whereas β-cell lysis and presentation of islet antigen might promote activation of autoreactive T-cells, it could also suppress the function of these cells by promoting Treg activity. Whereas repeated/sustained infections might lead to the accumulation of autoreactive T-cells within the memory pool, they could also induce suppressor mechanisms that will hinder autoimmunity.
(Diabetes. 2008;57(11):2863-2871)

Syphilis in Pregnancy

Syphilis in pregnancy could threatening the fetus. T. pallidum could crosses the placenta, resulting in fetal infection. Vertical transmission can occur at any time during pregnancy and at any stage of syphilis. Vertical transmission of syphilis is more common in primary (50%) and secondary syphilis (50%), compared with early latent (40%), late latent (10%), and tertiary syphilis (10%). Seventy to one hundred per cent of infants born to untreated infected mothers are infected. Pregnancies complicated by syphilis may result in intrauterine growth restriction, non-immune hydrops fetalis, stillbirth, preterm delivery, and spontaneous abortion in up to 50% of pregnancies. Women who had documented treatment for syphilis in the past do not need treatment during current or subsequent pregnancies.
Penicillin is the drug of choice for treating all stages of syphilis. Parenteral rather than oral treatment has been the route of choice as the therapy is supervised and bioavailability is guaranteed. Most women treated during pregnancy will deliver before their serological response to treatment can be assessed definitively. Neonates born to such women should be evaluated for congenital syphilis. For the treatment of early syphilis during pregnancy is procaine penicillin 750 mg daily for 10 days. If it is not possible to give daily procaine penicillin on the weekend, then either long-acting procaine penicillin in aluminium stearate, 2 million units (MU) or long-acting benethamine penicillin 1.2 MU should be given IM on the Friday. Patients with penicillin allergy: erythromycin 500 mg four times a day should be given for 14 days. Alternatively, azithromycin 500 mg should be given daily for 10 days. In addition to this, examination, tests, and treatment of all babies at birth should be carried out. Desensitization to penicillin may be considered, followed by the first-line treatment. Mothers treated with erythromycin or azithromycin may be considered for retreatment with doxycycline after delivery and when breast-feeding is stopped.
(Expert Rev Vaccines. 2008;7(10):1465-1473)

Inappropriate Antibiotic Prescribing Contributes To The Higher Bacterial Resistance

Inappropriate antibiotic prescribing contributes to the problem of higher bacterial resistance. Bacterial resistance to antibiotics is a major public health problem, increasing morbidity and mortality as well as healthcare costs.

Rates of antimicrobial resistance were higher in countries with the highest consumption of antibiotics. In countries with the highest use of antibiotics, prescription rates peaked during cold and flu seasons. The antibiotics were prescribed for sore throat during 73% of visits although the prevalence of sore throat caused by bacterial infection among adults is between 5% and 17%. Moreover, most of these patients received antibiotics that were not recommended for pharyngitis, with a high number of prescriptions being for extended-spectrum antibiotics. More than half of children with sore throats received antibiotics, a rate significantly higher than the regular prevalence of bacterial pharyngitis. Furthermore, more than one quarter of these children received an inappropriate antibiotic.
In a study it was found that the rates of resistance of S. pneumoniae to penicillin, amoxicillin-clavulanate, and cefdinir were 16%, 6.4%, and 19.2%, respectively. The least effective agents against S. pneumoniae were trimethoprim-sulfamethoxazole and azithromycin, with resistance rates of 23.5% and 34%, respectively. In a study of resistance in urinary tract infections in one health maintenance organization in the United States, the prevalence of resistance among isolates of Escherichia coli to ampicillin, cephalothin, and sulfamethoxazole exceeded 20% in each of the study years 1992 to 1996. The overall prevalence of resistance to trimethoprim-sulfamethoxazole doubled between 1992 and 1996.

Rotavirus among Children Worldwide

A hospital-based surveillance reports indicate that during 2001-2008, rotavirus accounted for approximately 40% of hospitalizations for diarrhea among children aged <5>85% of these deaths occurring in low-income countries of Africa and Asia. Two licensed rotavirus vaccines have shown efficacy of 85%-98% against severe rotavirus diarrhea in trials conducted in the Americas and Europe and they have been introduced into routine immunization programs in 11 countries in these regions and in Australia. Although the two licensed rotavirus vaccines differ in strain composition (i.e., one is monovalent, and one is pentavalent), both appear to provide protection against a variety of strains, including some strains not included in either of the licensed vaccines.
(MMWR. 2008;57(46):1255-1257)

CD4 Cell Count and AIDS-Defining Malignancies (ADM)

CD4 cell count is strongly associated with the risk of death from both AIDS-defining malignancies (ADM) and non-AIDS-defining malignancies (nADM). Non-AIDS events have become an important cause of mortality as individuals with HIV infection survive to older ages and have started to suffer from similar age-related diseases to the HIV-uninfected population.
Rate of death of nADM is higher than from ADM in all patients other than those with very low CD4 cell counts. Lung cancer is the most common fatal nADM, concordance with the high prevalence of smoking among the HIV-infected population.
Age is also a strong predictor of death from malignancies, suggesting that, at similar CD4 cell counts, older patients are at greater risk of dying from malignancy. This may be a consequence of the higher incidence of cancers in older individuals, as well as an increased likelihood of death in older individuals, irrespective of the cause. However, this may also reflect reduced immune system activity in the elderly. Interestingly, the HIV RNA level was only weakly associated with ADM mortality and was not independently associated with nADM mortality.
Non-AIDS-defining malignancies was related to combination antiretroviral (cART) exposure. The individuals taking effective cART are less likely to die from ADM and, as a result, may be more likely to die from nADM. In contrast, patients dying from ADM may be more likely to have stopped or never received cART.
(AIDS. 2008;22(16):2143-2153)

The Immunologic Cascade of Kawasaki Syndrom Trigerred by An Infectious Agent?

Kawasaki syndrome (KS) is the most common cause of acquired heart disease in children. This acute, self-limited vasculitis results in permanent coronary artery damage in up to 25% of untreated children. High dose intravenous gamma globulin reduces the risk of coronary artery aneurysm to 3-5% if administered early in the course of disease. However, without a specific diagnostic test, affected children may be difficult to recognize, and delayed diagnosis and treatment continue to result in potentially preventable morbidity and mortality. The etiology of Kawasaki syndrome (KS) remains unknown despite 30 years of intensive search for an agent.
Associations have been observed between antecedent respiratory illness and KS. It is proposed that an agent causing KS could first infect the upper respiratory tract before triggering a systemic immunologic response. Researchers found an increased IgA plasma cell infiltration of the upper respiratory tract and coronary arteries in KS patients, therefore, further support the respiratory route as a potential portal of entry for the causative agent. The presence of IgA-secreting plasma cells in the upper respiratory tract mimics the response seen in autopsies of children who died of known viral respiratory infection such as respiratory syncytial virus.
(Pediatr Infect Dis J. 2008;27(11):981-985)