XDR-TB in the United States

CDC investigators analyzed 15 years of surveillance data of culture-confirmed cases of tuberculosis from the 50 states and the District of Columbia, identifying 201,399 with isoniazid- and rifampin-susceptibility results.

Toll-like Receptor 4 Polymorphisms and Aspergillosis in Stem-cell Transplantation

Single nucleotide polymorphisms were examined within TLR2, TLR3, TLR4, and TLR9 in a population of 336 HSCT recipients and their unrelated donors. Using multivariate Cox regression analysis, two donor TLR4 haplotypes were found to be associated with increased risk of developing invasive aspergillosis in the HSCT recipients.

Quality Improvement Interventions and Surgical Antimicrobial Prophylaxis

In this study, 44 acute care hospitals each randomly sampled 100 surgical cases (cardiac, hip, or knee replacement, hysterectomy) at both baseline and during the remeasurement phase of the study.

Altitude Sickness and Adventure Travel

Adventure travel and ecotourism has become a huge industry, and certain destinations are becoming ever more popular. Current estimates suggest that more than 80,000 people travel annually to Nepal alone to trek.

2008 Prevention of Influenza Guidelines: Changes to Consider

This report updates the 2007 recommendations by the CDC Advisory Committee on Immunization Practices (ACIP) with regard to the use of influenza vaccine and antiviral agents.

Travelers and Eosinophilia

There is a broad differential diagnosis for eosinophilia, defined as an absolute eosinophil count of > 500 cells/µl, yet cases due to helminthic disease probably occur more often in routine travelers than in the general population. There is a high index of suspicion concerning potential eosinophilia in immigrants and refugees.

Pneumonic Tularemia in Brooklyn, New York

A Brooklyn, NY, resident presented in early june with a one-week history of fever, headaches, left-sided pleuritic chest pain, and a pleural effusion.

Updates by Carol A. Kemper, MD, FACP

Lourdes has been an important Catholic pilgrimage site for the elderly and infirm since 1858. This year marks the 150th anniversary of the apparition known as the "Lady of Lourdes," which was observed on multiple occasions that year by a 14-year-old peasant girl out searching for firewood.

Pharmacology Watch: Are 5-á Reductase Inhibitors Associated with Hip Fractures?

In the issue: 5-á reductase inhibitors and hip fracture in men; the effects of drug-reimbursement policy on outcomes; new guidelines for type 2 diabetes; beta-blocker-associated brady-cardia is linked to CVD events; FDA Updates.

Clinical Briefs in Primary Care supplement

December 1, 2008