Flu season is here once again and flu vaccine is recommended for everyone 6 months and older in the United States. Continue reading
I remain mystified by the debate over whether electronic cigarettes and vaping are more safe than harmful. Especially when this debate involves medical professionals. In July, one of my favorite journals, Annals of Internal Medicine, carried pro and con opinion Continue reading
In the Sept 8, 2015, issue of JAMA, investigators present new data on the prevalence of diabetes and prediabetes in U.S. adults as of 2012. A quick scan of the article is an alarming experience, though the authors point out there is some reason for optimism. Continue reading
Now that the summer solstice is in the rearview mirror, it is time to start reminding patients about the importance of and appropriate use of sunscreen. People of all ethnicities and skin colorations can benefit from sunscreen, though lighter skinned Continue reading
I was recently asked to give a 15-minute rapid update on changes in infectious diseases that would be of interest both generally and for an audience of family physicians at the CAFP Clinical Update in San Francisco.
The list of interesting items was long and I pared the brief discussion to a few items. The list:
- Antibiotics in severe sepsis
- Clostridium difficile
- HIV pre-exposure prophylaxis (PrEP)
- Moxifloxacin failure in short course TB
- Acute skin and skin structure infections (ASSSI)
- Carbapenem-resistant enterococcus
- Polyvalent pneumococcal vaccine
I have culled the following points from the long part of the short talk:
Antibiotics in sepsis – no comment as this wasn’t relevant to most PCPs.
Chikungunya – a mosquito-borne viral illness with over 6,600 cases in U.S. travelers to endemic areas of the Caribbean and even a few home grown cases in Florida – expect to see more in the southeastern U.S.
Dengue – getting close to a vaccine for this other mosquito-spread disease.
EV-D68 – this echovirus causes respiratory illness, particularly in the young with asthma, but it has now also been linked with a polio-like motor paralysis from which recovery is slow and/or incomplete.
Influenza – the vaccine was off-target this past influenza season. But we have learned that vaccination of a pregnant mother does extend protection to the newborn.
Measles – multistate outbreak linked to a source at Disneyland and spread among the unimmunized and in some cases the immunized. Perhaps Disneyland is not the Happiest Place on Earth for a while. 169 cases of measles reported to the CDC from January 1 to May 1, 2015, in 27 states. Wasn’t measles elimination in the US announced in 2000?
Microbiome – fascinating science about how the personal microbiome can affect individual health. Why are 80% of antibiotics used in animal husbandry? It has long been known that antibiotics cause animals to gain weight! Get that!
Moxifloxacin failure in 4 month treatment course of smear-positive TB in combination with other drugs compared to standard treatment regimens.
Carbapenem-resistant enterococcus – spread by endoscope with some fatal outcomes. Makes me sad to be a Bruin alum.
Pneumococcal conjugate vaccine – recommended for those needing pneumonia prophylaxis. Be aware of the separation and sequencing of this new vaccine and the older pneumococcal polysaccharide vaccine 23 (Pneumovax).
That leaves Ebola, HCV, C diff, PrEP, and ASSSI, which I will address in my next blog post.
Marshall Kubota, MD
OK, for those quasi-regular readers of this blog, and we know there are at least four of you out there, you’re already aware that many of our posts address how to effectively treat patients. What works. What doesn’t. What is known and what falls into the realm of the art Continue reading
I love telomeres! And just what are they? They are repetitive DNA sequences at the ends of chromosomes that undergo attrition (shortening) with division of somatic cells. Why is this important? Well, telomeres protect the integrity of the DNA and shortening of Continue reading
Scientists at the University of Leeds investigated the hypothesis that forced air hand dryers, touted for their greenness, might spread bacteria due to aerosolization of contaminated particles. E.L.Best, et.al., recently published a study in the Journal of Hospital infection comparing the propensity of three common hand drying techniques Continue reading