Urinary Tract Infections in Older People with Long-Term Indwelling Catheters

Catheter-associated urinary tract infection (CA-UTI) is a relatively common infection, especially among older people with long-term indwelling urethral catheter. The term CA-UTIis used to refer to symptomatic urinary tract infection in individuals withindwelling catheter. In general, less than 30 days with an indwelling urinary catheter is considered short term while 30 days or more is deemed as long term or chronic. Older people with chronic indwelling catheters have significantly increased risk of morbidity from CA-UTI compared to those with bacteriuria without long-term catheters.

In long-term-care facilities, an estimated 5-10% of residents require chronic indwelling catheters. Indwelling catheters are used more commonly in men than in women living in these facilities, with urinary retention being the most common reason. In a survey of nursing homes, the overall incidence and prevalence of symptomatic CA-UTI were found to be 29% and 2%, respectively. In one study, CA-UTI rate of 3.2 per 1,000 catheter-days (range: 0-7.3) have been reported in people with chronic urinary catheters. CA-UTI is a common source of bacteremia (50%) among long-term care residents. Read more..............

Prevalence of Human Herpes Virus 6 (HHV-6) in Patients with Hemodialysis

Human Herpes Virus 6 (HHV-6) is a virus which especially causes infection in CD4+ T lymphocytes and ranks among the herpes group that is widely seen all over the world. It is reported that more than half of the adults in developed countries and 80-100% of the population in developing countries is infected with this virus. HHV-6 infection is generally asymptomatic in healthy individuals. 

While it may cause infectious mononucleosis-like syndrome and chronic fatigue syndrome in adults, it is the causative agent of sixth disease (exanthema subitum) in children. As it can stay in the latent phase, reactivation may cause severe diseases with primary or secondary infections in immunocompromised patients. The virus especially causes infection in CD4+ T lymphocytes and staysin the latent phase in the lymphoid tissue. 

The main modes of transmission of HHV-6 are body secretions such as infected saliva but it can be transmitted with blood and blood products that are infected with the virus. Therefore, it is thought that immunocompromised hemodialysis patients who have multiple blood transfusions due to various reasons and who collectively use devices like hemodialysis machines are in the risk group for HHV-6 infection. Read more.........................

How to find anti-microbial peptides that are potential therapeutic agents against HIV?

Recently scientists developed an In Silico mathematical algorithm and Profile Hidden Markov Models (HMMER)method for identification of peptides that can be a potential therapeutic agent in the treatment of HIV. By these methods we can identify the peptides that can inhibit HIV replication.Since the discovery of Human Immunodeficiency Virus (HIV) more than 30 years ago, the Acquired Immunodeficiency Syndrome (AIDS) is considered as one of the major clinical diseases and a health problem around the globe, especially in Sub-Saharan Africa. 

The driving force behind the development of High Active Antiretroviral Therapy (HAART) for HIV treatment hasbeen inevitable due to the emergence of HIV progression. This demand has continuously been met by the pharmaceutical industry by developing new drugs or by modifying the existing medication in a timely fashion. Notwithstanding these advancements, the rapid emergence of resistance to current treatment regimens is even a greater problem for life-threatening HIV infections due to single class of HAART treatment and non-adherence to medication, therefore a daunting clinical problem.  Read more..............

Nodal donovanosis, a signal to HIV infection

Donovanosis [granuloma inguinale] is caused by Calymmatobacterium granulomatis, a Gram-negative, facultative, obligate, intracellular, pleomorphic bacterium that is phylogenetically most closely related to and placed within the Klebsiella genus. Categorized as a cause of genital ulcer disease, it typically forms painless, beefy red genital ulcers with raised margins and a friable clean base.

Auto-inoculation, hematogenous spread and oral sex have been implicated in the pathogenesis of extragenital donovanosis that occurs in 3-6% of patients,mainly in the lip, gums, cheek, palate, pharynx, neck, nose, larynx, chest,bone and liver. Lymph node involvement by C. granulomatosis is documented rarely in the literature, mainly as case reports in the pre-acquired immunodeficiency syndrome (AIDS) era. Notwithstanding these contributions to the global literature, to date, extragenital donovanosis in human immunodeficiency virus (HIV)-infected patients is documented very rarely. Read more..................

Empyema Caused by Unusual Pathogen Capnocytophaga

Empyema is a collection of pus in the pleural space. It is typically a serious complication of pneumonia with high morbidity and mortality rates.The most common organisms causing empyema are gram positive organisms such as Staphylococcus and Streptococcus. Management of empyema includes drainage by chest tube or surgery and use of appropriate antibiotics. Capnocytophagaempyemais extremely rare and to our knowledge there is only few cases that have been reported. Capnocytophaga is a group of long, thin, fusiform, slowly growing, facultative anaerobic, Gram-negative rods with gliding motility whose growth is optimal in a CO2-enriched atmosphere; hence the name Capnocytophaga (consumption of CO2). 

Capnocytophagaspecies are part of the normal oral flora in dogs, cats, and humans and were once associated with periodontal disease but are now considered commensals in dental plaque of humans. Capnocytophagainfections can have varied clinical presentations, such as periodontal disease, respiratory tract infections, ophthalmic lesions, traumatic pericarditis, mediastinal abscess, brain abscess, meningitis, and peritonitis. Read more................

The Health Significance of Families Seen through the Recent Measles Outbreak

Earlier this year, at least 95 measles cases were linked to Disneyland, the fabled family destination. In this commentary, I leverage the recent rise of U.S. measles cases to illuminate the ways in which families’ social traits matter for individual and public health. I conclude with suggestions for increasing scholarship in this exciting field within social epidemiology.

Current medical care and research tends to focus on individual risk and protective factors, often overlooking how family ties and experiences influence health. Even when we implicitly realize that families influence health, our conceptual models and data structures often reduce families to individual traits and, thus, obscure their importance. 

This is exemplified in measles patients’ medical charts. Of the 159 documented measles cases presenting during the first half of 2013 in the U.S., 63% were children and 81% were unvaccinated. Five percent of the unvaccinated, pediatric patients missed their vaccination opportunities; 13% were too young for vaccination; and 79% had philosophical objections. Yet it is important to recognize who had the philosophical objections and missed the vaccination opportunities: it was the parents, not the children. This expedient recording of the parents’ behavior as a trait of the patient erases the family unit entirely, masking the ways in which familial ties influence health. Read more.................

The Expanding Potential for Cohort Studies to Inform Priorities for Cancer Prevention

A lead series of cohorts has been run by the American Cancer Society (ACS) which has led U.S. prospective studies documenting the link between smoking cigarettes and lung cancer from the first study of over 188,000 men, to the Cancer Prevention Study 1, follow-up of 1 million men and women and also documenting the benefits of stopping smoking where after more than one year the risk waslower than current smokers and took more than 10 years to return to the risk of never smokers. Subsequent follow-up data informed the estimates of tobacco smoking to cancer mortality in the USA providing essential input to the report by Doll and Peto on the potential to prevent cancer. 

Further updates of the ACS cohorts refined our understanding of the burden of tobacco across decades . The Cancer Prevention Study cohorts have also contributed leadership to documenting the burden due to overweight and obesity setting the stage for the International Agency for Research on Cancer report on this topic and global estimates . Like other cohorts studying lifestyle and diet data , the ACS also contributed major data on mortality due to alcohol. Read more...............