Archive for September 7, 2012

Cancer biomarkers in HIV patients.

Curr Opin HIV AIDS. 2010 Nov  V.5 N.6  P.531-7.

Ambinder RF, Bhatia K, Martinez-Maza O, Mitsuyasu R.

Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, MD 21287, USA. rambind1@jhmi.edu

Abstract

PURPOSE OF REVIEW:

In this review, we update investigations related to cancer biomarkers in HIV-infected populations.

RECENT FINDINGS:

CD4 lymphocyte count is associated with primary central nervous system lymphoma (PCNSL), systemic non-Hodgkin’s lymphoma (NHL) (except perhaps for Burkitt lymphoma), Kaposi’s sarcoma, cervical cancer, and anal cancer. HIV load is associated with Burkitt lymphoma and systemic NHL (but not PCNSL), with Kaposi’s sarcoma and with anal cancer. CD40 ligand incorporated into the HIV envelope and expression of activation-induced cytidine deaminase may help explain the relationship between HIV load and Burkitt lymphoma. Genetic polymorphisms have been identified that are linked to lymphoma in HIV patients. B-cell activation as manifest in immunoglobulin light chain production may be an important marker for NHL risk. Cytokines and related molecules (IL10, sCD30) may identify patients at high risk for NHL. Epstein-Barr virus (EBV) in cerebrospinal fluid (CSF) is useful as a marker for PCNSL, although with the falling incidence of PCNSL, the specificity of the test has been called into question. EBV and Kaposi’s sarcoma-associated herpesvirus (KSHV) have not yet emerged as especially promising markers of risk for either lymphoma or Kaposi’s sarcoma.

SUMMARY:

CD4 lymphocyte count, HIV load, germline genetic polymorphisms, cytokine and related molecules, and immunoglobulin light chains all show increasing promise as biomarkers of malignancy in HIV patients.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3055562/pdf/nihms274983.pdf

 

September 7, 2012 at 2:51 pm

Guidance for control of infections with carbapenem-resistant or carbapenemase-producing Enterobacteriaceae in acute care facilities.

MMWR Morb Mortal Wkly Rep. 2009 Mar 20  V.58 N.10  P.256-60.

Centers for Disease Control and Prevention (CDC).

Abstract

Infection with carbapenem-resistant Enterobacteriaceae (CRE) or carbapenemase-producing Enterobacteriaceae is emerging as an important challenge in health-care settings. Currently, carbapenem-resistant Klebsiella pneumoniae (CRKP) is the species of CRE most commonly encountered in the United States. CRKP is resistant to almost all available antimicrobial agents, and infections with CRKP have been associated with high rates of morbidity and mortality, particularly among persons with prolonged hospitalization and those who are critically ill and exposed to invasive devices (e.g., ventilators or central venous catheters). This report provides updated recommendations from CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC) for the control of CRE or carbapenemase-producing Enterobacteriaceae in acute care (inpatient) facilities. For all acute care facilities, CDC and HICPAC recommend an aggressive infection control strategy, including managing all patients with CRE using contact precautions and implementing Clinical and Laboratory Standards Institute (CLSI) guidelines for detection of carbapenemase production. In areas where CRE are not endemic, acute care facilities should 1) review microbiology records for the preceding 6-12 months to determine whether CRE have been recovered at the facility, 2) if the review finds previously unrecognized CRE, perform a point prevalence culture survey in high-risk units to look for other cases of CRE, and 3) perform active surveillance cultures of patients with epidemiologic links to persons from whom CRE have been recovered. In areas where CRE are endemic, an increased likelihood exists for imporation of CRE, and facilities should consider additional strategies to reduce rates of CRE. Acute care facilities should review these recommendations and implement appropriate strategies to limit the spread of these pathogens.

FULL TEXT

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5810a4.htm

September 7, 2012 at 2:49 pm


Calendar

September 2012
M T W T F S S
 12
3456789
10111213141516
17181920212223
24252627282930

Posts by Month

Posts by Category