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February 08, 2010 Efficacy of a Single-Session HIV Prevention Intervention for Black Women: A Group Randomized Controlled Trial - AIDS and Behavior Diallo DD et al. – The study findings suggest that a single–session intervention delivered to pre–existing groups of black women is an efficacious approach to HIV prevention. This study also demonstrates that a CBO can develop and deliver a culturally appropriate, effective HIV prevention intervention for the population it serves and, with adequate resources and technical assistance, rigorously evaluate its intervention.... Performance of the AST-to-Platelet Ratio Index as a Noninvasive Marker of Fibrosis in Pediatric Patients With Chronic Viral Hepatitis - Journal of Pediatric Gastroenterology and Nutrition McGoogan KE et al. – All of the patients 0 to 20 years old with chronic hepatitis B or C presenting at a tertiary medical center from 1992 to 2008 were identified. Thirty–six patients were evaluated with 48 biopsy results. The areas under the receiver operating characteristic curve were 0.71 for fibrosis and 0.52 for cirrhosis. When examining subgroups, the APRI performed better in older patients and in those with vertically transmitted hepatitis C virus. Further research into APRI and the other noninvasive markers of fibrosis in children with chronic viral hepatitis is warranted.... February 05, 2010 Psychosocial Correlates of HIV Sexual Protective Behavior Among Puerto Rican Women Residing in the Bronx, New York - Health Care for Women International Dixon D et al. – Increased condom use with nonprimary partners was associated with higher HIV/AIDS prevention self–efficacy. Thus, primary versus nonprimary relationships appeared to represent distinct contexts for HIV sexual risk behavior, with implications for different intervention strategies based upon relationship contexts for Latina women.... Use of web services for computerized medical decision support, including infection control and antibiotic management, in the intensive care unit - Journal of Telemedicine and Telecare Steurbaut K et al. – After the implementation and test phase, the COSARA software was installed on a physician's office PC and then on the bedside PCs of the patients. Initial evaluation indicated that the services had been integrated easily into the daily clinical workflow of the medical staff. The use of a service oriented architecture with web service technology for the development of advanced decision support in the ICU offers several advantages over classical software design approaches.... Managing UTIs in debilitated patients - The Clinical Advisor Schaeffer AJ – Structural or functional abnormalities of the urinary tract are common in debilitated patients. The urinary tract is frequently compromised due to aging and acquired effects of obstruction (e.g., stones or enlargement of the prostate gland). Early imaging of the urinary tract using CT or ultrasound should be performed. If at all possible, any obstruction must be relieved by either catheter drainage or removal of the obstructing focus. Initially, antimicrobial therapy must be broad–spectrum to cover multiple organisms and drug resistance. Once–daily aminoglycoside therapy is effective and reduces morbidity but must be carefully monitored. Oral therapy should be instituted when clinically indicated.... February 04, 2010 Bronchiolitis: Recent Evidence on Diagnosis and Management - Pediatrics Zorc JJ et al. – Viral bronchiolitis is a leading cause of acute illness and hospitalization of young children. Research into the variation in treatment and outcomes for bronchiolitis across different settings has led to evidence–based clinical practice guidelines. Ongoing investigation continues to expand this body of evidence. Authors of recent surveillance studies have defined the presence of coinfections with multiple viruses in some cases of bronchiolitis. Underlying comorbidities and young age remain the most important predictors for severe bronchiolitis. Pulse oximetry plays an important role in driving use of health care resources. Evidence–based reviews have suggested a limited role for diagnostic laboratory or radiographic tests in typical cases of bronchiolitis. Several large, recent trials have revealed a lack of efficacy for routine use of either bronchodilators or corticosteroids for treatment of bronchiolitis. Preliminary evidence suggests a potential future role for a combination of these therapies and other novel treatments such as nebulized hypertonic saline.... Burden of Influenza-Related Hospitalizations Among Children With Sickle Cell Disease - Pediatrics Bundy DG et al. – IRHs are substantially more common among children with SCD than among those without the disease, which supports the potential importance of vigorous influenza vaccination efforts that target children with SCD.... Estimated Burden of Rotavirus-Associated Diarrhea in Ambulatory Settings in the United States - Pediatrics Flores AR et al. – Before the rotavirus vaccine, rotavirus seemed to be associated with a large number of outpatient and ED visits among young children. Rotavirus vaccine has the potential to reduce many outpatient and ED visits.... Serogroup B meningococcal vaccines - an unfinished story - The Lancet Infectious Diseases Sadarangani M et al. – In this review the authors look at the development of serogroup B vaccines over the past 40 years. Outer membrane vesicle vaccines have been successfully used to control geographically isolated epidemics, but most have not been highly immunogenic in young children or provided broad cross–protection from infections with other strains. Vaccines based on subcapsular antigens have recently produced promising results in early clinical trials, and the disease burden might be substantially reduced over the next few years.... Do pneumococcal conjugate vaccines provide any cross-protection against serotype 19A? - BMC Pediatrics Hausdorff WP et al. – Taken together, these results suggest that 19F–conjugates can provide some protection against 19A disease. The magnitude of this protection in a given setting will likely depend on several factors. These include the anti–19A immunogenicity of the specific vaccine formulation, the number of doses of that formulation needed to elicit the response, and the burden of 19A disease that occurs after those doses. It is possible that a modest protective effect may be obscured by the presence of countervailing selection pressures (such as high antibiotic use) that favor an increase in colonization with antibiotic–nonsusceptible strains of 19A.... More News...