Blood Test May Be Used To Detect Pancreatic Cancer In Its Early Stages

On NBC Nightly News (6/24, story 8, 1:35, Holt), NBC’s Anne Thompson reported that “a study in the journal Nature says a blood test may be the answer to identifying” pancreatic cancer “in its early stages.”

        The Houston Chronicle (6/25, Hawryluk) reports that researchers at the University of Texas MD Anderson Cancer Center “found that the presence of” a particular “protein could distinguish with 100 percent accuracy whether patients had early stage pancreatic cancer or chronic pancreatitis, a major risk factor for the cancer.” The study indicated that “levels of the protein were markedly lower after surgical removal of a patient’s tumors.”

        On its website, NBC News (6/25, Carroll) reports that the “protein turns up in tiny virus-sized particles, called exosomes, which are excreted by all of the body’s cell.” This protein, however, “turns up in exosomes only when there is cancer, so its presence could be an early, and testable, marker for the disease.”

        The Los Angeles Times (6/25, Healy) “Science Now” blog reports that “the finding ‘offers the possibility for early detection of pancreatic cancer and help in designing potential curative surgical options,’ the authors...wrote.” HealthDay (6/25, Norton) also covers the story.

Women Exposed To Higher Levels Of DDT In Utero May Face Higher Risk Of Breast Cancer Later In Life

TIME (6/17, Worland) reports that research published in the Journal of Clinical Endocrinology & Metabolism indicated that “women who had been exposed to higher levels of the pesticide DDT while in utero face increased risk of breast cancer later in life than those who were exposed to lower levels.”

        On its website, NBC News (6/17, Fox, Silverman) reports that investigators “studied blood taken from women during more than 20,000 pregnancies from 1959 through 1967.” These women “gave birth to 9,300 daughters during that time.”

        The Washington Post (6/17, Cha) “To Your Health” blog reports that the investigators “found that elevated levels of DDT in the mother’s blood were associated with” nearly “a four-fold increase in her daughter’s risk of breast cancer and that this was independent of the mother’s history of breast cancer.” The researchers “also determined that those with higher levels of exposure were diagnosed with more advanced breast cancer.” Approximately “83 percent of those who got breast cancer had estrogen-receptor positive breast cancer and were more likely to develop HER2-positive breast cancer.”

        On its website, Fox News (6/17, Cappon) reports that the “54-year study from the Endocrine Society is the first to directly link breast cancer risk to in utero exposure to the chemical pesticide DDT.”

Study: Most Patients With Appendicitis Can Be Treated With Antibiotics Alone

The New York Times (6/17, Kolata, Subscription Publication) reports that research published in JAMA “provides the best evidence to date that most patients” with appendicitis “can be treated with antibiotics alone.” The research “involved 530 patients aged 18 to 60 who agreed to have their treatment — antibiotics or surgery — decided at random.”

        TIME (6/17, Osborn) reports that although “272 of the 273 appendectomy surgeries were successful, 186 of the patients treated with antibiotics did not require surgery at all.” Patients “in the antibiotic group who did ultimately require surgery during a one-year follow-up period (70 patients) showed no signs of complications associated with delaying the procedure.”

        CNN (6/17, Storrs) reports that prior research has “compared appendectomy with antibiotics, but most of them have relied on clinical examination to diagnose uncomplicated appendicitis.” The new “study relied on CT scans, which are a more accurate way to diagnose the disease and to make sure only patients with simple cases are studied...said” lead author Dr. Paulina Salminen.HealthDay (6/17, Reinberg) and Medical Daily (6/17, Scutti) also cover the story.

Proton Pump Inhibitors May Increase Heart Attack Risk

The New York Times (6/11, Bakalar) “Well” blog reports that research published in PLOS One suggests that “proton pump inhibitors...may increase the risk for heart attack.”

        The Washington Post (6/11, Bernstein) “To Your Health” blog reports that “after combing through 16 million electronic records of 2.9 million patients in two separate databases,” investigators “found that people who take the medication to suppress the release of stomach acid are 16 percent to 21 percent more likely to” experience a heart attack. Nicholas J. Leeper, an author of the study, “said the Food and Drug Administration ‘should be aware of these findings,’ but agreed that only a large, prospective clinical study...could establish whether the drugs are actually causing more heart attacks.”

        On its website, CBS News (6/11, Seidman) reports, however, that “analysis of patients using another type of antacid drugs called H2 blockers...did not show this increased risk.” The study received funding from The National Institutes of Health.

        Medscape (6/11, Pullen) reports that in an email to Medscape Medical News, Joel Rubenstein, MD, chair of the American Gastroenterological Association Institute Clinical Practice Section, wrote, “I would advise against making any changes in the management of patients based on this study. The results are intriguing and deserve further study. But the signal of an association is a weak one, and could easily be due to confounding by other factors, such as obesity, or due to initial misdiagnosis of angina as [gastroesophageal reflux disease].”

CDC To Issue Warning To US Physicians About MERS

David Muir reported on ABC World News (6/10, story 8, 1:05, Muir) that the CDC will issue a warning as early as tomorrow about “the deadly MERS virus.” The CDC is “sounding the alarm for American doctors now,” as more than 1,200 people have been infected around the world and the death toll is “approaching 500.” Richard Besser, MD, added that “the big concern is that the person who brought it into South Korea and spread it around hospitals might be something called a ‘super spreader’ – someone who can spread it to people easier than others.”

        The New York Times (6/11, Choe, Subscription Publication) reports, “With at least nine deaths, 122 confirmed cases and more than 3,400 who may have been exposed,” South Korea is now “experiencing an outbreak of MERS second in size only to that in Saudi Arabia, where it originated in 2012.” Yesterday, experts with the World Health Organization visiting that country “recommended that ‘all patients’ with fevers or respiratory symptoms be questioned about possible exposure to MERS.” The article also discusses the quarantine in place until June 18 in the village of Jangdeok where a case of MERS was reported. While villagers rail against the strict measures of the quarantine, people elsewhere in South Korea are voicing anger at the government for not doing more to contain the MERS outbreak.

        The Wall Street Journal (6/11, Kwaak, Gale, Subscription Publication) reports that fatality rates from MERS are significantly lower in South Korea than they have been in the Middle East. This week, the WHO disclosed that researchers around the globe are investigating if the MERS virus there has mutated.

        Meanwhile, the AP (6/11, Kim) reports that yesterday, “experts from the World Health Organization and South Korea...urged the reopening of more than 2,700 schools closed over fears” of the virus.

        In an opinion piece for CNN (6/10, Vox), physician journalist Ford Vox, MD points out that the US could learn some lessons from the outbreak of MERS in South Korea. Dr. Vox draws parallels to last year’s Ebola outbreak in Dallas, TX, in which poor communication and panic figured prominently. Currently, “South Korea is dealing with familiar problems of panic and insufficient guidance, but it is also putting into place some innovative new measures surrounding quarantine that our public health officials should consider,” such as “monitoring cell phone signals for those under quarantine and...using monitors who frequently call and check on those under quarantine.”

        The NPR (6/10, Hu) “Goats and Soda” blog and “All Things Considered” program focus on smartphone monitoring of people under quarantine orders. Focusing on the economic effects of the MERS outbreak in South Korea are the AP (6/11, Lee), Bloomberg News (6/11, Gale), and Reuters (6/11, Park, Kim).

PULMONARY MEDICINE POWERPOINT 3 (TUBERCULOSIS)

1)Self-Study Modules

Module 1: Transmission and Pathogenesis of TB (text only version)
Download complete Power Point Presentation   (2M)
Download Participant Guide   (832K)

·         Introduction (5 slides)

·         History of TB (10 slides)

·         TB Transmission (9 slides)

·         Drug-Resistant TB (6 slides)

·         TB Pathogenesis (16 slides)

·         Progression from LTBI to TB Disease (9 slides)

·         Sites of TB Disease (4 slides)

·         TB Classification System (4 slides)

·         Case Studies (5 slides)

Module 2: Epidemiology of TB (text only version)
Download complete Power Point Presentation   (1M)
Download Participant Guide   (326K)

·         Introduction (3 slides)

·         Epidemiology of TB (16 slides)

·         TB Case Rate (6 slides)

·         People at High Risk for Becoming Infected with Mycobacterium tuberculosis (28 slides)

·         People at High Risk for Developing TB Disease after Infection with Mycobacterium tuberculosis(11 slides)

·         Case Studies (3 slides)

Module 3: Targeted Testing and the Diagnosis of Latent TB Infection and TB Disease (text only version)
Download complete Power Point Presentation   (2M)
Download Participant Guide   (430K)

·         Introduction (3 slides)

·         Targeted Testing (8 slides)

·         Diagnosis of LTBI (60 slides)

·         Diagnosis of TB Disease (50 slides)

·         Reporting TB Cases (5 slides)

·         Case Studies (16 slides)

Module 4: Treatment of Latent TB Infection and TB Disease (text only version)
Download complete Power Point Presentation   (1.8M)
Download Participant Guide   (358K)

·         Introduction (4 slides)

·         Treatment of LTBI (59 slides)

·         Treatment of TB Disease (73 slides)

·         Case Studies (17 slides)

Module 5: Infectiousness and Infection Control (text only version)
Download complete Power Point Presentation   (1.3M)
Download Participant Guide   (380K)

·         Introduction (3 slides)

·         Infectiousness (9 slides)

·         TB Infection Control (18 slides)

·         Administrative Controls (5 slides)

·         Environmental Controls (10 slides)

·         Respiratory-Protection Controls (15 slides)

·         TB Risk Assessment (5 slides)

·         Infection Control in Nontraditional Facility-Based Settings (7 slides)

·         TB Infection Control in the Home (9 slides)

·         Case Studies (12 slides)

2)Core Curriculum on Tuberculosis: What the Clinician Should Know

Download complete Power Point Presentation (194 slides)   – (20M)
Text only version

Table of Contents

·         Chapter 1: Overview of TB Epidemiology in the United States (21 slides)

·         Chapter 2: Transmission and Pathogenesis of TB (20 slides)

·         Chapter 3: Testing for TB Infection and Disease (26 slides)

·         Chapter 4: Diagnosis of TB Disease (26 slides)

·         Chapter 5: Treatment for Latent Tuberculosis Infection (20 slides)

·         Chapter 6: Treatment of TB Disease (36 slides)

·         Chapter 7: TB Infection Control (23 slides)

·         Chapter 8: Community TB Control (22 slides)

3)Prevention and Control of Tuberculosis in Correctional and Detention Facilities

Table of Contents

Download complete Power Point Presentation (181 slides)   – (2M) Text-Only Version

·         Introduction (3 slides)

·         Summary of Changes from 1996 Recommendations from CDC (6 slides)

·         Background (10 slides)

·         Screening (42 slides)

·         Case Reporting (3 slides)

·         Airborne Infection Isolation (4 slides)

·         Environmental Controls (5 slides)

·         Respiratory Protection (8 slides)

·         Diagnosis and Treatment of Latent Tuberculosis Infection (LTBI) and Tuberculosis (TB) Disease(35 slides)

·         Discharge Planning (12 slides)

·         Contact Investigation (22 slides)

·         TB Training and Education of Correctional Workers and Inmates (11 slides)

·         Program Evaluation (13 slides)

·         Collaboration and Responsibilities (4 slides)

·         References and Additional Resources (3 slides

4)Guidelines for Preventing the Transmission of M. tuberculosisin Health-Care Settings

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Text Only Version

·         Introduction 
(7 slides)

·         Transmission and Pathogenesis 
(14 slides)

·         Fundamentals of Infection Control 
(7 slides)

·         Recommendations for Preventing M. tuberculosis Transmission in Health-Care Settings (30 slides)

·         Infection Control Program (5 slides)

·         TB Risk Assessment (17 slides)

·         TB Testing Frequency (3 slides)

·         Evaluation (4 slides)

·         Training and Education (1 slide)

·         Managing TB Patients: General Recommendations (51 slides)

·         Airborne Infection Isolation (AII) Policies and Practices (8 slides)

·         Diagnosis (2 slides)

·         AII Precautions for Specific Settings (16 slides)

·         Training and Education (1 slide)

·         Infection Control Surveillance (1 slide)

·         Evaluation (3 slides)

·         Collaborate with Health Departments (1 slide)

·         Environmental Controls (7 slides)

·         Respiratory Protection (12 slides)

·         Estimating Infectiousness of Patients (5 slides)

·         Diagnostic Procedures for Latent TB Infection and TB Disease (23 slides)

·         Treatment Procedures for LTBI and TB Disease(8 slides)

5)Investigation of Contacts of Persons with Infectious Tuberculosis

Download complete set (109 slides) in Power Point format   – (640 KB) Text Only Version

·         Introduction(8 slides)

·         Decisions to Initiate a Contact Investigation (10 slides)

·         Investigating the Index Patient and Sites of Transmission (18 slides)

·         Assigning Priorities to Contacts (7 slides)

·         Diagnostic and Public Health Evaluation of Contacts (12 slides)

·         Medical Treatment for Contacts with LTBI (6 slides)

·         When to Expand a Contact Investigation (3 slides)

·         Communicating Through the News Media (6 slides)

·         Data Management and Evaluation of Contact Investigations(3 slides)

·         Confidentiality and Consent in Contact Investigations(3 slides)

·         Staff Training for Contact Investigations (2 slides)

·         Contact Investigations in Special Circumstances(13 Slides)

·         Source-Case Investigations(6 slides)

·         Cultural Competency and Social Network Analysis(8 Slides)

6) Targeted Tuberculosis (TB) Testing and Treatment of Latent TB Infection

7) Treatment of Tuberculosis 

    source:  http://www.cdc.gov