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  1. Article: Osteomyelitis: an update for hospitalists.

    Howell, William R / Goulston, Claudia

    Hospital practice (1995)

    2011  Volume 39, Issue 1, Page(s) 153–160

    Abstract: Osteomyelitis is a common and challenging condition for hospitalists to manage. The 3 main types of osteomyelitis that are commonly seen in the hospital setting are 1) contiguous spread from decubitus or diabetic ulcers, 2) hematogenous spread, such as ... ...

    Abstract Osteomyelitis is a common and challenging condition for hospitalists to manage. The 3 main types of osteomyelitis that are commonly seen in the hospital setting are 1) contiguous spread from decubitus or diabetic ulcers, 2) hematogenous spread, such as in vertebral or long bone metaphyses, and 3) infections associated with a prosthetic joint. In patients with diabetes, osteomyelitis is the underlying cause of about 20% of foot infections, and greatly increases the chance that the patient will eventually need an amputation and be subject to perioperative risks. Osteomyelitis from hematogenous spread is increasing. The prevalence of vertebral osteomyelitis is also increasing, particularly in intravenous drug users and patients treated with immune-modulating agents. Prosthetic joint infections are perhaps the most challenging type to treat, and require hospitalists, orthopedic surgeons, and infectious disease specialists to work closely together to plan for effective treatment. Due to increasing antibiotic resistance, the microorganisms involved are also proving more difficult to treat. Emerging resistance to the commonly used antibiotics is resulting in changes in treatment choices. Community-acquired methicillin-resistant Staphylococcus aureus is commonly seen, and there is increasing concern about emerging vancomycin resistance. Treatment of osteomyelitis is still based largely on expert opinion rather than evidence from controlled studies.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Biofilms ; Diagnostic Imaging ; Hospitalists ; Humans ; Osteomyelitis/diagnosis ; Osteomyelitis/drug therapy ; Osteomyelitis/microbiology
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2011-02
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2570453-9
    ISSN 2377-1003 ; 2154-8331 ; 8750-2836
    ISSN (online) 2377-1003
    ISSN 2154-8331 ; 8750-2836
    DOI 10.3810/hp.2011.02.386
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Leptotrichia bacteremia in patients receiving high-dose chemotherapy.

    Couturier, Marc Roger / Slechta, E Susan / Goulston, Claudia / Fisher, Mark A / Hanson, Kimberly E

    Journal of clinical microbiology

    2012  Volume 50, Issue 4, Page(s) 1228–1232

    Abstract: Leptotrichia spp. are anaerobic, pencil-shaped, Gram-negative rods that are part of the normal oral and intestinal human flora. Although not typically considered pathogenic, invasive Leptotrichia infections have been reported in immunosuppressed patients. ...

    Abstract Leptotrichia spp. are anaerobic, pencil-shaped, Gram-negative rods that are part of the normal oral and intestinal human flora. Although not typically considered pathogenic, invasive Leptotrichia infections have been reported in immunosuppressed patients. A perceived rise in the identification of Leptotrichia spp. at our institution prompted a retrospective evaluation of these infections. Laboratory and clinical records were reviewed to identify Leptotrichia culture-positive patients. Over a 5-year period, 68 Leptotrichia-positive specimens were identified. Of these, 21% (14/68) were identified in original samples submitted from 13 different patients at our institution, and the remainder (79% [54/68]) were unknown isolates referred from outside hospitals for molecular identification. All in-house Leptotrichia were identified from blood cultures. Only 64% (9/14) of these grew on solid media, and 5 were a part of polymicrobial bacteremias containing other enteric pathogens. All local patients were receiving chemotherapy and a majority received hematopoietic stem cell transplant (HSCT) (11/13). All had neutropenic fever with symptoms of mucositis and/or enteritis. Most of the HSCT patients (73% [8/11]) were autologous recipients hospitalized after recent high-dose chemotherapy for multiple myeloma. L. hongkongensis, a novel species, was found in the majority of myeloma cases (63% [5/8]). In conclusion, we suggest that Leptotrichia spp. may be an underappreciated cause of bacteremia, particularly in multiple myeloma patients receiving cytotoxic chemotherapy for autologous HSCT. In our cohort, these infections were associated with neutropenic fever from an enteric source, and most isolates remained sensitive to standard antibiotics.
    MeSH term(s) Anti-Bacterial Agents/pharmacology ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Bacteremia/microbiology ; Fusobacteriaceae Infections/microbiology ; Hematopoietic Stem Cell Transplantation ; Humans ; Leptotrichia/drug effects ; Leptotrichia/genetics ; Microbial Sensitivity Tests ; Molecular Typing ; Multiple Myeloma/complications ; Multiple Myeloma/therapy ; Phylogeny ; RNA, Bacterial/genetics ; RNA, Ribosomal, 16S/genetics ; Retrospective Studies
    Chemical Substances Anti-Bacterial Agents ; RNA, Bacterial ; RNA, Ribosomal, 16S
    Language English
    Publishing date 2012-01-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 390499-4
    ISSN 1098-660X ; 0095-1137
    ISSN (online) 1098-660X
    ISSN 0095-1137
    DOI 10.1128/JCM.05926-11
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Homeostatic proliferation fails to efficiently reactivate HIV-1 latently infected central memory CD4+ T cells.

    Bosque, Alberto / Famiglietti, Marylinda / Weyrich, Andrew S / Goulston, Claudia / Planelles, Vicente

    PLoS pathogens

    2011  Volume 7, Issue 10, Page(s) e1002288

    Abstract: Homeostatic proliferation ensures the longevity of central memory T-cells by inducing cell proliferation in the absence of cellular differentiation or activation. This process is governed mainly by IL-7. Central memory T-cells can also be stimulated via ... ...

    Abstract Homeostatic proliferation ensures the longevity of central memory T-cells by inducing cell proliferation in the absence of cellular differentiation or activation. This process is governed mainly by IL-7. Central memory T-cells can also be stimulated via engagement of the T-cell receptor, leading to cell proliferation but also activation and differentiation. Using an in vitro model of HIV-1 latency, we have examined in detail the effects of homeostatic proliferation on latently infected central memory T cells. We have also used antigenic stimulation via anti-CD3/anti-CD28 antibodies and established a comparison with a homeostatic proliferation stimulus, to evaluate potential differences in how either treatment affects the dynamics of latent virus populations. First, we show that homeostatic proliferation, as induced by a combination of IL-2 plus IL-7, leads to partial reactivation of latent HIV-1 but is unable to reduce the size of the reservoir in vitro. Second, latently infected cells are able to homeostatically proliferate in the absence of viral reactivation or cell differentiation. These results indicate that IL-2 plus IL-7 may induce a detrimental effect by favoring the maintenance of the latent HIV-1 reservoir. On the other hand, antigenic stimulation efficiently reactivated latent HIV-1 in cultured central memory cells and led to depletion of the latently infected cells via virus-induced cell death.
    MeSH term(s) CD4-Positive T-Lymphocytes/immunology ; CD4-Positive T-Lymphocytes/virology ; Cell Proliferation ; Cells, Cultured ; HIV-1/immunology ; HIV-1/pathogenicity ; HIV-1/physiology ; Homeostasis/immunology ; Humans ; Interleukin-2/metabolism ; Interleukin-7/metabolism ; Models, Molecular ; Receptors, Antigen, T-Cell/immunology ; Virus Activation ; Virus Latency/immunology
    Chemical Substances Interleukin-2 ; Interleukin-7 ; Receptors, Antigen, T-Cell
    Language English
    Publishing date 2011-10-06
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2205412-1
    ISSN 1553-7374 ; 1553-7366
    ISSN (online) 1553-7374
    ISSN 1553-7366
    DOI 10.1371/journal.ppat.1002288
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Cytomegalovirus reactivation following autologous peripheral blood stem cell transplantation for multiple myeloma in the era of novel chemotherapeutics and tandem transplantation.

    Kim, Jong Hun / Goulston, Claudia / Sanders, Stephanie / Lampas, Mary / Zangari, Maurizio / Tricot, Guido / Hanson, Kimberly E

    Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation

    2012  Volume 18, Issue 11, Page(s) 1753–1758

    Abstract: Cytomegalovirus (CMV) is an important pathogen after allogeneic transplantation. However, few studies have examined CMV reactivation after autologous peripheral blood stem cell transplantation (APBSCT) to treat multiple myeloma (MM), especially in the ... ...

    Abstract Cytomegalovirus (CMV) is an important pathogen after allogeneic transplantation. However, few studies have examined CMV reactivation after autologous peripheral blood stem cell transplantation (APBSCT) to treat multiple myeloma (MM), especially in the setting of the newer chemotherapeutic agents and/or 2 sequential APBSCTs (ie, tandem transplantation). A retrospective chart review of patients with MM who underwent either single APBSCT or tandem transplantation was conducted to evaluate the incidence, risk factors, and outcomes of CMV infection at a single institution. A total of 104 patients with MM underwent transplantation during the study period, including 66 patients who received tandem transplantation. The majority of patients (66 of 104; 63.5%) were CMV-seropositive, and CMV viremia was frequently detected in this subgroup (32 of 66; 48.5%). No primary CMV infections were identified. CMV reactivation was more common in recipients of tandem transplantation than in recipients of single APBSCT (P < .001). In addition, patients who developed CMV viremia were more likely to have received conditioning therapy with melphalan, bortezomib, dexamethasone, and thalidomide compared with those without CMV reactivation (P = .015). However, on multiple logistic regression analysis, only receipt of tandem transplantation was significantly associated with CMV reactivation (odds ratio, 5.112; 95% confidence interval, 1.27-20.60; P = .022). Febrile episodes of CMV viremia were observed in 17 patients (17 of 32; 53.1%), and invasive CMV disease was diagnosed in 1 patient. Our data suggest that CMV reactivation after APBSCT for MM is relatively common, and that viremia is often associated with fever. CMV surveillance should be considered, especially when tandem transplantation is performed using combination chemotherapy with high-dose melphalan.
    MeSH term(s) Aged ; Antiviral Agents/therapeutic use ; Boronic Acids/therapeutic use ; Bortezomib ; Cytomegalovirus/drug effects ; Cytomegalovirus/physiology ; Cytomegalovirus Infections/drug therapy ; Cytomegalovirus Infections/etiology ; Cytomegalovirus Infections/virology ; Female ; Humans ; Male ; Melphalan/therapeutic use ; Middle Aged ; Multiple Myeloma/immunology ; Multiple Myeloma/therapy ; Myeloablative Agonists/therapeutic use ; Peripheral Blood Stem Cell Transplantation/adverse effects ; Peripheral Blood Stem Cell Transplantation/methods ; Peripheral Blood Stem Cell Transplantation/mortality ; Pyrazines/therapeutic use ; Retrospective Studies ; Risk Factors ; Thalidomide/therapeutic use ; Transplantation Conditioning ; Transplantation, Autologous ; Viral Load/drug effects ; Viremia/drug therapy ; Viremia/etiology ; Viremia/virology ; Virus Activation
    Chemical Substances Antiviral Agents ; Boronic Acids ; Myeloablative Agonists ; Pyrazines ; Thalidomide (4Z8R6ORS6L) ; Bortezomib (69G8BD63PP) ; Melphalan (Q41OR9510P)
    Language English
    Publishing date 2012-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1474865-4
    ISSN 1523-6536 ; 1083-8791
    ISSN (online) 1523-6536
    ISSN 1083-8791
    DOI 10.1016/j.bbmt.2012.06.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: The major genetic determinants of HIV-1 control affect HLA class I peptide presentation.

    Pereyra, Florencia / Jia, Xiaoming / McLaren, Paul J / Telenti, Amalio / de Bakker, Paul I W / Walker, Bruce D / Ripke, Stephan / Brumme, Chanson J / Pulit, Sara L / Carrington, Mary / Kadie, Carl M / Carlson, Jonathan M / Heckerman, David / Graham, Robert R / Plenge, Robert M / Deeks, Steven G / Gianniny, Lauren / Crawford, Gabriel / Sullivan, Jordan /
    Gonzalez, Elena / Davies, Leela / Camargo, Amy / Moore, Jamie M / Beattie, Nicole / Gupta, Supriya / Crenshaw, Andrew / Burtt, Noël P / Guiducci, Candace / Gupta, Namrata / Gao, Xiaojiang / Qi, Ying / Yuki, Yuko / Piechocka-Trocha, Alicja / Cutrell, Emily / Rosenberg, Rachel / Moss, Kristin L / Lemay, Paul / O'Leary, Jessica / Schaefer, Todd / Verma, Pranshu / Toth, Ildiko / Block, Brian / Baker, Brett / Rothchild, Alissa / Lian, Jeffrey / Proudfoot, Jacqueline / Alvino, Donna Marie L / Vine, Seanna / Addo, Marylyn M / Allen, Todd M / Altfeld, Marcus / Henn, Matthew R / Le Gall, Sylvie / Streeck, Hendrik / Haas, David W / Kuritzkes, Daniel R / Robbins, Gregory K / Shafer, Robert W / Gulick, Roy M / Shikuma, Cecilia M / Haubrich, Richard / Riddler, Sharon / Sax, Paul E / Daar, Eric S / Ribaudo, Heather J / Agan, Brian / Agarwal, Shanu / Ahern, Richard L / Allen, Brady L / Altidor, Sherly / Altschuler, Eric L / Ambardar, Sujata / Anastos, Kathryn / Anderson, Ben / Anderson, Val / Andrady, Ushan / Antoniskis, Diana / Bangsberg, David / Barbaro, Daniel / Barrie, William / Bartczak, J / Barton, Simon / Basden, Patricia / Basgoz, Nesli / Bazner, Suzane / Bellos, Nicholaos C / Benson, Anne M / Berger, Judith / Bernard, Nicole F / Bernard, Annette M / Birch, Christopher / Bodner, Stanley J / Bolan, Robert K / Boudreaux, Emilie T / Bradley, Meg / Braun, James F / Brndjar, Jon E / Brown, Stephen J / Brown, Katherine / Brown, Sheldon T / Burack, Jedidiah / Bush, Larry M / Cafaro, Virginia / Campbell, Omobolaji / Campbell, John / Carlson, Robert H / Carmichael, J Kevin / Casey, Kathleen K / Cavacuiti, Chris / Celestin, Gregory / Chambers, Steven T / Chez, Nancy / Chirch, Lisa M / Cimoch, Paul J / Cohen, Daniel / Cohn, Lillian E / Conway, Brian / Cooper, David A / Cornelson, Brian / Cox, David T / Cristofano, Michael V / Cuchural, George / Czartoski, Julie L / Dahman, Joseph M / Daly, Jennifer S / Davis, Benjamin T / Davis, Kristine / Davod, Sheila M / DeJesus, Edwin / Dietz, Craig A / Dunham, Eleanor / Dunn, Michael E / Ellerin, Todd B / Eron, Joseph J / Fangman, John J W / Farel, Claire E / Ferlazzo, Helen / Fidler, Sarah / Fleenor-Ford, Anita / Frankel, Renee / Freedberg, Kenneth A / French, Neel K / Fuchs, Jonathan D / Fuller, Jon D / Gaberman, Jonna / Gallant, Joel E / Gandhi, Rajesh T / Garcia, Efrain / Garmon, Donald / Gathe, Joseph C / Gaultier, Cyril R / Gebre, Wondwoosen / Gilman, Frank D / Gilson, Ian / Goepfert, Paul A / Gottlieb, Michael S / Goulston, Claudia / Groger, Richard K / Gurley, T Douglas / Haber, Stuart / Hardwicke, Robin / Hardy, W David / Harrigan, P Richard / Hawkins, Trevor N / Heath, Sonya / Hecht, Frederick M / Henry, W Keith / Hladek, Melissa / Hoffman, Robert P / Horton, James M / Hsu, Ricky K / Huhn, Gregory D / Hunt, Peter / Hupert, Mark J / Illeman, Mark L / Jaeger, Hans / Jellinger, Robert M / John, Mina / Johnson, Jennifer A / Johnson, Kristin L / Johnson, Heather / Johnson, Kay / Joly, Jennifer / Jordan, Wilbert C / Kauffman, Carol A / Khanlou, Homayoon / Killian, Robert K / Kim, Arthur Y / Kim, David D / Kinder, Clifford A / Kirchner, Jeffrey T / Kogelman, Laura / Kojic, Erna Milunka / Korthuis, P Todd / Kurisu, Wayne / Kwon, Douglas S / LaMar, Melissa / Lampiris, Harry / Lanzafame, Massimiliano / Lederman, Michael M / Lee, David M / Lee, Jean M L / Lee, Marah J / Lee, Edward T Y / Lemoine, Janice / Levy, Jay A / Llibre, Josep M / Liguori, Michael A / Little, Susan J / Liu, Anne Y / Lopez, Alvaro J / Loutfy, Mono R / Loy, Dawn / Mohammed, Debbie Y / Man, Alan / Mansour, Michael K / Marconi, Vincent C / Markowitz, Martin / Marques, Rui / Martin, Jeffrey N / Martin, Harold L / Mayer, Kenneth Hugh / McElrath, M Juliana / McGhee, Theresa A / McGovern, Barbara H / McGowan, Katherine / McIntyre, Dawn / Mcleod, Gavin X / Menezes, Prema / Mesa, Greg / Metroka, Craig E / Meyer-Olson, Dirk / Miller, Andy O / Montgomery, Kate / Mounzer, Karam C / Nagami, Ellen H / Nagin, Iris / Nahass, Ronald G / Nelson, Margret O / Nielsen, Craig / Norene, David L / O'Connor, David H / Ojikutu, Bisola O / Okulicz, Jason / Oladehin, Olakunle O / Oldfield, Edward C / Olender, Susan A / Ostrowski, Mario / Owen, William F / Pae, Eunice / Parsonnet, Jeffrey / Pavlatos, Andrew M / Perlmutter, Aaron M / Pierce, Michael N / Pincus, Jonathan M / Pisani, Leandro / Price, Lawrence Jay / Proia, Laurie / Prokesch, Richard C / Pujet, Heather Calderon / Ramgopal, Moti / Rathod, Almas / Rausch, Michael / Ravishankar, J / Rhame, Frank S / Richards, Constance Shamuyarira / Richman, Douglas D / Rodes, Berta / Rodriguez, Milagros / Rose, Richard C / Rosenberg, Eric S / Rosenthal, Daniel / Ross, Polly E / Rubin, David S / Rumbaugh, Elease / Saenz, Luis / Salvaggio, Michelle R / Sanchez, William C / Sanjana, Veeraf M / Santiago, Steven / Schmidt, Wolfgang / Schuitemaker, Hanneke / Sestak, Philip M / Shalit, Peter / Shay, William / Shirvani, Vivian N / Silebi, Vanessa I / Sizemore, James M / Skolnik, Paul R / Sokol-Anderson, Marcia / Sosman, James M / Stabile, Paul / Stapleton, Jack T / Starrett, Sheree / Stein, Francine / Stellbrink, Hans-Jurgen / Sterman, F Lisa / Stone, Valerie E / Stone, David R / Tambussi, Giuseppe / Taplitz, Randy A / Tedaldi, Ellen M / Theisen, William / Torres, Richard / Tosiello, Lorraine / Tremblay, Cecile / Tribble, Marc A / Trinh, Phuong D / Tsao, Alice / Ueda, Peggy / Vaccaro, Anthony / Valadas, Emilia / Vanig, Thanes J / Vecino, Isabel / Vega, Vilma M / Veikley, Wenoah / Wade, Barbara H / Walworth, Charles / Wanidworanun, Chingchai / Ward, Douglas J / Warner, Daniel A / Weber, Robert D / Webster, Duncan / Weis, Steve / Wheeler, David A / White, David J / Wilkins, Ed / Winston, Alan / Wlodaver, Clifford G / van't Wout, Angelique / Wright, David P / Yang, Otto O / Yurdin, David L / Zabukovic, Brandon W / Zachary, Kimon C / Zeeman, Beth / Zhao, Meng

    Science (New York, N.Y.)

    2010  Volume 330, Issue 6010, Page(s) 1551–1557

    Abstract: Infectious and inflammatory diseases have repeatedly shown strong genetic associations within the major histocompatibility complex (MHC); however, the basis for these associations remains elusive. To define host genetic effects on the outcome of a ... ...

    Abstract Infectious and inflammatory diseases have repeatedly shown strong genetic associations within the major histocompatibility complex (MHC); however, the basis for these associations remains elusive. To define host genetic effects on the outcome of a chronic viral infection, we performed genome-wide association analysis in a multiethnic cohort of HIV-1 controllers and progressors, and we analyzed the effects of individual amino acids within the classical human leukocyte antigen (HLA) proteins. We identified >300 genome-wide significant single-nucleotide polymorphisms (SNPs) within the MHC and none elsewhere. Specific amino acids in the HLA-B peptide binding groove, as well as an independent HLA-C effect, explain the SNP associations and reconcile both protective and risk HLA alleles. These results implicate the nature of the HLA-viral peptide interaction as the major factor modulating durable control of HIV infection.
    MeSH term(s) Black or African American/genetics ; Alleles ; Amino Acids/physiology ; Antigen Presentation ; CD8-Positive T-Lymphocytes/immunology ; Cohort Studies ; Disease Progression ; Genes, MHC Class I ; Genome-Wide Association Study ; HIV Antigens/immunology ; HIV Infections/ethnology ; HIV Infections/genetics ; HIV Infections/immunology ; HIV Infections/virology ; HIV Long-Term Survivors ; HIV-1/immunology ; HLA-A Antigens/chemistry ; HLA-A Antigens/genetics ; HLA-A Antigens/immunology ; HLA-A Antigens/metabolism ; HLA-B Antigens/chemistry ; HLA-B Antigens/genetics ; HLA-B Antigens/immunology ; HLA-B Antigens/metabolism ; HLA-C Antigens/chemistry ; HLA-C Antigens/genetics ; HLA-C Antigens/immunology ; HLA-C Antigens/metabolism ; Haplotypes ; Hispanic or Latino/genetics ; Humans ; Immunity, Innate ; Logistic Models ; Models, Molecular ; Polymorphism, Single Nucleotide ; Protein Conformation ; Viral Load ; White People/genetics
    Chemical Substances Amino Acids ; HIV Antigens ; HLA-A Antigens ; HLA-B Antigens ; HLA-C Antigens
    Language English
    Publishing date 2010-11-04
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, N.I.H., Intramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 128410-1
    ISSN 1095-9203 ; 0036-8075
    ISSN (online) 1095-9203
    ISSN 0036-8075
    DOI 10.1126/science.1195271
    Database MEDical Literature Analysis and Retrieval System OnLINE

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