Infectious Diseases

Host: Anthony Alessi, MD

Guest: James Sejvar, MD

How is the CDC monitoring neurological complications from the H1N1 vaccine as it relates to the risk of Guillain-Barre syndrome? Dr. James Sejvar, neuroepidemiologist in the division of viral and rickettsial diseases at the National Center for Infectious Diseases and the Center for Disease Control and Prevention, outlines for host Dr. Anthony Alessi the historical association between swine flu vaccination and Guillain-Barre syndrome.

Guest: Norman Edelman, MD

Host: Matt Birnholz, MD

Host: Michael Greenberg, MD

We are moving closer to the height of what many feel will be an extraordinarily busy flu season, with H1N1 and the seasonal flu both central parts of the discussion. We don't know exactly how serious H1N1 will be, but we do know that it's here, that many more people could get sick, and that we have to be prepared to deal with it. Hosts Dr. Michael Greenberg and Dr. Matt Birnholz speak with Dr. Norman Edelman, chief medical officer for the American Lung Association and a professor of preventive medicine and internal medicine at the State University of New York at Stony Brook.

Dr. Birnholz and Dr. Greenberg will also give you their take on an amusing recitation of the health reform bill in the House known as HR 3200. They will also play back the winning entry in an entertaining yet informative contest to create a public service announcement on H1N1, co-sponsored by the U.S. Department of Health and Human Services. You won't want to miss it!

Host: Jay Goldstein, MD

Guest: Mansour Mohamadzadeh, PhD

Researchers have developed an oral vaccine utilizing probiotics and, in preclinical studies, have found it successful in providing immunity against anthrax. Why are probiotics a good delivery component, and why might this method encourage a greater degree of response than the traditional vaccine injection? Dr. Mansour Mohamadzadeh, associate professor of medicine in the division of gastroenterology at Northwestern University Feinberg School of Medicine, tells host Dr. Jay Goldstein about this new vaccine delivery method. Will oral vaccines soon be ready for clinical trials?

Host: Martin Samuels, MD

Guest: Abraham Verghese, MD, MACP

What does treating a patient with a stigmatized illness teach a physician about treating all illness? Dr. Abraham Verghese, professor for the theory and practice of medicine at Stanford University School of Medicine, joins host Dr. Martin Samuels to discuss the effects of stigmatized medicine on the physician-patient relationship, and other topics.

Host: Mark Nolan Hill, MD

Guest: Jeffrey Klausner, MD, MPH

Detection and treatment of HIV in the United States has improved dramatically since the peak of the epidemic here in the 1980s, but there is far more work to be done. HIV transmission is one area of heightened concern, particularly those cases spread by newly infected persons who remain undiagnosed. Though tests are available to diagnose HIV in the acute phase, many experts believe we must improve these tests to really make headway in reducing the incidence of HIV in the United States. Dr. Jeffrey Klausner, a deputy health officer and director of the STD Prevention and Control Services Section at the San Francisco Department of Public Health, joins host Dr. Mark Nolan Hill to lay out the path toward progress in detecting acute cases of HIV infection. Newer, more effective tests are available, but must be adopted around the United States, and as Dr. Klausner looks ahead, a point-of-care rapid exam, though still in development, could eventually change the paradigm for early-stage HIV detection.

Host: Charles Turck, PharmD, BCPS, BCCCP

Guest: Michael Rybak, PharmD, MPH, PhD

Vancomycin has come full circle in recent years. First used as an alternative to penicillin nearly a half-century ago, it was surpassed by methicillin and other semisynthetic penicillins that were regarded as less toxic. Paradoxically, the subsequent rise of methicillin-resistant Staphylococcus aureus (MRSA) has reestablished vancomycin as the primary antibiotic treatment for MRSA infections. With this in mind, what do we know about its pharmacodynamics that allows us to institute optimal monitoring strategies for this drug? Host Dr. Charles Turck welcomes Dr. Michael Rybak, associate dean for research, professor of pharmacy and medicine, and director of the Anti-Infective Research Laboratory at the Eugene Applebaum College of Pharmacy & Health Sciences at Wayne State University in Detroit.

Host: Michael Greenberg, MD and Larry Kaskel, MD

Guest: Joan Nichols, PhD

Events surrounding the spread of H1N1 influenza virus have dominated the news over the course of the last few weeks. We are all receiving calls from patients worried that they may have symptoms, while others are concerned that they may be at risk. Everyone has questions: Is there any need to think about stockpiling Tamiflu and other antiviral products, and should we recommend that at-risk patients start on a prophylactic antiviral regimen? How long will it be until we have vaccine resources at hand to combat the virus? Hosts Dr. Michael Greenberg and Dr. Larry Kaskel sort through your questions, as well as those you are getting from your patients, with the help of Dr. Joan Nichols, associate director of research at the Galveston National Biocontainment Laboratory, our nation's first national biocontainment facility, based in Galveston, Texas. Dr. Nichols, who is also an associate professor of microbiology & immunology at the University of Texas Medical Branch at Galveston, will also explore a few symptoms of the H1N1 virus that may allow us to distinguish the infection from that of the more commonplace seasonal influenza.

Host: Jay Goldstein, MD

Guest: Christian Stone, MD, MPH

Incidents of Clostridium difficile, or C.diff, are increasing in the US. Are patients with ulcerative colitis or Crohn's disease more at risk for developing C. difficile infection than other patients? Is this due to an increased use of antibiotics in hospitals, or are other factors playing a role? Join host Dr. Jay Goldstein as he welcomes Dr. Christian Stone, associate professor of medicine at Washington University School of Medicine in St. Louis, to discuss the recent trends of C. difficile infections among inflammatory bowel disease patients.

Host: Charles Turck, PharmD, BCPS, BCCCP

Guest: Michael Gabay, PharmD, JD

Culled from human plasma, intravenous immunoglobulin (IVIG) is an expensive and limited resource. These constraints underscore the importance of ensuring that our clinical uses of IVIG are in line with the applications for which we have best demonstrated its efficacy. Yet IVIG has only amassed a short list of FDA-approved indications, and is often employed as an off-label therapy. In what areas is our use of IVIG best supported by the literature, and is this consistent with how the agent is most commonly used? Host Dr. Charles Turck examines these questions and more with Dr. Michael Gabay, clinical assistant professor at the University of Illinois at Chicago College of Pharmacy, where he directs the university's Drug Information Group and Prior Authorization Services.

Host: Jennifer Shu, MD, FAAP

Guest: Caroline Hall, MD

Respiratory syncytial virus (RSV) is a well-known cause of hospitalization in infants, but new research suggests the burden of illness may be more substantial than previously recognized in healthy, older children as well. Investigators estimate over two million children under the age of five require medical treatment for RSV each year. Because it can be difficult to prevent and treat RSV infections, is there a role for a vaccine against the illness? Host Dr. Jennifer Shu welcomes Dr. Caroline Hall, professor of pediatrics and medicine at the University of Rochester School of Medicine and Dentistry, to explore these questions. Dr. Hall also explains how the characteristics of the virus and its mechanisms of transmission contribute to its proliferation.