Friday, September 29, 2006

BMJ, 30th September

Tomorrow's BMJ includes:

a clinical review article on management of meningococcal disease in children -;333/7570/685

a news piece on the current outbreak of E. coli O157:H7 associated disease in the USA, caused by spinach -

another news piece, this time reporting a survey of doctors that indicated that most did not feel the government was prepared for an "avian influenza pandemic" -

an article arguing that reliance on RCTs is not helpful in resource poor settings. For example, when studies (which were not RCTs) began showing that oral rehydration therapy was effective to counter dehydration caused by diarrhoea, the WHO started an ORT programme. There were no RCTs until ten years after this date. The authors argue that clinical experience and other sorts of studies can be an effective evidence base.

And then there are some letters about extreme drug resistant TB (which I have mentioned before) and about plagiarism. One of those looks at keeping records of studies in a field, and how that can help spot studies that don't quite fit, or which repeat already known data; another looks at citations - where it is not clear how a citation supports an assertion, and where it is not clear if an assertion is supported by any citation; and the last looks at using Google to detect plagiarism.

Entire table of contents is at present at

The joy of cataloguing

I was also struck by this Guardian item. A graduate student has found an up-till-now lost poem by Robert Frost, which was written in pencil by the author inside a copy of one of his poetry collections. That particular copy was given to a friend, and it ended up in the Library of the University of Virginia. The student, Robert Stilling, was reading some of Frost's correspondence, in the Library, and made the connection between a letter mentioning the book, and the actual copy of that book held in the Library.

This all goes to show:

You never know when something in the Library collections (or the medical literature, either, for that matter) will become important;
Cataloguing some material in detail is important: presumably the library catalogue (or catalog) recorded the provenance of that patricular copy of the book.

Marc Abraham's "Improbable Research" column last week talked about library materials being lost because they were not catalogued accurately. He was talking about Irish Gaelic materials being catalogued as if "Na" was the first word of the title, when in fact it means "The". I have found this so many times over the years, even with titles in French and German, let alone more unusual languages. Filing "The Lancet" under "The", even...

More at:,,1883689,00.html (Frost),,1880490,00.html (Improbable Research)

Connectivity Map

Today's Guardian has a very small item about this, which it describes as a "Medical Google" and the "human connectivity map". It refers to an article in Science, and I suspect it is this:

This is the "Connectivity Map", a reference collection of gene expression profiles. The profiles come from cells treated with various small molecules, and it is hoped that the Map will aid the discovery of connections between diseases, physiological processes and the actions of drugs.

Thursday, September 21, 2006

Extreme drug resistant TB

Wednesday 13th's Guardian carries a report of extreme drug resistant TB (XDR-TB) in South Africa. They report what happened at a hospital in Tugela Ferry in Zulu kingdom. When antiviral drugs eventually became available, doctors noticed a great improvement, but there was a group of patients whose immune systems responded well, but who did not get any better. XDR-TB is resistant to every first line drug.

The article discusses concerns over what will happen if the disease spreads, and about what the government is doing about it. Apparently the national health minister did not attend a meeting last week of WHO, CDC and South African experts to discuss what to do about XDR-TB.

Dr. Alan Cann also discusses XDR-TB on his blog

See also:

Nature for 14 September
Lancet for 16-22 September
Science for 15 September

Monday, September 18, 2006


That last post, on JAMA's theme issue on malaria, was the 600th to this blog.

JAMA theme issue on malaria

JAMA is planning a theme issue on malaria, and is asking for papers. Those received before 15 December 2006 stand the best chance of publication.


How prepared are we for an influenza pandemic?

Iain Stephenson, of this very hospital, is the author of an editorial on this subject, in the Lancet of 16-22 September.

Wednesday, September 13, 2006

Legionnaires' disease

Today's Guardian reports an increase in the number of cases of legionnaires' disease, with the HPA investigating 120 cases reported to it since the start of August. This is twice the number reported in the corresponding period last year.

The HPA's general information on the disease is at, with a press statement about the increase in cases at

Tuesday, September 12, 2006

Infectious diseases: preparing for the future

Science (8th September) reports a Foresight project that has produced a report on this. The project compared the UK, China and sub-Saharan Africa. It looked especially at detection of infection and identified eight areas where improved detection would help:

1. New diseases (SARS, BSE) and variants (H5N1)
2. Infections resistant to antibiotics
3. Zoonoses, including foodborne infection
4. HIV/AIDS, malaria and TB
5. Epidemic plant diseases
6. Acute respiratory infections, including influenza
7. Sexually transmitted infection
8. Animal diseases

Read Science's report of this at The Foresight papers (and other things) are at

Thursday, September 07, 2006

Acinetobacter baumannii

One day soon I will get round to posting all the things in my "to be blogged" folder. I am very behind again.

Meanwhile, a supplement to Clinical Infectious Diseases has crossed my desk: Serious infections in the intensive care unit: Pseudomonas aeruginosa and Acinetobacter baumannii, which appears to concentrate on antimicrobial resistance. It is Clinical Infectious Diseases 2006, 43 Suppl. 2, and University members (on campus) can access it here.