News in brief - March 22/29, 2004

Pneumonia-risk calculator available for handhelds - Blood screening stymies spread of West Nile virus - Harmless virus linked to longer life expectancy for HIV-positive men - Children more likely to inherit heart disease from moms than from dads

Pneumonia-risk calculator available for handhelds

The Agency for Healthcare Research and Quality has available a clinical decision-support tool for personal digital assistants that is designed to help physicians determine whether a patient with community-acquired pneumonia should be treated at home or in the hospital.

The Pneumonia Severity Index Calculator is based on a clinical algorithm produced in 1997 by an AHRQ-funded research team. The algorithm has been validated in a broad, randomized controlled trial and was shown to be safe, cost-effective and to improve satisfaction by enabling patients to be treated at home rather than the hospital when appropriate, according to the agency.

Community-acquired pneumonia contracted outside of a hospital or nursing home affects approximately 4 million Americans and costs about $10 billion to treat each year. Nearly all of those costs are spent on treating patients who are hospitalized for care.

AHRQ identified a sizable number of low-risk patient who could be treated safely as outpatients, but noted that these patients must be accurately identified before such treatment is recommended.

The tool is available for download from the AHRQ Web site (pda.ahrq.gov/).

Blood screening stymies spread of West Nile virus

The screening of blood for West Nile virus by blood banks has likely prevented more than 1,000 transfusion-related infections during the second half of 2003, say researchers from the Centers for Disease Control and Prevention.

"This is an amazing success story," said Susan Montgomery, DVM, a CDC researcher who presented the finding at the International Conference on Emerging Infectious Disease on March 1. "The entire blood community went from the identification of a problem in the blood supply to the development and implementation of a solution nationwide within a year."

In 2002, health authorities confirmed 23 cases of West Nile virus infection associated with blood transfusions. It is estimated that as many as 500 people with high levels of virus in their blood donated blood that year. To reduce the risk of transfusion transmission, U.S. blood banks began screening donations for West Nile virus in July 2003.

Over a six-month period, from late June to December 2003, nearly 6 million blood donations were screened for the virus. Over 1,000 donations tested positive for the virus and were removed from the blood supply.

Harmless virus linked to longer life expectancy for HIV-positive men

Long-term infection with GB virus type C, a bloodborne pathogen not linked to any disease, is associated with a greater survival for men infected with HIV, according to a study published in the New England Journal of Medicine this month.

Scientists have long studied the possible role that this virus may have in the course of HIV infection with mixed results. This is the first study to look at length of infection as playing a role.

Researchers at several academic institutions funded by the National Institute of Allergy and Infectious Diseases analyzed blood samples taken five years apart from HIV-infected men. Those who had GBV-C infection in both samples lived the longest with 75% surviving at least 11 years after infection. Only 39% of men who showed no evidence of the virus, and 16%of those who had the virus in the first sample but not the second were still alive after 11 years.

Authors of the paper wrote that a better understanding of this process may lead to better ways to control HIV.

Children more likely to inherit heart disease from moms than from dads

Patients whose mother has cardiac disease are more likely to develop heart problems than those whose father has such illness, according to a study presented at the American College of Cardiology meeting in New Orleans this month.

Researchers at Johns Hopkins University in Baltimore studied nearly 700 middle-aged adults, including many who had a parent who suffered a cardiac event before 60. Nearly 15% of subjects with a maternal history of heart disease had a cardiac event in approximately a 10-year period while only 12.3% of those with a paternal history did. Just over 10% of those with no family history had an event. The reason for this is unknown, but the presenters said physicians who identify patients with family history should pay additional attention to minimizing changeable risk factors. "They should compulsively look for other risk factors, such as hypertension, elevated cholesterol and obesity, and aggressively manage them," said Pamela Ouyang, MD, lead author and an associate professor of medicine at Johns Hopkins.