News in brief - Oct. 16, 2006

CDC calls for physicians to report C. diff in sick infants - Study questions treatment of small kidney cancers - Egg-throwing prank can cause serious eye injuries - Researchers study 1918 flu virus - IBS linked to other ills

CDC calls for physicians to report C. diff in sick infants

The Centers for Disease Control and Prevention is calling for physicians to contact the agency with information about clusters of gastrointestinal illness in infants who test positive for Clostridium difficile, according to an alert issued Sept. 14 by the CDC's Division of Healthcare Quality Promotion.

Large numbers of infants have this bacteria in their systems, although it's unusual for them to be sickened by it. In response to reports of clusters of neonates developing illness linked to this bug, the CDC is actively attempting to gather information on similar outbreaks to determine the true magnitude of the problem.

The CDC is asking physicians who have seen an increase in children younger than 2 with diarrhea or other stomach trouble who tested positive for this infection either this year or last to e-mail the agency (hip@cdc.gov).

Study questions treatment of small kidney cancers

The number of kidney cancers detected and treated has increased, but so has the death rate from this disease, according to a study published in the Sept. 20 Journal of the National Cancer Institute.

"With increased early detection and treatment of small tumors, we would expect to see a decrease in mortality associated with kidney cancer," said Brent K. Hollenbeck, MD, senior author and assistant professor of urology at the University of Michigan Medical School.

Researchers analyzed data on 34,503 kidney cancer patients gathered by the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. The age-adjusted incident rate for this carcinoma increased from 7.1 cases per 100,000 people in 1983 to 10.8 in 2002, and this increase was caused primarily by the increase in detection of small tumors. Surgery for this disease increased at a similar rate, but mortality increased from 1.5 deaths per 100,000 in 1983 to 6.5 in 2002.

The authors say these numbers suggest that current treatment strategies, particularly for small renal masses, need re-evaluation.

"This calls to question the effectiveness of our current treatment strategy," said John M. Hollingsworth, MD, lead author and a fifth-year surgery resident. "Perhaps there are some patients with small kidney tumors for whom surgery is not the best option."

Egg-throwing prank can cause serious eye injuries

Throwing raw eggs at people is more dangerous than a prankster may think, according to research in the Sept. 20 Emergency Medicine Journal.

Researchers studied 13 patients who had sustained eye injuries as a result of being hit by an egg and found a lengthy list of damage, including tears and severe bruising of the retina; disruption of the light receptor cells in the eye; and raised internal pressure, which was capable of damaging the optic nerve and causing permanent loss of vision.

"The dimensions of an egg are similar to those of a squash ball, with a considerably greater weight, meaning that eggs as missiles can easily fit into the orbital rim, causing severe blunt injury even when thrown by hand," the authors wrote.

Researchers study 1918 flu virus

The influenza virus that caused so many deaths in 1918 and 1919 was lethal because it elicited a severe immune system response, according to a paper published in the Oct. 5 Nature.

Researchers used functional gene expression analysis on mice that were infected with a reconstructed version of this virus. They found that pro-inflammatory and cell death pathways were highly activated. This response was more severe than in animals infected with bugs that did not have a history of being quite so lethal.

"The host's immune system may be overreacting and killing off too many cells, and that may be a key contributor to what makes this virus more pathogenic," said John C. Kash, PhD, lead author and research assistant professor of microbiology at the University of Washington.

This study is the latest one to attempt to elucidate why the 1918 flu was so deadly in order to determine strategies for fighting other strains that may be just as devastating.

For instance, last month, researchers at UMDNJ-New Jersey Medical School in Newark sent out a call for people born before 1915 who were around people who died in the pandemic. The goal is to profile their antibodies and determine if they can be used to provide protection if the 1918 strain recurs.

Those interested in participating should contact Eric Altschuler, MD, PhD, by phone: 973-972-5439.

IBS linked to other ills

Patients who develop irritable bowel syndrome are also prone to migraines, depression and chronic pain, according to a study published last month in BMC Gastroenterology.

Boston University researchers analyzed six years of a large health plan's claims data, from 1996 to 2002. The characteristics of the 97,593 patients with an ICD-9 code for irritable bowel syndrome were compared with 27,402 people without this disorder. Those with IBS were 40% more likely to be depressed, 60% more likely to experience migraines and 80% more likely to have fibromyalgia.

The authors of this paper suggest that this research confirms an association previously suggested by much smaller studies and may be useful for predicting the use of health services.