Serogroup B Neisseria meningitidis (MenB) is a major cause of disease in early childhood. Gossger and colleagues assessed the immunogenicity of a multicomponent MenB (4CMenB) vaccine—given either separately or concomitantly with routine infant vaccines—in a randomized trial that enrolled 1885 infants. The authors report that the 4CMenB vaccine was immunogenic when administered with routine vaccines at 2, 4, and 6 or 2, 3, and 4 months of age and interfered minimally with the response to concomitantly administered infant vaccinations. In an editorial, Messonnier and Cohn discuss progress toward an infant MenB vaccine.
Fluoroquinolones are efficacious for uncomplicated cystitis, but increasing rates of fluoroquinolone resistance are a concern. In a clinical trial that enrolled 300 women with acute uncomplicated cystitis, Hooten and colleagues assessed 30-day clinical cure rates among women randomly assigned to a 3-day regimen of cefpodoxime—a broad-spectrum, third-generation cephalosporin—or a 3-day regimen of ciprofloxacin. The authors report that compared with ciprofloxacin, cefpodoxime did not meet prespecified noninferiority criteria for achieving clinical cure of acute uncomplicated cystitis in women.
In an analysis of data from 9766 postmenopausal women with hormone receptor− positive breast cancer, van de Water and colleagues examined the association between age at diagnosis and breast cancer outcomes. Among their findings was that increasing age at diagnosis was associated with higher breast cancer–specific mortality.
Pentavalent rotavirus (RV5) vaccines were not associated with intussusception in prelicensure clinical trials. However, recent examination of international postlicensure data suggested a possible increased risk of intussusception in the first week following the initial vaccine dose. In an analysis of data from 786 725 RV5 doses (309 844 first doses) administered to US infants aged 4 to 34 weeks, Shui and colleagues found no increased risk of intussusception 1 to 7 days and 1 to 30 days following RV5 vaccination.
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An elderly nursing home resident presents with an increasingly painful pressure ulcer. Reddy and colleagues analyzed data from 15 studies (representing 985 patients and 1056 chronic wounds) to assess the accuracy of clinical signs and symptoms and the utility of noninvasive wound cultures in the diagnosis of chronic wound infections. They found that the presence of increasing pain may make infection of a chronic wound more likely; however, its absence does not rule out infection. Further evidence is needed to determine which, if any, wound swab culture has diagnostic utility.
Several weeks after initiating chemotherapy with tretinoin, cytarabine, and daunorubicin, a patient with acute promyelocytic leukemia developed a low-grade fever and purple rash. What would you do next?
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For your patients: Information about intussusception.
This Week in JAMA. JAMA. 2012;307(6):539. doi:10.1001/jama.2012.107