Browsing by Author "Johnston, BL"
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Item Open Access Alemtuzumab and Natalizumab: The Monoclonal Antibody Story Continues(2006-01-01) Johnston, BL; Conly, JMIn the July/August 2006 issue of this journal, the infectious complications associated with the use of infliximab, etanercept and adalimumab were reviewed (1). These represent only three of the many monoclonal antibodies either licensed or in clinical trials for therapeutic use in cancer and autoimmune disease or to prevent rejection in both solid organ and hematopoietic stem cell transplantation. While most of these agents have not been associated with increased infection rates, alemtuzumab and natalizumab have gained particular attention related to either the frequency or type of infection seen in some individuals who have received them.Item Open Access Clostridium difficile: The Evolving Story(2007-01-01) Johnston, BL; Conly, JMItem Open Access Colistin: The phoenix Arises(2006-01-01) Conly, JM; Johnston, BLThe polymyxins were discovered in the 1940s and represent a group of closely related polypeptide antibiotics obtained from Bacillus polymyxa, which was originally isolated from soil (1,2). Although they have been used extensively worldwide in topical otic and ophthalmic solutions for decades, the intravenous formulations were gradually abandoned in most parts of the world in the early 1980s because of the reported high incidence of nephrotoxicity (3-5). As a result, the use of polymyxin preparations has been mainly restricted to the treatment of lung infections due to multidrug-resistant (MDR) gram-negative bacteria in patients with cystic fibrosis (6,7). The emergence of bacteria resistant to most classes of commercially available antibiotics and the shortage of novel antimicrobial agents with activity against gram-negative microorganisms have led to the reemergence of polymyxins as a valuable addition to the therapeutic armamentarium. It was thus considered timely to review colistin and its emerging role in managing infections due to MDR gram-negative bacteria.Item Open Access Community-Associated Methicillin-Resistant Staphylococcus aureus: Continuing to Evolve(2008-01-01) Johnston, BL; Conly, JMItem Open Access Is Mumps Making a Comeback?(2007-01-01) Conly, JM; Johnston, BLItem Open Access Letter from the Authors(2010-01-01) Conly, John M; Johnston, BLItem Open Access Listeria: A Persistent Food-Borne Pathogen(2008-01-01) Conly, JM; Johnston, BLItem Open Access Lyme Disease: Is It or Is It Not?(2005-01-01) Johnston, BL; Conly, JMThis past summer, Lyme disease was the topic of a Focus section in the Globe and Mail (1). In this section, the reporter described her experience of having physicians unable and then unwilling to diagnose her symptoms of "skin on fire, dizziness and chest pains, twitching muscles, and trouble keeping balance" as Lyme disease following a tick bite three years previously on Prince Edward Island. She reported finding support for her diagnosis after obtaining a positive test from a California laboratory and after seeing approximately 20 physicians. In her article, she speaks to the controversy surrounding the diagnosis and treatment of Lyme disease, and the tension it creates between those who believe they have it and the physicians they see.Item Open Access Macrolide Resistance in Streptococcus pneumoniae: Fallacy or Fact?(2002-01-01) Conly, JM; Johnston, BLItem Open Access Natural Disasters, Corpses and the Risk of Infectious Diseases(2005-01-01) Conly, JM; Johnston, BLThe recent occurrence of the category 4 Hurricane Katrina devastated the United States? Gulf Coast. The hurricane caused widespread destruction and flooding, and left hundreds of thousands of people homeless. The mounting death toll was reported at almost 300 deaths as of September 8, 2005 (1,2). The unfolding events and high death toll have left an unusual situation in which there are many decomposing corpses either lying on the streets or floating in the flood waters. The presence of these corpses in open settings, such as in public places and in the water that has inundated much of the city of New Orleans, naturally raises concerns about the occurrence of infectious disease epidemics (3). In the aftermath of large natural disasters, instinctive uncertainties arise among workers and the general population with respect to the appropriate handling and disposal of dead bodies and human remains. Given the recent occurrence of Hurricane Katrina as a large natural disaster and the unprecedented setting of the numerous corpses requiring disposal, it was considered timely to review the infectious disease risks associated with the handling of dead bodies.Item Open Access Norwalk Virus -- Off and Running(2003-01-01) Conly, JM; Johnston, BLItem Open Access Ode to Oseltamivir and Amantadine?(2006-01-01) Conly, JM; Johnston, BLInfluenza A and B viruses are the two major types of influenza viruses that cause human epidemic disease. Influenza A viruses are further categorized into subtypes based on two surface antigens: hemagglutinin (H) and neuraminidase (N). Influenza B viruses are not categorized into subtypes (1). Influenza A viruses are found in many animal species, including humans, ducks, chickens, pigs, whales, horses and seals, whereas influenza B viruses circulate only among humans. The H antigen contains common and strain-specific antigens, demonstrates antigenic variation, and acts as a site of attachment of the virus to host cells to initiate infection (1). The N antigen contains subtype-specific antigens and also demonstrates antigenic variation between subtypes. It is a surface glycoprotein possessing enzymatic activity essential for viral replication in both influenza A and B viruses. The N antigen allows the release of newly produced virions from infected host cells, prevents the formation of viral aggregates after release from the host cells, and prevents viral inactivation by respiratory mucous (2,3). It is thought that this enzyme may also promote viral penetration into respiratory epithelial cells and may contribute to the pathogenicity of the virus by promoting production of proinflammatory cytokines such as interleukin-1 and tumour necrosis factor from macrophages (4-6).Item Open Access Osteomyelitis Management: More Art Than Science?(2007-01-01) Johnston, BL; Conly, JMItem Open Access Physical Plant Design and Engineering Controls to Reduce Hospital-Acquired Infections(2006-01-01) Conly, JM; Johnston, BLThe importance of the environment as a reservoir for microorganisms implicated in disease transmission in the hospital setting has been increasingly recognized, especially with respect to dialysis units, ventilation in specialized areas, and the proper use of disinfectants (1). Inherent within the environmental setting is the importance of physical plant design. Several studies have underscored the importance of optimizing design standards to maximize patient and health care worker (HCW) safety, including the prevention of hospital-acquired infections in patients (2-6). Ulrich et al (7) recently completed an evidence-based review, entitled 'The role of the physical environment in the hospital of the 21st century: A once-in-a-lifetime opportunity', for the Center for Health Design in California (USA), which was funded by the Robert Wood Johnson Foundation. Ulrich and colleagues identified over 600 studies that examined the hospital environment and its effects on staff effectiveness, patient safety, patient and family stress, quality and costs. They suggested that one of the important elements in improving patient safety is the reduction of the risk of hospital-acquired infections through improved facility design.Item Open Access Point-of-Care Testing for HIV: HIV Counselling and Testing(2002-01-01) Johnston, BL; Conly, JMItem Open Access Routine Adult Immunization in Canada: Recommendations and Performance(2002-01-01) Johnston, BL; Conly, JMItem Open Access Solid Organ Transplantation and HIV: A Changing Paradigm(2008-01-01) Johnston, BL; Conly, JMItem Open Access The Changing Face of Canadian Immigration: Implications for Infectious Diseases(2008-01-01) Johnston, BL; Conly, JMItem Open Access The Human Papillomavirus Vaccine: The Promise of Cervical Cancer Prevention(2007-01-01) Johnston, BL; Conly, JMItem Open Access The Infectious Diseases Consequences of Monkey Business(2008-01-01) Conly, JM; Johnston, BL