Hep. C transmission by tears.

Hepatitis C and ocular surface disease. AU Jacobi C, Wenkel H, Jacobi A, Korn K, Cursiefen C, Kruse FE SO Am J Ophthalmol. 2007;144(5):705. PURPOSE: To assess the frequency of changes in the ocular surface and the presence of hepatitis C virus (HCV) in tear samples of patients with chronic HCV infection. DESIGN: Prospective, nonrandomized, clinical, interdisciplinary, single-center study. METHODS: Seventy-one patients with previously untreated chronic HCV infection and a control group consisting of 66 patients without systemic HCV infection were enrolled in the trial. The patients with HCV infection were screened for ocular symptoms, visual acuity, and ocular changes. Tear production was measured by the Jones test. Conjunctival impression cytologic analysis was performed. The presence of HCV ribonucleic acid (RNA) in tear and blood samples was determined by quantitative polymerase chain reaction. RESULTS: On examination, systemic HCV infection was present for a median of 30 months. Fifty percent of all HCV patients showed a decrease in tear production measured by the Jones test. Apart from epithelial changes related to dry eye syndrome in 12 patients,two patients presented mild peripheral corneal thinning. Polymerase chain reaction analysis detected HCV RNA in five (10%) of 52 tear samples. HCV RNA levels in tear samples (mean, 1.0 x 10(4) copies/ml) were considerably lower than in blood samples (mean, 5.3 x 10(5) copies/ml). CONCLUSIONS: Dry eye syndrome is the most frequently observed ocular feature in HCV infection. Patients with HCV infection (age range, 21 to 60 years) compared with the controls had a significant lower tear production (P = .05). The presence of HCV RNA in 10% of tear samples emphasizes the potential risk of viral transmission through tears. AD Department of Ophthalmology, University of Erlangen, Erlangen, Germany. christina.jacobi@augen.imed.uni-erlangen.de PMID 17870047

UTRECHT Univ. Hospital: Prof HENK LOKHORST on DARATUMUMAB for Multiple Myeloma

http://myeloma.org/ArticlePage.action?tabId=0&menuId=0&articleId=4118&aTab=-4 VIDEO of Prof LOKHORST on DARATUMUMAB trials.

ProMED:OBITUARY Dr. J.H.STEELE DVM(Mich.) MPH(Harvard)

OBITUARY: JAMES HARLAN STEELE ***************************** A ProMED-mail post ProMED-mail is a program of the International Society for Infectious Diseases Date: 11 Nov 2013 From: Peter Cowan, ProMED-mail Animal Disease Assistant Moderator Yesterday [10 Nov 2013], we all witnessed the exit of a lion. Over his 100-year-plus lifespan, James Harlan Steele was a true pioneer in Public Health and the rebirth of One Health. He was tenacious in his quest to enlarge the role of veterinary medicine in public health, emboldened by the conviction that any avenue that can benefit the health and well-being of people leads to a more progressive, rational and fair state of affairs for his community, country, and the world. Steele set the direction, found the resources, selected and cultivated enough talented people to achieve his dream of One Health, which was manifested as the establishment of vital veterinary public health infrastructure at the state, national, and international levels. He literally built the 1st of many veterinary public health programs in the United States and the world beginning at CDC in 1946. Dr. Steele was a systems thinker, a strategic analyst, and a magnet for bright, young talented veterinarians, physicians, and other health professionals. He took the idea of One Health and implemented it, building a framework for programs such as rabies control, which could showcase what One Health, 1st named by Steele as Veterinary Public Health, could do. Dr. Steele received a doctorate of veterinary medicine from Michigan State University in 1941 and an MPH from Harvard University in 1942. Until yesterday [10 Nov 2013], he was the oldest living graduate of the Harvard School of Public Health. He founded and named the 1st Veterinary Public Health program at CDC and within the United States Public Health Service where he served for many years. Early on, Jim worked closely with Alex Langmuir and was so critical to the implementation and growth of CDC's EIS training program through the 1950s and 1960s that he was inducted as an honorary EIS member in 1976. He served as Assistant Surgeon General for Veterinary Affairs and the 1st Chief Veterinary Officer of the USPHS. He played a critical part at the 1st meeting of the Veterinary Public Health Expert Committee on Zoonosis at WHO. He played an inspirational role in the development of several European Veterinary Public Health Services, particularly in West Germany. Professor Steele was the Editor in Chief of the CRC Handbook of Zoonoses series and a consultant to the Control of Communicable Disease Manual for decades. These accomplishments are only a brief mention of his activities and barely scratch the surface of his impact both nationally and internationally. Jim's honors and awards are almost too numerous to count. In 1971, he joined the University of Texas School of Public Health's Infectious Disease Center, where he served as Professor until his 80th birthday. He then went into "retirement," which consisted of a whirlwind of writing, editing, consulting, and mentoring that would dwarf the output of many younger people. He was incredibly sharp and active right up to the end, engaging at over 100 years of age in an update of his work on tuberculosis, a short history of One Health, and planning for a special symposium entitled the James H. Steele Challenge: A better world through One Health. His video speech last July [2013] to the American Veterinary Medical Association's 150th anniversary was an inspiration, not solely because he had lived through 2/3rds of the existence of that professional organization dating back to the U.S. Civil War, but because of the forwardness of the thoughts in his speech. To have a vision to hand over to others at age 100 is truly remarkable. Jim loved to tell stories related to the history and purpose of Veterinary Public Health. He recalled this experience many times to many of us: "In 1945, at the end of WW II, Joseph Mountin, a physician and chief of the USPHS's Bureau of State Services, met with him to discuss the global origin and importance of zoonotic diseases. He challenged Steele by saying: "What are you veterinarians going to do for public health now that the war is over?" Jim Steele's response was vital to the future of veterinary public health and the rest of his career. Eventually, he suggested the creation of a program within USPHS that would work on zoonotic diseases. He looked down the hall and saw Dental Public Health and Public Health Nursing and decided Veterinary Public Health would do just fine. He further recommended the establishment of a corps of veterinary officers within the USPHS so that veterinarians who became Commissioned Corps members would have a place in the structure. Craig Carter, at the University of Kentucky, has written a very nice biography entitled One Man, One Medicine, One Health: The James H. Steele story. Over his career, Jim had big megaphones at CDC, WHO, USDA, PAHO, APHA and AVMA, which he used to advocate for acceptance of the idea of One Health. He developed programs which served as models the world over and that proved that good animal health meant good human health, which, in turn, translates to good economic health. Steele played a seminal role in the rebirth of the idea of One Health. His efforts finally flowered in full bloom in the 1st decade of the 21st century, embodied by the wide acceptance of One Health and activities worldwide in response to HPAI H5N1 and other emerging disease threats. Notwithstanding his gargantuan accomplishments and his photographic memory, Jim's singular quality was mentoring. He loved people, especially young people, and for the last 2 decades of his life, everyone was young to Jim. He loved to work with people, and so very many of them became friends. He was an optimist with a sense of humor, and the jokes he made on the occasion of his 100th birthday were too rich to repeat here. He had charisma to the maximum extent, but he was also a hard driving realist who knew how to fund and build programs the world over. He was never too busy, and he truly knew how to listen. Whether the problem was epidemiological or personal, Jim would provide sound advice, oftentimes guiding his mentees towards their own solutions. Jim loved to think and do; he loved to listen and comfort. The list of Jim's "students" included not only those for whom he had acted as a professor at the University of Texas School of Public Health but also so many individuals at CDC and the United States Public Health Service as well as veterinary colleges and the United States Department of Agriculture. The width of the swath cut by Jim's mentees was truly impressive. Bill Foege, the former director of CDC, said at Jim's 90th annual birthday lecture that Jim's seminal contribution was that the health of humans and the health of animals are inseparable. This premise was Jim's greatest gift and allowed us to develop a more rational public health future, because you cannot consider the health of people without considering the health of animals. Dr. Foege finished Jim's 90th birthday address with the following paragraph, which bears repeating now: "And so our tribute to a long life well lived as a generalist, specialist, globalist, futurist, moralist, optimist, and gift giver is mixed with gratitude, gratefulness, and the anticipation of the next decade being the best ever. On behalf of countless generations, yet unborn, we say: Thank you Jim, for this greatest gift." Yes, a lion has roared, and we are all the better for it. -- Peter Cowen ProMED-mail Animal Disease Assistant Moderator