Legal, financial, and public health consequences of HIV contamination of blood and blood products in the 1980s and 1990s

Ensuring the safety of the blood supply connects politics and science. The business and service sectors share responsibility for the collection and processing of blood donations, and government agencies perform regulatory and surveillance roles. The onset of the AIDS epidemic has challenged the interface among these systems, leading to widespread fears about compromised safety of the blood supply. Because of public concern about blood-supply decisions made in the 1980s, developed countries in the 1990s established reimbursement programs for persons with transfusion-acquired viral infections from blood or blood products, adopted diagnostic tests and procedures that improved the safety of the blood supply, and held criminal judicial investigations of government officials and industry leaders accused of delaying implementation of potential blood-safety measures. In contrast, developing countries continue to struggle with blood-supply safety issues. This paper summarizes the current status of these safety concerns in developed countries, where viral transmission from contaminated blood or blood products is extremely rare, and in developing countries, where up to 10% of HIV infections result from transfusion of blood or blood products.     

Adjacent QT dispersion: A good predictor of ventricular arrhythmias after myocardial infarction

The 12-lead surface electrocardiogram adjacent QTc dispersion, which is the maximum difference of corrected QT interval between two adjacent leads, is a simple method to determine regional variation in repolarization and refractoriness. The aim of this study is to evaluate adjacent QTc dispersion as a marker of susceptibility to ventricular arrhythmias after myocardial infarction. A total of 135 consecutive patients with acute myocardial infarction were enrolled in the study. Adjacent QTc, measured by lens magnifier, was calculated on the first, second and third days after acute myocardial infarction. On the second day after acute myocardial infarction, adjacent QTc dispersion was significantly greater in patients with ventricular arrhythmias (P < 0.001). Adjacent QTc dispersion on the first and fifth day after acute myocardial infarction was not associated with development of ventricular arrhythmias. On the second day after acute myocardial infarction, adjacent QTc dispersion is a simple and feasible method for prediction of ventricular arrhythmias.     

A single dose of self-transcribing and replicating RNA-based SARS-CoV-2 vaccine produces protective adaptive immunity in mice

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Erythromycin base-induced rash and liver function disturbances.

OBJECTIVE: To report a case of erythromycin base-induced rash and liver function disturbances. CASE SUMMARY: A patient with erythema nodosum and high antistreptolysin-O titers was treated with erythromycin on the assumption that occult streptococcal infection was the cause of the erythema nodosum. Forty-eight hours after the initiation of therapy the patient developed fever, severe generalized rash, pruritus, and cholestatic and hepatocellular liver function disturbances. Extensive evaluation to determine the cause of liver function disturbances was unrevealing. Marked improvement was noticed within days after cessation of erythromycin. DISCUSSION: Case reports in the literature on the adverse effects of erythromycin and its derivatives were reviewed. The possible immunologic mechanism involved is postulated. CONCLUSIONS: Erythromycin base must be added to the list of erythromycin derivatives that can cause rash and liver function disturbances. The concomitant appearance of fever, rash, jaundice, and liver function disturbances raises the possibility of hypersensitivity as the mechanism for the liver disturbances.