A prominent theme in this month’s issue is that of the importance of the development and dissemination of guidelines. In a health in action paper Holger Schunemann and colleagues describe the development and pilot testing of a systematic and transparent approach by WHO to develop rapid advice guidelines about the pharmacological management of H5N1 avian influenza infection; the editorial comments on this paper and the new revision of the International Health Regulations. Incidentally, the WHO paper has an unprecedented number of translations also available – 17 in total, in languages ranging from German to Laos. This is the highest number of translations we have seen for a single article since we started encouraging them; sadly we don’t have any for the editorial yet – if anyone feels moved to translate it themselves, under our license they are of course free to do so. The dissemination and development of guidelines also comes up in another health in action article from Italy which discusses the Italian Drug Agency’s effort to ensure that physicians have access to reliable independent evidence on drug effectiveness and safety. Another paper by Geoffrey Lomax and colleagues discusses the principles that guided the medical and ethical standards of the California Institute for Regenerative Medicine, which recently received $3 billion over 10 years in public funding of stem cell research. Guidelines are also important in the promotion of diseases that can tend to be overlooked; in an essay Peter Barnes discusses one such disease, COPD.
Two articles point out practical issues in delivering health care. One, from a group of authors at Médecins Sans Frontières graphically describes the difficulty of providing HIV care in conflict settings. One important factor, for HIV infected patients as well as many others, is nutrition, a topic further discussed by Ulrich Schaible and Stefan Kaufmann in their research in translation article on malnutrition and infection.
HIV and other infections are prominent topics in the research articles this month. Three articles explore various aspects of HIV and AIDS: the role of HIV in phagocytic clearance of pregnancy-associated malaria parasites; cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti; and the depletion of memory CD4+ T Cells in HIV infection.
Reflecting the intense current research interest in influenza – as discussed in the WHO guidelines paper – this topic comes up in two papers, one on the modeling of vaccination strategies and a second on the development of human monoclonal antibodies against H5N1 influenza.
Other research papers reflect the breath of papers submitted to us. Endocrinology is represented by three papers: how childhood conditions may influence adult progesterone levels, and what the implications are of that for age at menarche and ovarian function; the role of muscle mitochondrial ATP Synthesis and glucose transport and phosphorylation in type 2 diabetes; and TXNIP as a marker and regulator of peripheral glucose homeostasis.
Other papers document clinically relevant relationships: one on an important interaction of traditional non-steroidal anti-inflammatory drugs and postmenopausal hormone therapy; another on how the potentially deleterious consequences of 100% oxygen therapy can be mitigated by the addition of 5% CO2.
Neurology is the subject of two papers: one on an association of Human Herpesvirus-6B with Mesial Temporal Lobe Epilepsy; another on lithium as a potential therapy for Spinocerebellar Ataxia Type 1, tested in a mouse model of that disease.
Finally, two oncology papers tackle topics of great clinical importance: the first suggests that one particular isoform of the transcription factor AML1 can potentiate stem and progenitor cell engraftment after bone marrow transplantation; the second paper looks at the role of the interferon signaling pathway in T Lymphocytes from patients with metastatic melanoma.