INTRODUCTION

Over the last 25 years, the incidence of fungal infections has increased dramatically. Predominantly a nosocomial complication, invasive fungal infections are growing in the expanding population of at-risk hospitalized patients. The greatest risk lies in the ever-increasing number of immunocompromised patients, including patients with human immunodeficiency virus (HIV) infection and those receiving chemotherapy or other immunosuppressive agents.

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Six years ago, a letter to the editor was published in The New England Journal of Medicine from a physician who suggested using metal detectors to prevent the risk of injuries from metal objects during magnetic resonance imaging (MRI). Unfortunately, his suggestion was spurred by the tragic death of a six-year-old child in New York who suffered a skull fracture and intra-cranial hemorrhage when the magnet pulled an oxygen tank into the machine at high speed.

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I Ahe Pacific Northwest Economic Region (PNWER) is a statutory public-private partnership composed of legislators, governments, and businesses in the U.S. and Canada, namely the northwestern states of Alaska, Idaho, Montana, Oregon, and Washington and the Western Canadian provinces British Columbia, Alberta, and the Yukon Territory.

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COLD-fX Pharmaceuticals (USA) Inc., based in New York, has launched COLD-fX, a dietary supplement intended to strengthen the immune system. The company is a wholly owned subsidiary of CV Technologies of Edmonton, Canada.

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Our work in drug utilization evaluation (DUE) and monitoring continues to be robust. For example, although we use the proprietary CPOE system known as “LastWord,” we continue to make specific recommendations almost monthly with respect to pharmacists’ documentation and deletion of certain warnings on drug allergies.

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In the April 2006 issue of P&T, I discussed the work of one of our key committees at Thomas Jefferson University Hospital, namely, the medication quality subcommittee of the P&T committee. As I noted then, I have had the privilege, for many years, of chairing this committee, which is staffed by senior members of our pharmacy department. Members are drawn from throughout our academic medical center.

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Among patients recommended for treatment in accordance with guidelines of the AASLD and the Asia-Pacific Association for Study of the Liver (APASL) were those who were HBeAg-positive with ALT levels at two or more times the upper limit of normal (ULN). HBeAg loss or HBeAg seroconversion (un-detectable serum HBV DNA) and virological response favored telbivudine.

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