Wednesday, May 30, 2007

Extensively Drug-Resistant Tuberculosis (XDR TB) PODCAST

Emergence of Extensively Drug Resistant Tuberculosis - PODCAST. Extensively drug-resistant tuberculosis (XDR TB) outbreaks have been reported in South Africa, and strains have been identified on 6 continents. Dr. Peter Cegielski, team leader for drug-resistant TB with the Division of Tuberculosis Elimination at CDC, comments on a multinational team's report on this emerging global public health threat.

M. tuberculosis bacteria  CDC/Ronald W. SmithwickHere we see Mycobacterium tuberculosis in a sputum smear is stained using fluorescent acid-fast stain.
M. tuberculosis is an acid-fast bacterium (AFB), and is therefore, undetectable when stained using a Gram stain technique.
However, using this method, the M. tuberculosis bacteria glow yellow under ultraviolet light microscopy.
Photomicrograph of a sputum sample containing Mycobacterium tuberculosis. M. tuberculosis bacteria can attack any part of the body, but usually the lungs causing Tuberculosis. It is spread when infected individuals cough or sneeze, releasing microdroplets into the air that contain the bacteria, which others then inhale.M. tuberculosis bacteria. CDC
CDC, A photomicrograph of Mycobacterium tuberculosis bacteria from a sputum specimen, and viewed with Ziehl-Neelsen stain.Extensively drug-resistant tuberculosis (XDR TB) is a relatively rare type of multidrug-resistant tuberculosis (MDR TB). It is resistant to almost all drugs used to treat TB, including the two best first-line drugs: isoniazid and rifampin. XDR TB is also resistant to the best second-line medications: fluoroquinolones and at least one of three injectable drugs (i.e., amikacin, kanamycin, or capreomycin).
Because XDR TB is resistant to the most powerful first-line and second-line drugs, patients are left with treatment options that are much less effective and often have worse treatment outcomes.

XDR TB is of special concern for persons with HIV infection or other conditions that can weaken the immune system. These persons are more likely to develop TB disease once they are infected, and also have a higher risk of death once they develop TB disease.

The risk of acquiring XDR TB in the United States appears to be relatively low. However, it is important to acknowledge the ease at which TB can spread. As long as XDR TB exists, the United States is at risk and must address the threat. Morbidity rate 70%

Investigation of U.S. Traveler with Extensively Drug–Resistant Tuberculosis (XDR TB) Fact Sheets Morbidity and Mortality Weekly Reports (MMWRs) Technorati Tags: and or and and or

Tuesday, May 29, 2007

President Ronald Reagan The Moscow Summit 05/29/88

President Reagan and Soviet General Secretary Gorbachev in Red Square during the Moscow Summit. 5/31/88. Courtesy Ronald Reagan LibraryOn January 15, 1988, President Ronald Reagan directed the Secretary of Defense to establish the On-Site Inspection Agency (OSIA). Its mission was to carry out the on-site inspection and escort responsibilities of the United States under the provisions of the Intermediate Range Nuclear Forces (INF) Treaty.

Signed on December 8, 1987, by President Reagan and Soviet General Secretary Mikhail Gorbachev, the INF Treaty enjoined the two countries to eliminate all ground-launched missiles (approximately 2,700 missiles) with ranges between 500 and 5,500 kilometers.
National teams of inspectors would monitor and report on the elimination of these missile systems and other significant provisions of the treaty. The INF Treaty was ratified by the U.S. Senate and the USSR's Supreme Soviet in the spring of 1988, and the instruments of ratification were exchanged at the Reagan-Gorbachev Moscow Summit of June 1, 1988.C47449-17, President Reagan and Soviet General Secretary Gorbachev signing the INF treaty ratification at the Grand Kremlin palace during the Moscow Summit. 6/1/88. Courtesy Ronald Reagan Library
C47276-4A, President Reagan and Nancy Reagan greeting Moscow citizens on Arbat Street during the Moscow Summit.5/29/88. Courtesy Ronald Reagan LibraryExactly 30 days later the first phase of the treaty began. On-site inspections were a major component of this and all subsequent phases of the treaty. They had immediate significance, both as a barometer for measuring adherence to the treaty and as a precedent for entering into future arms control treaties and agreements.
In negotiating arms control treaties with the Soviet Union, the United States had proposed on-site inspections as a part of treaty verification for more than 30 years. However, until the late 1980s few treaties or agreements had included the provision.C47450-20, President Reagan and Soviet General Secretary Gorbachev shake hands after signing the INF Treaty ratification in the Grand Kremlin Palace during the Moscow Summit. 6/1/88. Courtesy Ronald Reagan Library
One, the Stockholm Document of September 1986, was a multilateral arms control agreement signed by the United States, the Soviet Union, and 33 European nations.

It went into effect on January 1, 1987, and permitted on-site challenge inspections by small, four-person teams of military officers of large-scale, scheduled military exercises. If a military force of more than 17,000 took part in an exercise, the participating states had to provide notification 42 days in advance and issue an invitation to all of the signatories to send an on-site inspection team to observe the exercise.

There was no right of refusal. However, the agreement limited nations that were not members of the same alliance (i.e., NATO or the Warsaw Pact) to a single challenge inspection each per year. This provision limited the number of inspections. In 1987, the first full year of the Stockholm Document, there were only five on-site challenge inspections. The United States conducted a single on-site inspection under the agreement in l987. On-Site Inspections Under the Intermediate-range Nuclear Forces Treaty

Speak the Truth about Democratic Erosion in Russia. Just weeks before assuming her responsibilities as National Security Adviser in 2000, Condoleezza Rice wrote about the deleterious consequences of not speaking honestly about Russia’s internal problems: “The United States should not be faulted for trying to help. But, as the Russian reformer Grigori Yavlinsky has said, the United States should have ‘told the truth’ about what was happening [inside his country].”

She then attacked “the ‘happy talk’ in which the Clinton administration engaged.” Dr. Rice’s message is even truer today. The aim of speaking the truth is not to lecture Putin or try to persuade him to change his ways, but rather to demonstrate solidarity with Russian human rights and democracy activists.

Direct personal engagement of Russian democratic activists also matters. When Ronald Reagan traveled to the Soviet Union in May 1988, he discussed arms control and regional conflicts with Soviet leader Mikhail Gorbachev. Yet, Reagan did not let his friendship and cooperation with Gorbachev overshadowed his other agenda while in town – human rights. Speaking in Helsinki the day before entering the Soviet Union for the first time, Reagan proclaimed that “There is no true international security without respect for human rights…

The greatest creative and moral force in this world, the greatest hope for survival and success, for peace and happiness, is human freedom.” During his stay in the Soviet capital, Reagan echoed this theme in action and words many times, whether in his speech to students at Moscow State University or in a luncheon with nearly a hundred human rights activists at the American ambassador’s residence. Reagan did not simply show up for a photo op with these enemies of the Soviet dictatorship.

He ordered that the ambassador’s finest silverware and linens be used to accord these human rights activists the same respect that he showed for his Soviet counterpart. American officials must again adopt a similar strategy of using meetings with Russian democratic and human rights activists to help elevate attention to their cause and help prevent these brave people from further harassment from the Russian government. Russia: Rebuilding the Iron Curtain

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