scholarly journals Malaria Chemoprophylaxis: Strategies for Risk Groups

2008 ◽  
Vol 21 (3) ◽  
pp. 466-472 ◽  
Author(s):  
Patricia Schlagenhauf ◽  
Eskild Petersen
Keyword(s):  
Side Effects ◽  
Indigenous Population ◽  
Absolute Risk ◽  
Specific Area ◽  
Risk Groups ◽  
Risk Of Infection ◽  
Malarial Infection ◽  
The Best Approximation ◽  
Populations At Risk

SUMMARY The risk of malaria for travelers varies from region to region and depends on the intensity of transmission, the duration of the stay in the area of endemicity, the style of travel, and the efficacy of preventive measures. The decision to recommend chemoprophylaxis to travelers to areas with a low risk of malarial infection is especially difficult because the risk of infection must be balanced with the risk of experiencing side effects. If the risk of side effects by far exceeds the risk of infection, the traveler needs information on measures against mosquito bites and advice on prompt diagnosis and self-treatment. The risk is difficult to quantify, and the absolute risk for travelers to most areas is not known, especially because the populations at risk are unknown. We propose here that the best approximation of the risk to the traveler to a specific area is to use the risk to the indigenous population as a guideline for the risk to the traveler, and we provide examples on how risk in the indigenous population can be used for the estimation of risk of malarial infection for travelers. Special groups are long-term visitors and residents, who often perceive risk differently, cease using chemoprophylaxis, and rely on self-diagnosis and treatment. For long-term visitors, the problem of fake drugs needs to be discussed. Strategies for chemoprophylaxis and self-treatment of pregnant women and small children are discussed. So far, malaria prophylaxis is recommended to prevent Plasmodium falciparum infections, and primaquine prophylaxis against persistent Plasmodium vivax and Plasmodium ovale infections in travelers is not recommended.

scholarly journals Do Face Masks Increase the Rate of Staphylococcus Aureus Infection as Secondary Infection during Covid-19?

2021 ◽  
Vol 8 (2) ◽  
pp. 01-04
Author(s):  
Mahdi Bozorgnia
Keyword(s):  
Staphylococcus Aureus ◽  
Side Effects ◽  
Bacterial Infection ◽  
Secondary Infection ◽  
Viral Diseases ◽  
Protective Device ◽  
Risk Of Infection ◽  
Bacterial Diseases ◽  
Aureus Infection

Nowadays due to the coronavirus disease 2019 (COVID-19) and to save our lives, we have to use masks in a wider range. Since masks are now considered a protective device to prevent some bacterial or viral diseases, especially COVID-19, and the advice is that we should use them to save our lives and the lives of others. It is true that masks have many benefits, but maybe they are also harmful. It seems that is possible in long- term masking, itself cause side effects or even other diseases. Therefore, since masks are now more widely used, its advantages and even disadvantages are important to us. We think, maybe there are harms that may cause other bacterial diseases as secondary bacterial infection that may be confused with COVID-19 because they may have similar symptoms or may increase the severity of it. In this article, we review Staphylococcus Aureus that may be exacerbate or cause infectious diseases and increase the risk of infection. We may be able to prevent them with some recommendations.

scholarly journals Long-term maintenance rituximab for ANCA-associated vasculitis: relapse and infection prediction models

Rheumatology ◽  
2020 ◽  
Author(s):  
Mark E McClure ◽  
Yajing Zhu ◽  
Rona M Smith ◽  
Seerapani Gopaluni ◽  
Joanna Tieu ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Prediction ◽  
Prediction Models ◽  
Risk Groups ◽  
Risk Of Infection ◽  
Risk Prediction Models ◽  
Anca Associated Vasculitis ◽  
Term Maintenance

Abstract Objectives Following a maintenance course of rituximab (RTX) for ANCA-associated vasculitis (AAV), relapses occur on cessation of therapy, and further dosing is considered. This study aimed to develop relapse and infection risk prediction models to help guide decision making regarding extended RTX maintenance therapy. Methods Patients with a diagnosis of AAV who received 4–8 grams of RTX as maintenance treatment between 2002 and 2018 were included. Both induction and maintenance doses were included; most patients received standard departmental protocol consisting of 2× 1000 mg 2 weeks apart, followed by 1000 mg every 6 months for 2 years. Patients who continued on repeat RTX dosing long-term were excluded. Separate risk prediction models were derived for the outcomes of relapse and infection. Results A total of 147 patients were included in this study with a median follow-up of 63 months [interquartile range (IQR): 34–93]. Relapse: At time of last RTX, the model comprised seven predictors, with a corresponding C-index of 0.54. Discrimination between individuals using this model was not possible; however, discrimination could be achieved by grouping patients into low- and high-risk groups. When the model was applied 12 months post last RTX, the ability to discriminate relapse risk between individuals improved (C-index 0.65), and once again, clear discrimination was observed between patients from low- and high-risk groups. Infection: At time of last RTX, five predictors were retained in the model. The C-index was 0.64 allowing discrimination between low and high risk of infection groups. At 12 months post RTX, the C-index for the model was 0.63. Again, clear separation of patients from two risk groups was observed. Conclusion While our models had insufficient power to discriminate risk between individual patients they were able to assign patients into risk groups for both relapse and infection. The ability to identify risk groups may help in decisions regarding the potential benefit of ongoing RTX treatment. However, we caution the use of these prediction models until prospective multi-centre validation studies have been performed.

Cutaneous ulcers following hydroxyurea therapy

Phlebologie ◽  
2004 ◽  
Vol 33 (06) ◽  
pp. 202-205 ◽  
Author(s):  
K. Hartmann ◽  
S. Nagel ◽  
T. Erichsen ◽  
E. Rabe ◽  
K. H. Grips ◽  
...  
Keyword(s):  
Side Effects ◽  
Side Effect ◽  
Antineoplastic Agent ◽  
Limited Time ◽  
Myeloproliferative Diseases ◽  
Dermatological Side Effects ◽  
Chronic Myeloproliferative Diseases ◽  
Hydroxyurea Therapy

SummaryHydroxyurea (HU) is usually a well tolerated antineoplastic agent and is commonly used in the treatment of chronic myeloproliferative diseases. Dermatological side effects are frequently seen in patients receiving longterm HU therapy. Cutaneous ulcers have been reported occasionally.We report on four patients with cutaneous ulcers whilst on long-term hydroxyurea therapy for myeloproliferative diseases. In all patients we were able to reduce the dose, or stop HU altogether and their ulcers markedly improved. Our observations suggest that cutaneous ulcers should be considered as possible side effect of long-term HU therapy and healing of the ulcers can be achieved not only by cessation of the HU treatment, but also by reducing the dose of hydroxyurea for a limited time.

Long-term side effects following pneumonectomy: A case report and review of the literature

2019 ◽  
Author(s):  
BA Högerle ◽  
EL Bulut ◽  
L Klotz ◽  
F Eichhorn ◽  
M Eichhorn ◽  
...  
Keyword(s):  
Case Report ◽  
Side Effects ◽  
Review Of The Literature

ANALYSIS OF ABDOMINAL TYPHOID INCIDENCE IN THE SOUTH REGION OF THE KYRGYZ REPUBLIC

2020 ◽  
pp. 43-48
Author(s):  
Zakirova J.S. ◽  
Nadirbekova R.A. ◽  
Zholdoshev S.T.
Keyword(s):  
Drinking Water ◽  
Typhoid Fever ◽  
Risk Groups ◽  
The Body ◽  
Kyrgyz Republic ◽  
Radiation Factor ◽  
High Quality ◽  
Two Generations ◽  
Immunological Deficiency

The article analyze the long-term morbidity, spread of typhoid fever in the southern regions of the Kyrgyz republic, and remains a permanent epidemic focus in the Jalal-Abad region, where against the low availability of the population to high-quality drinking water, an additional factor on the body for more than two generations and radiation factor, which we confirmed by the spread among the inhabitants of Mailuu-Suu of nosological forms of the syndrome of immunological deficiency, as a predictor of risk groups for infectious diseases, including typhoid fever.

Long-Term Follow-Up of Early Cochlear Implant Device Activation

2021 ◽  
pp. 1-11
Author(s):  
Stefanie Bruschke ◽  
Uwe Baumann ◽  
Timo Stöver
Keyword(s):  
Speech Recognition ◽  
Side Effects ◽  
Cochlear Implant ◽  
Surgical Techniques ◽  
Control Group ◽  
First Year ◽  
Safe Procedure ◽  
Sound Processor

Background: The cochlear implant (CI) is a standard procedure for the treatment of patients with severe to profound hearing loss. In the past, a standard healing period of 3–6 weeks occurred after CI surgery before the sound processor was initially activated. Advancements of surgical techniques and instruments allow an earlier initial activation of the processor within 14 days after surgery. Objective: Evaluation of the early CI device activation after CI surgery within 14 days, comparison to the first activation after 4–6 weeks, and assessment of the feasibility and safety of the early fitting over a 12 month observation period were the objectives of this study. Method: In a prospective study, 127 patients scheduled for CI surgery were divided into early fitting group (EF, n = 67) and control group (CG, n = 60). Individual questionnaires were used to evaluate medical and technical outcomes of the EF. Medical side effects, speech recognition, and follow-up effort were compared with the CG within the first year after CI surgery. Results: The early fitting was feasible in 97% of the EF patients. In the EF, the processor was activated 25 days earlier than in the CG. No major complications were observed in either group. At the follow-up appointments, side effects such as pain and balance problems occurred with comparable frequency in both groups. At initial fitting, the EF showed a significantly higher incidence of medical minor complications (p < 0.05). When developing speech recognition within the first year of CI use, no difference was observed. Furthermore, the follow-up effort within the first year after CI surgery was comparable in both groups. Conclusions: Early fitting of the sound processor is a feasible and safe procedure with comparable follow-up effort. Although more early minor complications were observed in the EF, there were no long-term wound healing problems caused by the early fitting. Regular inspection of the magnet strength is recommended as part of the CI follow-up since postoperative wound swelling must be expected. The early fitting procedure enabled a clear reduction in the waiting time between CI surgery and initial sound processor activation.

scholarly journals Rituximab-Containing Risk-Adapted Treatment Strategy in Nodular Lymphocyte Predominant Hodgkin Lymphoma: 7-Years Follow-Up

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1760
Author(s):  
Novella Pugliese ◽  
Marco Picardi ◽  
Roberta Della Pepa ◽  
Claudia Giordano ◽  
Francesco Muriano ◽  
...  
Keyword(s):  
Side Effects ◽  
Hodgkin Lymphoma ◽  
Prognostic Score ◽  
Single Agent ◽  
Response To Therapy ◽  
Baseline Risk ◽  
Historical Cohort ◽  
Treatment Groups

Background: Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a rare variant of HL that accounts for 5% of all HL cases. The expression of CD20 on neoplastic lymphocytes provides a suitable target for novel treatments based on Rituximab. Due to its rarity, consolidated and widely accepted treatment guidelines are still lacking for this disease. Methods: Between 1 December 2007 and 28 February 2018, sixteen consecutive newly diagnosed adult patients with NLPHL received Rituximab (induction ± maintenance)-based therapy, according to the baseline risk of German Hodgkin Study Group prognostic score system. The treatment efficacy and safety of the Rituximab-group were compared to those of a historical cohort of 12 patients with NLPHL who received Doxorubicin, Bleomycin, Vinblastine, Dacarbazine (ABVD) chemotherapy followed by radiotherapy (RT), if needed, according to a similar baseline risk. The primary outcome was progression-free survival (PFS) and secondary outcomes were overall survival (OS) and side-effects (according to the Common Terminology Criteria for Adverse Events, v4.03). Results: After a 7-year follow-up (range, 1–11 years), PFS was 100% for patients treated with the Rituximab-containing regimen versus 66% for patients of the historical cohort (p = 0.036). Four patients in the latter group showed insufficient response to therapy. The PFS for early favorable and early unfavorable NLPHLs was similar between treatment groups, while a better PFS was recorded for advanced-stages treated with the Rituximab-containing regimen. The OS was similar for the two treatment groups. Short- and long-term side-effects were more frequently observed in the historical cohort. Grade ≥3 neutropenia was more frequent in the historical cohort compared with the Rituximab-group (58.3% vs. 18.7%, respectively; p = 0.03). Long-term non-hematological toxicities were observed more frequently in the historical cohort. Conclusion: Our results confirm the value of Rituximab in NLPHL therapy and show that Rituximab (single-agent) induction and maintenance in a limited-stage, or Rituximab with ABVD only in the presence of risk factors, give excellent results while sparing cytotoxic agent- and/or RT-related damage. Furthermore, Rituximab inclusion in advanced-stage therapeutic strategy seems to improve PFS compared to conventional chemo-radiotherapy.

Physiological Pacing: A New Road to Future

2021 ◽  
pp. 263246362097804
Author(s):  
Vanita Arora ◽  
Pawan Suri
Keyword(s):  
Side Effects ◽  
Fibrous Tissue ◽  
Cardiac Pacing ◽  
His Bundle ◽  
Anatomy And Physiology ◽  
Long Term Follow Up ◽  
Pacing Lead ◽  
The Right

Anatomy and physiology are the basis of human body functioning and as we have progressed in management of various diseases, we have understood that physiological intervention is always better than an anatomical one. For more than 50 years, a standard approach to permanent cardiac pacing has been an anatomical placement of transvenous pacing lead at the right ventricular apex with a proven benefit of restoring the rhythm. However, the resultant ventricular dyssynchrony on the long-term follow-up in patients requiring more than 40% ventricular pacing led to untoward side effects in the form of heart failure and arrhythmias. To counter such adverse side effects, a need for physiological cardiac pacing wherein the electrical impulse be transmitted directly through the normal conduction system was sought. His bundle pacing (HBP) with an intriguing alternative of left bundle branch pacing (LBBP) is aimed at restoring such physiological activation of ventricles. HBP is safe, efficacious, and feasible; however, localization and placement of a pacing lead at the His bundle is challenging with existing transvenous systems due to its small anatomic size, surrounding fibrous tissue, long-learning curve, and the concern remains about lead dislodgement and progressive electrical block distal to the HBP lead. In this article, we aim to take the reader through the challenging journey of HBP with focus upon the hardware and technique, selective versus nonselective HBP, indications and potential disadvantages, and finally the future prospects.

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