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Infectious Diseases (infectious + diseases)
Kinds of Infectious Diseases Terms modified by Infectious Diseases Selected AbstractsEVIDENCE-BASED PEDIATRIC INFECTIOUS DISEASES (pbk)JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 1-2 2009Professor Keith Grimwood No abstract is available for this article. [source] INFECTIOUS DISEASES, SECURITY AND ETHICS: THE CASE OF HIV/AIDSBIOETHICS, Issue 9 2008MICHAEL J. SELGELID ABSTRACT Securitization of infectious diseases may involve suspension of ordinary human rights and liberties. In the event of an epidemic, therefore, it is important to limit the occasions upon which draconian disease control measures are implemented in the name of security. The term ,security', moreover, should not be used too loosely if it is to retain force and meaning in political discourse. It may be argued that the bar for disease securitization should be set high so that it is limited to contexts involving rapidly spreading pathogens. Such an approach, however, would rule out securitization of more slowly spreading, endemic diseases such as HIV/AIDS. An advantage of characterizing HIV/AIDS as a security threat in developing countries, where the burden of the disease is concentrated, is that this is likely to mobilize resources needed to improve the situation there. That is, if HIV/AIDS is convincingly framed as a security threat, then governments may recognize self-interested reasons to ramp up control measures. Following consideration of arguments for narrow (excluding HIV/AIDS) versus broad (including HIV/AIDS) conceptions of security, we conclude that the legitimacy of ,securitizing' HIV/AIDS ultimately turns on empirical and semantic issues, and we emphasize the importance of distinguishing (1) the nature of the threat posed by HIV/AIDS and (2) the measures required to address that threat. [source] Are there Characteristics of Infectious Diseases that Raise Special Ethical Issues?1DEVELOPING WORLD BIOETHICS, Issue 1 2004Charles B. Smith ABSTRACT This paper examines the characteristics of infectious diseases that raise special medical and social ethical issues, and explores ways of integrating both current bioethical and classical public health ethics concerns. Many of the ethical issues raised by infectious diseases are related to these diseases' powerful ability to engender fear in individuals and panic in populations. We address the association of some infectious diseases with high morbidity and mortality rates, the sense that infectious diseases are caused by invasion or attack on humans by foreign micro-organisms, the acute onset and rapid course of many infectious diseases, and, in particular, the communicability of infectious diseases. The individual fear and community panic associated with infectious diseases often leads to rapid, emotionally driven decision making about public health policies needed to protect the community that may be in conflict with current bioethical principles regarding the care of individual patients. The discussion includes recent examples where dialogue between public health practitioners and medical-ethicists has helped resolve ethical issues that require us to consider the infected patient as both a victim with individual needs and rights and as a potential vector of disease that is of concern to the community. [source] International Organizations in Transfer of Infectious Diseases: Iterative Loops of Adoption, Adaptation, and MarketingGOVERNANCE, Issue 2 2004Gill Walt Over the past few years increasing attention has been given to the role of international organizations in the diffusion of policy ideas and promotion of particular macro-level policies. Much of the attention has been on the ideological driving forces behind such policies, and on the extent to which the policies are externally imposed. There has been limited discussion on the bread-and-butter, technical policies of international organizations, and how they devise, adopt, adapt, and then promote what come to be seen as policies of global "best practice." This paper seeks to redress this gap by looking at the process of transfer of two infectious disease policies between international and national levels. It demonstrates that international organizations play different roles in policy transfer at particular stages in the process. The paper suggests that health policy transfer is a long adaptive process, made up of several iterative loops, as research and clinical practices developed in one or more countries are adopted, adapted, and taken up by international organizations which then mobilize support for particular policies, market, and promote them. Assumptions that new ideas about policies flow "rationally" into existing decision making are challenged by the processes analyzed here. Policy transfer, given the experience of these infectious diseases policies, goes through separate, "bottom-up," research-oriented, and "top-down" marketing-oriented loops. Individuals and different configurations of networks play key roles linking these loops. In the process, complex, context-specific policies are repackaged into simplified guidelines for global best practice, leading to considerable contestation within the policy networks. [source] The Politics of Emerging and Resurgent Infectious Diseases edited by Jim Whitman.HEALTH ECONOMICS, Issue 4 20012000., Basingstoke, Macmillan Press No abstract is available for this article. [source] Risk factors for fibrosis progression in HIV/HCV coinfected patients from a retrospective analysis of liver biopsies in 1985,2002HIV MEDICINE, Issue 5 2006M Schiavini Objectives To identify predictive factors for moderate/severe liver fibrosis and to analyse fibrosis progression in paired liver biopsies from HIV-positive patients with chronic hepatitis C virus (HCV) infection. Methods HIV/HCV coinfected patients followed at the 2nd Department of Infectious Diseases of L. Sacco Hospital in Milan, Italy, with at least one liver biopsy specimen were retrospectively evaluated. Results A total of 110 patients were enrolled in the study. In a univariate analysis, predictive factors of Ishak,Knodell stage ,3 were a history of alcohol abuse [odds ratio (OR) 3.6, P=0.004], alanine aminotransferase level >100 IU/L at biopsy (OR 2.4, P=0.05), necro-inflammatory grade ,9 (OR 37.14, P<0.0001) and CD4 count <350 cells/,L at nadir (OR 5.3, P=0.05). In a multivariate analysis, age >35 years (OR 3.19, P=0.04) and alcohol abuse (OR 4.36, P=0.002) remained independently associated with Ishak,Knodell stage. Paired liver biopsies were available in 36 patients; 18 showed an increase of at least one stage in the subsequent liver biopsy. Either in a univariate or in a multivariate analysis, a decrease of CD4 cell count of more than 10% between two biopsies (OR 6.85, P=0.002) was significantly associated with liver fibrosis progression. Conclusion Our findings highlight the relevance of encouraging a withdrawal of alcohol consumption in people with chronic HCV infection and of carrying out close follow-up of patients, especially if they are more than 35 years old. It is therefore mandatory to evaluate HIV/HCV coinfected patients for anti-HCV treatment and to increase CD4 cell count through antiretroviral therapy in order to reduce the risk of fibrosis progression and to slow the evolution of liver disease. [source] Association of early annual peak influenza activity with El Niño southern oscillation in JapanINFLUENZA AND OTHER RESPIRATORY VIRUSES, Issue 4 2008Hassan Zaraket Background, Seasonality characterizing influenza epidemics suggests susceptibility to climate variation. El Niño southern oscillation (ENSO), which involves two extreme events, El Niño and La Niña, is well-known for its large effects on inter-annual climate variability. The influence of ENSO on several diseases has been described. Objectives, In this study, we attempt to analyze the possible influence of ENSO on the timing of the annual influenza activity peak using influenza-like illness report data in Japan during 1983,2007. Materials, Influenza surveillance data for 25 influenza epidemics, available under the National Epidemiological Surveillance of the Infectious Diseases, was used in this study. ENSO data were obtained from the Japan Meteorological Agency. Results, Influenza-like illness peak week varied largely during the study period, ranging between 4th and 11th weeks (middle of winter to early spring). The average of peak week during ENSO cycles (n = 11, average = 4·5 ± 0·9) was significantly earlier than in non-ENSO years (n = 14, average = 7·6 ± 2·9; P = 0·01), but there was no significant difference in the peak timing between hot (El Niño) and cold (La Niña) phases. Earlier peaks of influenza activity were observed in 16, out of 25, epidemics. These coincided with 10 (90·9%) out of 11 ENSO and 6 (85·7%) out of seven large-scale epidemics. Conclusion, Influenza activity peak occurred earlier in years associated with ENSO and/or large scale epidemics. [source] Abstracts presented at the Annual Scientific Meeting of the Australasian Society for Infectious Diseases, 2004INTERNAL MEDICINE JOURNAL, Issue 9-10 2004Article first published online: 11 OCT 200 First page of article [source] Proceedings of the Annual Scientific Meeting of the Australasian Society for Infectious Diseases, 2003INTERNAL MEDICINE JOURNAL, Issue 9-10 2003Article first published online: 26 SEP 200 First page of article [source] Proceedings of the Annual Scientific Meeting of the Australasian Society for Infectious Diseases, 2002INTERNAL MEDICINE JOURNAL, Issue 11 2002Article first published online: 16 OCT 200 First page of article [source] Proceedings of the 2001 Annual Scientific Meeting of the Australasian Society for Infectious DiseasesINTERNAL MEDICINE JOURNAL, Issue 8 2001Article first published online: 9 OCT 200 First page of article [source] Eikinella corrodens wound infection in a diabetic foot: a brief reportINTERNATIONAL WOUND JOURNAL, Issue 4 2005Shmouel Ovadia Abstract Eikinella corrodens normally forms part of the flora of the oral cavity and mucous membranes of the respiratory tract. It is usually associated with dental, head and neck infections (Cohen, Powderly, 2004, Infectious Diseases) and is considered to be an unusual cause of orthopaedic infections. We recently treated a diabetic patient with E. corrodens osteomyelitis of the fifth metatarsophalangeal joint, a phenomenon which has been reported in only three cases previously (Konugres et al., 1987, E. corrodens as a cause of osteomyelitis in the feet of the diabetic patients. Report of three cases). We recommend including E. corrodens in the spectrum of causative pathogens in diabetic foot infections. [source] Workshop on Immunizations in Older Adults: Identifying Future Research AgendasJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2010Kevin P. High MD Goals for immunization in older adults may differ from those in young adults and children, in whom complete prevention of disease is the objective. Often, reduced hospitalization and death but also averting exacerbation of underlying chronic illness, functional decline, and frailty are important goals in the older age group. Because of the effect of age on dendritic cell function, T cell-mediated immune suppression, reduced proliferative capacity of T cells, and other immune responses, the efficacy of vaccines often wanes with advanced age. This article summarizes the discussion and proceedings of a workshop organized by the Association of Specialty Professors, the Infectious Diseases Society of America, the American Geriatrics Society, the National Institute on Aging, and the National Institute of Allergy and Infectious Diseases. Leading researchers and clinicians in the fields of immunology, epidemiology, infectious diseases, geriatrics, and gerontology reviewed the current status of vaccines in older adults, identified knowledge gaps, and suggest priority areas for future research. The goal of the workshop was to identify what is known about immunizations (efficacy, effect, and current schedule) in older adults and to recommend priorities for future research. Investigation in the areas identified has the potential to enhance understanding of the immune process in aging individuals, inform vaccine development, and lead to more-effective strategies to reduce the risk of vaccine-preventable illness in older adults. [source] Hospital Charges Attributable to a Primary Diagnosis of Infectious Diseases in Older Adults in the United States, 1998 to 2004JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2008Aaron T. Curns MPH OBJECTIVES: To describe total and average hospital charges associated with infectious disease (ID) hospitalizations and specific ID categories and to estimate ID hospitalization rates in adults aged 65 and older in the United States from 1998 through 2004. DESIGN: Retrospective analysis of hospital discharge data obtained from the Nationwide Inpatient Sample for 1998 through 2004. SETTING: United States. PATIENTS: Older adults hospitalized in the United States from 1998 through 2004. MEASUREMENTS: Hospital charges and hospitalization rates for IDs described according to year, age group, sex, U.S. Census region, and ID category. Charges for non-ID hospitalizations were also described. Hospital charges were adjusted for inflation. RESULTS: From 1998 through 2004, total charges for ID hospitalizations exceeded $261 billion and accounted for 13% of all hospital charges for older adults. Total charges for ID hospitalizations increased from $31.4 billion in 1998 to $45.7 billion in 2004. The average annual ID hospital charge was lower than the average annual non-ID hospital charge during the study period ($21,342 vs $22,787, P<.001). The average annual rate for ID hospitalizations was 503 per 10,000 older adults, which remained stable during the study period. CONCLUSION: The total charges for ID hospitalizations and for all hospitalizations in older adults in the United States increased 45% and nearly 40%, respectively, during the 7-year study period, whereas the population of older adults grew by only 5%. Sustained increases of such magnitude will have major implications for the U.S. healthcare system as it prepares for the more than doubling of the older U.S. adult population during the first 30 years of this century. [source] Presence of tropical spastic paraparesis/human T-cell lymphotropic virus type 1-associated myelopathy (TSP/HAM)-like among HIV-1-infected patients,JOURNAL OF MEDICAL VIROLOGY, Issue 3 2008Jorge Casseb Abstract Human immunodeficiency virus type 1 (HIV-1) and human T-cell lymphotropic virus types 1 and 2 (HTLV-1 and -2) are retroviruses that share similar routes of transmission and some individuals may have a dual infection. These co-infected subjects may be at increased risk for tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM)-like. To study the prevalence of tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM) among co-infected HIV-1/HTLV-1 subjects. Since July 1997, our group has been following a cohort to study the interaction of HTLV with HIV and/or hepatitis C virus (HCV), as well as HTLV-1-only infected asymptomatic carriers or those already presenting with TSP/HAM. During these 9 years, 296 HTLV-1-infected individuals were identified from a total of 538 patients who were referred to our clinic at the Institute of Infectious Diseases "Emílio Ribas," in São Paulo, Brazil. All subjects were evaluated by two neurologists, blinded to the HTLV status. TSP/HAM diagnosis was based on Kagoshima diagnostic criteria. Results: A total of 38 HIV-1/HTLV-1 co-infected subjects were identified in this cohort: Twenty-six had already been diagnosed with AIDS and 12 remained asymptomatic. Six of 38 co-infected subjects (18%) were diagnosed as having TSP/HAM and also AIDS, and for 5 of them TSP/HAM was their first illness. One additional incident case was diagnosed after 2 years of follow-up. No modifications on HIV-1 viral load was seen. In contrast, the co-infected with TSP/HAM-like group showed higher HTLV-1 proviral load (505,±,380 vs. 97,±,149 copies/104 PBMC, P,= 0.012) than asymptomatic co-infected subjects, respectively. The incidence of myelopathy among HIV-1/HTLV-1 co-infected subjects is probably higher than among patients infected only with HTLV-1, and related to a higher HTLV-1 proviral load. Thus, HTLV-1/2 screening should be done for all HIV-1-infected patients in areas where HTLV-1 infection is endemic. J. Med. Virol. 80:392,398, 2008. © 2008 Wiley-Liss, Inc. [source] Infectious Diseases of Refugees and Immigrants: HookwormJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 5 2002Amy Roberts RN This series is based on the Infectious Diseases section of the web site Refugee Health , Immigrant Health, available on the World Wide Web at http://www.baylor.edu/~Charles_Kemp/refugee_health.htm. The site was developed through a contract with the Texas Department of Health as part of an ongoing effort to improve the health of refugees and immigrants. [source] Infectious Diseases of Refugees and Immigrants: Giardiasis (Giardia lamblia)JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 12 2001Amy Roberts MSN This series is based on the Infectious Diseases section of the web site Refugee Health , Immigrant Health, available on the World Wide Web at http://www.baylor.edu/~Charles_Kemp/refugee_health.htm. The site was developed through a contract with the Texas Department of Health as part of an ongoing effort to improve the health of refugees and immigrants. [source] Infectious Diseases of Refugees and Immigrants: Dengue FeverJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 6 2001Amy Roberts FNP, PhDC This series is based on the Infectious Diseases section of the web site Refugee Health , Immigrant Health, available on the World Wide Web at http://www.baylor.edu/Charles_Kemp/refugee_health.htm. The site was developed through a contract with the Texas Department of Health as part of an ongoing effort to improve the health of refugees and immigrants. [source] Real-Time Polymerase Chain Reaction: A Novel Molecular Diagnostic Tool for Equine Infectious DiseasesJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 1 2006N. Pusterla The focus of rapid diagnosis of infectious disease of horses in the last decade has shifted from the conventional laboratory techniques of antigen detection, microscopy, and culture to molecular diagnosis of infectious agents. Equine practitioners must be able to interpret the use, limitations, and results of molecular diagnostic techniques, as they are increasingly integrated into routine microbiology laboratory protocols. Polymerase chain reaction (PCR) is the best-known and most successfully implemented diagnostic molecular technology to date. It can detect slow-growing, difficult-to-cultivate, or uncultivatable microorganisms and can be used in situations in which clinical microbiology diagnostic procedures are inadequate, time-consuming, difficult, expensive, or hazardous to laboratory staff. Inherent technical limitations of PCR are present, but they are reduced in laboratories that use standardized protocols, conduct rigid validation protocols, and adhere to appropriate quality-control procedures. Improvements in PCR, especially probe-based real-time PCR, have broadened its diagnostic capabilities in clinical infectious diseases to complement and even surpass traditional methods in some situations. Furthermore, real-time PCR is capable of quantitation, allowing discrimination of clinically relevant infections characterized by pathogen replication and high pathogen loads from chronic latent infections. Automation of all components of PCR is now possible, which will decrease the risk of generating false-positive results due to contamination. The novel real-time PCR strategy and clinical applications in equine infectious diseases will be the subject of this review. [source] Chemokine Receptor 2 (CCR2) in Atherosclerosis, Infectious Diseases, and Regulation of T-Cell PolarizationMICROCIRCULATION, Issue 3-4 2003ISRAEL F. CHARO ABSTRACT Infiltration of tissues by monocyte-derived macrophages is a prominent component of a wide-range of diseases, including atherosclerosis, glomerulonephritis, encephalitis, infectious diseases, and virtually all syndromes characterized by chronic inflammation. The molecular signals responsible for this directed migration are incompletely understood, but members of the chemokine family, especially the monocyte chemoattractant proteins (MCPs) (MCP-1 to MCP-5) are emerging as key players. Cells that respond to the MCPs do so because they express chemokine receptor 2 (CCR2), the cognate receptor. This review will summarize evidence supporting a key role for CCR2 in the pathogenesis of atherosclerosis, infections with intracellular pathogens, and regulation of the type I adaptive immune response. [source] Herpes zoster in older adults. (Duke University Medical Center, Durham, NC) Clinical Infectious Diseases.PAIN PRACTICE, Issue 4 20011486., 2001;32:148 Herpes zoster (HZ) strikes millions of older adults annually worldwide and disables a substantial number of them via postherpetic neuralgia (PHN). Key aged-related clinical, epidemiological, and treatment features of zoster and PHN are reviewed in this article. HZ is caused by renewed replication and spread of the varicella-zoster virus (VZV) in sensory ganglia and afferent peripheral nerves in the setting of age-related, disease-related, and drug-related decline in cellular immunity to VZV. VZV-induced neuronal destruction and inflammation causes the principal problems of pain, interference with activities in daily living, and reduced quality of life in elderly patients. Recently, attempts to reduce or eliminate HZ pain have been bolstered by the findings of clinical trials that antiviral agents and corticosteroids are effective treatment for HZ and that tricyclic antidepressants, topical lidocaine, gabapentin, and opiates are effective treatment for PHN. Although these advances have helped, PHN remains a difficult condition to prevent and treat in many elderly patients. Comment by Miles Day, M.D. This article reviews the epidemiology clinical features diagnosis and treatment of acute herpes zoster. It also describes the treatment of postherpetic neuralgia. While this is a good review for the primary care physician, the discussion for the treatment for both acute herpes zoster and postherpetic neuralgia do not mention invasive therapy. It is well documented in pain literature that sympathetic blocks with local anesthetic and steroid as well as subcutaneous infiltration of active zoster lesions not only facilitate the healing of acute herpes zoster but also prevents or helps decrease the incidence of postherpetic neuralgia. All patients who present to the primary care physician with acute herpes zoster should have an immediate referral to a pain management physician for invasive therapy. The treatment of postherpetic neuralgia is a challenging experience both for the patient and the physician. While the treatments that have been discussed in this article are important, other treatments are also available. Regional nerve blocks including intercostal nerve blocks, root sleeve injections, and sympathetic blocks have been used in the past to treat postherpetic neuralgia. If these blocks are helpful, one can proceed with doing crynourlysis of the affected nerves or also radio-frequency lesioning. Spinal cord stimulation has also been used for those patients who are refractory to noninvasive and invasive therapy. While intrathecal methylprednisolone was shown to be effective in the study quoted in this article one must be cautious not to do multiple intrathecal steroid injections in these patients. Multilple intrathecal steroid injections can lead to archnoiditis secondary to the accumulation of the steroid on the nerve roots and in turn causing worsening pain. [source] Book review: The Geographic Spread of Infectious Diseases: Models and Applications.AMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 3 2010Computational Biology, Princeton Series in Theoretical No abstract is available for this article. [source] Latest news and product developmentsPRESCRIBER, Issue 21 2007Article first published online: 3 DEC 200 NSAIDs and SSRIs increase GI bleeding Taking an NSAID and an SSRI increases the risk of GI bleeding more than six-fold compared with taking neither drug, a meta-analysis shows (Aliment Pharmacol Ther online: 5 Oct 2007; doi:10.1111/j.1365-2036.20 07.03541.x). The analysis included four observational studies involving a total of 153 000 patients, and 101 cases reported in postmarketing surveillance. Compared with nonuse, the odds ratio for upper GI haemorrhage in patients taking an SSRI alone was 2.36; the number needed to harm (NNH) was 411 for one year's treatment in patients aged over 50 with no risk factors. For those taking an SSRI and an NSAID, it was 6.33 (NNH 106). Of 22 cases where treatment duration was known, the median time to onset of bleeding was 25 weeks and five occurred within one month. The MHRA warns of this interaction in its latest issue of Drug Safety Update, noting: ,corticosteroids, antiplatelet agents, and SSRIs may increase the risk of GI ulceration or bleeding. NSAIDs may enhance the effects of anticoagulants, such as warfarin'. MHRA warning on NSAID safety The MHRA reminds prescribers of new restrictions on prescribing piroxicam and the risks associated with ketorolac and ketoprofen in its latest Drug Safety Update (2007;1:Issue 3). Treatment with piroxicam should now only be initiated by a specialist as a second-line drug; patients currently taking it should be reviewed at the next routine appointment. Piroxicam is no longer indicated for any acute indications. These restrictions do not apply to topical piroxicam (Feldene gel). Ketorolac and ketoprofen are associated with a higher risk of adverse GI effects than other NSAIDs. The MHRA advises prescribers to adhere to the licensed indications that limit oral ketorolac therapy to seven days (two days for continuous iv or im use) and the maximum dose of ketoprofen to 100-200mg. Inhaled steroids may increase the risk of pneumonia in patients with COPD. In the TORCH study (N Engl J Med 2007;356:775-89), fluticasone (Flixotide) and fluticasone plus salmeterol (Seretide) were associated with a significantly increased risk compared with salmeterol alone. The MHRA recommends vigilance for signs of pneumonia or bronchitis in patients with COPD who are treated with inhaled steroids; affected patients should have their treatment reconsidered. Other issues reviewed in Drug Safety Update include: a more intense reaction after revaccination with the pneumococcal vaccine, Pneumovax II; exacerbation of osteonecrosis of the jaw by dental surgery in patients taking a bisphosphonate; a lower maximum dose for lorazepam (4mg for severe anxiety, 2mg for severe insomnia) rare reactions with botulinum toxin; and the cardiovascular safety and risk of fractures with the glitazones. Antibiotic resistance GPs who reduce their antibiotic prescribing achieve a significant reduction in bacterial resistance, a study from Wales has shown (Br J Gen Pract 2007;57:785-92). The analysis of 164 225 coliform isolates from urine samples submitted from 240 general practices found a 5.2 per cent decrease in ampicillin resistance in practices with the greatest reductions in total antibiotic prescribing. Overall, ampicillin resistance decreased by 1 per cent for every reduction of 50 amoxicillin prescriptions per 1000 patients. Trimethoprim resistance showed a similar trend. Mortality risk with discontinuing statins Patients who discontinue statin therapy after acute stroke are almost three times more likely to die than those who do not, an Italian study shows (Stroke 2007;38:2652-7). Follow-up of 631 patients discharged after acute stroke revealed that 39 per cent discontinued statin therapy. The hazard ratio for all-cause mortality in the first 12 months was 2.78 compared with those who continued treatment; this compared with a hazard ratio of 1.81 for stopping antiplatelet therapy. The authors argue that patient care should be improved during the transition from hospital to outpatient primary care. ACEI ± ARB = ADRs Combining an ACE inhibitor and an angiotensin-II receptor blocker increases the risk of adverse effects in patients with symptomatic left ventricular dysfunction, according to a US study (Arch Intern Med 2007;167:1930-6). Meta-analysis of four trials involving a total of 17 337 patients followed up for about two years showed that, compared with therapy including an ACE inhibitor, combined treatment increased the risk of stopping treatment due to adverse events by 38 per cent in patients with heart failure and by 17 per cent in patients with MI. The authors estimate that, for every 1,000 patients treated, 25 will discontinue treatment due to adverse effects and 17 will develop renal dysfunction. WOSCOPS: statin protection continues Pravastatin reduces the risk of death years after treatment has stopped, according to a follow-up of the WOSCOPS study (N Engl J Med 2007;357:1477-86). The West of Scotland Coronary Prevention Study originally randomised men with hypercholesterolaemia but no history of myocardial infarction (MI) to treatment with pravastatin or placebo. After five years, the combined incidence of death from CHD or nonfatal MI was reduced from 7.9 to 5.5 per cent in the treatment group. During the 10 years after completion of the trial, the incidence of the combined end-point was 8.6 per cent in those originally assigned to pravastatin and 10.3 per cent in the placebo group. All- cause mortality was also reduced over the entire 15-year period. The proportions of patients still taking a statin in the middle of this period, ie five years after the trial ended, were 39 per cent of the placebo group. Prescribing policies on HRT need reappraisal Health authorities should reconsider their policy on prescribing HRT, the International Menopause Society (IMS) says. In an open letter, the IMS says current safety concerns over HRT use are founded, but have been misinterpreted in observational studies, such as the Women's Health Initiative, that led to changes in guidelines. The IMS says HRT is the most effective treatment for vasomotor and urogenital symptoms and the risk:benefit profile is favourable until age 60. Low-dose oestrogen or the transdermal route of administration may lead to a more favourable risk profile. Flu vaccine does cut morbidity and mortality Following The Lancet's commentary doubting the effectiveness of flu vaccination (Lancet Infectious Diseases 2007;7:658-66), a US cohort study has found that it does reduce morbidity and mortality (N Engl J Med 2007;357:1373-81). The observational study included 713 872 person-seasons in older people living in the community over a 10year period from 1990 to 2000. Vaccination was associated with a 48 per cent reduction in the risk of death and a 27 per cent reduction in admission for pneumonia or flu. These benefits changed little in subgroups or with age. Copyright © 2007 Wiley Interface Ltd [source] The Economical Control of Infectious Diseases*THE ECONOMIC JOURNAL, Issue 492 2004Mark Gersovitz The structure of representative agents and decentralisation of the social planner's problem provide a framework for the economics of infection and associated externalities. Optimal implementation of prevention and therapy depends on: (1) biology including whether infection is person to person or by vectors; (2) whether the infected progress to recovery and susceptibility, immunity, or death; (3) costs of interventions; (4) whether interventions target everyone, the uninfected, the infected, or contacts between the two; (5) individual behaviour leading to two types of externalities. By way of example, if people recover to be susceptible, government subsidies should equally favour prevention and therapy. [source] Quarantine in Severe Acute Respiratory Syndrome (SARS) and Other Emerging Infectious DiseasesTHE JOURNAL OF LAW, MEDICINE & ETHICS, Issue 2003Jane Speakman No abstract is available for this article. [source] Modeling Infectious Diseases in Humans and Animals by KEELING, M. J. and ROHANI, P.BIOMETRICS, Issue 3 2008Carol Y. Lin No abstract is available for this article. [source] The Economics of Controlling Infectious Diseases on Dairy FarmsCANADIAN JOURNAL OF AGRICULTURAL ECONOMICS, Issue 3 2002Junwook Chi Cost-effective disease control on the dairy farm can enhance productivity and subsequently profitability. Previous economic studies on animal disease have focused on production losses and evaluation of disease eradication programs and have provided little guidance on the optimal prevention action. This paper presents a theoretical model on the economics of livestock disease and develops an empirical model to determine the optimal set of control strategies for four production-limiting cattle diseases: bovine viral diarrhea (BVD), enzootic bovine leukosis (EBL), Johne's Disease (JD) and neosporosis. Control functions indicating the prevalence of infection with each of the four diseases for each of the 10 strategies are estimated. The optimal strategies that minimize total disease cost (direct production losses and control expenditures) are provided for each disease on the basis of farm survey results from the maritime provinces. The results emphasize the importance of introduction checks before new animals enter the herd and adequate vaccination protection as cost-effective control strategies. Lutter contre la maladie d'une manière rentable dans les élevages de bovins laitiers peut déboucher sur un meilleur rendement et des profits plus élevés. Les études économiques antérieures s'intéressant à cet aspect portaient essentiellement sur les pertes de production et l'évaluation des programmes d'éradication. Elles donnaient peu d'indications sur la solution idéale au niveau de la prévention. Cet article présente un modèle théorique de l'économique des maladies du bétail et aboutit à un modèle empirique permettant d'établir le jeu optimal de moyens pour lutter contre quatre maladies réduisant la production animale : la diarrhée à virus des bovins (DVB), la leucose bovine enzootique (LBE), la paratuberculose et la néosporose. Les auteurs estiment les fonctions qui indiquent la prévalence d'une infection pour chacune des quatre maladies retenues, dans le cadre des dix stratégies examinées. Ensuite, ils présentent les meilleures stratégies, à savoir celles qui minimisent le coût total de la maladie (pertes de production directes et dépenses associées à la lutte contre la maladie), pour chaque maladie en fonction des résultats d'un sondage auprès des éleveurs des provinces de l'Atlantique. Tout indique que les méthodes de lutte les plus rentables sont l'examen de l'animal avant son addition au troupeau et une vaccination qui protègera les bêtes de manière adéquate. [source] Protein,Carbohydrate Interactions in Infectious Diseases.CHEMMEDCHEM, Issue 4 2007Edited by Carole No abstract is available for this article. [source] Fighting infections due to multidrug-resistant Gram-positive pathogensCLINICAL MICROBIOLOGY AND INFECTION, Issue 3 2009G. Cornaglia Guest Editor Growing bacterial resistance in Gram-positive pathogens means that what were once effective and inexpensive treatments for infections caused by these bacteria are now being seriously questioned, including penicillin and macrolides for use against pneumococcal infections and,in hospitals,oxacillin for use against staphylococcal infections. As a whole, multidrug-resistant (MDR) Gram-positive pathogens are rapidly becoming an urgent and sometimes unmanageable clinical problem. Nevertheless, and despite decades of research into the effects of antibiotics, the actual risk posed to human health by antibiotic resistance has been poorly defined; the lack of reliable data concerning the outcomes resulting from antimicrobial resistance stems, in part, from problems with study designs and the methods used in resistence determination. Surprisingly little is known, too, about the actual effectiveness of the many types of intervention aimed at controlling antibiotic resistance. New antibiotics active against MDR Gram-positive pathogens have been recently introduced into clinical practice, and the antibiotic pipeline contains additional compounds at an advanced stage of development, including new glycopeptides, new anti-methicillin-resistant Staphylococcus aureus (MRSA) ,-lactams, and new diaminopyrimidines. Many novel antimicrobial agents are likely to be niche products, endowed with narrow antibacterial spectra and/or targeted at specific clinical problems. Therefore, an important educational goal will be to change the current, long-lasting attitudes of both physicians and customers towards broad-spectrum and multipurpose compounds. Scientific societies, such as the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), must play a leading role in this process. [source] Guidelines for the validation and application of typing methods for use in bacterial epidemiologyCLINICAL MICROBIOLOGY AND INFECTION, Issue 2007A. Van Belkum For bacterial typing to be useful, the development, validation and appropriate application of typing methods must follow unified criteria. Over a decade ago, ESGEM, the ESCMID (Europen Society for Clinical Microbiology and Infectious Diseases) Study Group on Epidemiological Markers, produced guidelines for optimal use and quality assessment of the then most frequently used typing procedures. We present here an update of these guidelines, taking into account the spectacular increase in the number and quality of typing methods made available over the past decade. Newer and older, phenotypic and genotypic methods for typing of all clinically relevant bacterial species are described according to their principles, advantages and disadvantages. Criteria for their evaluation and application and the interpretation of their results are proposed. Finally, the issues of reporting, standardisation, quality assessment and international networks are discussed. It must be emphasised that typing results can never stand alone and need to be interpreted in the context of all available epidemiological, clinical and demographical data relating to the infectious disease under investigation. A strategic effort on the part of all workers in the field is thus mandatory to combat emerging infectious diseases, as is financial support from national and international granting bodies and health authorities. [source] | ||||||||||||||||||||||||||||||||||||||||