Dengue is an important arboviral infection that affects about 40% of the world population. It is found mainly in topical and subtropical areas of the world mainly in developing countries but it range is spreading including the United States. A review of common arboviruses can be found here. It is a flaviavirus with 4 distinct serotypes named DENV-1 through DENV-4 and is spread by A. aegypti a day biting mosquito. Infection with one serotype confers immunity to that serotype but not the others. It does offer some protection for cross-infection but this only lasts a few months. Incubation period is 3-14 days with an average of 7 after exposure.
A primary infection is usually benign. A second infection with another serotype or multiple infections with different serotypes can cause severe infections.
Dengue fever (DF) presents with skin flushing and abrupt high fever (often biphasic 39.4-40.5C) but could also usually be lower that lasts for 5-7 days. Myalgia and pain especially headache or retroorbital pain is generally constant but remits in a few days. Anorexia, nausea, emesis or abdominal pain occur. Fatigue, lethargy or restlessness are also common. A maculopapular, blanching rash over the body occurs often on day 3-4 of fever and fades with time. DF is sometimes referred to as break-bone fever because of the intense fever.
Dengue hemorrhagic fever or Dengue shock syndrome (DHF/DSS) are different in that patients have the same symptoms but start to have signs of …
Authors: Tanzella G, Motos A, Battaglini D, Meli A, Torres A
Introduction: Community-acquired pneumonia (CAP) has the highest rate of mortality of all infectious diseases, especially among the elderly. Severe CAP (sCAP) is defined as a CAP in which intensive care management is required and is associated with an unfavorable clinical course. Areas covered: This review aims to identify prevention strategies for reducing the incidence of CAP and optimized management of sCAP. We highlight the main prevention approaches for CAP, focusing on the latest vaccination plans and on the influence of health-risk behavio…
Cardiothoracic surgeons can apply for up to $10,000 for formal education and training in biomedical ethics in a program at a North American ethics center through the Cardiothoracic Ethics Forum. The Forum, a joint project of the AATS and STS that is responsible for ethics education in cardiothoracic surgery, has established a scholarship for cardiothoracic surgeons or trainees who are interested in biomedical ethics and show promise of providing leadership for the continuing development and flourishing of ethics education for cardiothoracic surgery.
The objective of this study was to determine whether osteoarthritis had an impact on outcomes of prostate cancer including death, local recurrence and/or metastasis and to determine whether cartilage oligomeric matrix protein was involved. We performed a retrospective case-control study of patients with prostate cancer with and without the diagnosis of osteoarthritis and completed immunohistochemistry (IHC) analysis of prostate (n=20) and lymph node (n=7) surgical specimens. We evaluated death, local recurrence and metastatic disease by various IHC biomarkers including prostate specific membrane antigen (PSMA), cartilage o…
Publication date: Available online 16 August 2019Source: Regulatory Toxicology and PharmacologyAuthor(s): Paul Baldrick, James W. Hutchings, Matthew D. Heath, Murray A. SkinnerAbstractPQ Birch represents an allergen-specific immunotherapy for the treatment of birch pollinosis. It consists of native birch pollen extract chemically modified with glutaldehyde adsorbed to L-tyrosine in its microcrystalline form with addition of the adjuvant Monophosphoryl Lipid A (MPL®). A nonclinical safety testing strategy was designed based upon interpretation of current legislation and regulatory intelligence and comprised genotoxicity…
ConclusionsAlthough maternal Tdap and influenza vaccination coverage increased substantially from 2010 to 2017 among large, geographically diverse U.S. cohorts, coverage remained suboptimal, potentially putting newborns at risk of pertussis and influenza. Strategies to increase maternal vaccination coverage could target women identified to have a reduced likelihood of vaccination: those who are younger, black, residing in rural areas, with multiple gestation, and a prepregnancy inpatient admission.
Publication date: September 2019Source: American Journal of Preventive Medicine, Volume 57, Issue 3Author(s):
Patient is a 25 year old guy who found several ticks attached while biking/camping in an area with high lyme prevalence. Around 1 month later, he developed flu-like symptoms but doesn’t remember seeing the EM rash. 3 months later he is now experiencing fatigue, malaise, exertional chest “heaviness”, palpitations, dizziness. Western blot is IgG positive for Lyme. He has never been treated for Lyme before.
His primary care is an NP who referred him to Infectious Disease, but when he…
Why won’t Infectious Disease evaluate this possible Lyme Disease patient?
Authors: Lyudmer M, Levy BJ, Holtzman AJ, Sankaranarayanan S, Tabeayo E, Gruson KI
INTRODUCTION: Plain radiographs of the shoulder are routinely obtained for patients presenting with atraumatic shoulder pain, although the diagnostic utility of this imaging modality is unclear. Despite this, patients often prefer to obtain radiographs and may associate them with a more satisfactory visit.
METHODS: New patients presenting with atraumatic shoulder pain were provided with information regarding the potential advantages and disadvantages of plain radiographs as part of their visit. Patients then decided whet…
A new TV Show from The New York Times on FX and Hulu.
A first-of-its-kind FDA approval represents a major win for Zimmer Biomet and, most importantly, the field of scoliosis treatment.
Called The Tether â Vertebral Body Tethering System, the device is intended to treat growing children and adolescents whose spinal curves are approaching or have reached the range where surgical treatment is an option. It is intended to correct the most common form of scoliosis (idiopathic scoliosis) that has not responded to conservative treatment options, such as external bracing.
âThis decision takes an innovative surgical approach, vertebral body tetherin…