Junxiong Pang, Yee-Sin Leo, David C Lye
PURPOSE OF REVIEW: This review aims to update and summarize the current knowledge about clinical features, management, and risk factors of adult dengue patients requiring intensive care with consequently higher risk of mortality. RECENT FINDINGS: Increasingly, there are more adult dengue patients who require intensive care. This may be due to a shift in epidemiology of dengue infection from mainly a pediatric disease toward adult disease. In addition, multiorgan dysfunction was observed to be a key risk factor for ICU admission and mortality...
October 2016: Current Opinion in Critical Care
Thomas F Patterson, George R Thompson, David W Denning, Jay A Fishman, Susan Hadley, Raoul Herbrecht, Dimitrios P Kontoyiannis, Kieren A Marr, Vicki A Morrison, M Hong Nguyen, Brahm H Segal, William J Steinbach, David A Stevens, Thomas J Walsh, John R Wingard, Jo-Anne H Young, John E Bennett
It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.
August 15, 2016: Clinical Infectious Diseases
Chris Beyrer, Stefan D Baral, Chris Collins, Eugene T Richardson, Patrick S Sullivan, Jorge Sanchez, Gift Trapence, Elly Katabira, Michel Kazatchkine, Owen Ryan, Andrea L Wirtz, Kenneth H Mayer
Gay, bisexual, and other men who have sex with men (MSM) continue to have disproportionately high burdens of HIV infection in countries of low, middle, and high income in 2016. 4 years after publication of a Lancet Series on MSM and HIV, progress on reducing HIV incidence, expanding sustained access to treatment, and realising human rights gains for MSM remains markedly uneven and fraught with challenges. Incidence densities in MSM are unacceptably high in countries as diverse as China, Kenya, Thailand, the UK, and the USA, with substantial disparities observed in specific communities of MSM including young and minority populations...
July 9, 2016: Lancet
Jean-Louis Vincent, Matteo Bassetti, Bruno François, George Karam, Jean Chastre, Antoni Torres, Jason A Roberts, Fabio S Taccone, Jordi Rello, Thierry Calandra, Daniel De Backer, Tobias Welte, Massimo Antonelli
Infections occur frequently in critically ill patients and their management can be challenging for various reasons, including delayed diagnosis, difficulties identifying causative microorganisms, and the high prevalence of antibiotic-resistant strains. In this review, we briefly discuss the importance of early infection diagnosis, before considering in more detail some of the key issues related to antibiotic management in these patients, including controversies surrounding use of combination or monotherapy, duration of therapy, and de-escalation...
May 17, 2016: Critical Care: the Official Journal of the Critical Care Forum
Nisha Thampi, Derek Stephens, Elizabeth Rea, Ian Kitai
BACKGROUND: Patients may unexpectedly deteriorate clinically and/or radiographically during the course of appropriate treatment for tuberculosis. These events have been extensively studied in human immunodeficiency virus-positive patients; however, there are few data about immunocompetent children and adolescents. METHODS: We studied all human immunodeficiency virus-negative patients treated for tuberculosis at our center between January 2002 and July 2009. Demographics, sites of disease at diagnosis and deterioration, and actions at the time of deterioration were reviewed...
February 2012: Pediatric Infectious Disease Journal
Yogesh Jain
No abstract text is available yet for this article.
March 23, 2015: BMJ: British Medical Journal
Giovanni Sotgiu, Giovanni Battista Migliori
No abstract text is available yet for this article.
May 2, 2015: Lancet
Patrick N A Harris, Paul A Tambyah, David L Paterson
The spread of extended-spectrum β-lactamase (ESBL) genes in Enterobacteriaceae such as Escherichia coli or Klebsiella spp is a major challenge to modern medical practice. Carbapenems are the treatment of choice for serious infections caused by ESBL producers; however, carbapenem resistance has increased globally. ESBL producers might be susceptible to β-lactam-β-lactamase inhibitor (BLBLI) combination antibiotics such piperacillin-tazobactam or amoxicillin-clavulanate. These drugs are frequently avoided in serious infections caused by ESBL producers because of the inoculum effect in-vitro (especially for piperacillin-tazobactam), animal data suggesting inferior efficacy when compared with carbapenems, concerns about pharmacokinetic-pharmacodynamic drug target attainment with standard doses, and poor outcomes shown in some observational studies...
April 2015: Lancet Infectious Diseases
Daniel G Colley, Amaya L Bustinduy, W Evan Secor, Charles H King
Human schistosomiasis--or bilharzia--is a parasitic disease caused by trematode flukes of the genus Schistosoma. By conservative estimates, at least 230 million people worldwide are infected with Schistosoma spp. Adult schistosome worms colonise human blood vessels for years, successfully evading the immune system while excreting hundreds to thousands of eggs daily, which must either leave the body in excreta or become trapped in nearby tissues. Trapped eggs induce a distinct immune-mediated granulomatous response that causes local and systemic pathological effects ranging from anaemia, growth stunting, impaired cognition, and decreased physical fitness, to organ-specific effects such as severe hepatosplenism, periportal fibrosis with portal hypertension, and urogenital inflammation and scarring...
June 28, 2014: Lancet
Mayara L Bastos, Hamidah Hussain, Karin Weyer, Lourdes Garcia-Garcia, Vaira Leimane, Chi Chiu Leung, Masahiro Narita, Jose M Penã, Alfredo Ponce-de-Leon, Kwonjune J Seung, Karen Shean, José Sifuentes-Osornio, Martie Van der Walt, Tjip S Van der Werf, Wing Wai Yew, Dick Menzies
BACKGROUND: Individualized treatment for multidrug-resistant (MDR) tuberculosis and extensively drug-resistant (XDR) tuberculosis depends upon reliable and valid drug susceptibility testing (DST) for pyrazinamide, ethambutol, and second-line tuberculosis drugs. However, the reliability of these tests is uncertain, due to unresolved methodological issues. We estimated the association of DST results for pyrazinamide, ethambutol, and second-line drugs with treatment outcomes in patients with MDR tuberculosis and XDR tuberculosis...
November 15, 2014: Clinical Infectious Diseases
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