RESUMEN
Chagas disease is a parasite infection primarily transmitted to humans via the bite of triatomine insect vectors. Up to 8 million people are estimated to be infected with Chagas disease in the Americas. Patients who do not receive treatment can develop severe cardiac debility, gastrointestinal organ dysfunction, and may die. The changing demographics of the United States, a consequence of changing immigration patterns, means that healthcare providers are more likely to encounter patients with Chagas disease, and must understand its cause, pathogenesis, diagnosis, and treatment.
Asunto(s)
Enfermedad de Chagas , Reacción de Fase Aguda , Cardiomiopatías/etiología , Enfermedad de Chagas/diagnóstico , Enfermedad de Chagas/epidemiología , Enfermedad de Chagas/parasitología , Enfermedad de Chagas/terapia , Enfermedad Crónica , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Megacolon/etiología , Nifurtimox/administración & dosificación , Nitroimidazoles/administración & dosificación , Tripanocidas/administración & dosificación , Trypanosoma cruzi/patogenicidad , Estados Unidos/epidemiologíaRESUMEN
Surgical site infections (SSIs) occur near or at the incision site and/or deeper underlying tissue spaces and organs within 30 days of a surgical procedure (or up to 90 days for implanted prosthetics). SSIs are the most common healthcare-associated infections experienced by patients who undergo surgery, increase overall cost and length of hospital stay, and are largely preventable. This article reviews the recently updated CDC guidelines for preventing SSIs.
Asunto(s)
Antiinfecciosos/administración & dosificación , Profilaxis Antibiótica , Centers for Disease Control and Prevention, U.S. , Guías de Práctica Clínica como Asunto , Infección de la Herida Quirúrgica/prevención & control , Corticoesteroides/administración & dosificación , Artroplastia , Glucemia , Transfusión Sanguínea , Temperatura Corporal , Humanos , Inmunosupresores/administración & dosificación , Infusiones Intravenosas , Factores de Tiempo , Estados UnidosRESUMEN
Zika virus is a flavivirus transmitted to humans via the bite of infected mosquitoes. A recent outbreak in Brazil has spread to several surrounding countries, and the virus also has been reported in the United States. The virus is associated with microcephaly among newborns whose mothers were infected. Because no vaccine or treatment is available, efforts have focused on preventing mosquito bites and advising pregnant women and women trying to get pregnant to avoid active areas of Zika virus transmission. Clinicians should understand the infection, its diagnosis and testing, and monitor pregnant women for travel history to outbreak regions and for the presence of clinical symptoms. Patient education on preventive measures offers the best option to avoid Zika virus infection.
Asunto(s)
Enfermedades Transmisibles Emergentes , Viaje , Infección por el Virus Zika , Virus Zika , Adulto , Centers for Disease Control and Prevention, U.S. , Femenino , Humanos , Hidrocefalia/virología , Recién Nacido , Masculino , Embarazo , Estados UnidosRESUMEN
The largest-ever outbreak and first epidemic of Ebola virus disease is affecting several West African countries. Early symptoms of Ebola can mimic those of other tropical diseases. In a world of rapid global travel, physician assistants need to be capable of identifying patients at greatest risk for developing Ebola. Clinicians also should be familiar with associated symptoms, diagnosis, and treatment considerations.
Asunto(s)
Epidemias , Fiebre Hemorrágica Ebola/diagnóstico , Fiebre Hemorrágica Ebola/epidemiología , África Occidental/epidemiología , Fiebre Hemorrágica Ebola/terapia , Fiebre Hemorrágica Ebola/virología , Humanos , Evaluación de SíntomasRESUMEN
Cancer patients have unique problems associated with hepatitis C virus (HCV) infection and treatment not seen in the general population. HCV infection poses additional challenges and considerations for the management of cancer, and vice versa. HCV infection also can lead to the development of cancer, particularly hepatocellular carcinoma and non-Hodgkin lymphoma. In severely immunocompromised cancer patients, diagnosis of HCV infection requires increased reliance on RNA detection techniques. HCV infection can affect chemotherapy, and delay of HCV infection treatment until completion of chemotherapy and achievement of cancer remission may be required to decrease the potential for drug-drug interactions between antineoplastic agents and HCV therapeutics and potentiation of side effects of these agents. In addition, hematopoietic stem cell transplant (HSCT) recipients have an increased risk of early development of cirrhosis and fibrosis. Whether this increased risk applies to all patients regardless of cancer treatment is unknown. Furthermore, patients with cancer may have poorer sustained virological responses to HCV infection treatment than do those without cancer. Unfortunately, not all cancer patients are candidates for HCV infection therapy. In this article, we review the challenges in managing HCV infection in cancer patients and HSCT recipients.
Asunto(s)
Hepatitis C/complicaciones , Neoplasias/complicaciones , Antivirales/uso terapéutico , Trasplante de Células Madre Hematopoyéticas , Hepacivirus/genética , Hepatitis C/tratamiento farmacológico , Hepatitis C/virología , HumanosRESUMEN
Viral and Group A beta-hemolytic streptococcal (GAS) pharyngitis have overlapping signs and symptoms, but distinguishing between the two is critical to proper treatment. Antibacterial therapy is appropriate for GAS pharyngitis and may help prevent complications.
Asunto(s)
Antibacterianos/uso terapéutico , Faringitis/diagnóstico , Infecciones Estreptocócicas/diagnóstico , Streptococcus pyogenes , Humanos , Faringitis/tratamiento farmacológico , Faringitis/microbiología , Fiebre Reumática/prevención & control , Infecciones Estreptocócicas/tratamiento farmacológico , Infecciones Estreptocócicas/microbiologíaAsunto(s)
Antiinfecciosos/uso terapéutico , Antituberculosos/uso terapéutico , Infecciones por Mycobacterium no Tuberculosas/tratamiento farmacológico , Mycobacterium/crecimiento & desarrollo , Infecciones Oportunistas/tratamiento farmacológico , Farmacorresistencia Bacteriana , Humanos , Huésped Inmunocomprometido , Incidencia , Pruebas de Sensibilidad Microbiana , Mycobacterium/patogenicidad , Infecciones por Mycobacterium no Tuberculosas/epidemiología , Infecciones Oportunistas/epidemiología , PrevalenciaAsunto(s)
Antiinfecciosos/provisión & distribución , Infecciones/tratamiento farmacológico , Reposicionamiento de Medicamentos , Sustitución de Medicamentos , Foscarnet/provisión & distribución , Foscarnet/uso terapéutico , Humanos , Meropenem , Tienamicinas/provisión & distribución , Tienamicinas/uso terapéutico , Combinación Trimetoprim y Sulfametoxazol/provisión & distribución , Combinación Trimetoprim y Sulfametoxazol/uso terapéuticoAsunto(s)
Meningitis Bacterianas/terapia , Antibacterianos/uso terapéutico , Humanos , Meningitis Bacterianas/diagnóstico , Meningitis Bacterianas/tratamiento farmacológico , Meningitis Bacterianas/microbiología , Examen Físico , Infecciones Neumocócicas/diagnóstico , Infecciones Neumocócicas/terapia , Streptococcus pneumoniae/fisiologíaAsunto(s)
Infecciones del Sistema Respiratorio/virología , Bocavirus , Infecciones por Coronavirus/complicaciones , Humanos , Metapneumovirus , Infecciones por Paramyxoviridae/complicaciones , Parechovirus , Infecciones por Parvoviridae/complicaciones , Infecciones por Picornaviridae/complicaciones , Poliomavirus , Infecciones por Polyomavirus , Rhinovirus/clasificaciónRESUMEN
The authors outline the process through which the infectious diseases department at The M. D. Anderson Cancer Center successfully integrated physician assistants into patient care services, as judged by an overall increase in departmental productivity, broadened patient care coverage, and physician satisfaction with midlevel services.