Infectious disease clinics of North America
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Schistosomiasis is a tropical parasitic disease, caused by blood-dwelling worms of the genus Schistosoma. The main human species are S mansoni (occurring in Africa and South America) and S japonicum (South and East Asia) causing intestinal and hepatosplenic schistosomiasis, and S haematobium (Africa) causing urinary schistosomiasis. Severe symptoms develop in predilected people with heavy and long-standing infections. ⋯ The diagnosis of schistosomiasis relies on microscopic examination of stools or urine, serologic tests, and imaging. Praziquantel is the drug of choice, active against all species in a single or a few oral doses. Current control strategies consist mainly of preventive therapy in communities or groups at risk.
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Infect. Dis. Clin. North Am. · Mar 2012
ReviewReuse of medical devices: implications for infection control.
Reuse of both single-use and multiuse medical devices is a common practice and can result in transmission of infection when appropriate sterilization or reprocessing does not occur. Reuse of single-use devices can be problematic because there are no clear standards for reprocessing, although data regarding adverse outcomes are limited. Single-use devices are commonly reused, appropriately or inappropriately, in resource-limited settings because of cost constraints. Reuse of medical devices raises important legal and ethical questions.
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Catheter-acquired urinary infection is the most common device-associated healthcare-acquired infection. Although most patients are asymptomatic, symptomatic infection may occur and is associated with increased morbidity and costs. ⋯ The most effective way to prevent these infections is to restrict indwelling urinary catheter use to limited indications, and to discontinue use of a catheter as soon as feasible. Alternate means of managing bladder emptying, including external condom catheters for men and intermittent catheterization for patients with neurologic impairment of bladder emptying, should be used when possible.
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Infect. Dis. Clin. North Am. · Mar 2012
ReviewCardiovascular implantable electronic device associated infections.
Infectious complications of cardiovascular implantable electronic devices (CIED) have risen out of proportion to overall increases in use. Although CIED can provide potentially life-saving benefits, device-associated infections can be a devastating complication. This article examines the epidemiology and microbiology of CIED infection and reviews specific host and procedural risk factors. Recent advances in the diagnosis of CIED infections and the multifaceted approach required for successful management in this complex patient population are also considered.
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Infect. Dis. Clin. North Am. · Dec 2011
ReviewMediators of systemic inflammatory response syndrome and the role of recombinant activated protein C in sepsis syndrome.
The systemic inflammatory response syndrome, the host's response to infection involves a series of cascading events that mobilize a series of mediators involving the immune system, complement, and the coagulation cascade. Although the initial focus of mediators is to limit infection, this cascade may run amok and cause the development of hypotension, vascular instability, and disseminated intravascular coagulation, leading to morbidity and mortality in the host. Several therapeutic trials have focused on the modulation of these mediators, but use of recombinant human activated protein C in patients with severe sepsis is the only one that has shown a benefit in clinical trials.