Journal of travel medicine
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The importance of trained interpreters for ensuring adequate communication with limited English proficiency patients is well-established. However, in many contexts, health professionals continue to rely on ad hoc interpreters, such as bilingual employees or patients' relatives to provide linguistic assistance. This is worrisome because these strategies have been shown to be associated with poor quality health care. ⋯ Simply making professional interpreter services available to healthcare professionals does not appear to guarantee their use for limited French proficiency (LFP) patients. Future efforts should focus on developing procedures for systematically identifying patients needing linguistic assistance, linguistic assistance strategies that are responsive to provider and institutional contexts and constraints, and institutional directives to ensure use of qualified interpreters for all medically important communication with LFP patients.
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Multicenter Study Comparative Study Clinical Trial
Virosomal hepatitis a vaccine: comparing intradermal and subcutaneous with intramuscular administration.
Vaccination against hepatitis A virus (HAV) is unaffordable to many developing countries. Substantial reductions in cost occur when vaccines are administered intradermally at low doses. Aluminum-free HAV vaccines are considered more suitable for intradermal use than traditional vaccines which can cause long-lasting local reactions. Thus, we compared the immunogenicity and safety of an aluminum-free virosomal HAV vaccine (Epaxal) administered by different routes: intradermal (i.d.), subcutaneous (s.c.), and intramuscular (i.m.). ⋯ The aluminum-free virosomal HAV vaccine Epaxal is highly immunogenic and well tolerated when administered either via i.d., s.c., or i.m. Vaccination via the i.d. route may confer significant cost savings over the conventional i.m. route.
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Case Reports
Unusual location of an inoculation lesion in a traveler with African tick-bite fever returning from South Africa.
African tick-bite fever is a common tick-borne rickettsiosis in sub-Saharan Africa. It is an acute febrile illness associated with one (or more) inoculation eschar, an inconstant eruption, and local lymphadenopathies. We describe the first case of mucosal inoculation lesion on the vulva in a female traveler returning from South Africa.
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The majority of published studies on Hajj-related diseases were based on hospitalized patient cohorts. ⋯ Health risks associated with the Hajj in our experience are much more related to crowding conditions than to travel. Our work suggests that the studies performed in Saudi specialized units probably overestimate the part of certain diseases within the spectrum of Hajj-associated diseases. Our results also suggest that old female Hajjes should be considered as a high-risk population and that preventive measures should be reinforced before departing for Saudi Arabia.
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The decision whether to immediately evacuate an international traveler who has become ill is a challenge for physicians of aeromedical evacuation companies. The aim of this study is to characterize international aeromedical evacuations in order to identify predictive factors that indicate urgent evacuation. ⋯ Patient age, availability of local resources, and locations are the criteria associated with the need for immediate aeromedical evacuation. Creation of a specific standardized scoring system based on these criteria could be of great value to help physicians of aeromedical evacuation companies in initial management of cases.