Se Asian J Trop Med
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Se Asian J Trop Med · Sep 2004
Case ReportsDisseminated strongyloidiasis successfully treated with extended duration ivermectin combined with albendazole: a case report of intractable strongyloidiasis.
We describe a patient with an overlapping syndrome disseminated strongyloidiasis and gram-negative sepsis. She was previously treated with albendazole 400 mg/day 14 days before admission without success. ⋯ Strongyloides larvae disappeared from the stool by day 4 and from the sputum by day 10. No side effects were encountered during hospitalization or at the 1-month follow-up visit.
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A prospective observational study was conducted in a neonatal intensive care unit to identify factors associated with the development of ventilator-associated pneumonia (VAP) in 170 infants aged less than 30 days who required mechanical ventilation for longer than 48 hours. VAP occurred in 85 infants (50 cases per 100 mechanically-ventilated infants) or 70.3 cases per 1,000 ventilator days. Stepwise logistic regression analysis identified 3 factors independently associated with VAP: umbilical catheterization [adjusted odds ratio (AOR)=2.5; 95% confidence interval (CI)=1.3 to 4.7; p=0.007]; respiratory distress syndrome (AOR=2.0; 95% CI=1.0 to 3.9; p=0.03); and insertion of orogastric tube (AOR=3.0; 95% CI=1.3 to 7.2; p=0.01). ⋯ Leukocytosis and blood gas values could not predict the presence of VAP. The mortality of infants with VAP (29.4%) did not differ significantly from that of infants without VAP (30.6%) (p=0.87). Certain clinical interventions might potentially affect the incidence of VAP and outcome associated with VAP.
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Se Asian J Trop Med · Sep 2004
Economic burden of varicella in Singapore--a cost benefit estimate of implementation of a routine varicella vaccination.
Varicella is a common childhood illness that can result in significant morbidity and mortality. As early as 1995, recommendations for routine varicella vaccination have been published, but have not been universally implemented, with cost of vaccination as a major reason. Though available from 1996, the vaccine has yet to be routinely implemented in Singapore. ⋯ In comparison, the cost of a vaccination program was found to be US$3.3 million per annum. The cost per case averted was US$104. From a societal point of view, for every dollar invested in a vaccination program, we would save about US$2 dollars.