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181. Amebiasis (Follow-up)

, and diloxanide furoate) are best suited for such therapy. [ , ] This recommendation is based on 2 arguments: first, that invasive disease may develop, and second, that shedding of E histolytica cysts in the environment is a public health concern. [ ] Asymptomatic E dispar infections should not be treated, but because this organism is a marker of fecal-oral contamination, educational efforts should be initiated. [ ] Metronidazole is the mainstay of therapy for invasive amebiasis. [ , , ] Tinidazole has been (...) agent (eg, paromomycin or diloxanide furoate) to prevent a relapse. [ ] Amebic liver abscess of up to 10 cm can be cured with metronidazole without drainage. [ ] Clinical defervescence should occur during the first 3-4 days of treatment. Failure of metronidazole therapy may be an indication for surgical intervention. Treatment with a luminal agent should also follow. [ ] Chloroquine has also been used for patients with hepatic amebiasis. Dehydroemetine (available from the Centers for Disease Control

2014 eMedicine Pediatrics

182. Amebiasis (Overview)

migrants from and travelers to endemic regions, men who have sex with men, and immunosuppressed or institutionalized individuals. E histolytica is transmitted via ingestion of the cystic form (infective stage) of the protozoa. Viable in the environment for weeks to months, cysts can be found in fecally contaminated soil, fertilizer, or water or on the contaminated hands of food handlers. Fecal-oral transmission can also occur in the setting of anal sexual practices or direct rectal inoculation through (...) scenarios may favor inpatient care. See , a Critical Images slideshow, to help make an accurate diagnosis. Next: Pathophysiology E histolytica is a pseudopod-forming, nonflagellated protozoal parasite that causes proteolysis and tissue lysis (hence the species name) and can induce host-cell apoptosis (see the image below). Humans and perhaps nonhuman primates are the only natural hosts. Life cycle of Entamoeba histolytica. Ingestion of E histolytica cysts (see the first image below) from the environment

2014 eMedicine Pediatrics

183. Foreign Body Removal, Wound

for traumatic nail removal. Cast cutter was used to remove shoe through which nail was embedded. Following placement of a nerve block, the nail was then cut at the surface of the foot with bolt cutter and removed with steady pulling, with remaining nail fragment traveling from plantar to dorsal foot surface. See , a Critical Images slideshow, to help identify various foreign objects and determine appropriate interventions and treatment options. Missed foreign bodies frequently result in physician (...) visual inspection of the area of localized pain is the first step in determining whether a foreign body is visible. Levine et al demonstrated that 78% of foreign bodies were discovered after physical examination and exploration alone, without the use of imaging. [ ] To achieve adequate visualization, a hemostatic field of the wound should be established using either direct pressure, a properly placed tourniquet proximal to the wound, or application of newer hemostatic agents such as Gelfoam

2014 eMedicine.com

184. Salivary Gland Neoplasms

in the table below. Common parotid neoplasms. A study from the Netherlands, by Valstar et al, found an overall 20-year recurrence rate for salivary gland pleomorphic adenomas of 6.7%, with the first recurrence arising at a median of 7 years. The study also reported that recurrence risk factors for these lesions included positive and uncertain resection margins, as well as younger age at diagnosis. Those located in the minor salivary glands had a lower recurrence risk than did pleomorphic adenomas (...) , which encodes a nonhistone chromosomal high mobility group protein that is involved in structural regulation of the chromosome and transcription. This gene is located at 12q13-15. Because these rearrangements are unique to pleomorphic adenomas amongst salivary gland neoplasms, interrogation of these rearrangements by RT-PCR or FISH may aid in diagnosis. In mucoepidermoid carcinoma, the t(11;19)(q21;p13) chromosomal translocation has be identified in up to 70% of cases. This translocation creates

2014 eMedicine Surgery

185. Lionfish and Stonefish (Overview)

in humans. Toxicon . 2003 Jul. 42(1):79-83. . Halstead BW, Auerbach PS. Dangerous Aquatic Animals of the World: A Color Atlas: With Prevention, First Aid, and Treatment . St Louis, Mo: Mosby; 1992. 85-88. Hare JA, Whitfield PE. An integrated assessment of the introduction of lionfish (Pterois volitans/miles) to the western Atlantic Ocean. NOAA Technical Memorandum NOS NCCOS 2 . Silver Spring, Md: NOAA/NOS/NCCOS; 2003. 21. Hodgson WC. Pharmacological action of Australian animal venoms. Clin Exp Pharmacol (...) Scorpaenidae are 12-13 dorsal spines, two pelvic spines, and three anal spines. Each spine is associated with a pair of venom glands. A loose integumentary sheath covers each spine. The sheath is pushed down the spine during envenomation, causing compression of the venom glands located at the base of the spines. Venom then travels from the glands through anterolateral depressions in the spines and into the wound, in a manner analogous to that of a stingray envenomation. The pectoral spines, while often

2014 eMedicine Emergency Medicine

186. Psychosocial and Environmental Pregnancy Risks (Diagnosis)

, especially congenital anomalies. The rate of congenital anomalies in the general population is 3% for defects that are detectable at birth in live-born infants and 6% for defects detected by the end of the first year of life. Because the baseline risk is small, if an exposure conveys a modestly increased risk, a large population of infants is required to detect an increase in anomalies. In addition, the gestational window is critical because exposures outside certain gestational periods may be nontoxic (...) the second and third trimester of pregnancy (eg, Chernobyl, maternal thyroid ablation) is associated with an increased risk of onset of childhood thyroid cancer, but with a less than 5-year lag time; these cancers are also associated with increased morbidity and aggressiveness. Intervention Clearly, preventing exposure during the first trimester is advisable. Informed counseling is needed for patients with conditions that require diagnostic imaging, and it is even more necessary for patients who must

2014 eMedicine.com

187. Schistosomiasis (Diagnosis)

Effects on Women. Reviews in Obstetrics & Gynecology . 2010. 3:28-32. Corachan M. Schistosomiasis and international travel. Clin Infect Dis . 2002 Aug 15. 35(4):446-50. . Houston S, Kowalewska-Grochowska K, Naik S, McKean J, Johnson ES, and Warren K. First Report of Schistosoma mekongi Infection with Brain Involvement. Clinical Infectious Diseases . 2004. 38:e1-6. Mohammed AZ, Edino ST, Samaila AA. Surgical pathology of schistosomiasis. J Natl Med Assoc . 2007 May. 99(5):570-4. . . Leder K, Weller P (...) . [ ] (See Etiology and Epidemiology.) Sometimes referred to as bilharzias, bilharziasis, or snail fever, schistosomiasis was discovered by Theodore Bilharz, a German surgeon working in Cairo, who first identified the etiological agent Schistosoma hematobium in 1851. [ ] A Schistosoma egg is seen below. Egg of Schistosoma hematobium, with its typical terminal spine. Most human schistosomiasis is caused by S haematobium, S mansoni , and S japonicum . Less prevalent species, such as S mekongi and S

2014 eMedicine.com

188. Infertility (Diagnosis)

courtesy of Jairo E. Garcia, MD. Infertility. Clear preovulatory cervical mucus. Image courtesy of Jairo E. Garcia, MD. Infertility. Fern pattern of preovulatory mucus. Image courtesy of Jairo E. Garcia, MD. At this point, the mucus organizes itself, forming multiple microchannels so the spermatozoa can travel through. During this journey, the spermatozoa simultaneously undergo activation and capacitation. [ ] In addition, the mucus acts as a filter for abnormal spermatozoa and cellular debris present (...) . The relationship between müllerian anomalies and infertility is not entirely clear except when absolute absence of the uterus, cervix, vagina, or a combination of these occurs. Premature delivery has been associated with cervical incompetence, unicornuate uterus associated with a blind horn, and septate uterus. Septate uterus may also be responsible for implantation problems and first-trimester miscarriages. Acquired defects associated with a traumatic delivery, dilatation and curettage, intrauterine device

2014 eMedicine.com

189. Pneumonia, Fungal (Diagnosis)

suspected. Many classes of antifungal agents are now available, including the classic antibiotics; first-, second-, and third-generation triazoles; and the echinocandins. Amphotericin B is less frequently used and, when used, is often given as a liposomal formulation to decrease toxicity. [ ] Next: Risk Factors Workers or farmers with heavy exposure to bird, bat, or rodent droppings or other animal excreta in endemic areas are predisposed to any of the endemic fungal pneumonias, such as , in which (...) are ubiquitous, are usually found worldwide, and tend to cause disease in hosts with abnormal immune defenses. For instance, C neoformans can affect people with intact immune systems at a rate of 0.2 cases per million population per year. Prior to the advent of highly active antiretroviral therapy (HAART), approximately 80-90% of patients with acquired immunodeficiency syndrome (AIDS) developed . [ ] Morbidity and mortality in fungal infection and pneumonia The endemic fungal pneumonias are generally self

2014 eMedicine.com

190. Tinea Pedis (Diagnosis)

with accompanying mass movements of troops and refugees, the general increase in available means of travel, and the rise in the use of occlusive footwear have all combined to make T rubrum the world's most prevalent dermatophyte. [ ] The first reported case of tinea pedis in the United States was noted in Birmingham, Alabama, in the 1920s. World War I troops returning from battle may have transported T rubrum to the United States. Other Medscape tinea articles include , , , , , , and . Next: Pathophysiology T (...) : Courtney M Robbins, MD; Chief Editor: Dirk M Elston, MD Share Email Print Feedback Close Sections Sections Tinea Pedis Overview Background Tinea pedis has afflicted humanity for centuries, so it is perhaps surprising that the condition was not described until Pellizzari did so in 1888. [ ] The first report of tinea pedis was in 1908 by Whitfield, who, with Sabouraud, believed that tinea pedis was a very rare infection caused by the same organisms that produce . Tinea pedis is the term used

2014 eMedicine.com

191. Amebiasis (Diagnosis)

migrants from and travelers to endemic regions, men who have sex with men, and immunosuppressed or institutionalized individuals. E histolytica is transmitted via ingestion of the cystic form (infective stage) of the protozoa. Viable in the environment for weeks to months, cysts can be found in fecally contaminated soil, fertilizer, or water or on the contaminated hands of food handlers. Fecal-oral transmission can also occur in the setting of anal sexual practices or direct rectal inoculation through (...) scenarios may favor inpatient care. See , a Critical Images slideshow, to help make an accurate diagnosis. Next: Pathophysiology E histolytica is a pseudopod-forming, nonflagellated protozoal parasite that causes proteolysis and tissue lysis (hence the species name) and can induce host-cell apoptosis (see the image below). Humans and perhaps nonhuman primates are the only natural hosts. Life cycle of Entamoeba histolytica. Ingestion of E histolytica cysts (see the first image below) from the environment

2014 eMedicine Pediatrics

192. Chondroblastoma (Treatment)

, Nakashima Y, Iwasa Y, Nakao R, Yanagisawa A. Immunohistochemical analysis for Sox9 reveals the cartilaginous character of chondroblastoma and chondromyxoid fibroma of the bone. Hum Pathol . 2010 Feb. 41(2):208-13. . Daugaard S, Christensen LH, Høgdall E. Markers aiding the diagnosis of chondroid tumors: an immunohistochemical study including osteonectin, bcl-2, cox-2, actin, calponin, D2-40 (podoplanin), mdm-2, CD117 (c-kit), and YKL-40. APMIS . 2009 Jul. 117(7):518-25. . . Santiago FR, Del Mar (...) to surgery in the management of chondroblastoma and suggested that it should be considered as a first-line treatment. Previous Next: Complications In addition to recurrence, many complications can occur after treatment of chondroblastomas, including the following: Infection Development of degenerative joint changes Fracture through the lesion Failure of osteoarticular allografts, if used Premature physeal closure and subsequent limb-length discrepancy or angular deformity of the limb Malignant

2014 eMedicine Surgery

193. Amebiasis (Treatment)

, and diloxanide furoate) are best suited for such therapy. [ , ] This recommendation is based on 2 arguments: first, that invasive disease may develop, and second, that shedding of E histolytica cysts in the environment is a public health concern. [ ] Asymptomatic E dispar infections should not be treated, but because this organism is a marker of fecal-oral contamination, educational efforts should be initiated. [ ] Metronidazole is the mainstay of therapy for invasive amebiasis. [ , , ] Tinidazole has been (...) agent (eg, paromomycin or diloxanide furoate) to prevent a relapse. [ ] Amebic liver abscess of up to 10 cm can be cured with metronidazole without drainage. [ ] Clinical defervescence should occur during the first 3-4 days of treatment. Failure of metronidazole therapy may be an indication for surgical intervention. Treatment with a luminal agent should also follow. [ ] Chloroquine has also been used for patients with hepatic amebiasis. Dehydroemetine (available from the Centers for Disease Control

2014 eMedicine Pediatrics

194. Lionfish and Stonefish (Diagnosis)

in humans. Toxicon . 2003 Jul. 42(1):79-83. . Halstead BW, Auerbach PS. Dangerous Aquatic Animals of the World: A Color Atlas: With Prevention, First Aid, and Treatment . St Louis, Mo: Mosby; 1992. 85-88. Hare JA, Whitfield PE. An integrated assessment of the introduction of lionfish (Pterois volitans/miles) to the western Atlantic Ocean. NOAA Technical Memorandum NOS NCCOS 2 . Silver Spring, Md: NOAA/NOS/NCCOS; 2003. 21. Hodgson WC. Pharmacological action of Australian animal venoms. Clin Exp Pharmacol (...) Scorpaenidae are 12-13 dorsal spines, two pelvic spines, and three anal spines. Each spine is associated with a pair of venom glands. A loose integumentary sheath covers each spine. The sheath is pushed down the spine during envenomation, causing compression of the venom glands located at the base of the spines. Venom then travels from the glands through anterolateral depressions in the spines and into the wound, in a manner analogous to that of a stingray envenomation. The pectoral spines, while often

2014 eMedicine Emergency Medicine

195. Guidelines for the management of community-acquired pneumonia in adults

choice for CAP treated in the community 8.8 Should general practitioners administer antibiotics prior to hospital transfer in those patients who need admission? 8.9 When should the first dose of antibiotics be given to patients admitted to hospital with CAP? 8.10 Empirical antibiotic choice for adults hospitalised with low severity CAP 8.11 Empirical antibiotic choice for adults hospitalised with moderate severity CAP 8.12 Empirical antibiotic choice for adults hospitalised with high severity CAP (...) locations where emergency oxygen is used. [D] What general investigations should be done in a patient admitted to hospital? 9. All patients should have the following tests performed on admission: – Oxygenation saturations and, where neces- sary, arterial blood gases in accordance with the BTS guideline for emergency oxygen use in adult patients. [B+] – Chest radiograph to allow accurate diagnosis. [B+] – Urea and electrolytes to inform severity assessment. [B+] – C-reactive protein to aid diagnosis

2009 British Infection Association

196. Preventing and Managing Violence in the Workplace

Appendix D-12: Workplace Violence/Client Aggression Event Report Form and Investigation Tool 125 Appendix D-13: Environmental Control Procedures Checklist 129 Appendix D-14: Preparing for a Meeting With a Potentially Violent Client 132 Appendix D-15: Work-related Travel Procedures 134 Appendix D-16 Sample Terms of Reference – Workplace Violence Prevention Multidisciplinary Committee 139 Appendix D-17: Sample Workplace Violence Prevention Policy 141 Appendix D-18: Workplace Violence Reporting Procedures (...) that was created to enable users to understand the relationships between and among the key factors. Understanding the framework is critical to using the guideline effectively. We suggest that you spend time reading and reflecting upon the framework as a first step. 2. Identify an area of focus: Once you have studied the framework, we suggest that you identify an area of focus for yourself, your situation, or your organization. Select an area that you believe needs attention to provide a violence-free, nurse

2009 Registered Nurses' Association of Ontario

197. Ostomy Care & Management

a validated classification tool to monitor for complications. IV 10 Identify risk factors that influence stomal and peristomal complications. III 11 Review the client’s medication profile to ensure that maximum absorption and effectiveness will be achieved in relation to the type of ostomy. IV 12 Avoid insertion of a glycerin suppository into a colostomy in order to aid evacuation of effluent. Ib 13 Counselling by a Registered Dietician should be performed for clients with an ostomy who are at risk (...) ) systematically reviewed the literature and noted that women tended to report that body image factors were the most negative aspect of stoma surgery. Impaired body image is associated with symptoms of weakness, fragility, unattractiveness and feelings of stigma. Persson and Helstrom (2002) reported a phenomenological study of nine subjects who emphasized the initial shock and emotional distress they experienced when the stoma was first vi - sualized. A classic study addressing this issue noted that impaired

2009 Registered Nurses' Association of Ontario

198. Point-of-Care influenza diagnostic tests

kits 17 Table 3 Effect of POCT on patient management 23 Table 4 POCT for the detection of influenza A subtypes 29 Table 5 Search terms utilised 36 Table 6 Literature sources used in assessment 36 Figures Figure 1 The structure of an influenza virus particle (Conger 2005) 6 Figure 2 The QuickVue influenza test A + B (Charles & Grayson 2007) 10 ii Point-of-care influenza diagnostic tests Executive Summary Nichols et al (2007) defined point-of-care testing (POCT) as “laboratory testing conducted close (...) 2003, the avian influenza A (H5N1) has caused a pandemic in domestic poultry and the wild bird population. This strain is not readily transmitted to humans but has infected at least 300 humans (laboratory confirmed) with a 60 per cent case-fatality rate. There are several rapid influenza diagnostic tests available that are capable of detecting the presence of either influenza A, influenza B or influenza A and B. Influenza A POCT kits are capable of testing whether or not a patient has been infected

2008 Australia and New Zealand Horizon Scanning Network

199. Evaluation of Therapeutic Management in ESBL-infected Patients or Carriers by Providing and Sharing a Free Tool

as an anonymous questionnaire about sexual practices. In addition to usual outpatient treatment an examination and an evaluation of a possible sexually transmitted infection (STI) will be realized. Some questions about risk factors traditionally associated with carriage of resistant bacteria will also be investigated with the aid of the questionnaire such as: use of antibiotics during the year, travel in areas at risk. Outcome Measures Go to Primary Outcome Measures : enterobacteria ESBLs [ Time Frame (...) ) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02011009 Recruitment Status : Completed First Posted : December 13, 2013 Last Update Posted : July 24, 2018 Sponsor: Centre Hospitalier Universitaire de Nice Information provided by (Responsible Party): Centre Hospitalier Universitaire de Nice Study Details

2013 Clinical Trials

200. Intravenous Chemotherapy or Oral Chemotherapy in Treating Patients With Previously Untreated Stage III-IV HIV-Associated Non-Hodgkin Lymphoma

. ClinicalTrials.gov Identifier: NCT01775475 Recruitment Status : Active, not recruiting First Posted : January 25, 2013 Last Update Posted : December 4, 2018 Sponsor: AIDS Malignancy Consortium Collaborators: National Cancer Institute (NCI) The EMMES Corporation Information provided by (Responsible Party): AIDS Malignancy Consortium Study Details Study Description Go to Brief Summary: This randomized phase II trial studies how well intravenous (IV) chemotherapy or oral chemotherapy works in treating patients (...) NCI-2012-01695 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) ) First Posted: January 25, 2013 Last Update Posted: December 4, 2018 Last Verified: November 2018 Additional relevant MeSH terms: Layout table for MeSH terms Lymphoma Lymphoma, Non-Hodgkin Precursor Cell Lymphoblastic Leukemia-Lymphoma Lymphoma, Large B-Cell, Diffuse Lymphoma, Large-Cell, Immunoblastic Plasmablastic Lymphoma Lymphoma, AIDS-Related Neoplasms by Histologic Type Neoplasms Lymphoproliferative Disorders

2013 Clinical Trials

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