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HIV infection HIV infection - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search HIV infection Last reviewed: August 2018 Last updated: September 2018 Important updates US and EU drug regulators warn of possible increased risk of neural tube defects in babies born to women taking dolutegravir The US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have both issued alerts after preliminary results (...) continue to monitor results from the ongoing study and would issue further advice as additional data become available. Summary Globally, 1.8 million people were newly infected in 2017. Most people are infected through sexual contact, before birth or during delivery, during breastfeeding, or when sharing contaminated needles and syringes. Diagnosis is established using an HIV antibody test and confirmed using a more specific test. Patients should be clinically staged according to World Health
Urinary tract infections in men Urinary tract infections in men - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Urinary tract infections in men Last reviewed: August 2018 Last updated: September 2018 Summary Rarely occurs before 50 years of age. Often associated with abnormal structure or function of the urinary tract (complicated UTI). Catheter-associated UTI is the most common cause of nosocomial infection. Imaging (...) of the urinary tract is recommended for men with persistent haematuria, voiding dysfunction without a clearly identifiable cause such as benign prostatic hyperplasia (BPH), failure of initial therapy, or signs of upper tract infection. Should generally be treated with a fluoroquinolone antibiotic for 7 to 14 days. Asymptomatic bacteriuria does not require treatment except before urological procedures. Definition Urinary tract infection (UTI) is an inflammatory reaction of the urinary tract epithelium
Screening for Syphilis Infection in Pregnant Women: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. Importance: The incidence of syphilis and congenital syphilis in the United States has increased after reaching historic lows in the early 2000s. Objective: To systematically review literature on the effectiveness and harms of screening for syphilis in pregnancy and the harms of penicillin treatment in pregnancy to inform the US Preventive Services Task (...) ) found no false-negatives with treponemal tests, and 1 study (n = 139) demonstrated the prozone phenomenon (false-negative response from high antibody titer) with rapid plasma reagin screening using undiluted samples (2.9%). No studies were identified for harms of penicillin in pregnancy. Conclusions and Relevance: Screening for syphilis infection in pregnant women is associated with reduced incidence of congenital syphilis, and available evidence supports the need for reflexive testing for positive
Screening for Syphilis Infection in Pregnant Women: US Preventive Services Task Force Reaffirmation Recommendation Statement. Importance: Untreated syphilis infection in pregnant women can be transmitted to the fetus (congenital syphilis) at any time during pregnancy or at birth. Congenital syphilis is associated with stillbirth, neonatal death, and significant morbidity in infants (eg, bone deformities and neurologic impairment). After a steady decline from 2008 to 2012, cases of congenital (...) syphilis markedly increased from 2012 to 2106, from 8.4 to 15.7 cases per 100 000 live births (an increase of 87%). At the same time, national rates of syphilis increased among women of reproductive age. Objective: To update the US Preventive Services Task Force (USPSTF) 2009 recommendation on screening for syphilis infection in pregnant women. Evidence Review: The USPSTF commissioned a reaffirmation evidence update to identify new and substantial evidence sufficient enough to change its prior
Urological Infections Urological Infections | Uroweb Guidelines › Urological Infections Urological Infections To access the pdfs & translations of individual guidelines, please as EAU member. Non-EAU members can view the web versions. To become an EAU member, click . EAU Central Office PO Box 30016 NL-6803 AA ARNHEM The Netherlands
Sepsis-3 Septic Shock Criteria and Associated Mortality Among Infected Hospitalized Patients Assessed by a Rapid Response Team 29778659 2018 08 06 1931-3543 154 2 2018 Aug Chest Chest Sepsis-3 Septic Shock Criteria and Associated Mortality Among Infected Hospitalized Patients Assessed by a Rapid Response Team. 309-316 S0012-3692(18)30741-4 10.1016/j.chest.2018.05.004 Rapid response teams (RRTs) respond to hospitalized patients with deterioration and help determine subsequent management (...) , including ICU admission. In such patients with sepsis and septic shock, the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) clinical criteria have a potential role in detection, risk stratification, and prognostication; however, their accuracy in comparison with the systemic inflammatory response syndrome (SIRS)-based septic shock criteria is unknown. We sought to evaluate prognostic accuracy of the Sepsis-3 criteria for in-hospital mortality among infected hospitalized
Institutional Protocols for Vaginal Preparation With Antiseptic Solution and Surgical Site Infection Rate in Women Undergoing Cesarean Delivery During Labor 29995743 2018 07 28 1873-233X 132 2 2018 Aug Obstetrics and gynecology Obstet Gynecol Institutional Protocols for Vaginal Preparation With Antiseptic Solution and Surgical Site Infection Rate in Women Undergoing Cesarean Delivery During Labor. 371-376 10.1097/AOG.0000000000002745 To evaluate the association of institutional protocols (...) for vaginal preparation with antiseptic solution and the surgical site infection rate in women undergoing cesarean delivery during labor. This is a secondary analysis of a multicenter randomized controlled trial of adjunctive azithromycin prophylaxis for cesarean delivery performed in laboring patients with viable pregnancies. The primary outcome for this analysis was the rate of superficial or deep surgical site infection within 6 weeks postpartum, as per Centers for Disease Control and Prevention
Systematic Review with Meta-Analysis: Concomitant Therapy vs. Triple Therapy for the First-Line Treatment of Helicobacter pylori Infection 30171216 2018 09 01 1572-0241 2018 Aug 31 The American journal of gastroenterology Am. J. Gastroenterol. Systematic Review with Meta-Analysis: Concomitant Therapy vs. Triple Therapy for the First-Line Treatment of Helicobacter pylori Infection. 10.1038/s41395-018-0217-2 Whether concomitant therapy is superior to triple therapy of various treatment lengths (...) for the first-line treatment of H. pylori remains controversial. The objective of this study is to compare the efficacy of concomitant therapy and triple therapy given for 5-14 days. Randomized control trials (RCTs) comparing the efficacy of concomitant therapy for 5-14 days and proton pump inhibitor-amoxicillin-clarithromycin (PAC)-based triple therapy for 5-14 days in the first-line treatment of adult patients with H. pylori infection published from 1990 to January 2018 were searched from the PubMed
A Comparison of the Quick Sequential (Sepsis-Related) Organ Failure Assessment Score and the National Early Warning Score in Non-ICU Patients With/Without Infection 30130262 2018 08 21 1530-0293 2018 Aug 20 Critical care medicine Crit. Care Med. A Comparison of the Quick Sequential (Sepsis-Related) Organ Failure Assessment Score and the National Early Warning Score in Non-ICU Patients With/Without Infection. 10.1097/CCM.0000000000003359 The Sepsis-3 task force recommended the quick Sequential (...) (Sepsis-Related) Organ Failure Assessment score for identifying patients with suspected infection who are at greater risk of poor outcomes, but many hospitals already use the National Early Warning Score to identify high-risk patients, irrespective of diagnosis. We sought to compare the performance of quick Sequential (Sepsis-Related) Organ Failure Assessment and National Early Warning Score in hospitalized, non-ICU patients with and without an infection. Retrospective cohort study. Large U.K. General
Dolutegravir rilpivirine (Juluca) - For the treatment of human immunodeficiency virus type 1 (HIV-1) infection in adults who are virologically suppressed (HIV-1 RNA copies <50 copies/mL) on a stable antiretroviral regimen
Risk of Serious and Opportunistic Infections Associated With Treatment of Inflammatory Bowel Diseases 29655835 2018 08 13 2018 08 13 1528-0012 155 2 2018 08 Gastroenterology Gastroenterology Risk of Serious and Opportunistic Infections Associated With Treatment of Inflammatory Bowel Diseases. 337-346.e10 S0016-5085(18)30445-1 10.1053/j.gastro.2018.04.012 The risk of infection associated with tumor necrosis factor antagonists (anti-TNF) and thiopurines (combination therapy) is uncertain. We (...) assessed the risk of serious and opportunistic infections in patients with inflammatory bowel disease (IBD) treated with thiopurine monotherapy, anti-TNF monotherapy, or combination therapy in a large cohort of patients in France. We performed a nationwide population-based study of patients (18 years or older) with a diagnosis of IBD in the French national health insurance database; we collected data from January 1, 2009 until December 31, 2014. The risks of serious and opportunistic infections
Prevention of Nosocomial Infections in Critically Ill Patients With Lactoferrin: A Randomized, Double-Blind, Placebo-Controlled Study 30015668 2018 08 16 1530-0293 46 9 2018 Sep Critical care medicine Crit. Care Med. Prevention of Nosocomial Infections in Critically Ill Patients With Lactoferrin: A Randomized, Double-Blind, Placebo-Controlled Study. 1450-1456 10.1097/CCM.0000000000003294 To obtain preliminary evidence for the efficacy of lactoferrin as a preventative measure for nosocomial (...) infections and inform the conduct of a definitive study. Phase 2, multicenter, randomized, double-blind, placebo-controlled study. Medical-surgical ICUs. Adult, critically ill patients receiving invasive mechanical ventilation. Randomized, eligible, consenting patients expected to require invasive mechanical ventilation more than 48 hours received lactoferrin both enterally and via an oral swab or a placebo of sterile water for up to 28 days. Of the 214 patients who were randomized, 212 received at least
Prognostic value of the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification in patients with no-option chronic limb-threatening ischemia 29802042 2018 05 26 1097-6809 2018 May 22 Journal of vascular surgery J. Vasc. Surg. Prognostic value of the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification in patients with no-option chronic limb-threatening ischemia. S0741-5214(18)30422-1 10.1016/j.jvs.2018.02.028 The Wound, Ischemia (...) , and foot Infection (WIfI) classification was developed to assess amputation risk and hence to aid in clinical decision-making in patients with chronic limb-threatening ischemia (CLTI). WIfI has been validated in multiple CLTI cohorts worldwide. In this study, we examined the relationship between WIfI stage and clinical outcomes in a well-defined subpopulation of CLTI patients considered not eligible for conventional revascularization. The aim of this study was to assess the prognostic value of the WIfI
Predicting Failure in Early Acute Prosthetic Joint Infection Treated With Debridement, Antibiotics, and Implant Retention: External Validation of the KLIC Score 29691168 2018 07 22 1532-8406 33 8 2018 Aug The Journal of arthroplasty J Arthroplasty Predicting Failure in Early Acute Prosthetic Joint Infection Treated With Debridement, Antibiotics, and Implant Retention: External Validation of the KLIC Score. 2582-2587 S0883-5403(18)30299-7 10.1016/j.arth.2018.03.041 Debridement, antibiotics (...) , and implant retention (DAIR) is a widely used treatment modality for early acute prosthetic joint infection (PJI). A preoperative risk score was previously designed for predicting DAIR failure, consisting of chronic renal failure (K), liver cirrhosis (L), index surgery (I), cemented prosthesis (C), and C-reactive protein >115 mg/L (KLIC). The aim of this study was to validate the KLIC score in an external cohort. We retrospectively evaluated patients with early acute PJI treated with DAIR between 2006
HIV Viral Suppression Trends Over Time Among HIV-Infected Patients Receiving Care in the United States, 1997 to 2015: A Cohort Study. Background: Because HIV viral suppression is essential for optimal outcomes and prevention efforts, understanding trends and predictors is imperative to inform public health policy. Objective: To evaluate viral suppression trends in people living with HIV (PLWH), including the relationship of associated factors, such as demographic characteristics and integrase