Archive for June 16, 2016

Zika Virus -Rapid Spread in the Western Hemisphere

Annals of Internal Medicine May 3, 2016  V.164 N.9 P.613-615

Lin H. Chen, MD; and Davidson H. Hamer, MD

From Mount Auburn Hospital, Cambridge, and the Center for Global Health and Development, Boston University School of Public Health, Boston, Massachusetts.

Zika virus, a mosquito-borne flavivirus that causes febrile illness associated with rash, has been rapidly emerging in the Western Hemisphere over the past few months. The virus was rarely identified until outbreaks occurred on Yap Island in the Federated States of Micronesia in 2007, French Polynesia in 2013, and Easter Island in 2014. It was initially detected in Brazil in 2015, in the northeast, and was subsequently identified in other states and several South American countries, including Colombia, Ecuador, Suriname, Venezuela, French Guyana, and Paraguay (1). Local transmission has been documented in Central America (Panama, El Salvador, Honduras, and Guatemala), the Caribbean (Martinique, Puerto Rico, Dominican Republic, and Haiti), and Mexico. Transmission has also occurred in travelers returning from the infected regions to nonendemic countries, including the United States, Canada, Japan, and Western Europe. As of 22 January 2016, a total of 20 countries and territories in the Americas have Zika virus circulation (1). The explosive spread mirrors the emergence of chikungunya, which was first detected in the Americas (St. Martin) in 2013 and rapidly disseminated throughout the region (2)….


June 16, 2016 at 3:40 pm

Steroid-Based Therapy and Risk of Infectious Complications

PLoS Med 2016 May 24; 13:e1002024

Lionel Rostaing, Paolo Malvezzi

Clinique Universitaire de Néphrologie, Unité de Transplantation Rénale, CHU Grenoble, La Tronche, France

Lionel Rostaing

Université Toulouse III Paul Sabatier, Toulouse, France

INSERM U563, IFR–BMT, CHU Purpan, Toulouse, France

Steroid-based therapy is widely used in the treatment of different diseases, across many health care settings. In a study based on the National Health and Nutrition Examination Survey (NHANES), conducted between 1999 and 2005, the prevalence of long-duration glucocorticoid use in the United States general population was 1.2% (95% CI 1.1–1.4) [1].

In a study of the United Kingdom general population, over 20 years, the long-term use of glucocorticoids (>3 months) was 0.75% (95% CI 0.74–0.75) [2].

Over this time period, long-term corticosteroid prescriptions for rheumatoid arthritis, polymyalgia rheumatica/giant cell arteritis, ulcerative colitis, asthma, chronic obstructive pulmonary disease (COPD), and Crohn’s disease were evident.

In addition, among patients with a solid-organ transplant, who number more than 1 million worldwide, at least 50% take 5–10 mg of glucocorticoids per day over the long term.

With this in mind, it is of utmost importance that patients are managed in the best way with regards to side effects, particularly infectious complications…..



June 16, 2016 at 3:23 pm


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