Archive for April 9, 2017

Treatment of brucellosis: a systematic review of studies in recent twenty years.

Caspian J Intern Med. 2013 Spring;4(2):636-41.

Alavi SM1, Alavi L.

Author information

1Jundishapur Infectious and Tropical Diseases Research Center, Jundishapur University of Medical Sciences, Ahvaz, Iran.

Abstract

BACKGROUND:

The treatment of human brucellosis is controversial. The purpose of this study was to search published clinical trial papers to provide a simple and effective treatment in brucellosis.

METHODS:

Many studies on brucellosis treatment in a twenty- year span from 1993 to 2012 were searched in PubMed, Web of Science (ISI), Scopus, Google Scholar, Magiran, Iranmedex and SID. The studies that were searched and classified in groups according to combination therapy and monotherapy and their results in treatment outcome were compared. Regimens with lower treatment failure or relapse were considered as more suitable for brucellosis treatment.

RESULTS:

The comparison of combined doxycycline and rifampicin (DR) with a doxycycline plus streptomycin (DS) favors the latter regimen. The combined doxycycline/cotrimoxazole (DCTM) showed similar effect with DR. The treatment with the combined regimen including quinolones was similar to DR but with higher relapse rates. Higher relapse rate was searched in monotherapy (13% vs. 4.8%) and in short-term (less than 4 weeks) treatment regimen (22% vs. 4.8%), respectively. Although in children, clinical trials were limited but showed cotrimoxazole plus rifampin for six weeks was the best treatment regimen.

CONCLUSION:

In uncomplicated brucellosis in adult patients, doxycycline-aminoglycoside combination is the first choice with doxycycline- rifampin and doxycycline-cotrimoxazole should be the alternative regimens. The other oral regimens including quinolones may be considered as alternatives. Cotrimoxazole plus rifampin for six weeks may be the regimen of choice for the treatment of patients younger than 8 years old. Gentamicin for 5 days plus cotrimoxazole for six weeks may be a suitable alternative regimen.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3755828/pdf/cjim-4-636.pdf

Advertisements

April 9, 2017 at 7:35 pm

Polymerase chain reaction-based assays for the diagnosis of human brucellosis.

Ann Clin Microbiol Antimicrob. 2014 Aug 1;13:31.                      

Wang Y, Wang Z, Zhang Y, Bai L, Zhao Y, Liu C, Ma A, Yu H.

Abstract

Polymerase chain reaction (PCR) is an in vitro technique for the nucleic acid amplification, which is commonly used to diagnose infectious diseases. The use of PCR for pathogens detection, genotyping and quantification has some advantages, such as high sensitivity, high specificity, reproducibility and technical ease. Brucellosis is a common zoonosis caused by Brucella spp., which still remains as a major health problem in many developing countries around the world. The direct culture and immunohistochemistry can be used for detecting infection with Brucella spp. However, PCR has the potential to address limitations of these methods. PCR are now one of the most useful assays for the diagnosis in human brucellosis. The aim of this review was to summarize the main PCR techniques and their applications for diagnosis and follow-up of patients with brucellosis. Moreover, advantages or limitation of the different PCR methods as well as the evaluation of PCR results for treatment and follow-up of human brucellosis were also discussed.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236518/pdf/s12941-014-0031-7.pdf

April 9, 2017 at 7:34 pm

Vaccinations for rheumatoid arthritis.

Curr Rheumatol Rep. 2014 Aug;16(8):431.

Perry LM1, Winthrop KL, Curtis JR.

Author information

1Division of Arthritis & Rheumatic Diseases, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.

Abstract

Patients with rheumatoid arthritis (RA) suffer an increased burden of infectious disease-related morbidity and mortality and have twice the risk of acquiring a severe infection compared to the general population.

This increased risk is not only a result of the autoimmune disease but is also attributed to the immunosuppressive therapies that are commonly used in this patient population. Given the increase in infection-related risks in RA, there is great interest in mitigating such risk.

A number of vaccines are available to the rheumatologist, with a handful that are of importance for RA patients in the United States.

The goal of this paper is to highlight the most recent literature on the key vaccines and the specific considerations for the rheumatologist and their RA patients, with a particular focus on influenza, pneumococcal, and herpes zoster vaccines.

It is important for rheumatologist to understand and be aware of which vaccines are live and what potential contraindications exist for giving vaccines to RA patients.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4080407/pdf/nihms-604880.pdf

April 9, 2017 at 7:32 pm

Pneumocystis jirovecii Pneumonia in Rheumatoid Arthritis Patients: Risks and Prophylaxis Recommendations.

Clin Med Insights Circ Respir Pulm Med. 2015 Sep 6;9(Suppl 1):29-40.                   

Mori S1, Sugimoto M2.

Author information

1Department of Rheumatology, Clinical Research Center for Rheumatic Diseases, NHO Kumamoto Saishunsou National Hospital, Kumamoto, Japan.

2Division of Respiratory Medicine, Department of Medicine, Social Insurance Omuta Tenryo Hospital, Fukuoka, Japan.

Abstract

Pneumocystis jirovecii infection causes fulminant interstitial pneumonia (Pneumocystis pneumonia, PCP) in patients with rheumatoid arthritis (RA) who are receiving biological and/or nonbiological antirheumatic drugs. Recently, we encountered a PCP outbreak among RA outpatients at our institution. Hospital-acquired, person-to-person transmission appears to be the most likely mode of this cluster of P. jirovecii infection. Carriage of P. jirovecii seems a time-limited phenomenon in immunocompetent hosts, but in RA patients receiving antirheumatic therapy, clearance of this organism from the lungs is delayed. Carriers among RA patients can serve as sources and reservoirs of P. jirovecii infection for other susceptible patients in outpatient facilities. Development of PCP is a matter of time in such carriers. Considering the poor survival rates of PCP cases, prophylactic antibiotics should be considered for RA patients who are scheduled to receive antirheumatic therapy. Once a new case of PCP occurs, we should take prompt action not only to treat the PCP patient but also to prevent other patients from becoming new carriers of P. jirovecii. Short-term prophylaxis with trimethoprim-sulfamethoxazole is effective in controlling P. jirovecii infection and preventing future outbreaks of PCP among RA patients.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562607/pdf/ccrpm-suppl.1-2015-029.pdf

April 9, 2017 at 7:30 pm

Atypical Presentation of Disseminated Zoster in a Patient with Rheumatoid Arthritis.

Case Rep Med. 2015;2015:124840.     

Patel N1, Singh D1, Patel K1, Ahmed S1, Anand P1.

Author information

1Department of Medicine, Nassau University Medical Center, East Meadow, NY 11554, USA.

Abstract

Patients with rheumatoid arthritis (RA) have 2-fold increased risk of herpes zoster. In literature, limited information exists about disseminated cutaneous zoster in RA patients. An 83-year-old African-American female with RA presented with generalized and widespread vesicular rash covering her entire body. Comorbidities include hypertension, type II diabetes, and dyslipidemia. Patient was on methotrexate 12.5 mg and was not receiving any corticosteroids, anti-TNF therapy, or other biological agents. The patient was afebrile (98F) with no SIRS criteria. Multiple vesicular lesions were present covering patient’s entire body including face. Lesions were in different stages, some umbilicated with diameter of 2-7cm. Many lesions have a rim of erythema with no discharge. On admission, patient was also pancytopenic with leukocyte count of 1.70k/mm(3). Biopsies of lesions were performed, which were positive for Varicella antigen. Subsequently, patient was started on Acyclovir. The patient’s clinical status improved and rash resolved. Our patient presented with “atypical” clinical picture of disseminated cutaneous zoster with no obvious dermatome involvement. Disseminated zoster is a potentially serious infection that can have an atypical presentation in patients with immunocompromised status. High index of suspicion is needed to make the diagnosis promptly and to initiate therapy to decrease mortality and morbidity.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4609790/pdf/CRIM2015-124840.pdf

April 9, 2017 at 7:29 pm

Role of Serologic and Molecular Diagnostic Assays in Identification and Management of Hepatitis C Virus Infection

Journal of Clinical Microbiology February 2016 V.54 N.2 P.265-273                 

Minireviews

Gavin Cloherty, Andrew Talal, Kelly Coller, Corklin Steinhart, John Hackett Jr., George Dawson, Juergen Rockstroh, and Jordan Feld

aAbbott Diagnostics, Abbott Park, Illinois, USA

bUniversity at Buffalo, Buffalo, New York, USA

cViiV Healthcare, Research Triangle Park, North Carolina, USA

dUniversity Bonn, Bonn, Germany

eUniversity of Toronto, Toronto, Canada

The drugs available for the treatment of hepatitis C virus (HCV) have evolved to provide shorter treatment duration and higher rates of sustained virologic response (SVR), and the role of HCV infection diagnostic tests has had to evolve in order to meet changing clinical needs. This review gives an overview on the role of HCV infection diagnostic testing (molecular and serological tools) used in the diagnosis and management of HCV infection. All of this critical information guides physician decisions to optimize patient clinical outcomes. Also discussed is the future direction of diagnostic testing in the context of further advances in drug development.

PDF

http://jcm.asm.org/content/54/2/265.full.pdf

April 9, 2017 at 7:23 pm

Epidemiología de la infección por grampositivos resistentes

Revista Española de Quimioterapia Septiembre 2016 V.29 Supl.1

EMILIA CERCENADO

PDF

http://www.seq.es/seq/0214-3429/29/sup1/2cercenado.pdf

April 9, 2017 at 7:18 pm

Older Posts


Calendar

April 2017
M T W T F S S
« Mar   May »
 12
3456789
10111213141516
17181920212223
24252627282930

Posts by Month

Posts by Category