Posts filed under ‘GUIDELINES’

IDSA GUIDELINES – Diagnosis of Tuberculosis in Adults and Children

Clinical Infectious Diseases January 15, 2017 V.64 N.2 P.111-115

David M. Lewinsohn, Michael K. Leonard, Philip A. LoBue, David L. Cohn, Charles L. Daley, Ed Desmond, Joseph Keane, Deborah A. Lewinsohn, Ann M. Loeffler, Gerald H. Mazurek, Richard J. O’Brien, Madhukar Pai, Luca Richeldi, Max Salfinger, Thomas M. Shinnick, Timothy R. Sterling, David M. Warshauer, and Gail L. Woods

1 Oregon Health & Science University, Portland, Oregon,

2 Emory University School of Medicine and

3 Centers for Disease Control and Prevention, Atlanta, Georgia,

4 Denver Public Health Department, Denver, Colorado,

5 National Jewish Health and the University of Colorado Denver, and

6 California Department of Public Health, Richmond;

7 St James’s Hospital, Dublin, Ireland;

8 Francis J. Curry International TB Center, San Francisco, California;

9 Foundation for Innovative New Diagnostics, Geneva, Switzerland;

10 McGill University and McGill International TB Centre, Montreal, Canada;

11 University of Southampton, United Kingdom;

12 National Jewish Health, Denver, Colorado,

13 Vanderbilt University School of Medicine, Vanderbilt Institute for Global Health, Nashville, Tennessee,

14 Wisconsin State Laboratory of Hygiene, Madison, and

15 University of Arkansas for Medical Sciences, Little Rock

Background

Individuals infected with Mycobacterium tuberculosis (Mtb) may develop symptoms and signs of disease (tuberculosis disease) or may have no clinical evidence of disease (latent tuberculosis infection [LTBI]). Tuberculosis disease is a leading cause of infectious disease morbidity and mortality worldwide, yet many questions related to its diagnosis remain.

Methods

A task force supported by the American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America searched, selected, and synthesized relevant evidence. The evidence was then used as the basis for recommendations about the diagnosis of tuberculosis disease and LTBI in adults and children. The recommendations were formulated, written, and graded using the Grading, Recommendations, Assessment, Development and Evaluation (GRADE) approach.

Results

Twenty-three evidence-based recommendations about diagnostic testing for latent tuberculosis infection, pulmonary tuberculosis, and extrapulmonary tuberculosis are provided. Six of the recommendations are strong, whereas the remaining 17 are conditional.

Conclusions

These guidelines are not intended to impose a standard of care. They provide the basis for rational decisions in the diagnosis of tuberculosis in the context of the existing evidence. No guidelines can take into account all of the often compelling unique individual clinical circumstances.

PDF

https://cid.oxfordjournals.org/content/64/2/111.full.pdf+html

January 12, 2017 at 6:21 pm

Visceral leishmaniasis in immunocompromised diagnostic and therapeutic approach and evaluation of the recently released IDSA guidelines.

Infez Med. 2016 Dec 1;24(4):265-271.

Pagliano P, Ascione T, Di Flumeri G, Boccia G, De Caro F.

Visceral Leishmaniasis (VL) is a chronic infectious disease endemic in tropical and sub-tropical areas including the Mediterranean basin, caused by a group of protozoan parasites of the genus Leishmania and transmitted by phlebotomine sandflies.

Typically, VL is classified as a zoonotic infection when Leishmania infantum is the causative agent and as an anthroponotic one when L. donovani is the causative agent. Immunocompromised patients, in particular HIV positive, are considered at risk of VL.

They may present atypical signs and poor response to the treatment due to a compromission of T-helper and regulatory cells activity. Also pregnancy can be considered a condition predisposing to Leishmania reactivation and to the changes in immune response, due to a switch toward a Th2 response reported in this condition of the life.

Laboratory diagnosis is based on microscopy for parasites detection on bone-marrow or spleen aspirates. Value of serology remains high in term of sensibility, but a positive test has to be confirmed by microscopy or molecular tests.

Hypergammaglobulinemia and pancytopenia are the main alteration identified by blood examination. Treatment is based on use of liposomal amphotericin B (L-AmB) whose administration is associated to lower incidence of side effects, in respect to antimonials and other formulations of AmB. Use of Miltefosine needs further investigation when L. infantum is the causative agent. Relapses to treatment are observed in coinfected HIV patients. They can benefit of a second cycle, but cumulative efficacy of the treatment can be low.

PDF

http://www.infezmed.it/media/journal/Vol_24_4_2016_2.pdf

January 12, 2017 at 9:02 am

Infectious Diseases Society of America Guidelines for the Diagnosis and Treatment of Asymptomatic Bacteriuria in Adults

Clinical Infectious Diseases March 2005 V.40 P.643-654

Lindsay E. Nicolle,1 Suzanne Bradley,2 Richard Colgan,3 James C. Rice,4 Anthony Schaeffer,5 and Thomas M. Hooton6

1 University of Manitoba, Winnipeg, Canada;

2 University of Michigan, Ann Arbor;

3 University of Maryland, Baltimore;

4 University of Texas, Galveston;

5 Northwestern University, Chicago, Illinois; and

6 University of Washington, Seattle

PDF

http://cid.oxfordjournals.org/content/40/5/643.full.pdf+html

December 21, 2016 at 3:36 pm

Practice guidelines for the management of bacterial meningitis.

Clin Infect Dis. 2004 Nov 1;39(9):1267-84.

Tunkel AR1, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM, Whitley RJ.

Author information

1Drexel University College of Medicine, Philadelphia, PA 19129, USA. allan.tunkel@drexel.edu 

PDF

http://cid.oxfordjournals.org/content/39/9/1267.full.pdf+html

December 16, 2016 at 6:29 pm

IDSA GUIDELINE – Diagnosis and Treatment of Leishmaniasis – Clinical Practice Guidelines by the IDSA and ASTMH CID

Clinical Infectious Diseases December 15, 2016 V.63 N.12 P.1539-1557

Naomi Aronson1, Barbara L. Herwaldt2, Michael Libman3, Richard Pearson4, Rogelio Lopez-Velez5, Peter Weina6, Edgar M. Carvalho7, Moshe Ephros8, Selma Jeronimo9, and Alan Magill10
1Uniformed Services University of the Health Sciences, Bethesda, Maryland
2Centers for Disease Control and Prevention, Atlanta, Georgia
3McGill University Health Centre, Montreal, Quebec, Canada
4University of Virginia School of Medicine, Charlottesville
5Ramón y Cajal University Hospital, Madrid, Spain
6Walter Reed National Military Medical Center, Bethesda, Maryland
7Gonçalo Moniz Research Center, FIOCRUZ, Salvador, Bahia, Brazil
8Carmel Medical Center, Haifa, Israel
9Federal University of Rio Grande do Norte, Natal, Brazil
10Bill and Melinda Gates Foundation, Seattle, Washington

It is important to realize that leishmaniasis guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. The IDSA and ASTMH consider adherence to these guidelines to be voluntary, with the ultimate determinations regarding their application to be made by the physician in the light of each patient’s individual circumstances.
PDF
https://cid.oxfordjournals.org/content/63/12/1539.full.pdf+html

https://cid.oxfordjournals.org/content/63/12/e202.full.pdf+html

December 11, 2016 at 11:57 am

Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention Clinical Practice Guidelines: Diagnosis of Tuberculosis in Adults and Children

Clin Infect Dis. December 8, 2016.

David M. Lewinsohn1,a, Michael K. Leonard2,a, Philip A. LoBue3,a, David L. Cohn4, Charles L. Daley5, Ed Desmond6, Joseph Keane7, Deborah A. Lewinsohn1, Ann M. Loeffler8, Gerald H. Mazurek3, Richard J. O’Brien9, Madhukar Pai10, Luca Richeldi11, Max Salfinger12, Thomas M. Shinnick3, Timothy R. Sterling13, David M. Warshauer14, and Gail L. Woods15

1 Oregon Health & Science University, Portland, Oregon,

2 Emory University School of Medicine and

3 Centers for Disease Control and Prevention, Atlanta, Georgia,

4 Denver Public Health Department, Denver, Colorado,

5 National Jewish Health and the University of Colorado Denver, and

6 California Department of Public Health, Richmond;

7 St James’s Hospital, Dublin, Ireland;

8 Francis J. Curry International TB Center, San Francisco, California;

9 Foundation for Innovative New Diagnostics, Geneva, Switzerland;

10 McGill University and McGill International TB Centre, Montreal, Canada;

11 University of Southampton, United Kingdom;

12 National Jewish Health, Denver, Colorado,

13 Vanderbilt University School of Medicine, Vanderbilt Institute for Global Health, Nashville, Tennessee,

14 Wisconsin State Laboratory of Hygiene, Madison, and

15 University of Arkansas for Medical Sciences, Little Rock

Abstract

Background.

Individuals infected with Mycobacterium tuberculosis (Mtb) may develop symptoms and signs of disease (tuberculosis disease) or may have no clinical evidence of disease (latent tuberculosis infection [LTBI]). Tuberculosis disease is a leading cause of infectious disease morbidity and mortality worldwide, yet many questions related to its diagnosis remain.

Methods.

A task force supported by the American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America searched, selected, and synthesized relevant evidence. The evidence was then used as the basis for recommendations about the diagnosis of tuberculosis disease and LTBI in adults and children. The recommendations were formulated, written, and graded using the Grading, Recommendations, Assessment, Development and Evaluation (GRADE) approach.

Results.

Twenty-three evidence-based recommendations about diagnostic testing for latent tuberculosis infection, pulmonary tuberculosis, and extrapulmonary tuberculosis are provided. Six of the recommendations are strong, whereas the remaining 17 are conditional.

Conclusions.

These guidelines are not intended to impose a standard of care. They provide the basis for rational decisions in the diagnosis of tuberculosis in the context of the existing evidence. No guidelines can take into account all of the often compelling unique individual clinical circumstances.

PDF

https://cid.oxfordjournals.org/content/early/2016/12/08/cid.ciw694.full.pdf+html

December 9, 2016 at 7:10 pm

Vaccinations for pregnant women.

Obstet Gynecol. 2015 Jan;125(1):212-26.

Swamy GK1, Heine RP.

Author information

1Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Duke University, Durham, North Carolina.

Abstract

In the United States, eradication and reduction of vaccine-preventable diseases through immunization has directly increased life expectancy by reducing mortality.

Although immunization is a public priority, vaccine coverage among adult Americans is inadequate.

The Institute of Medicine, the Community Preventive Services Task Force, and other public health entities have called for the development of innovative programs to incorporate adult vaccination into routine clinical practice.

Obstetrician-gynecologists are well suited to serve as vaccinators of women in general and more specifically pregnant women.

Pregnant women are at risk for vaccine-preventable disease-related morbidity and mortality and adverse pregnancy outcomes, including congenital anomalies, spontaneous abortion, preterm birth, and low birth weight.

In addition to providing direct maternal benefit, vaccination during pregnancy likely provides direct fetal and neonatal benefit through passive immunity (transplacental transfer of maternal vaccine-induced antibodies).

This article reviews: 1) types of vaccines; 2) vaccines specifically recommended during pregnancy and postpartum; 3) vaccines recommended during pregnancy and postpartum based on risk factors and special circumstances; 4) vaccines currently under research and development for licensure for maternal-fetal immunization; and 5) barriers to maternal immunization and available patient and health care provider resources.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4286306/pdf/nihms639082.pdf

December 4, 2016 at 10:52 am

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