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Meningitis Manual Text
Laboratory Methods for the Diagnosis of MENINGITIS Caused by Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae Centers for Disease Control and Prevention August, 1998 Laboratory Methods for the Diagnosis of Meningitis Caused by Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae Table of Contents Introduction………………………………………………………………………………… 1 Acknowledgments ……………………………………………………………………….. 2 I. Epidemiology of Meningitis Caused by Neisseria meningitidis, Haemophilus influenzae and Streptococcus pneumoniae,…………………………………………… 3 II. General Considerations ......................................................................................................... 5 A. Record Keeping ................................................................................................................... 5 III. Collection and Transport of Clinical Specimens ................................................................... 6 A. Collection of Cerebrospinal Fluid (CSF)............................................................................... 6 A1. Lumbar Puncture ................................................................................................... 6 B. Collection of Blood .............................................................................................................. 7 B1. Precautions ............................................................................................................ 7 B2. Sensitivity of Blood Cultures ................................................................................ -
Targeted Topical Delivery of Retinoids in the Management of Acne Vulgaris: Current Formulations and Novel Delivery Systems
pharmaceutics Review Targeted Topical Delivery of Retinoids in the Management of Acne Vulgaris: Current Formulations and Novel Delivery Systems Gemma Latter 1, Jeffrey E. Grice 2, Yousuf Mohammed 2 , Michael S. Roberts 2,3 and Heather A. E. Benson 1,* 1 School of Pharmacy and Biomedical Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth 6845, Australia; [email protected] 2 Therapeutics Research Group, The University of Queensland Diamantina Institute, School of Medicine, University of Queensland, Translational Research Institute, Brisbane 4109, Australia; jeff[email protected] (J.E.G.); [email protected] (Y.M.); [email protected] (M.S.R.) 3 School of Pharmacy and Medical Sciences, University of South Australia, Basil Hetzel Institute for Translational Health Research, Adelaide 5011, Australia * Correspondence: [email protected]; Tel.: +61-8-9266-2338 Received: 19 August 2019; Accepted: 17 September 2019; Published: 24 September 2019 Abstract: Acne vulgaris is a common inflammatory pilosebaceous condition that affects 80–90% of adolescents. Since the introduction of tretinoin over 40 years ago, topical retinoid products have been a mainstay of acne treatment. The retinoids are very effective in addressing multiple aspects of the acne pathology as they are comedolytic and anti-inflammatory, and do not contribute to antibiotic resistance or microbiome disturbance that can be associated with long-term antibiotic therapies that are a common alternative treatment. However, topical retinoids are associated with skin dryness, erythema and pain, and may exacerbate dermatitis or eczema. Thus, there is a clear need to target delivery of the retinoids to the pilosebaceous units to increase efficacy and minimise side effects in surrounding skin tissue. -
Cumulative Irritation Comparison of Adapalene Gel and Solution with 2 Tazarotene Gels and 3 Tretinoin Formulations
THERAPEUTICS FOR THE CLINICIAN Cumulative Irritation Comparison of Adapalene Gel and Solution With 2 Tazarotene Gels and 3 Tretinoin Formulations Alan Greenspan, MD; Christian Loesche, MD; Nancy Vendetti; Kathleen Georgeian; Richard Gilbert, PhD; Michel Poncet, PhD; Michael D. Baker, BS; Pascale Soto, RPh Forty-two subjects with normal skin were enrolled gel 0.025%, and 1 discontinued adapalene in a single-center study to assess the cumula- gel 0.1%. None of the subjects discontinued use tive irritancy potential of adapalene (Differin® of the white petrolatum or the adapalene solu- gel 0.1% and Differin solution 0.1%) compared tion 0.1%. Adapalene gel and solution 0.1% with tazarotene (Tazorac® gels 0.05% and 0.1%), were statistically (PϽ.01) less irritating than tretinoin (Retin-A Micro® gel 0.1%, Avita® cream both tazarotene gels 0.1% and 0.05%, tretinoin 0.025%, and Avita gel 0.025%), and white petro- microsphere gel 0.1%, and tretinoin gel 0.025%, latum (negative control). All test materials were and they were not statistically different from applied randomly, under occlusion, to sites tretinoin gel 0.025%. located on either side of the midline— the mid Cutis. 2003;72:76-81. thoracic area of the subjects’ backs. All patches were applied daily, Monday through Friday, to dapalene (Differin®) is a naphthoic-acid the same sites, unless the degree of reaction to derivative with retinoid activity that is a test product or adhesive necessitated removal A effective in the treatment of mild to moder- (grade 3). ate acne vulgaris.1-4 Adapalene, in both gel and Thirty-eight of the 42 subjects (90.5%) com- cream formulations, at the marketed and approved pleted the study. -
Topical Budesonide for Treating Giant Rectal Pseudopolyposis
ANTICANCER RESEARCH 25: 2961-2964 (2005) Topical Budesonide for Treating Giant Rectal Pseudopolyposis CHARALAMPOS PILICHOS1, ATHENA PREZA1, MARIA DEMONAKOU2, DIMITRIOS KAPATSORIS1 and CONSTANTINOS BOURAS1 1First Department of Internal Medicine and 2Department of Pathology, Sismanogleion Hospital, Athens, Greece Abstract. Pseudopolyps are a frequent finding in the course of Case Report inflammatory bowel disease. They are non-neoplastic lesions resulting from a regenerative and healing process that leaves A 45-year-old male patient was admitted to our service in July inflamed colonic mucosa in polypoid configuration. Data about 2002 for acute rectal bleeding. All laboratory tests were their management is lacking. "Giant" pseudopolyps can be normal, except an increase of aminotransferases level (>10 N) mistaken for adenocarcinomas and, as they rarely regress with and a serological profile consistent with acute hepatitis B or a medical management alone, a surgical resection is often required. flare of chronic hepatitis B (HbsAg +, HbsAb –, HbeAg –, A case of giant pseudopolyposis treated non-surgically, in a patient HbeAb +, HbcAb-IgM +). The patient underwent lower with concomitant ulcerative colitis and chronic hepatitis B, is gastro-intestinal endoscopy and multiple biopsies were taken reported, representing a co-morbidity complicating an eventual from a bulky rectal mass lesion (Figure 1). Histological study conservative treatment. The clinical implementation of topical revealed alterations compatible with inflammatory bowel budesonide was originally tested, resulting in clinical, endoscopic disease (IBD) with no dysplasia (Figure 2). Because of the and histological remission. Budesonide seems a promising therapy atypical macroscopic features and the high suspicion of rectal for IBD, particularly when a comorbidity with viral hepatitis exist. -
New Insights Into the Effect of Amorolfine Nail Lacquer
Review article New insights into the effect of amorolfine nail lacquer C. Flagothier, C. Pie´ rard-Franchimont and G. E. Pie´ rard Department of Dermatopathology, University Hospital of Lie`ge, Lie`ge, Belgium Summary Despite improvements in antifungal strategies, the outcome of treating onychomycoses often remains uncertain. Several factors account for treatment failure, of which the pharmacokinetics and pharmacodynamics of the antifungal are of importance. The taxonomic nature and ungual location of the fungus cannot be neglected, besides the type of nail and its growth rate. In addition, the biological cycle of the fungus and the metabolic activity of the pathogen likely play a marked influence in drug response. The presence of natural antimicrobial peptides in the nail is also probably a key feature controlling the cure rates. There are many outstanding publications that cover the full spectrum of the field. The purpose of this review is to put in perspective some facets of activity of the topical treatment using amorolfine nail laquer. The antifungal activity of the drug is likely less pronounced in onychomycosis than that expected from conventional in vitro studies. However, the nail laquer formulation should reduce the propensity to form antifungal-resistant spores and limit the risk of reinfection. Key words: amorolfine, antifungal, fungus, onychomycosis, spore. Topical treatments are often considered to be less Introduction efficacious than current oral treatments. However, some During the last 2 decades, the efficacy of treating topical formulations may provide effects that cannot be onychomycoses has been considerably improved by achieved by other treatments. In discussing the treat- the introduction of new generations of potent antifun- ment of onychomycosis, it should not be forgotten that gals. -
Practice Parameters for the Surgical Treatment of Ulcerative Colitis Howard Ross, M.D
PRACTICE PARAMETERS Practice Parameters for the Surgical Treatment of Ulcerative Colitis Howard Ross, M.D. • Scott R. Steele, M.D. • Mika Varma, M.D. • Sharon Dykes, M.D. Robert Cima, M.D. • W. Donald Buie, M.D. • Janice Rafferty, M.D. Prepared by the Standards Practice Task Force of the American Society of Colon and Rectal Surgeons he American Society of Colon and Rectal Surgeons the most common surgical indication for UC. Whether is dedicated to assuring high-quality patient care it is secondary to an inability to control symptoms, poor Tby advancing the science, prevention, and manage- quality of life, risks/side effects of chronic medical therapy ment of disorders and diseases of the colon, rectum, and (especially long-term corticosteroids), noncompliance, or anus. The Standards Committee is composed of Society growth failure, patients may opt for surgery in the elective members who are chosen because they have demonstrat- or semielective setting.3 Complete removal of all the poten- ed expertise in the specialty of colon and rectal surgery. tial disease-bearing tissue is theoretically curative in UC. This Committee was created to lead international efforts Operative options include an abdominal colectomy or total in defining quality care for conditions related to the co- proctocolectomy with either a permanent end ileostomy or lon, rectum, and anus. This is accompanied by develop- surgical construction of a “new” rectum through an IPAA ing Clinical Practice Guidelines based on the best available that restores GI continuity.4,5 All these procedures may evidence. These guidelines are inclusive, and not prescrip- be performed by using open or minimally invasive tech- tive. -
SARS-Cov-2) (Coronavirus Disease [COVID-19]
CPT® Category I and Proprietary Laboratory Analyses (PLA) Codes for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) Most recent changes to this medium descriptor document: • Addition of 8 Category I codes (0004A, 0051A, 0052A, 0053A, 0054A, 0064A, 91305, 91306) accepted by the CPT Editorial Panel. Codes 0004A, 0051A, 0052A, 0053A, 0054A, 0064A, 91305, 91306 and all related references will be published in CPT 2023. • Deleted codes in this document appear with a strikethrough. It is important to note that further CPT Editorial Panel or Executive Committee actions may affect these codes and/or descriptors. For this reason, code numbers and/or descriptor language in the CPT code set may differ at the time of publication. In addition, further Panel actions may result in gaps in code number sequencing. The following code was accepted at the March 2020 CPT Editorial Panel meeting for the 2021 CPT production cycle. This code is effective immediately on March 13, 2020. Released to Code Medium Code Descriptor Effective Publication AMA website ⚫87635 IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ March 13, 2020 March 13, 2020 CPT® 2021 The following codes were accepted and revised at the April 2020 CPT Editorial Panel meeting for the 2021 CPT production cycle. These codes are effective immediately on April 10, 2020. IMMUNOASSAY INFECTIOUS AGT ANTIBODY 86318 QUAL/SEMIQUAN 1 STEP METH April 10, 2020 April 10, 2020 CPT® 2021 #⚫86328 IA INFECTIOUS AGT ANTIBODY SARS-COV-2 COVID-19 April 10, 2020 April 10, 2020 CPT® 2021 ⚫86769 ANTB SEVERE AQT RESPIR SYND SARS-COV-2 COVID- April 10, 2020 April 10, 2020 CPT® 2021 19 The following code was accepted by the Executive Committee of the CPT Editorial Panel. -
Candida Auris
microorganisms Review Candida auris: Epidemiology, Diagnosis, Pathogenesis, Antifungal Susceptibility, and Infection Control Measures to Combat the Spread of Infections in Healthcare Facilities Suhail Ahmad * and Wadha Alfouzan Department of Microbiology, Faculty of Medicine, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait; [email protected] * Correspondence: [email protected]; Tel.: +965-2463-6503 Abstract: Candida auris, a recently recognized, often multidrug-resistant yeast, has become a sig- nificant fungal pathogen due to its ability to cause invasive infections and outbreaks in healthcare facilities which have been difficult to control and treat. The extraordinary abilities of C. auris to easily contaminate the environment around colonized patients and persist for long periods have recently re- sulted in major outbreaks in many countries. C. auris resists elimination by robust cleaning and other decontamination procedures, likely due to the formation of ‘dry’ biofilms. Susceptible hospitalized patients, particularly those with multiple comorbidities in intensive care settings, acquire C. auris rather easily from close contact with C. auris-infected patients, their environment, or the equipment used on colonized patients, often with fatal consequences. This review highlights the lessons learned from recent studies on the epidemiology, diagnosis, pathogenesis, susceptibility, and molecular basis of resistance to antifungal drugs and infection control measures to combat the spread of C. auris Citation: Ahmad, S.; Alfouzan, W. Candida auris: Epidemiology, infections in healthcare facilities. Particular emphasis is given to interventions aiming to prevent new Diagnosis, Pathogenesis, Antifungal infections in healthcare facilities, including the screening of susceptible patients for colonization; the Susceptibility, and Infection Control cleaning and decontamination of the environment, equipment, and colonized patients; and successful Measures to Combat the Spread of approaches to identify and treat infected patients, particularly during outbreaks. -
AHFS Pharmacologic-Therapeutic Classification System
AHFS Pharmacologic-Therapeutic Classification System Abacavir 48:24 - Mucolytic Agents - 382638 8:18.08.20 - HIV Nucleoside and Nucleotide Reverse Acitretin 84:92 - Skin and Mucous Membrane Agents, Abaloparatide 68:24.08 - Parathyroid Agents - 317036 Aclidinium Abatacept 12:08.08 - Antimuscarinics/Antispasmodics - 313022 92:36 - Disease-modifying Antirheumatic Drugs - Acrivastine 92:20 - Immunomodulatory Agents - 306003 4:08 - Second Generation Antihistamines - 394040 Abciximab 48:04.08 - Second Generation Antihistamines - 394040 20:12.18 - Platelet-aggregation Inhibitors - 395014 Acyclovir Abemaciclib 8:18.32 - Nucleosides and Nucleotides - 381045 10:00 - Antineoplastic Agents - 317058 84:04.06 - Antivirals - 381036 Abiraterone Adalimumab; -adaz 10:00 - Antineoplastic Agents - 311027 92:36 - Disease-modifying Antirheumatic Drugs - AbobotulinumtoxinA 56:92 - GI Drugs, Miscellaneous - 302046 92:20 - Immunomodulatory Agents - 302046 92:92 - Other Miscellaneous Therapeutic Agents - 12:20.92 - Skeletal Muscle Relaxants, Miscellaneous - Adapalene 84:92 - Skin and Mucous Membrane Agents, Acalabrutinib 10:00 - Antineoplastic Agents - 317059 Adefovir Acamprosate 8:18.32 - Nucleosides and Nucleotides - 302036 28:92 - Central Nervous System Agents, Adenosine 24:04.04.24 - Class IV Antiarrhythmics - 304010 Acarbose Adenovirus Vaccine Live Oral 68:20.02 - alpha-Glucosidase Inhibitors - 396015 80:12 - Vaccines - 315016 Acebutolol Ado-Trastuzumab 24:24 - beta-Adrenergic Blocking Agents - 387003 10:00 - Antineoplastic Agents - 313041 12:16.08.08 - Selective -
The Management of Common Skin Conditions in General Practice
Management of Common Skin Conditions In General Practice including the “red rash made easy” © Arroll, Fishman & Oakley, Department of General Practice and Primary Health Care University of Auckland, Tamaki Campus Reviewed by Hon A/Prof Amanda Oakley - 2019 http://www.dermnetnz.org Management of Common Skin Conditions In General Practice Contents Page Derm Map 3 Classic location: infants & children 4 Classic location: adults 5 Dermatology terminology 6 Common red rashes 7 Other common skin conditions 12 Common viral infections 14 Common bacterial infections 16 Common fungal infections 17 Arthropods 19 Eczema/dermatitis 20 Benign skin lesions 23 Skin cancers 26 Emergency dermatology 28 Clinical diagnosis of melanoma 31 Principles of diagnosis and treatment 32 Principles of treatment of eczema 33 Treatment sequence for psoriasis 34 Topical corticosteroids 35 Combination topical steroid + antimicrobial 36 Safety with topical corticosteroids 36 Emollients 37 Antipruritics 38 For further information, refer to: http://www.dermnetnz.org And http://www.derm-master.com 2 © Arroll, Fishman & Oakley, Department of General Practice and Primary Health Care, University of Auckland, Tamaki Campus. Management of Common Skin Conditions In General Practice DERM MAP Start Is the patient sick ? Yes Rash could be an infection or a drug eruption? No Insect Bites – Crop of grouped papules with a central blister or scab. Is the patient in pain or the rash Yes Infection: cellulitis / erysipelas, impetigo, boil is swelling, oozing or crusting? / folliculitis, herpes simplex / zoster. Urticaria – Smooth skin surface with weals that evolve in minutes to hours. No Is the rash in a classic location? Yes See our classic location chart . -
WO 2017/173059 Al 5 October 2017 (05.10.2017) P O P C T
(12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization I International Bureau (10) International Publication Number (43) International Publication Date WO 2017/173059 Al 5 October 2017 (05.10.2017) P O P C T (51) International Patent Classification: BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DJ, DK, DM, C12N 9/26 (2006.01) DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, HN, HR, HU, ID, IL, IN, IR, IS, JP, KE, KG, KH, KN, (21) International Application Number: KP, KR, KW, KZ, LA, LC, LK, LR, LS, LU, LY, MA, PCT/US20 17/024981 MD, ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, (22) International Filing Date: NI, NO, NZ, OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, 30 March 2017 (30.03.2017) RU, RW, SA, SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, (25) Filing Language: English ZA, ZM, ZW. (26) Publication Language: English (84) Designated States (unless otherwise indicated, for every (30) Priority Data: kind of regional protection available): ARIPO (BW, GH, 62/3 15,400 30 March 2016 (30.03.2016) US GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, ST, SZ, 62/457,584 10 February 2017 (10.02.2017) US TZ, UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU, 15/473,994 30 March 2017 (30.03.2017) US TJ, TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, DK, EE, ES, FI, FR, GB, GR, HR, HU, IE, IS, IT, LT, LU, (71) Applicant: AMICUS THERAPEUTICS, INC. -
Tanibirumab (CUI C3490677) Add to Cart
5/17/2018 NCI Metathesaurus Contains Exact Match Begins With Name Code Property Relationship Source ALL Advanced Search NCIm Version: 201706 Version 2.8 (using LexEVS 6.5) Home | NCIt Hierarchy | Sources | Help Suggest changes to this concept Tanibirumab (CUI C3490677) Add to Cart Table of Contents Terms & Properties Synonym Details Relationships By Source Terms & Properties Concept Unique Identifier (CUI): C3490677 NCI Thesaurus Code: C102877 (see NCI Thesaurus info) Semantic Type: Immunologic Factor Semantic Type: Amino Acid, Peptide, or Protein Semantic Type: Pharmacologic Substance NCIt Definition: A fully human monoclonal antibody targeting the vascular endothelial growth factor receptor 2 (VEGFR2), with potential antiangiogenic activity. Upon administration, tanibirumab specifically binds to VEGFR2, thereby preventing the binding of its ligand VEGF. This may result in the inhibition of tumor angiogenesis and a decrease in tumor nutrient supply. VEGFR2 is a pro-angiogenic growth factor receptor tyrosine kinase expressed by endothelial cells, while VEGF is overexpressed in many tumors and is correlated to tumor progression. PDQ Definition: A fully human monoclonal antibody targeting the vascular endothelial growth factor receptor 2 (VEGFR2), with potential antiangiogenic activity. Upon administration, tanibirumab specifically binds to VEGFR2, thereby preventing the binding of its ligand VEGF. This may result in the inhibition of tumor angiogenesis and a decrease in tumor nutrient supply. VEGFR2 is a pro-angiogenic growth factor receptor