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Mmrv Vaccine
VACCINE INFORMATION STATEMENT (Measles, Mumps, Many Vaccine Information Statements are available in Spanish and other languages. MMRV Vaccine Rubella and See www.immunize.org/vis Varicella) Hojas de información sobre vacunas están disponibles en español y en muchos otros What You Need to Know idiomas. Visite www.immunize.org/vis These are recommended ages. But children can get the Measles, Mumps, Rubella and second dose up through 12 years as long as it is at least 1 Varicella 3 months after the first dose. Measles, Mumps, Rubella, and Varicella (chickenpox) can be serious diseases: Children may also get these vaccines as 2 separate shots: MMR (measles, mumps and rubella) and Measles varicella vaccines. • Causes rash, cough, runny nose, eye irritation, fever. • Can lead to ear infection, pneumonia, seizures, brain 1 Shot (MMRV) or 2 Shots (MMR & Varicella)? damage, and death. • Both options give the same protection. Mumps • One less shot with MMRV. • Causes fever, headache, swollen glands. • Children who got the first dose as MMRV have • Can lead to deafness, meningitis (infection of the brain had more fevers and fever-related seizures (about and spinal cord covering), infection of the pancreas, 1 in 1,250) than children who got the first dose as painful swelling of the testicles or ovaries, and, rarely, separate shots of MMR and varicella vaccines on death. the same day (about 1 in 2,500). Rubella (German Measles) Your doctor can give you more information, • Causes rash and mild fever; and can cause arthritis, including the Vaccine Information Statements for (mostly in women). MMR and Varicella vaccines. -
Clinical Reviewer: [Joohee Lee ] STN: [125508/153 ]
Clinical Reviewer: [Joohee Lee ] STN: [125508/153 ] Application sBLA Type STN 125508/153 CBER February 1, 2016 Received Date PDUFA Goal December 1, 2016 Date Division / DVRPA /OVRR Office Priority Review No Reviewer Joohee Lee Name(s) Review October 6, 2016 Completion Date / Stamped Date Supervisory Concurrence Lucia Lee, M.D., Team Leader, CRB1 Jeff Roberts, M.D., Chief, CRB1 Applicant Merck Established Human Papillomavirus 9-valent Vaccine, Recombinant Name (Proposed) Gardasil 9 Trade Name Pharmacologic Vaccine Class Page i Clinical Reviewer: [Joohee Lee ] STN: [125508/153 ] Formulation(s), A 0.5 mL dose contains: including Recombinant virus-like particles (VLPs) of the major capsid (L1) Adjuvants, etc protein of HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58)* adsorbed on preformed aluminum-containing adjuvant (Amorphous Aluminum Hydroxyphosphate Sulfate or AAHS) *Amounts of HPV type L1 protein are as follows: 30 mcg/40mcg/60mcg/40mcg/20mcg/20mcg/20mcg/20mcg/20mcg, respectively. Dosage 0.5-mL suspension for intramuscular injection as a single-dose Form(s) and vial and prefilled syringe Route(s) of Administration Dosing Two-dose regimen: 0 and 6 to 12 months Regimen A 3- dose regimen (0, 2 and 6 months) is approved for use in individuals 9 through 26 years of age (STN 125508/0) Page ii Clinical Reviewer: [Joohee Lee ] STN: [125508/153 ] Indication(s) and Intended This supplement introduces a 2-dose regimen in addition to the Population(s) licensed 3-dose regimen. The intended population for the 2- dose regimen is girls and boys 9 through 14 years of age. -
Measles Diagnostic Tool
Measles Prodrome and Clinical evolution E Fever (mild to moderate) E Cough E Coryza E Conjunctivitis E Fever spikes as high as 105ºF Koplik’s spots Koplik’s Spots E E Viral enanthem of measles Rash E Erythematous, maculopapular rash which begins on typically starting 1-2 days before the face (often at hairline and behind ears) then spreads to neck/ the rash. Appearance is similar to “grains of salt on a wet background” upper trunk and then to lower trunk and extremities. Evolution and may become less visible as the of rash 1-3 days. Palms and soles rarely involved. maculopapular rash develops. Rash INCUBATION PERIOD Fever, STARTS on face (hairline & cough/coryza/conjunctivitis behind ears), spreads to trunk, Average 8-12 days from exposure to onset (sensitivity to light) and then to thighs/ feet of prodrome symptoms 0 (average interval between exposure to onset rash 14 day [range 7-21 days]) -4 -3 -2 -1 1234 NOT INFECTIOUS higher fever (103°-104°) during this period rash fades in same sequence it appears INFECTIOUS 4 days before rash and 4 days after rash Not Measles Rubella Varicella cervical lymphadenopathy. Highly variable but (Aka German Measles) (Aka Chickenpox) Rash E often maculopapular with Clinical manifestations E Clinical manifestations E Generally mild illness with low- Mild prodrome of fever and malaise multiforme-like lesions and grade fever, malaise, and lymph- may occur one to two days before may resemble scarlet fever. adenopathy (commonly post- rash. Possible low-grade fever. Rash often associated with painful edema hands and feet. auricular and sub-occipital). -
NCCN Guidelines for Patients Anal Cancer
NCCN GUIDELINES FOR PATIENTS® 2021 Anal Cancer Presented with support from: Available online at NCCN.org/patients Ü Anal Cancer It's easy to get lost in the cancer world Let NCCN Guidelines for Patients® be your guide 9 Step-by-step guides to the cancer care options likely to have the best results 9 Based on treatment guidelines used by health care providers worldwide 9 Designed to help you discuss cancer treatment with your doctors NCCN Guidelines for Patients® Anal Cancer, 2021 1 About National Comprehensive Cancer Network® NCCN Guidelines for Patients® are developed by the National Comprehensive Cancer Network® (NCCN®) NCCN Clinical Practice NCCN Guidelines NCCN Guidelines in Oncology for Patients (NCCN Guidelines®) 9 An alliance of leading 9 Developed by doctors from 9 Present information from the cancer centers across the NCCN cancer centers using NCCN Guidelines in an easy- United States devoted to the latest research and years to-learn format patient care, research, and of experience 9 For people with cancer and education 9 For providers of cancer care those who support them all over the world Cancer centers 9 Explain the cancer care that are part of NCCN: 9 Expert recommendations for options likely to have the NCCN.org/cancercenters cancer screening, diagnosis, best results and treatment Free online at Free online at NCCN.org/patientguidelines NCCN.org/guidelines and supported by funding from NCCN Foundation® These NCCN Guidelines for Patients are based on the NCCN Guidelines® for Anal Cancer, Version 1.2021 — February 16, 2021. © 2021 National Comprehensive Cancer Network, Inc. All rights reserved. -
What Is Anal Cancer?
cancer.org | 1.800.227.2345 About Anal Cancer Overview and Types If you've been diagnosed with anal cancer or are worried about it, you likely have a lot of questions. Learning some basics is a good place to start. ● What Is Anal Cancer? Research and Statistics See the latest estimates for new cases of anal cancer and deaths in the US and what research is currently being done. ● Key Statistics for Anal Cancer ● What’s New in Anal Cancer Research? What Is Anal Cancer? Anal cancer is a type of cancer that starts in the anus. Cancer starts when cells in the body begin to grow out of control. To learn more about how cancers start and spread, see What Is Cancer?1 Normal structure and function of the anus 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 The anus is the opening at the lower end of the intestines. It's where the end of the intestines connect to the outside of the body. As food is digested, it passes from the stomach to the small intestine. It then moves from the small intestine into the main part of the large intestine (called the colon). The colon absorbs water and salt from the digested food. The waste matter that's left after going through the colon is known as feces or stool. Stool is stored in the last part of the large intestine, called the rectum. From there, stool is passed out of the body through the anus as a bowel movement. Gastrointestinal system (GI system) Structures of the anus The anus is connected to the rectum by the anal canal. -
HIV Infection and AIDS
G Maartens 12 HIV infection and AIDS Clinical examination in HIV disease 306 Prevention of opportunistic infections 323 Epidemiology 308 Preventing exposure 323 Global and regional epidemics 308 Chemoprophylaxis 323 Modes of transmission 308 Immunisation 324 Virology and immunology 309 Antiretroviral therapy 324 ART complications 325 Diagnosis and investigations 310 ART in special situations 326 Diagnosing HIV infection 310 Prevention of HIV 327 Viral load and CD4 counts 311 Clinical manifestations of HIV 311 Presenting problems in HIV infection 312 Lymphadenopathy 313 Weight loss 313 Fever 313 Mucocutaneous disease 314 Gastrointestinal disease 316 Hepatobiliary disease 317 Respiratory disease 318 Nervous system and eye disease 319 Rheumatological disease 321 Haematological abnormalities 322 Renal disease 322 Cardiac disease 322 HIV-related cancers 322 306 • HIV INFECTION AND AIDS Clinical examination in HIV disease 2 Oropharynx 34Neck Eyes Mucous membranes Lymph node enlargement Retina Tuberculosis Toxoplasmosis Lymphoma HIV retinopathy Kaposi’s sarcoma Progressive outer retinal Persistent generalised necrosis lymphadenopathy Parotidomegaly Oropharyngeal candidiasis Cytomegalovirus retinitis Cervical lymphadenopathy 3 Oral hairy leucoplakia 5 Central nervous system Herpes simplex Higher mental function Aphthous ulcers 4 HIV dementia Kaposi’s sarcoma Progressive multifocal leucoencephalopathy Teeth Focal signs 5 Toxoplasmosis Primary CNS lymphoma Neck stiffness Cryptococcal meningitis 2 Tuberculous meningitis Pneumococcal meningitis 6 -
Rubella (German Measles)
Rubella (German Measles) Frequently Asked Questions What is rubella? Rubella is a common childhood disease caused by a virus. It can last one to five days and is generally a mild disease. Who gets rubella? Rubella can affect anyone of any age. Once you have had the infection you are usually immune and cannot catch it again. There are still cases of rubella around the world where populations are not vaccinated against the disease. How do people get rubella? When an infected person coughs or sneezes, the virus is released into the air and enters another person’s body through the nose or throat. Rubella is contagious seven days before and seven days after the rash appears. The rubella virus may also be found in the blood, urine, and stool of people who have the illness. What are the symptoms of rubella? Symptoms of rubella show up 14 to 21 days after exposure. Symptoms are often mild, and up to half of people infected with rubella virus have no symptoms at all. Symptoms include: • Low-grade fever • Swollen glands or lymph nodes • Rash • Small red bumps on the roof of the mouth (known as Forchheimer’s sign) • Dry, flaking skin • Swollen or bloodshot eyes • Stuffy nose • Joint pain and swelling (arthritis) • Loss of appetite • Headache Are there complications with a rubella virus infection? Rubella is usually a mild disease in children; adults tend to have more complications. The most serious danger of rubella is to pregnant women and the developing fetus. A miscarriage or premature delivery may occur in pregnant women. -
Pathology of Anal Cancer
Pathology of Anal Cancer a b Paulo M. Hoff, MD, PhD , Renata Coudry, MD, PhD , a, Camila Motta Venchiarutti Moniz, MD * KEYWORDS Anal cancer Anal squamous intraepithelial neoplasia Squamous cell carcinoma Human papilloma virus (HPV) Molecular KEY POINTS Anal cancer is an uncommon tumor, squamous cell carcinoma (SCC) being the most frequent histology corresponding to 80% of all cases. Human papilloma virus (HPV) infection plays a key role in anal cancer development, en- coding at least three oncoproteins with stimulatory properties. SCC expresses CK5/6, CK 13/19, and p63. P16 is a surrogate marker for the presence of HPV genome in tumor cells. INTRODUCTION Anal cancer accounts for approximately 2.4% of gastrointestinal malignancies.1 Although anal cancer is a rare tumor, its frequency is increasing, especially in high- risk groups.2 Tumors in this location are generally classified as anal canal or anal margin. Squamous cell carcinoma (SCC) is the predominant type of tumor and shares many features with cervical cancer. Oncogenic human papilloma virus (HPV) infection plays a major role in both tumors.3 HIV infection is associated with a higher frequency of HPV-associated premalignant lesions and invasive tumors.4 Normal Anatomy of the Anus The anal canal is the terminal part of the large intestine and is slightly longer in male than in female patients. It measures approximately 4 cm and extends from the rectal ampulla (pelvic floor level) to the anal verge, which is defined as the outer open- ing of the gastrointestinal tract. The anal verge is at the level of the squamous- mucocutaneous junction with the perianal skin.5,6 The authors have nothing to disclose. -
Varicella (Chickenpox): Questions and Answers Q&A Information About the Disease and Vaccines
Varicella (Chickenpox): Questions and Answers Q&A information about the disease and vaccines What causes chickenpox? more common in infants, adults, and people with Chickenpox is caused by a virus, the varicella-zoster weakened immune systems. virus. How do I know if my child has chickenpox? How does chickenpox spread? Usually chickenpox can be diagnosed by disease his- Chickenpox spreads from person to person by direct tory and appearance alone. Adults who need to contact or through the air by coughing or sneezing. know if they’ve had chickenpox in the past can have It is highly contagious. It can also be spread through this determined by a laboratory test. Chickenpox is direct contact with the fluid from a blister of a per- much less common now than it was before a vaccine son infected with chickenpox, or from direct contact became available, so parents, doctors, and nurses with a sore from a person with shingles. are less familiar with it. It may be necessary to perform laboratory testing for children to confirm chickenpox. How long does it take to show signs of chickenpox after being exposed? How long is a person with chickenpox contagious? It takes from 10 to 21 days to develop symptoms after Patients with chickenpox are contagious for 1–2 days being exposed to a person infected with chickenpox. before the rash appears and continue to be conta- The usual time period is 14–16 days. gious through the first 4–5 days or until all the blisters are crusted over. What are the symptoms of chickenpox? Is there a treatment for chickenpox? The most common symptoms of chickenpox are rash, fever, coughing, fussiness, headache, and loss of appe- Most cases of chickenpox in otherwise healthy children tite. -
HPV, Anal Dysplasia and Anal Cancer
HPV, anal dysplasia FACT and anal cancer SHEET Published 2016 Summary Anal cancer typically develops over a period of years, beginning with a precancerous condition called anal dysplasia. CONTACT US Anal dysplasia occurs when clusters of abnormal cells form by telephone lesions in the mucosa lining of the anal canal (between the 1-800-263-1638 anus and the rectum). The lesions typically form inside the anal 416-203-7122 canal or just outside the anal opening. by fax 416-203-8284 Although there are over 100 different types of the human papillomavirus (HPV), anal dysplasia is usually caused by certain by e-mail strains of HPV which can be transmitted sexually. HPV can shut [email protected] off the proteins that help prevent dysplasia and cancer cells from developing, therefore leading to HPV-associated diseases by mail such as anal dysplasia. 555 Richmond Street West Suite 505, Box 1104 It is difficult to screen for anal dysplasia since the lesions are Toronto ON M5V 3B1 not detectable by routine examinations. As a result, anal dysplasia is often not detected until it has developed into anal cancer, which can be difficult to treat depending on the severity. Specific screening tests can detect dysplasia or precancerous changes. If these precancers are treated, anal cancer may be prevented. Anal cancer is usually treated with radiation and chemotherapy or with surgery. Although anal dysplasia may be treated successfully, individuals with HIV are at increased risk of it recurring and may need to be monitored closely by a trained physician. Consistent condom use reduces, but does not eliminate, the risk of transmitting HPV. -
Insights Into the Management of Anorectal Disease in the Coronavirus 2019 Disease Era
University of Massachusetts Medical School eScholarship@UMMS COVID-19 Publications by UMMS Authors 2021-07-09 Insights into the management of anorectal disease in the coronavirus 2019 disease era Waseem Amjad Albany Medical Center Et al. Let us know how access to this document benefits ou.y Follow this and additional works at: https://escholarship.umassmed.edu/covid19 Part of the Digestive System Diseases Commons, Gastroenterology Commons, Infectious Disease Commons, Telemedicine Commons, and the Virus Diseases Commons Repository Citation Amjad W, Haider R, Malik A, Qureshi W. (2021). Insights into the management of anorectal disease in the coronavirus 2019 disease era. COVID-19 Publications by UMMS Authors. https://doi.org/10.1177/ 17562848211028117. Retrieved from https://escholarship.umassmed.edu/covid19/285 Creative Commons License This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License This material is brought to you by eScholarship@UMMS. It has been accepted for inclusion in COVID-19 Publications by UMMS Authors by an authorized administrator of eScholarship@UMMS. For more information, please contact [email protected]. TAG0010.1177/17562848211028117Therapeutic Advances in GastroenterologyW Amjad, R Haider 1028117research-article20212021 Advances and Future Perspectives in Colorectal Cancer Special Collection Therapeutic Advances in Gastroenterology Review Ther Adv Gastroenterol Insights into the management of anorectal 2021, Vol. 14: 1–13 https://doi.org/10.1177/17562848211028117DOI: 10.1177/ disease in the coronavirus 2019 disease era https://doi.org/10.1177/1756284821102811717562848211028117 © The Author(s), 2021. Article reuse guidelines: Waseem Amjad, Rabbia Haider, Adnan Malik and Waqas T. Qureshi sagepub.com/journals- permissions Abstract: Coronavirus 2019 disease (COVID-19) has created major impacts on public health. -
Vaccine Information Statement
VACCINE INFORMATION STATEMENT Many Vaccine Information Statements are available in Spanish and other languages. MMRV (Measles, Mumps, Rubella, and See www.immunize.org/vis Hojas de información sobre vacunas están Varicella) Vaccine: What You Need to Know disponibles en español y en muchos otros idiomas. Visite www.immunize.org/vis 1 Why get vaccinated? 2 MMRV Vaccine Measles, mumps, rubella, and varicella are viral diseases that can MMRV vaccine may be given to children 12 months through 12 have serious consequences. Before vaccines, these diseases were years of age. Two doses are usually recommended: very common in the United States, especially among children. First dose: 12 through 15 months of age They are still common in many parts of the world. Second dose: 4 through 6 years of age Measles A third dose of MMR might be recommended in certain mumps Measles virus causes symptoms that can include fever, cough, outbreak situations. runny nose, and red, watery eyes, commonly followed by a rash There are no known risks to getting MMRV vaccine at the same that covers the whole body. time as other vaccines. Measles can lead to ear infections, diarrhea, and infection of the lungs (pneumonia). Rarely, measles can cause brain damage or Instead of MMRV, some children 12 months death. through 12 years of age might get 2 separate Mumps shots: MMR (measles, mumps and rubella) and Mumps virus causes fever, headache, muscle aches, tiredness, chickenpox (varicella). MMRV is not licensed for loss of appetite, and swollen and tender salivary glands under the people 13 years of age or older.