It may seem a daunting task to keep yourself and your loved ones free of infections. Beyond the obvious—steering clear of runny noses and hacking coughs—you may be wondering about some other practical ways of staying infection-free. Your skin acts as a natural barrier against harmful microbes that cause infections, but smart “bugs” have found alternative routes to get into your body and cause infection. By making a few simple behavioral changes (which ultimately reduce their access into your body), you can easily prevent the spread of many infectious diseases.
- Wash your hands frequently. Did you know that microbes can live on inert surfaces anywhere from a few minutes to several months? Imagine these disease-causing microbes living on your computer keyboard, your light-switch, or even on the pedestrian-crossing button next to the crosswalk!Surprisingly, most people don’t know the best way to effectively wash their hands. The CDC recommends washing thoroughly and vigorously with soap and water for at least 20 seconds, followed by hand-drying with a paper towel. In the absence of running water, an alcohol-based hand gel or wipe will suffice, although nothing beats good ol’ soap and water. This takes about as long as it does to sing “Happy Birthday”, so some hospitals recommend washing your hands for the duration of this simple tune!
- Don’t share personal items. Toothbrushes, towels, razors, handkerchiefs, and nail clippers can all be sources of infectious agents (bacteria, viruses, and fungi). In kindergarten, you were taught to share your toys, but keep your hands to yourself. Now try to remember to keep personal items to yourself as well!
- Cover your mouth when you cough or sneeze. In a similar vein, good personal hygiene includes not only personal cleanliness, but also the age-old practice of covering your mouth when you cough or sneeze. Why is this important if you aren’t sick? For most infections, the disease-causing microbe has already started growing and dividing long before any symptoms begin to show. Coughing or sneezing can spread these germs through microscopic droplets in the air. The current recommendation is to cover your mouth with your arm, sleeve, or crook of the elbow, rather than using your hands. Read more »
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Posted in medicalmatrix | February 13, 2010 | 
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Background
Anemia, like a fever, is a symptom of disease that requires investigation to determine the underlying etiology. Often, practicing physicians overlook mild anemia. This is similar to failing to seek the etiology of a fever. The purpose of this article is to provide a method of determining the etiology of an anemia.
Anemia is strictly defined as a decrease in red blood cell (RBC) mass. Methods for measuring RBC mass are time consuming, are expensive, and usually require transfusion of radiolabeled erythrocytes. Thus, in practice, anemia is usually discovered and quantified by measurement of the RBC count, hemoglobin (Hb) concentration, and hematocrit (Hct). These values should be interpreted cautiously because they are concentrations affected by changes in plasma volume. For example, dehydration elevates these values, and increased plasma volume in pregnancy can diminish them without affecting the RBC mass.
Pathophysiology
Erythroid precursors develop in bone marrow at rates usually determined by the requirement for sufficient circulating Hb to oxygenate tissues adequately. Erythroid precursors differentiate sequentially from stem cells to progenitor cells to erythroblasts to normoblasts in a process requiring growth factors and cytokines. This process of differentiation requires several days. Normally, erythroid precursors are released into circulation as reticulocytes.
Reticulocytes remain in the circulation for approximately 1 day before reticulin is excised by reticuloendothelial cells with the delivery of the mature erythrocyte into circulation. The mature erythrocyte remains in circulation for about 120 days before being engulfed and destroyed by phagocytic cells of the reticuloendothelial system. Read more »
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Background
Malaria, which predominantly occurs in tropical areas, is a potentially life-threatening disease caused by infection with Plasmodium protozoa transmitted by an infective female Anopheles mosquito vector. Individuals with malaria may present with fever and a wide range of symptoms.
The 4 Plasmodium species known to cause malaria include Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, and Plasmodium malariae. A fifth species, Plasmodium knowlesi, has recently been identified as a clinically significant pathogen in humans. Timely identification of the infecting species is extremely important, as P falciparum infection can be fatal and is often resistant to standard chloroquine treatment. In some cases, individuals with malaria are infected with multiple Plasmodium species. P falciparum and P vivax are responsible for most new infections. Each Plasmodium species has a defined area of endemicity, although geographic overlap is common. Species can usually be distinguished by morphology on a blood smear. P falciparum is distinguished from the rest of plasmodia by its high level of parasitemia and the banana shape of its gametocytes.
Malaria in travelers typically manifests weeks after the individual leaves the endemic area. Presentation more than 4 weeks after returning from the endemic area is unusual. In some individuals, disease manifests months or years later, usually due to the presence of P vivax or P ovale hypnozoites, which can remain dormant in the liver and reactivate years after infection. Relapse with P vivax or P ovale infection is rare more than 5 years after initial infection. Because symptomatic delay is common, history of even a remote exposure to an endemic area should be elicited. Symptoms of malaria are nonspecific, and, because timely diagnosis and treatment are necessary, malaria should be considered in all patients from tropical areas who present with fever. Read more »
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Background
Dengue, the most common arboviral illness transmitted worldwide, is caused by infection with 1 of the 4 serotypes of dengue virus, family Flaviviridae, genus Flavivirus (single-stranded nonsegmented RNA viruses). Dengue is transmitted by mosquitoes of the genus Aedes, which are widely distributed in subtropical and tropical areas of the world, and is classified as a major global health threat by the World Health Organization (WHO).
Initial dengue infection may be asymptomatic (50%-90%), may result in a nonspecific febrile illness, or may produce the symptom complex of classic dengue fever (DF). A small percentage of persons who have previously been infected by one dengue serotype develop bleeding and endothelial leak upon infection with another dengue serotype. This syndrome is termed dengue hemorrhagic fever (DHF), although dengue vasculopathy has been proposed as a better term, as fluid loss into tissue spaces can lead to prolonged shock and complications, including gastrointestinal bleeding, a greater fatality risk than bleeding per se. Some patients with dengue hemorrhagic fever develop shock (dengue shock syndrome [DSS]), which may cause death.
Dengue virus transmission follows two general patterns—epidemic dengue and hyperendemic dengue. Epidemic dengue transmission occurs when dengue virus is introduced into a region as an isolated event that involves a single viral strain. If the number of vectors and susceptible pediatric and adult hosts is sufficient, explosive transmission can occur, with an infection incidence of 25%-50%. Mosquito-control efforts, changes in weather, and herd immunity contribute to the control of these epidemics. Transmission appears to begin in urban centers and then spreads to the rest of a country. This is the current pattern of transmission in parts of Africa and South America, areas of Asia where the virus has reemerged, and small island nations. Travelers to these areas are at increased risk of acquiring dengue during these periods of epidemic transmission.
Hyperendemic dengue transmission is characterized by the continuous circulation of multiple viral serotypes in an area where a large pool of susceptible hosts and a competent vector (with or without seasonal variation) are constantly present. This is the predominant pattern of global transmission. In these populations, antibody prevalence increases with age and most adults are immune. Hyperendemic transmission appears to be a major risk for dengue hemorrhagic fever. Travelers to these areas are more likely to be infected than are travelers to areas that experience only epidemic transmission. Read more »
Tags: A, activation, addition, adult hosts, Aedes, aegypti, Africa, alanine, Albert Sabin, albumin, alpha, america areas, aminotransferase, analysis, ancestor, Asia, aspartate, bite, Bleeding, blood, C.
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This article focuses on common bacterial infections in pregnancy and describes the manifestations of these infections and the therapies used to treat them.
Bacterial infections can affect pregnant women from implantation of the fertilized ovum through the time of delivery and peripartum period. They may also affect the fetus and newborn. Many women with these infections are asymptomatic, necessitating both a high degree of clinical awareness and adequate screening.
Grop B Streptococcus
Group B Streptococcus (GBS) is the most common cause of life-threatening infections in newborns; thus, GBS is the primary focus of any discussion about infections and pregnancy. Infections caused by GBS affect both mother and child. Since the emergence of this pathogen in the 1970s, the increased use of intrapartum prophylaxis has decreased the infection rate by 70%.
Etiology
Streptococcus agalactiae, or GBS, is a facultative, beta-hemolytic, fastidious, gram-positive coccus. GBS can be found as part of normal vaginal, rectal, and oral flora. The virulence of the organism depends largely on the polysaccharide capsule.
Transmission
Twenty to 25% of pregnant women are asymptomatic carriers of vaginal or rectal GBS. Intrapartum transmission occurs via ascending spread or at the time of delivery.
Clinical spectrum
Because only 0.5-1% of mothers who carry GBS develop signs and symptoms of disease, clinical diagnosis of GBS infection can be problematic.
In pregnant women, GBS is a cause of cystitis, amnionitis, endometritis, and stillbirth. Occasionally, GBS has caused endocarditis and meningitis in pregnant women, while, in postpartum women, GBS has been identified as a cause of urinary tract infections (UTIs) and pelvic abscesses. Read more »
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