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Prophylactic Antibiotic Treatment during Hysteroscopy: A Systematic Review  [PDF]
Jannie Wijma, Paul J. Q. van der Linden
Open Journal of Obstetrics and Gynecology (OJOG) , 2015, DOI: 10.4236/ojog.2015.53022
Abstract:

Background: Overall, the use of antibiotics is increasing. We noticed different practices amongst different hospitals in their prophylactic use of antibiotics during operative hysteroscopy. This review investigates whether there is sufficient evidence to recommend antibiotic prophylaxis in operative hysteroscopy. Methods: We performed a systematic search in “Pubmed” using “hysteroscopy” and “antibiotic” and “prophylaxis” as search items. We found 16 hits of which 4 were suitable to include in our review. Findings: In an included Cochrane review no conclusion was drawn since no articles could be included. A prospective study by Nappiet al.[1]support the recommendation of the American College of Obstetricians and Gynaecologists not to prescribe routinely antibiotic prophylaxis in cases of hysteroscopic surgery. Bhattacharyaet al. conducted a prospective study that was ended prematurely. They conclude that there is no convincing evidence that prophylactic antibiotics are of value in hysteroscopy. A review by Morrillet al. yielded no new data. Conclusion: We did not find a significant increase in clinical relevant infectious symptoms after hysteroscopy in women treated with or without antibiotic prophylaxis, although data are insufficient to draw a definite conclusion. Therefore, we suggest a prospective study is mandatory on this topic.

Effective prophylaxis with rFVIIa in young haemophiliacs with inhibitors using a schedule similar to FVIII prophylaxis in non-inhibitor patients  [PDF]
María Fernanda López-Fernández, Carmen Altisent, Víctor Jiménez-Yuste, Faustino García-Candel, Carmen Sedano, Ana Cid, Eva Mingot, Ramiro Nú?ez, María José Paloma, Inmaculada Soto, Manuel Prieto
Health (Health) , 2013, DOI: 10.4236/health.2013.57155
Abstract:

Objective: To assess the role of early prophylaxis with recombinant activated factor VII (rFVIIa) in young haemophiliacs with inhibitors and to determine whether it can reduce bleeding episodes and prevent joint damage. Patients and Methods: Ten severe haemophiliacs, less of three years old, with up to four joint bleeds and inhibitors to FVIII who started early prophylaxis with rFVIIa, were included. A number of haemorrhages/year/patient and haemarthroses/ year/patient were compared before the start of prophylaxis, which include both the time before (initial period) and after inhibitor diagnosis (inhibitor period), with those during prophylaxis (prophylaxis period). Results: The mean time of inhibitor diagnosis was 15.6 months (range: 2.3-34.1). The mean time between inhibitor diagnosis and the start of prophylaxis was 7.1 months (range: 0-23.2), shorter than the time of rFVIIa prophylaxis (mean: 10.3 months; range: 4.1-32.0). Bleeding episodes for the three time periods were 45, 36 and 17, respectively, or 0.29 and 0.51 haemorrhages/year/patient in the two periods prior to prophylaxis compared to 0.17 during prophylaxis. Total haemarthroses for the three-time periods were 7, 5 and 5, respectively. The haemarthroses/year/patient in the pre-prophylaxis period were 0.032 and 0.070, compared to0.049 inthe prophylaxis period. rFVIIa schedules were either 90 μg/kg three times weekly or 90 μg/kg daily. Conclusions: Early prophylaxis with rFVIIa may be efficacious in young haemophiliacs with inhibitors, reducing joint bleeds. After the risky period of inhibitor presence, they are able to continue rFVIII prophylaxis with success assured to prevent arthropathy.

Are HIV Infected People Well Prepared to Travel? Polish Experience  [PDF]
Bartlomiej Mateusz Zalewski, Tomasz Mikula, Monika Romul, Monika Jablonska, Iwona Cielniak, Alicja Wiercinska-Drapalo
World Journal of AIDS (WJA) , 2014, DOI: 10.4236/wja.2014.42015
Abstract:

Introduction: This study aimed to identify knowledge about preparation for travel among Polish HIV infected patients. Materials and Methods: Our prospective questionnaire-based study assessed whether the abovementioned issues had an influence on travel plan decisions and whether HIV infected Polish people had any problems before and during travel. Results: All our 102 patients completed questionnaires. The majority sought pre-travel health advice. The mean duration of confirmed HIV infection was longer in travelers than in non-travelers (p = 0.02). More than half of travelers consulted with a physician prior to their journey but the most popular source of in-formation about the health risks of travelling was the internet while a doctor’s consultation was an alternative. Pre-travel prophylaxis was performed in less than 30% of patients. One of the most popular reasons for not travelling abroad was inadequate funds. Discussion: The situation of people with HIV in Poland is similar to that in other European countries. None of our patients had to give up their trip because of administrative barriers. HIV infected persons with a longer duration of infection were more willing to travel. One of the most popular reasons for not travelling abroad was inadequate funds. Among our patients, those afraid of potential health risks and inadequate funds are in the same proportion as in other countries. Conclusions: In our opinion, physicians should talk with HIV positive patients about their travel plans during routine visits. Polish HIV infected patients generally do not restrict their travel plans due to their HIV infection. The main sources of information for Polish HIV infected patients about possible problems during travel should be their doctor and additionally other sources of information like the internet.

Medical dental prophylaxis of endocarditis
Basilio, Regina C.;Loducca, Francisco E.;Haddad, Paulo C.;
Brazilian Journal of Infectious Diseases , 2004, DOI: 10.1590/S1413-86702004000500002
Abstract: antibiotics have long been the main reason for the increase in man's longevity. since their discovery, man has tried to reduce the level of infection by treating with antibiotics. at the same time, prophylactic use has been suggested, although this is controversial. their routine use is not recommended, and empirical treatments at non-therapeutic doses, and indiscriminately, should be avoided, because they may become dangerous and harmful, causing among other things, the prevalence of resistant microorganisms and the eventual potentiation of an increase in morbid states. infectious endocarditis is a systemic pathology that can start with a bacteremia, which comes either from dental procedures or/and chronic processes that already existed. its etiopathogeny consists of a combination of bacteremia and two other factors: cardiac injury, which can be congenital or/and acquired, and a debilitated immunological system (patients who have transplanted organs, or those who have auto-immune diseases, such as pemphigus vulgaris, systemic lupus erythematosus). the main goal is to prevent or to fight against the transient bacteremia, reducing its intensity and duration, and also to kill the bacteria in at-risk patients. in this way, infectious endocarditis can be prevented; the dental surgeon plays an important role in the prevention of this condition, which joins medical and dental aspects. this can be done by antibiotic prophylaxis. the dentist needs to be acquainted with the medical protocols of the heart health societies.
Rabies DNA Vaccines: Current Status and Future  [PDF]
Padinjaremattathil Thankappan Ullas, Anita Desai, Shampur Narayan Madhusudana
World Journal of Vaccines (WJV) , 2012, DOI: 10.4236/wjv.2012.21005
Abstract: Rabies continues to be a significant cause of human and animal mortality, despite the availability of safe and effective prophylactics. Apart from limited access, the cost and complex schedules of rabies biologics often impact on the success of post-exposure prophylaxis in humans in the endemic countries. Mass vaccination of dogs, critical in rabies control, often fails to achieve its goal in rabies-endemic countries due to logistic, animal and vaccine-related issues. DNA vaccination has been proposed as a cheaper and efficient strategy for rabies prophylaxis, and its feasibility has been demonstrated in a number of animal models including companion animals, since 1994. Despite the proven efficacy, the technology suffers from a few drawbacks that limit its large-scale application, such as delayed and weaker immune responses in larger animals. Recent advances in the field of vector design and delivery hold promise for enhancement of rabies DNA vaccine efficacy. The present article provides an overview of developments in the field of DNA rabies vaccination and its future prospects.
Medical Care after Cat Bites: A Typical Case and Review  [PDF]
Jarmo Oksi, U. Ahlmén-Laiho, M. Laine
International Journal of Clinical Medicine (IJCM) , 2014, DOI: 10.4236/ijcm.2014.56050
Abstract:

Pet cat bites are commonthe most typical patient being a child, and the most typical locality hands and face. The normal flora of a pet cat’s mouth houses very potent pathogens. Therapeutic measures include wound cleansing, prophylaxis against tetanus and possibly rabies. Antibiotic prophylaxis should be administered in the cases of all but the mildest superficial wounds especially if the wound is in the hand or face. We present a review on the medical care of cat bite wounds and a typical case of a patient who developed rapid symptoms and signs of infection after a pet cat bite and nearly required hospitalization. The clinical picture was consistent with a Pasteurella infection.

Role of Early Low-Molecular-Weight Heparin Prophylaxis in the Surgical Treatment of Degenerative Spinal Diseases in the Elderly Patients  [PDF]
Carlo Doria, Gianfilippo Caggiari, Giulia Raffaella Mosele, Leonardo Puddu, Paolo Tranquilli Leali
Surgical Science (SS) , 2016, DOI: 10.4236/ss.2016.79054
Abstract: Study Design: Retrospective review. Summary of Background Data: Deep vein thrombosis (DVT) and pulmonary embolism (PE) are potential complications following major orthopaedic surgical procedures. Venous thromboembolism (VTE) is the disease process underlying DVT and PE. Pharmacological options can be use low-molecular-weight heparin (LMWH). Objective: The purpose of this study is to evaluate the hemorrhage risk when LMWH is started after 24 hours from surgery and to assess venous thromboembolism and pulmonary embolism risk in patients undergoing early prophylaxis after spine surgery. Methods: A consecutive cohort of 100 patients undergoing spinal surgery. Diagnosis was multilevel lumbar spinal stenosis in 46 cases and, degenerative thoracolumbar kypho-scoliosis in 54 cases. Starting on the first postoperative day, patients were routinely administered daily prophylactic enoxaparin at 8 pm (40 mg). Analysis was performed to identify risk factors of VTE among five independent variables (age, sex, obesity defined as body mass index > 30 kg/m2, smoking, duration of surgery), with statistical significance defined as P < 0.05. Results: No deaths in this 100 patient cohort; 2 patients developed symptomatic pulmonary embolism during the first three postoperative days and 1 patient had thromboembolic complications, with acute deep venous thrombosis. Only one statistically significant predictor of acute VTE (duration of surgery, P < 0.05). Conclusion: LMWH prophylaxis seems to carry a very low hemorrhage risk and low rate of PE and DVT when started 24 hours after spine surgery. Prophylaxis with LMWH should be considered in all patients underwent major spinal surgery particularly when VTE risk factors are present.
Garenoxacin Prophylaxis for Febrile Neutropenia after Chemotherapy in Hematological Malignancies  [PDF]
Nobuhiko Nakamura, Takeshi Hara, Soranobu Ninomiya, Yuhei Shibata, Takuro Matsumoto, Hiroshi Nakamura, Junichi Kitagawa, Yasuhito Nannya, Masahito Shimizu, Nobuo Murakami, Hisashi Tsurumi
Open Journal of Internal Medicine (OJIM) , 2016, DOI: 10.4236/ojim.2016.64018
Abstract: Background: Febrile neutropenia is one of the most serious adverse events in patients with hematological malignancies and chemotherapy. The routine use of fluoroquinolone prophylaxis in patients with hematological malignancies is controversial. Therefore, we prospectively evaluated the efficacy and safety of prophylactic use of garenoxacin for febrile neutropenia. Patients and Methods: Consecutive adult patients with hematological malignancies who were at risk for chemotherapy-induced neutropenia lasting more than seven days were eligible for present study. They received oral garenoxacin (400 mg daily) from the neutrophil count decreased to less than 1000/μl and continued until the neutropenia had resolved. The primary endpoint was incidence of febrile neutropenia, and the secondary endpoints were the type and incidence of adverse events. Results: We enrolled 46 consecutive patients (median age, 59 years). The underlying diseases comprised acute myeloid leukemia (n = 17), acute lymphoblastic leukemia (n = 3), malignant lymphoma (n = 23), and multiple myeloma (n = 3). There were 23 febrile neutropenia episodes and 2 episodes of bacteremia. There were no grade 3 or 4 adverse events; however serum creatinine levels were significantly elevated after garenoxacin administration. The overall prophylactic efficacy of garenoxacin was 50%, and there were no infection-related deaths. Conclusions: Prophylactic use of garenoxacin is effective and safe in patients with hematological malignancies. (Clinical trial registration number: UMIN000004979).
Antibiotics Prophylaxis in Patients with CAKUT, Does It Actually Prevent UTI? A Single Center Experience at South Africa  [PDF]
Nneka Chioma Okoronkwo, Abdullahi Mudi, Cecil Levy, Thuli Khumalo, G. Moonsamy
Open Journal of Nephrology (OJNeph) , 2018, DOI: 10.4236/ojneph.2018.84011
Abstract: Background: Congenital anomalies of the kidney and urinary tract (CAKUT) are a well-documented risk factor for the development of urinary tract infection (UTI) in children. Prevention of UTI in this group of patients is advocated due to their increased risk of renal scarring, hypertension and end stage kidney failure. Methods: A 10-year retrospective review of CAKUT patients at the Johannesburg Academic Hospital, who were placed on prophylactic antibiotics over a certain period was done. The rate of UTI, the types of causative organisms isolated and the efficacy of prophylactic antibiotics in preventing UTI were documented. Results: Thirty-six (36) out of 134 patients had been started on prophylactic antibiotics after the diagnosis of CAKUT was made. There was a statistically significant association between the use of prophylactic antibiotics and the rate of UTI (p < 0.001). Patients who were not on a prophylactic antibiotic were five times more likely to have a UTI than those who were on a prophylactic antibiotic (OR = 5.21, P = 0.001, 95% CI: 1.9906 - 13.6277). There was a statistically significant association between the type of bacteria isolated and the use of antibiotic prophylaxis (p = 0.031). Conclusion: Antibiotic prophylaxis was very effective in decreasing the rate of UTI in our cohort of patients with CAKUT.
Malaria Prophylaxis: A Comprehensive Review
Francesco Castelli,Silvia Odolini,Beatrice Autino,Emanuele Foca,Rosario Russo
Pharmaceuticals , 2010, DOI: 10.3390/ph3103212
Abstract: The flow of international travellers to and from malaria-endemic areas, especially Africa, has increased in recent years. Apart from the very high morbidity and mortality burden imposed on malaria-endemic areas, imported malaria is the main cause of fever possibly causing severe disease and death in travellers coming from tropical and subtropical areas, particularly Sub-Saharan Africa. The importance of behavioural preventive measures (bed nets, repellents, etc.), adequate chemoprophylaxis and, in selected circumstances, stand-by emergency treatment may not be overemphasized. However, no prophylactic regimen may offer complete protection. Expert advice is needed to tailor prophylactic advice according to traveller (age, baseline clinical conditions, etc.) and travel (destination, season, etc.) characteristics in order to reduce malaria risk.
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