...Review Article 539 Dengue Prophylactic Platelet Transfusion—Changa Kurukularatne et al When Less is More: Can We Abandon Prophylactic Platelet Transfusion in Dengue Fever? Changa Kurukularatne,1,2MD, Frederico Dimatatac,1,2MD, Diana LT Teo,3MBBS, MSc, FRCPath, David C Lye,1,2,4 MBBS, FRACP, FAMS, Yee Sin Leo,1,2,5 M.Med (Int Med), FRCP, FAMS Abstract Dengue fever (DF) has several hematological manifestations including thrombocytopenia and increased bleeding risk. Prophylactic platelet transfusion—in the absence of major bleeding—is utilized in DF with thrombocytopenia with the intention of preventing hemorrhagic complications. However, prophylactic platelet transfusion in DF is neither standardized nor supported by clinical evidence. We conclude that risks, costs and poor resource utilization associated with prophylactic platelet transfusion in DF far outweigh any potential hematological benefit, and as such, should not constitute routine clinical practice. Ann Acad Med Singapore 2011;40:539-45 Key words: Thrombocytopenia, Preventitive, Arbovirus, Bleeding, Hemorrhage Introduction Dengue fever (DF) is the most common mosquito-borne human viral illness worldwide, and has rapidly spread to reach hyper-endemic proportions in the urban tropics over the last quarter of a century.1 With an estimated 2.5 billion people at risk and a global annual incidence of 50 million cases, DF has been identified as an example of a potential international public health emergency.2...
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...Leptospirosis Leptospirosis is an infectious disease caused by bacteria belonging to the genus Leptospira. Leptospirosis occurs worldwide, but is most prevalent in tropical and subtropical regions. Outbreaks can occur following excessive rainfall or flooding. Etiology Virtually all wild and domestic mammals can harbour the bacteria that cause leptospirosis in their kidneys and genital tracts and act as source of infection to humans and other animals. • Rodents were the first recognized carriers of leptospirosis and are considered the primary source of infection to human beings. • Cattle, buffaloes, horses, sheep, goat, pigs and dogs are also considered common reservoirs of the bacteria that causes leptospirosis. Pathophysiology • Leptospirosis can be transmitted to humans through cuts and abrasions of the skin, or through the mucous membranes of the eyes, nose and mouth with water contaminated with the urine of infected animals. As animals are constantly in our environment, there is a particular danger of getting leptospirosis when flooding occurs, such as following a typhoon or very heavy seasonal rains, because of exposure to contaminated water when wading in floodwaters. • Leptospirosis can occasionally also be transmitted through the drinking of water or ingestion of food contaminated with urine of infected animals, often rats. • Human-to-human transmission occurs only very rarely. Risk Factors Outbreaks of leptospirosis have been reported following natural...
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...Clinical guidelines Diagnosis and treatment manual for curative programmes in hospitals and dispensaries guidance for prescribing 2010 EDITION © Médecins Sans Frontières – January 2010 All rights reserved for all countries. No reproduction, translation and adaptation may be done without the prior permission of the Copyright owner. ISBN 2-906498-81-5 Clinical guidelines Diagnosis and treatment manual Editorial Committee: I. Broek (MD), N. Harris (MD), M. Henkens (MD), H. Mekaoui (MD), P.P. Palma (MD), E. Szumilin (MD) and V. Grouzard (N, general editor) Contributors: P. Albajar (MD), S. Balkan (MD), P. Barel (MD), E. Baron (MD), M. Biot (MD), F. Boillot (S), L. Bonte (L), M.C. Bottineau (MD), M.E. Burny (N), M. Cereceda (MD), F. Charles (MD), M.J de Chazelles (MD), D. Chédorge (N), A.S. Coutin (MD), C. Danet (MD), B. Dehaye (S), K. Dilworth (MD), F. Fermon (N), B. Graz (MD), B. Guyard-Boileau (MD), G. Hanquet (MD), G. Harczi (N), M. van Herp (MD), C. Hook (MD), K. de Jong (P), S. Lagrange (MD), X. Lassalle (AA), D. Laureillard (MD), M. Lekkerkerker (MD), J. Maritoux (Ph), J. Menschik (MD), D. Mesia (MD), A. Minetti (MD), R. Murphy (MD), J. Pinel (Ph), J. Rigal (MD), M. de Smet (MD), S. Seyfert (MD), F. Varaine (MD), B. Vasset (MD) (S) Surgeon, (L) Laboratory technician, (MD) Medical Doctor, (N) Nurse, (AA) Anaesthetist-assistant, (Ph) Pharmacist, (P) Psychologist We would like to thank the following doctors for their invaluable help:...
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...microbiology is critical for the practicing physician in any medical field. Bacteria, viruses, and protozoans have no respect for the distinction between ophthalmology, pediatrics, trauma surgery, or geriatric medicine. As a physician you will be faced daily with the concepts of microbial disease and antimicrobial therapy. Microbiology is one of the few courses where much of the "minutia" is regularly used by the practicing physician. This book attempts to facilitate the learning of microbiology by presenting the information in a clear and entertaining manner brimming with memory aids. Our approach has been to: 4) Create a conceptual, organized approach to the organisms studied so the student relies less on memory and more on logical pathophysiology. The text has been updated to include current information on rapidly developing topics, such as HIV and AIDS (vaccine efforts and all the new anti-HIV medications), Ebola virus, Hantavirus, E. coli outbreaks, Mad Cow Disease, and brand-new antimicrobial antibiotics. The mnemonics and cartoons in this book do not intend disrespect for any particular patient population or racial or ethnic group but are solely presented as memory devices to assist in the learning of a complex and important medical subject. We welcome suggestions for future editions. 1) Write in a conversational style for rapid assimilation. 2) Include numerous figures serving as "visual memory tools" and summary charts at the end of each chapter. These can be used for...
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...NINTH EDITION Burton’s MICROBIOLOGY FOR THE HEALTH SCIENCES Paul G. Engelkirk, PhD, MT(ASCP), SM(AAM) Biomedical Educational Services (Biomed Ed) Belton, Texas Adjunct Faculty, Biology Department Temple College, Temple, TX Janet Duben-Engelkirk, EdD, MT(ASCP) Biomedical Educational Services (Biomed Ed) Belton, Texas Adjunct Faculty, Biotechnology Department Temple College, Temple, TX Acquisitions Editor: David B. Troy Product Manager: John Larkin Managing Editor: Laura S. Horowitz, Hearthside Publishing Services Marketing Manager: Allison Powell Designer: Steve Druding Compositor: Maryland Composition/Absolute Service Inc. Ninth Edition Copyright © 2011 Lippincott Williams & Wilkins, a Wolters Kluwer business © 2007 Lippincott Williams & Wilkins, © 2004 Lippincott Williams & Wilkins, © 2000 Lippincott Williams & Wilkins, © 1996 Lippincott-Raven, © 1992, 1988, 1983, 1979 JB Lippincott Co. 351 West Camden Street Baltimore, MD 21201 Printed in the People’s Republic of China All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees...
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