Catálogo de publicaciones - libros

Group A streptococcal pharyngitis is defined as an acute infection of the oropharynx and sometimes the nasopharynx by . The purpose of this guideline is to provide recommendations for the accurate diagnosis and optimal treatment of Group A streptococcal pharyngitis in children and adults. Following these recommendations should result in fewer cases of acute rheumatic fever, fewer cases of suppurative complications (e.g., peritonsillar abcesses, cervical lymphadenitis, and mastoiditis), a more rapid return to usual activities, and a decrease in infectivity. This decrease in infectivity will result in a reduced transmission of Group A β-hemolytic streptococci among family members and close contacts of the patient. Another important benefit to the widespread use of this guideline will be the minimization of inappropriate antibiotic therapy use.

The 2002 guidelines from the Center for Disease Control (CDC) represents a revision of a prior set of guidelines represented by the CDC in 1996. Group B streptococcus (GBS) remains a leading cause of serious neonatal infection despite the significant efforts in the disease prevention through the 1990s, including recommendations presented by the CDC, the American College of Obstetricians and Gynecologists (ACOG), and by the American Academy of Pediatrics (AAP). The updated 2002 guidelines were based on clinical evidence and expert opinions gathered since the 1996 recommendations (). Significant changes in the newer guidelines included a recommendation for universal prenatal screening for GBS; detailed instructions on specimen collection, processing and testing; updated prophylaxis regimens for penicillin-allergic women; recommendations against routine antipartum antibiotic prophylaxis for GBS-colonized women undergoing planned cesarean deliveries prior to the onset of labor or the rupture of membranes; a suggested algorithm for management of threatened preterm delivery; and an updated algorithm for the management of newborns exposed to intrapartum antibiotics.

This chapter summarizes the Advisory Committee on Immunization Practices (ACIP) Adult Immunization Schedule for 2005 and 2006. Each vaccine is addressed in a similar manner—vaccine-preventable disease characteristics are briefly discussed, candidates for vaccination are discussed, followed by specifics of vaccination (dosage and administration, efficacy, side effects, and contraindications and cautions). Figure 1 and 2 are a copy of the Centers for Disease Control (CDC) Adult Immunization Schedules with footnotes.

Rabies is a viral infection transmitted through the saliva of infected mammals. The virus enters the central nervous system and causes encephalomyelitis, which is almost always fatal. Human cases of rabies are rare in the United States (average of two cases per year); however, international travelers to areas where canine rabies is still endemic have a greatly increased risk of exposure. Rabies among wildlife (raccoons, skunks, and bats) has been increasing in prevelance since the 1950s, accounting for 85% of all reported cases of animal rabies. Rabies among the wildlife occurs throughout the continental United States; Hawaii remains rabies free. Since 1980, 58% of the 36 human cases of rabies in the United States have been associated with bats. In most other countries, dogs remain the most common source of rabies transmission to humans.

One to two times a year every person in the United States has an episodic increase in the water content of their normal bowel movement, which then leads to an increase in the volume, frequency, or liquidity of their stools. It has been estimated that in the United States people have these diarrheal episodes up to 375 million times each year, resulting in 73 million physician consultations, 1.8 million hospitalizations, and 3100 deaths. When the Centers for Disease Control and Prevention (CDC) surveyed a population about their diarrheal illness, an estimated 31% used an antidiarrheal medication, 12% telephoned the physician or provider’s office, 8% visited a physician’s or other provider’s office, 5% used an antimicrobial agent, and 0.6% were hospitalized. In addition to the acute morbidity and mortality of diarrhea, some causes of infectious diarrhea result in serious long-term sequelae such as hemolytic uremic syndrome (HUS) with renal failure, Guillain-Barré syndrome, and malnutrition.

Worldwide, there are more than 8 million new cases of (TB) and 3 million deaths each year. In the United States, approx 15 million people are infected with TB. In 1965, shortly after isoniazid was found to be effective for the treatment of TB, the first recommendation for treating latent . infection (LTBI) in the general population was given. The American Thoracic Society recommended that all persons with evidence of previously untreated TB, with recent tuberculin test conversions, and all children younger than 3 yr of age with a positive tuberculin skin test (TST) should be treated with isoniazid. Despite broadened recommendations in 1967 and a more widespread number of people being treated with an inexpensive drug that was thought to have few side effects, the morbidity from TB never dramatically fell as had been projected. When the hepatotoxicity of isoniazid began to be recognized in the early 1970s a controversy erupted over what would be the appropriate age cutoff in low-risk people that would ensure the benefits of therapy for LTBI and outweigh the risks of treatment. Rifampin (RIF) was introduced for the treatment of LTBI in the early 1980s because the real and perceived problems with isoniazid’s hepatotoxicity and the long period of treatment required with isoniazid had impaired isoniazid’s widespread usefulness.

In August 2006 the Centers for Disease Control (CDC) issued the Sexually Transmitted Diseases Treatment Guidelines, 2006. The guidelines contain and establish the standard of care for the treatment of sexually transmitted diseases (STDs) nationwide. This chapter summarizes the most important points and the treatment regimens recommended in the guidelines, and follows the organization of the guidelines. All treatment regimens, as well as selected text presented here, are taken verbatim from the guidelines. In addition to treatment, it is essential to understand that counseling patients routinely about prevention of STD acquisition is an important aspect of routine clinical care of adolescents and adults.

Occupational exposure to potentially infectious agents has received great attention because of the advent of HIV and the growing awareness of the possible serious clinical ramifications of hepatitis C. However, there are more than 20 diseases that have been linked to needle-stick injury. The latter group of illnesses are beyond the scope of this chapter but should be considered when developing institutional policies or when providing care for exposed health care personnel (HCP). The following guidelines apply to any health care worker (HCW; e.g., employees, students, contractors, attending clinicians, public safety workers, volunteers).

The US Preventive Services Task Force recommends screening all women age 65 and over for osteoporosis using dual-energy X-ray absorptiometry (DXA) of the femoral neck. Neither the frequency of screening nor the age at which screening may stop are specified. Women at high risk should begin screening at age 60; however, the criteria for determining which women are at high risk are controversial. There is insufficient evidence to recommend for or against screening women younger than 60 or low-risk women aged 60–64. In making their recommendation, the US Preventive Services Task Force reviewed evidence related to five key questions, each of which is summarized next ().

About 70% of the nearly 60 million women who undergo Papanicolaou (Pap) testing each year in the United States will be told they have abnormal results. In the past, deciding who gets a colposcopy, when to repeat the Pap test, and which patients should be treated has been both confusing and controversial. The publication of two sets of guidelines from the American Society for Colposcopy and Cervical Pathology (ASCCP) has greatly clarified these issues. These new evidence-supported consensus-based guidelines provide algorithms for managing cervical cytological abnormalities and histologically confirmed cervical intraepithelial neoplasia (CIN). They were developed out of a consensus workshop convened by ASCCP in 2001 and subsequently published in and the . These new guidelines were preceded by revisions to the Bethesda System of nomenclature for cervical cytology. This updated terminology, as well as advances in the understanding of human papillomavirus (HPV) as a cervical cancer precursor and the increased use of advanced technologies like liquid-based cervical cytology and HPV-DNA typing, were key in developing these guidelines.