What Do You Do When the Rabies Vaccination Schedule is Off Schedule?

Discussion Rabies virus causes progressive encephalopathy and has a high fatality rate if not treated. Fortunately, post-exposure prophylaxis (PEP) regimens are highly effective. Any mammal is susceptible to rabies vaccine with domesticated dogs being important sources in some international locations and in the U.S. coyotes, fox, raccoon, and skunk and bats are important reservoirs. Rabies transmission from bats “…can occur from minor, seemingly unimportant, or unrecognized bites from bats.” Therefore contact should be minimized. PEP is considered for people who had significant contact, were known to be bitten or were in a room and might be unaware that the bat touched them or bit them. Examples would be a sleeping person or a child who was unattended and is now found to have a bat in the room. Current rabies vaccine schedule is a 4 dose series – Day 0, 3, 7 and 14. A fifth dose is given on day 28 for immunocompromised individuals. Vaccination is considered safe for pregnant women and should be given if PEP is indicated. Rabies immunoglobulin is also recommended to be given on Day 0. Once the PEP series is started it generally is continued. One reason to stop is if the bat tests negative for rabies, then the PEP can be stopped. It is recommended to consult current resources such as the Centers for Disease Control or local health department regarding current PEP treatment and individual circumstances. Learning Point It is important for the PEP to be gi...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news

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The objective of this study was to determine the serological prevalence of anti-Leptospira antibodies in meat dealers in the city of Tunja, Boyac á, Colombia. An observational, cross-sectional and descriptive study was carried out in a population of 186 operators from meat establishments in the city of Tunja. The samples were analyzed using the microagglutination test in order to determine the serovar that causes the infection. Each particip ant answer a survey with important questions about socio-demographic, epidemiological and occupational factors. A seroprevalence of 43% [n = 80; 95% confidence interval (CI): 36...
Source: Jornal Brasileiro de Patologia e Medicina Laboratorial - Category: Pathology Source Type: research
ABSTRACT Our aim was to report the unusual case of an anencephalic fetus that was born with the umbilical cord attached to its cephalic pole. The patient was a 16-year-old pregnant woman. Ultrasound evaluation at 17 weeks revealed a single fetus without cranial vault and brain parenchyma, compatible with anencephaly. Postnatal evaluation, through an autopsy, was consistent with this diagnosis. Moreover, it was observed that the umbilical cord was attached to the area cerebrovasculosa and there was the presence of a fibrous tissue, suggestive of an amniotic band. We have found only one similar case described in the literatu...
Source: Jornal Brasileiro de Patologia e Medicina Laboratorial - Category: Pathology Source Type: research
Discussion: These two cases demonstrate that singles vaccination is not an absolute protection against varicella zoster virus–related acute retinal necrosis. However, such vaccination may reduce the severity of the acute retinal necrosis.
Source: Retinal Cases and Brief Reports - Category: Opthalmology Tags: Case Report Source Type: research
Conclusion: Congenital retinal macrovessels can be complicated by macular edema. The high levels of hormones during pregnancy can affect the vessels' permeability and make this condition symptomatic through cystoid macular edema development.
Source: Retinal Cases and Brief Reports - Category: Opthalmology Tags: Case Report Source Type: research
Abstract Objective Frozen section examination is a rapid method for identifying products of conception in endometrial curetting, yet its accuracy is inconclusive. The purposes of this study is to determine the accuracy of frozen section analysis of endometrial curetting in pregnancies of unknown location, and to verify the relation of β -human chorionic gonadotrophin (hCG) level and endometrial thickness to the assessed accuracy. Methods We reviewed data from January 2009 to December 2014 of diagnostic curettages from women with suspected ectopic pregnancies sent for frozen section examination at a medical center. A f...
Source: Revista Brasileira de Ginecologia e Obstetricia - Category: OBGYN Source Type: research
Conclusion The CS rate in the United Arab Emirates (UAE) is higher than the global average rate and than the average rate in Asia, which highlights the need for more education of pregnant women and of their physicians in order to promote vaginal birth. A proper planning is needed to reduce the number of CSs in nulliparous women in order to prevent repeated CSs in the future. Monitoring both CS rates and outcomes is essential to ensure that policies, practices, and actions for the optimization of the utilization of CS lead to improved maternal and infant outcomes.
Source: Revista Brasileira de Ginecologia e Obstetricia - Category: OBGYN Source Type: research
Abstract Considering that myths and misconceptions regarding natural procreation spread rapidly in the era of easy access to information and to social networks, adequate counseling about natural fertility and spontaneous conception should be encouraged in any kind of health assistance. Despite the fact that there is no strong-powered evidence about any of the aspects related to natural fertility, literature on how to increase the chances of a spontaneous pregnancy is available. In the present article, the Brazilian Federation of Gynecology and Obstetrics Associations (FEBRASGO, in the Portuguese acronym) Committee on Endoc...
Source: Revista Brasileira de Ginecologia e Obstetricia - Category: OBGYN Source Type: research
Abstract Angiomyolipomas (AMLs) are rare benign tumors derived from mesenchymal tissue and composed of varying degrees of adipose tissue, muscle and blood vessels. Renal AMLs (RAMLs) are the result of a sporadic event, and, in most of cases, the diagnosis is usually incidental, but hemorrhage and shock may be present. During pregnancy, the size of AMLs may increase and they may rupture, probably due to the high expression of hormone receptors, and the increase in maternal circulation and abdominal pressure. The authors present a case of a woman with ruptured RAML submitted to urgent endovascular treatment four days after g...
Source: Revista Brasileira de Ginecologia e Obstetricia - Category: OBGYN Source Type: research
Authors: Spagnuolo A, Gridelli C Abstract Introduction: In recent years, immunotherapy has become an integral part of the treatment of many cancers, including non-small cell lung cancer (NSCLC). Precious therapeutic weapons impacting survival are monoclonal antibodies directed against the programmed death protein-1 (PD-1)/programmed death ligand-1 (PD-L1) immune checkpoint. Areas covered: Unfortunately, not all patients treated with checkpoint inhibitors have durable clinical responses. However, a better understanding of the complexity of interactions between the immune system and cancer, the latter capable of adop...
Source: Expert Review of Respiratory Medicine - Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research
Abstract Rabies is a fatal zoonotic disease preventable through timely and adequate post-exposure prophylaxis (PEP) to potentially exposed persons i.e. wound washing and antisepsis, a series of intradermal (ID) or intramuscular (IM) rabies vaccinations, and rabies immunoglobulin in WHO category III exposures. The 2010 WHO position on rabies vaccines recommended PEP schedules requiring up to 5 clinic visits over the course of approximately one month. Abridged schedules with less doses have potential to save costs, increase patient compliance, and thereby improve equitable access to life-saving PEP for at-risk popul...
Source: Vaccine - Category: Allergy & Immunology Authors: Tags: Vaccine Source Type: research
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