Assessing Fever in Returning Travelers: Part II

  Zika continues to be the virus of the day for returning travelers, but there are several other diseases that we need to consider in these patients when they present to us in the emergency department. Chikungunya is epidemic in many of the same countries as Zika and can be even more devastating. And Avian and MERS-CoV is still present in many countries. Unlike patients infected with Zika virus, these patients do require isolation to protect our health care staff from infection. Chikungunya Chikungunya, which means “to walk bent over,” was likely endemic but unrecognized in the United States before the mosquito eradication programs initiated in the 1950s. While the presentation of chikungunya is similar to that of dengue, with fever, a petechial rash, and arthralgias, bleeding is usually less severe. However, the associated arthralgias are much more painful and can last from months to years. Chikungunya has a similar incubation period as dengue, 2-14 days, but most patients present by day four. Treatment is supportive and includes adequate pain control; there are no medications that specifically treat chikungunya. Immunity does develop after infection with chikungunya, but it is short-lived and not lifelong. Until outbreaks of recent years, chikungunya was a painful disease with a high morbidity but a very low mortality; however, changes in the virus have increased disease severity. Chikungunya is now being transmitted by Aedes albopictus, a temperate mosquit...
Source: EPMonthly.com - Category: Emergency Medicine Authors: Tags: Uncategorized Source Type: news

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Publication date: 30 May 2020Source: New Scientist, Volume 246, Issue 3284Author(s): Adam Vaughan
Source: New Scientist - Category: Science Source Type: research
Publication date: 30 May 2020Source: New Scientist, Volume 246, Issue 3284Author(s): Alice Klein
Source: New Scientist - Category: Science Source Type: research
Publication date: Available online 30 March 2020Source: Journal of Genetics and GenomicsAuthor(s): Gang Liu, Haijuan Xiao, Linlin Liu, Lingyun Guo, Ruolan Guo, Xuyun Hu, Chanjuan Hao, Jingang Gui, Weiwei Jiao, Fang Xu, Adong Shen, Wei Li
Source: Journal of Genetics and Genomics - Category: Genetics & Stem Cells Source Type: research
Publication date: Available online 29 May 2020Source: Diagnostic and Interventional ImagingAuthor(s): T. Mayer, R.L. Cazzato, P. De Marini, P. Auloge, D. Dalili, G. Koch, J. Garnon, A. Gangi
Source: Diagnostic and Interventional Imaging - Category: Radiology Source Type: research
Publication date: Available online 29 May 2020Source: Diagnostic and Interventional ImagingAuthor(s): A. Ricquart Wandaele, A. Kastler, A. Comte, G. Hadjidekov, R. Kechidi, O. Helenon, B. Kastler
Source: Diagnostic and Interventional Imaging - Category: Radiology Source Type: research
In the clinic, I'm wearing respirator and face shield, but out in public, I'm un-masked. he/his/him
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
Authors: Loh HH, Yee A, Loh HS, Kanagasundram S, Francis B, Lim LL Abstract PURPOSE: Polycystic ovarian syndrome (PCOS) is a common disorder characterized by clinical or biochemical hyperandrogenism and ovulary dysfunction. Female sexual dysfunction (FSD) adversely affects quality of life and interpersonal relationships. We aimed to compare the prevalence of FSD in women with and without PCOS. METHODS: We pooled data from 28 observational studies involving 6256 women. Apart from the total prevalence of FSD, subgroup analyses based on different PCOS diagnostic criteria and obesity status (body mass index [BMI]&t...
Source: Hormones - Category: Endocrinology Tags: Hormones (Athens) Source Type: research
CONCLUSION: Concomitant use of L-carnitine and piracetam might have a muscle-protective effect and protection against simvastatin-induced myalgia. Furthermore, the formulation was safe and well tolerated by the subjects investigated in this trial.
. PMID: 32469304 [PubMed - as supplied by publisher]
Source: International Journal of Clinical Pharmacology and Therapeutics - Category: Drugs & Pharmacology Tags: Int J Clin Pharmacol Ther Source Type: research
Authors: Beck G, Yamashita R, Saeki C, Ogawa T, Shimizu M, Mochizuki H Abstract We herein report a 56-year-old Japanese woman who had been diagnosed with hereditary angioedema. She experienced progressing muscle weakness and pain in the upper and lower extremities. Blood tests revealed a marked increase in creatine kinase levels; however, myositis-specific autoantibodies were not detected. Serum C1-inhibitor activity and C4 levels were low. A muscle biopsy showed mild muscle fiber necrosis and C5b-9 deposition in the endomysial capillary vessel walls and sarcolemma, mimicking necrotizing myopathy. These results sug...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Authors: Sekiguchi Y, Iizuka H, Takizawa H, Sugimoto K, Sakajiri S, Inano T, Fukuda Y, Shirane S, Hamano Y, Tomita S, Izumi H, Okubo M, Nakamura N, Sawada T, Sekiguchi N, Noguchi M Abstract A 53-year-old woman had been diagnosed with rheumatoid arthritis (RA) in X-6. She was started on methotrexate (MTX) in X-1. She developed a cough, and chest computed tomography showed abnormalities. In X, MTX was discontinued, but the cough persisted. A lung biopsy revealed a diagnosis of nodular sclerosis classic Hodgkin lymphoma (CHL-NS). She was considered to have "other iatrogenic immunodeficiency-associated lymphoproli...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
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