Author: Liu
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Immunosuppression As An Individual Risk Factor
Immunosuppression is the major individual risk factor facilitating the development of disease from infection, particularly that caused by HIV infection. The spread of HIV to rural areas where VL is endemic, and the spread of VL to suburban areas, has resulted in a progressively increasing overlap between the two diseases, initially in the Mediterranean basin,…
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General Epidemiology Of Leishmaniasis Parasite
Leishmania are dimorphic parasites that present as two principal morphological stages: the intracellular amastigote, in the cells of the mammalian host mononuclear phagocyte system, and the flagellated promastigote, in the intestinal tract of the insect vector. Since the first Leishmania species was described (Laveran and Mesnil, 1903), the number of species has increased steadily, and…
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Is The Parasite Likely To Be Drug-Resistant?
In most areas of the world where malaria is transmitted, it is caused by drug-resistant parasites (Table 6). Antimalarial resistance has been described in all species of Plasmodium infecting humans, except P. ovale. P. falciparum resistance to most antimalarials, with the exception of artemisinin derivatives, has been documented. However, in only a few of these…
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There are three cardinal questions that must be addressed for optimal management of malaria: Is the infection caused by P. falciparum? Is the malaria complicated or severe? Is the parasite likely to be drug-resistant? The answers to these questions will greatly influence the decisions made in managing these patients.
Malaria And HIV Co-Infection Current evidence supports that HIV and malaria each negatively affect the outcome and course of the other. It has been suggested that HIV-related immune suppression compromises innate host malaria clearance mechanisms. In regions where malaria transmission is low or unstable, HIV-positive adults with malaria are two to fivefold more likely to…
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Disorders Of Sexual Development
Although some of the conditions associated with disorders of sexual development are diagnosed at birth or in early childhood (for example, girls with ambiguous genitalia at birth due to congenital adrenal hyperplasia, girls with descended testes due to the complete androgen insensitivity syndrome, children with ambiguous genitalia at birth due to mixed gonadal dysgenesis, partial…
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Treatment Of T. Gondii In Pregnant Women And Newborns With Congenital Toxoplasmosis
Prenatal treatment consists of spiramycin and sulfonamides combined with pyrimethamine (Charpiat et al., 2006a,b,c). The effectiveness of spiramycin is doubtful (Peyron et al., 2000; Charpiat et al., 2006d). Prenatal treatment has no effect on maternal–fetal transmission of T.gondii or on clinical manifestations in infants infected with congenital toxoplasmosis (Gilbert et al., 2001; Gras et al.,…
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Acquired Toxoplasma Infection In The Immunocompetent Individual
Symptomatic ocular infection with T. gondii is seen in immunocompetent persons who acquired infection after birth (Wilder, 1952; Holland, 2003). It was unclear for many years whether the burden of T. gondii ocular eye disease in adults was due to reactivation of congenital infection or to infection acquired after birth (Hogan, 1961). Initially, congenital infections…
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T. Gondii Infection In The Pregnant Woman And Newborn Child Incidence Of Toxoplasma Infection In Pregnant Women
The burden of congenital toxoplasmosis in Europe has recently been reviewed (Be´nard and Salmi, 2006a). The lowest incidence of maternal infection was observed in the northern European countries (from 0.13% in Norway to 0.5% in Sweden), and the highest incidence was reported from France of 1.5% and 1.6% (Ancelle and Goulet, 1996; Jeannel et al.,…
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T. Gondii Infections In Humans: Historical Perspective
The first human case ascribed to infection with T.gondii was a child with hydrocephalus reported by Janku in 1923 ( Janku, 1923). Sabin reported the first case of encephalitis due to T. gondii (Sabin, 1941), and encephalitis due to T. gondii in immunocompromised patients was first reported from patients with Hodgkin’s disease during immunosuppressive treatment…
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Performance-Based Payment Systems
In recent years there has been a great deal of interest in payment systems that reward performance. For example, doctors may receive bonuses based on performance targets, such as high immunization rates, or low surgical complication rates. Other payment systems reward providers according to how well they perform relative to their peers on various cost…