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  • ISSN: 2379-0636
    Early Online
    Volume 4, Issue 1
    Review Article
    Andrea Affronti* and Mario Cottone
    Background: The link between Cytomegalovirus (CMV) infection and Ulcerative Colitis (UC) is well known, but the exact direction of the causal relationship is difficult to assess. This uncertainty has a huge impact on therapeutic strategies, such as for the use of antivirals and the management of ongoing immunosuppression. The aim of this review is to discuss the main critical issues in this topic and find a clinically practical approach.
    Databases covered: MEDLINE, EMBASE and Cochrane were searched.
    Discussion: Real time PCR should be considered the best diagnostic test, both in tissue and blood, even though there are no standardized methods and no sure thresholds. CMV infections (systemic or intestinal) are more common in patients with an active severe form, while rare in the mild/inactive forms, and the prevalence is particularly high in patients with a steroid-refractory disease (above 30-40%).
    There is a general lack of long-term studies on the natural history of CMV-infected UC patients. There is no evidence of an unfavorable long-term impact of CMV on the course of severe UC, but in terms of short-term prognosis, in recent years a general consensus has been growing about the unfavorable effect of CMV infection/re-activation in UC.
    In the management of viremic patients a step by step, personalized approach should be preferred. As a general rule the antiviral treatment should be adopted in viremic steroid-resistant forms, receiving immuno-modulators (IM) which are generally safe, and an ongoing treatment with anti-TNF does not worsen the course of the infection. There is an indication to stop the IM therapy only if a severe systemic infection is diagnosed.
    Jan Peter Verhave*
    Bacteriologist and science writer Paul de Kruif initiated and promoted the treatment of syphilis patients with artificial fever. It was an alternative to both the long-term treatment with arsenic an bismuth, and the bouts of fever induced by malaria parasites. The idea was developed at the hospital of Dayton Ohio and eventually was as simple as blowing warm air over the body. G.M. industrialist George Kettering was the driving force, supplier of technical ideas and financial support. Initially, patients in the advanced stage (dementia paralytica) were treated with reasonable success, but gradually the experimenters also included infected and infective carriers at earlier stages of the disease. All the way, the opposition of the medical profession was fierce, not the least because De Kruif was not an MD, yet publishing regularly in the popular press about the achievements and progress (treatment in one day, plus light arsenic and bismuth). Eventually, the technique and the assisting medical staff were moved from Dayton to the Chicago Quarantine Hospital, after the US had joined the war. In order to protect healthy recruits, mainly women were treated (infected men were sent home!). After having treated hundreds of people, in 1943, penicillin turned out to be effective against syphilis and the machine fever had had its days.
    Gulbeyaz Can*, MeryemYildiz, and EmelEmineOzdemir RN
    Chemotherapy induced alopecia is one of the most common side effects experienced by cancer patients. It can be an important problem, which negatively affects patients' quality of life. Showing difference in severity, depending on the type of antineoplastic agents used in treatment, alopecia occurs approximately in 65% of the patients as hair loss after 2-3 weeks of initial chemotherapy treatment and it is considered as a cause of distress and trauma to cancer patients who are taking chemotherapy. Depending on cultural and personal characteristics, the reactions of patients to chemotherapy related alopecia differ. It may cause some patients to distance themselves from social life and tend to negative thinking. Some patients may need support in coping with this problem. Educating patients about alopecia, cooling the scalp during treatment, application of tourniquet and different pharmacological approaches were used in coping with this problem. However, the results obtained from these studies are controversial and none of them put forward an effective approach to deal with this problem. Therefore, the suggestions regarding chemotherapy-induced alopecia are usually based on the experiences of health experts and based on a limited number of randomized and non-randomized study reports.
    Giulio Di Diodato*
    Rationale: CA-CDI is an infectious gastrointestinal illness whose incidence is estimated to be between 10 to 61 cases per 100 000 population, with up to 50% of cases requiring hospitalization due to the severity of the disease. While antibiotic exposure and age=65 years are known risk factors for healthcare-associated Clostridium difficile infection (HA-CDI), the importance of antibiotic exposure in CA-CDI is less well defined. In addition, previous case-control studies have demonstrated a potential association between antibiotic exposure and subsequent risk of CA-CDI, they did not account for important time-invariant confounders because of the limitations of matching potentially leading to a biased estimate of the antibiotic-CA-CDI association.
    Richard Serunkuma Bbosa and Valerie Janet Ehlers*
    Background: Malaria is endemic and causes complications during 80.0% of pregnancies in Uganda.
    Objectives: This study attempted to identify factors that influence pregnant women's utilisation of anti-malaria services in the Buikwe District of Uganda.
    Method: Structured interviews were conducted with 400 pregnant women in the Buikwe District.
    Results: Pregnant women, who had progressed beyond primary school level education, were more likely to take intermittent preventive treatment drugs and to use long lasting insecticide treated nets to prevent malaria. Pregnant women were more likely to implement malaria-preventive actions if they lived within five kilometres of clinics, were satisfied with available health services and were knowledgeable about the malaria preventive measures.
    Conclusion: Although 97.9% of the interviewed pregnant women had taken intermittent preventive treatment and 84.2% of those who had received long lasting insecticide treated bed nets had utilised these nets, malaria prevention during pregnancy could be further improved. All pregnant women should attend antenatal clinics at least four times during each pregnancy, commencing during the first trimester of pregnancy to receive adequate health education and prenatal services, including the taking of two doses of intermittent preventive treatment and using long lasting insecticide treated bed nets throughout pregnancy.
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