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1/10. Infectious disease emergencies in primary care.

    Infectious disease emergencies can be described as infectious processes that, if not recognized and treated immediately, can lead to significant morbidity or mortality. These emergencies can present as common or benign infections, fooling the primary care provider into using more conservative treatment strategies than are required. This review discusses the pathophysiology, history and physical findings, diagnostic criteria, and treatment strategies for the following infectious disease emergencies: acute bacterial meningitis, ehrlichiosis, rocky mountain spotted fever, meningococcemia, necrotizing soft tissue infections, toxic shock syndrome, food-borne illnesses, and infective endocarditis. Because most of the discussed infectious disease emergencies require hospital care, the primary care clinician must be able to judge when a referral to a specialist or a higher-level care facility is indicated.
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ranking = 1
keywords = infectious disease
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2/10. Systematic reviews of infectious diseases.

    The World Wide Web provides ready access to a wealth of information on infectious diseases topics. Systematic reviews and practice guidelines help to focus that evidence with in-depth literature analysis of a specific question. These reviews are typically rigidly structured, often periodically updated, and include critical evaluation of available data. In this article, Web sites of organizations that publish systematic reviews and practice guidelines for infectious diseases are identified and reviewed with regard to ease of use, comprehensiveness, quality of information, and cost. Examples of information available in databases of practice guidelines and systematic reviews are provided. A hypothetical case is used to illustrate the use of electronic resources in evidence-based infectious diseases practice.
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ranking = 3.5
keywords = infectious disease
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3/10. Treating obsessive compulsive disorder: a new role for infectious diseases physicians?

    BACKGROUND: patients with psychiatric disorders are often seen by infectious disease physicians. Sometimes the psychiatric condition is the primary disorder, and the physician's main task is the early identification of the disorder and referral to specialist psychiatric services. On other occasions, the psychiatric condition will need to be addressed in addition to the infectious disease, and the physician aims to treat in conjunction with a psychiatrist. It is rare for referrals to be made from psychiatry to infectious diseases physicians. METHOD: A single case study is used to describe a modification of Danger Ideation Reduction Therapy (DIRT), a novel intervention for obsessive compulsive disorder (OCD). In our modification the infectious diseases physician plays a key, collaborative role in the psychological treatment of the patient. RESULTS: Although an uncontrolled trial, results from the modified DIRT protocol are encouraging and warrant replication in a randomised controlled trial. CONCLUSIONS: A collaborative approach by the infectious diseases physician, the microbiology laboratory and the psychologist can provide a valuable means of retaining patients with OCD in treatment and in the management of this common, disabling condition.
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ranking = 4.5
keywords = infectious disease
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4/10. Avoiding laboratory pitfalls in infectious diseases.

    In today's medical care environment, clinicians are challenged to order clinically relevant, cost effective laboratory tests and antibiotic therapy. Together, physicians and laboratories must have guidelines and strategies that can provide quality patient care, while minimising costs and preventing further emergence of antimicrobial drug resistance. Five clinical vignettes that demonstrate these principles are presented.
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ranking = 2
keywords = infectious disease
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5/10. Reproductive hazards facing female health care workers in the hospital: how the nurse practitioner can help.

    female health care workers are often exposed to occupational hazards that may adversely affect their reproductive health and the health of their children. This article presents an overview of the problem and, through a case study, focuses on a small sample of agents (aerosol antimicrobials, disinfectants, and infectious diseases) that represent common hospital exposures with reproductive implications. The nurse practitioner's role in identifying and counseling patients who may have exposures to reproductive hazards is discussed.
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ranking = 0.5
keywords = infectious disease
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6/10. Infectious disease marker testing of the autologous blood donor. A case study in clinical ethics.

    OBJECTIVE--The food and Drug Administration currently requires written authorization from the patient's physician before autologous units of blood that are positive or reactive for hepatitis b surface antigen or anti-human immunodeficiency virus can be shipped from a site of collection different from the site of transfusion. Additionally, the blood Products Advisory Committee has recommended the universal testing of all autologous units of blood. DESIGN--The case of an autologous blood donor with positive infectious disease markers is presented. The ethics of infectious disease testing of patients who preoperatively donate their own blood is discussed. RESULTS--Many ethical issues are raised by policies requiring infectious disease testing of the autologous blood donor. blood banking and transfusion medicine specialists should examine the ethical issues raised by regulatory mandates to perform infectious disease testing of the patient who desires to make a preoperative autologous blood donation. CONCLUSION--A policy that protects the rights of the patient as well as the rights and concerns of health care professionals should be pursued.
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ranking = 2
keywords = infectious disease
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7/10. Ethical issues in infectious diseases.

    Ethical behavior is an essential component of professional life. Developments in medical science continually test society's concepts of right and wrong, of virtue and morality. Ethical conflicts will be played out in public with greater frequency and intensity. physicians will be challenged to maintain high standards of ethical conduct despite the pressures that personal preference, society, and government may exert. We do not present neat solutions to ethical conflicts, but we describe a framework for understanding models of physician behavior and outline an approach to the analysis of problems.
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ranking = 2
keywords = infectious disease
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8/10. Recurrent infectious diseases in human CD53 deficiency.

    We report a familiar syndrome of recurrent heterogeneous infectious diseases, caused by bacteria, fungi, and viruses, which has as its only detectable defect the lack of CD53 antigen expression in neutrophils. All other assays ruled out known causes of recurrent infectious diseases due to either leukocyte adhesion or phagocytosis defects. CD53 belongs to the transmembrane-4 superfamily of proteins, which are a novel group of membrane proteins implicated in growth regulation and cell motility and possibly cell adhesion. We postulate that defects in these membrane proteins can be clinically manifested as complex recurrent infections.
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ranking = 3
keywords = infectious disease
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9/10. Infectious diseases presentations of munchausen syndrome by proxy: case report and review of the literature.

    munchausen syndrome by proxy is a form of abuse, usually of a child by a parent, in which a factitious illness is reported or produced in the child, resulting in unnecessary medical evaluations and treatments. A dramatic case of a 17-month-old infant with recurrent polymicrobial bacteremia prompted a review of cases diagnosed by the Pediatric Infectious Diseases consultation service at our referral children's hospital and a review of the infectious diseases presentations in the medical literature. The infectious diseases presentations of the syndrome as well as criteria for the diagnosis are reviewed and discussed.
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ranking = 1
keywords = infectious disease
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10/10. Psychiatric diseases presenting as infectious diseases.

    Although many psychiatric diseases have somatic manifestations, some focus on fears or delusions of infection. When a patient with a psychiatric basis for an apparent infection presents to an infectious disease physician, the physician may find the problem confusing, amusing, and ultimately frustrating until the psychiatric basis for disease is recognized. Some of these psychiatric disorders can be treated and controlled with medication and psychotherapy, although patients may resist psychiatric referral. This article reviews examples of psychiatric disorders in patients who present to the infectious disease physician, including factitious infection, malingering, obsessive compulsive disorder, phobias, veneroneuroses, somatization disorders, and delusional infection. The role that physicians play in amplifying these disorders is reviewed. Strategies for referral to psychiatric services are also discussed. patients with a psychiatric disease are seen in infectious disease practices more commonly than physicians realize.
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ranking = 3.5
keywords = infectious disease
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