This Handbook, an updated edition of the Management of Severe Malaria, provides new and revised practical guidance on the diagnosis and management of severe malaria.
Case Management; Guide for Tutors
Visit the Ebola Outbreak page on NEJM.org for a collection of articles and other resources, including powerful, personal essays with first-hand reporting from caregivers in the field, an interactive graphic with information on past and present Ebola outbreaks, and an audio interview with NIAID Direc...tor Dr. Anthony Fauci about the current epidemic and the promise of candidate vaccines and therapies. The page also offers clinical reports and management guidelines, and will be updated as more information on this world health crisis becomes available. FREE!
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Learn the ETAT+ guidelines on how to resuscitate a newborn baby who is born not breathing in this exciting 3D simulation training app. Navigate around a virtual reality hospital, find the equipment you need and quiz yourself with interactive quizzes, multiple-choice questions (MCQs) and perform simu...lated procedures.
In this simulated scenario, you are faced with a baby who is born not breathing and have to use your clinical skills to follow the ETAT + guidelines and save the baby's life. You are working against the clock and must select the correct medical equipment and carry out the key life-saving steps needed.
ETAT + guidelines for the management of paediatric emergencies are currently used for training healthcare professionals in Kenya, Uganda, Rwanda, Zimbabwe, Zambia, Malawi, Tanzania, Sierra Leone and Myanmar and are supported by the UK's Royal College of Paediatrics and Child Health.
LIFE (Life-saving Instruction for Emergencies) is a new smartphone and virtual reality (VR) medical simulation training platform for teaching healthcare workers in Africa and low-resource settings how to save lives using a fun and challenging 3D game. LIFE allows nurses, doctors, medical students, trainees and healthcare workers who want to learn key resus skills on their own smartphones, to enter a realistic 3D hospital environment using the latest game-engine technology to try out their skills on simulated patients.
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DIAGNOSIS, MANAGEMENT OF UNCOMPLICATED AND SEVERE MALARIA
User GuideThe toolkit is composed of three sections: Hospital and Health System Resources - includes a readiness assessment tool, the starting point in developing or enhancing a successful Antimicrobial Stewardship Program (ASP). The tool, a checklist developed by the CDC, should be shared with se...nior management, a senior leader for quality, purchasing directors, clinic managers, nurse managers, key physician leaders, risk managers, pharmacy leaders, infection preventionists and hospital epidemiologists, laboratory staff and information technology staff. For ease of use, it is divided into two sections, one for those just beginning a program, the other for those who wish to enhance an existing program. Clinician Resources - includes webinars, clinical evidence supporting appropriate use of antibiotics, implementation guides and related articles.Patient Resources - includes frequently asked questions, pamphlets and handouts on how patients can best engage in their care and resources on appropriate use of antibiotics.
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Overuse of antimicrobial agents occurs globally in both community and hospital settings. Misuse of antibiotics can lead to a variety of adverse outcomes, including the development of antimicrobial resistanceand increased cost of hospitalization. This issuehas been particularly problematic in de...veloping countries, where antibiotic-management programs rarely exist and where antibiotics can be purchased without aprescription. In Thailand, the rate of antibiotic resistance among gram-positive and gram-negative or-ganisms has increased significantly over the past decade. These findings provide compelling evidence ofthe need for more-rational use of antimicrobial agents in Thailand.
Clinical Infectious Diseases2006; 42:768–752006 by the Infectious Diseases Society of America.
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This is a guide for healthcare workers involved in patient care activities in a healthcare setting. It aims to show the type of personal protective equipment or PPE needed to correctly protect oneself. Based on the current available evidence, the WHO recommended PPE for the care of COVID patients ar...e CONTACT and DROPLET precautions, with the exception of aerosol producing procedures, which require CONTACT and AIRBORNE (hence, a respirator mask such as N95, FFP2, FFP3). Keeping in mind, PPE is part of a larger infection prevention and control bundle of measures and should be implemented as part of a multimodal strategy of management of COVID-19 patients. Only clinical staff who are trained and competent in the use of PPE should be allowed to enter the patient’s room.
This course is also available in the following languages:
العربية -македонски - 中文 - Shqip - français - ภาษาไทย - Português - Español - Nederlands - Tetun
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Histoplasmosis is a disease caused by the fungus Histoplasma capsulatum. This disease is highly endemic in some regions of North America, Central America, and South America and is also reported in certain countries of Asia and Africa. It often affects people with impaired immunity, including people ...living with HIV, among whom the most frequent clinical presentation is disseminated histoplasmosis. The symptoms of disseminated histoplasmosis are non-specific and may be indistinguishable from those of other infectious diseases, especially disseminated tuberculosis (TB), thus complicating diagnosis and treatment. Histoplasmosis is one of the most frequent opportunistic infections caused by fungal pathogens among people living with HIV in the Americas and may be responsible for 5–15% of AIDS-related deaths every year in this Region. These guidelines aim to provide recommendations for the diagnosis, treatment, and management of disseminated histoplasmosis in persons living with HIV
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This tool is designed to help governments, partners, and other stakeholders to estimate potential requirements for essential supplies to respond to the current pandemic of COVID-19. Although it gives users with an estimation of the number of cases, this calculator is not an epidemiological calculato...r.
The focus of this tool is to forecast essential supplies: it includes estimation of personal protective equipment, diagnostic equipment, biomedical equipment for case management, essential drugs for supportive care, and consumable medical supplies.
The COVID-19 ESFT tool is intended to be complimentary to the Health Workforce tools (Adaptt and the Workforce Estimator). Both tools use the same base clinical attack rate ranges and classify health workforce using ILO ISCO codes, but their outputs are intentionally different due to their primary focus.
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Anaesthesia Tutorial of the Week
The guide is organized into the major types of toxicities, the associated symp-toms, possible offending medications, and the suggested nursing assessments and interventions. Some symptoms (e.g. nausea) may be associated with a num-ber of underlying causes and may be mild, or a symptom of... a more serious medical situation requiring urgent attention. The pathophysiology for medica-tion-related fatigue and hypersalivation are unclear and these symptoms are not grouped under a specific type of toxicity. Additional information (comments) are provided for each toxicity to highlight relevant clinical information that may assist in management of side effects. Medications more strongly associated with the side effect appear in bold text. The appendices include tools nurses can use to more thoroughly assess patient complaints of pain, depression and neuropathy.
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Ivermectin is an antiparasitic drug approved for the treatment of parasitic infections, including strongyloidiasis and onchocerciasis in humans. There is a reported increase in the use of ivermectin for the prevention and treatment of COVID-19 by the public in African Union Member States.
Currently..., there is:
1. No scientific evidence from pre-clinical studies on the therapeutic effect of ivermectin for the management of COVID-19;
2. No evidence of its clinical efficacy for the management of patients with asymptomatic, mild, moderate or severe COVID-19; and
3. No safety data regarding the use of ivermectin for COVID-19 in the majority of the published studies.
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In the face of rapid increases in the number of hospitalizations due to COVID-19 in Latin America and the Caribbean, coupled with shortages of human and material resources, including medical equipment and gases, there is a need to redesign models of care in the Region to optimize available resources... and ensure that more patients receive the quantity and quality of oxygen they need. Oxygen is included in the World Health Organization’s list of essential medicines and is used to care for patients at all levels of integrated health services networks. The efficacy of oxygen use in the treatment of patients with respiratory conditions caused by COVID-19 has been demonstrated, but there is great opportunity to improve the effectiveness of its use if it is used in a rational, sustainable, and safe way. Bearing in mind that the efficacy of a health technology is measured by its benefit under actual conditions of use, practical actions can be taken to improve the use of medical oxygen and avoid oxygen shortages. A drug is considered to be used rationally when patients receive it according to their clinical needs, in doses appropriate to their individual needs, for an appropriate period, and at a low cost to them and their community. By providing instruction on the rational use of oxygen and promoting it, negative repercussions can be avoided, such as loss of efficacy as a result of activities related to oxygen storage, distribution, and administration. Rational use of oxygen also involves controlling waste due to leaks in storage and distribution systems, use of gas at incorrect pressures, use of incorrectly adjusted flowmeters, and disconnections, among other problems. Another aspect to consider is the provision of adequate technical support for all oxygen production systems, in terms of maintenance and calibration, availability of electrical energy, and specific knowledge about these systems. For these reasons, a set of guidelines has been put together for the development of an efficient management system to deal with situations of oxygen scarcity, both now and in the future.
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In the event of an accident or medical emergency, First Aid saves lives. Keeping the patient alive and safe until the arrival of expert professional help is a vital part of the chain of care which leads to recovery. The principle of First Aid must be simple skills, clearly taught and capable of bein...g performed in a stressful situation by those with no medical training. This manual is intended to offer a basic level of First Aid for members of the general public.
The contents of this manual are offered as a first edition of European First Aid Guidelines for general use. As such they are compatible with current practise, with other specialist guidelines (for example regarding the management of burns) and with the evidence base where one exists. These guidelines will be updated on a regular basis by the JOIN Clinical Working Group.
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In the event of an accident or medical emergency, First Aid saves lives. Keeping the patient alive and safe until the arrival of expert professional help is a vital part of the chain of care which leads to recovery. The principle of First Aid must be simple skills, clearly taught and capable of bein...g performed in a stressful situation by those with no medical training. This manual is intended to offer a basic level of First Aid for members of the general public.
The contents of this manual are offered as a first edition of European First Aid Guidelines for general use. As such they are compatible with current practise, with other specialist guidelines (for example regarding the management of burns) and with the evidence base where one exists. These guidelines will be updated on a regular basis by the JOIN Clinical Working Group.
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Lymphatic filariasis (LF) is a preventable neglected tropical disease (NTD) caused by infection with the filarial parasites Wuchereria bancrofti, Brugia malayi or B. timori. Mosquitos in the genera Culex, Anopheles, Mansonia and Aedes transmit the parasites from person to person. Lymphoedema and hyd...rocoele are the visible, chronic clinical consequences of the impairment of lymphatic vessels caused by infection with these parasites. WHO established the Global Programme to Eliminate Lymphatic Filariasis (GPELF) to stop transmission of infection by mass drug administration (MDA) of anthelminthics and to alleviate the suffering of people affected by the disease through morbidity management and disability prevention (MMDP). Since the start of GPELF, the number of infections has been reduced by 74% globally. The latest estimate is that 51.4 million people are infected.
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Leishmaniasis is a major vector-borne disease caused by obligate intramacrophage protozoa of the genus Leishmania, and transmitted by the bite of phlebotomine female sand flies of the genera Phlebotomus and Lutzomyia, in the old and new worlds, respectively. Among 20 well-recognized Leishmania speci...es known to infect humans, 18 have zoonotic nature, which include agents of visceral, cutaneous, and mucocutaneous forms of the disease, in both the old and new worlds. Currently, leishmaniasis show a wider geographic distribution and increased global incidence. Environmental, demographic and human behaviors contribute to the changing landscape for zoonotic cutaneous and visceral leishmaniasis. The primary reservoir hosts of Leishmania are sylvatic mammals such as forest rodents, hyraxes and wild canids, and dogs are the most important species among domesticated animals in the epidemiology of this disease. These parasites have two basic life cycle stages: one extracellular stage within the invertebrate host (phlebotomine sand fly), and one intracellular stage within a vertebrate host. Co-infection with HIV intensifies the burden of visceral and cutaneous leishmaniasis by causing severe forms and more difficult to manage. The disease is endemic to Ethiopia, and the clinical signs are not pathognomic. The visceral form (Kala-azar) may be confused with other similar conditions such as malaria, tropical splenomegaly, schistosomiasis, milliary tuberculosis, and brucellosis. Similarly, cutaneous leishmaniasis should be differentiated from disease like tropical ulcers, impetigo and leprosy. There are several methods of laboratory diagnosis of leishmaniasis, including parasitological, immunological and molecular. Different forms of treatments are available including oral, parenteral, and topical medications such as pentavalent antimonials, liposomal amphotericin B, miltefosine and paromomycin. Methods of control are largely limited to destruction of animal reservoirs, treatment of infected humans, and management of sand fly populations. Development of an effective vaccine against leishmaniasis has been largely unsuccessful and hinders its prevention.
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Lymphatic filariasis (LF) is an avoidable, debilitating, disfiguring disease caused by infection with the filarial parasites Wuchereria bancrofti, Brugia malayi and B. timori. Globally, 51.4 million people are
estimated to be infected. Lymphoedema and hydrocoele are the visible, chronic clinical co...nsequences of the lymphatic vessel impairment caused by infection with these parasites. Mosquitos in the genera Culex, Anopheles, Mansonia and Aedes transmit the parasites from person to person. 2020 marked the 20th year since WHO established the Global Programme to Eliminate Lymphatic Filariasis (GPELF) which aims to stop transmission of infection with mass drug administration (MDA) and to alleviate suffering among people affected by the disease through morbidity management and disability prevention (MMDP).
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Chagas heart disease (CHD) affects approximately 30% of patients chronically infected with the protozoa Trypanosoma cruzi. CHD is classified into four stages of increasing severity according to electrocardiographic, echocardiographic, and clinical criteria. CHD presents with a myriad of clinical man...ifestations, but its main complications are sudden cardiac death, heart failure, and stroke. Importantly, CHD has a higher incidence of sudden cardiac death and stroke than most other cardiopathies, and patients with CHD complicated by heart failure have a higher mortality than patients with heart failure caused by other etiologies. Among patients with CHD, approximately 90% of deaths can be attributed to complications of Chagas disease. Sudden cardiac death is the most common cause of death (55%-60%), followed by heart failure (25%-30%) and stroke (10%-15%). The high morbimortality and the unique characteristics of CHD demand an individualized approach according to the stage of the disease and associated complications the patient presents with. Therefore, the management of CHD is challenging, and in this review, we present the most updated available data to help clinicians and cardiologists in the care of these patients. We describe the clinical manifestations, diagnosis and classification criteria, risk stratification, and approach to the different clinical aspects of CHD using diagnostic tools and pharmacological and non-pharmacological treatments.
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