Episodes of recurrent Clostridium difficile infection (CDI) are difficult to treat for several reasons. Foremost, data are lacking to support any particular treatment strategy. In addition, treatment of recurrent episodes is not always successful, and repeated, prolonged treatment is often necessary. Identification of subgroups at risk for recurrent CDI may aid in diagnosing and treating these patients. Two likely mechanistic factors increasing the risk of recurrent CDI are an inadequate immune response to C. difficile toxins and persistent disruption of the normal colonic flora. Important epidemiologic risk factors include advanced age, continuation of other antibiotics, and prolonged hospital stays. Current guidelines recommend that the first recurrent episode be treated with the same agent (i.e., metronidazole or vancomycin) used for the index episode. However, if the first recurrence is characterized as severe, vancomycin should be used. A reasonable strategy for managing a subsequent episode involves tapering followed by pulsed doses of vancomycin. Other potentially effective strategies for recurrent CDI include vancomycin with adjunctive treatments, such as Saccharomyces boulardii, rifaximin “chaser” therapy after vancomycin, nitazoxanide, fecal transplantation, and intravenous immunoglobulin. New treatment agents that are active against C. difficile, but spare critical components of the normal flora, may decrease the incidence of recurrent CDI.
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For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.
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Showing posts with label c difficile. Show all posts
Showing posts with label c difficile. Show all posts
Friday, January 8, 2010
Thursday, April 23, 2009
WHAT DOES AN AIRLINE PASSENGER DO DURING A HEART ATTACK?
In-flight medical emergencies are increasing, and this is partly due to more people with medical conditions traveling by air. It is very important to note that unique environmental and physiological changes occur as a result of changes in pressure during routine commercial air travel. These changes can exacerbate preexisting medical conditions, such as cardiac and lung conditions.
Passengers should always notify a flight attendant whenever they are having a health problem. Although the flight crew has only very basic training on responding to medical emergencies, they have the ability to communicate via satellite phones to physicians on the ground, and several tele-medical companies routinely assist flight crews during in-flight medical emergencies by providing instructions on what to do. Many times there are medically trained fellow passengers who also readily volunteer to assist whenever the flight crew broadcasts a call for help.
All U.S–based commercial aircraft that carry more than 85 passengers, and most international air carriers, carry an automated external defibrillator, as well as both a basic and enhanced emergency medical kit. Only medical professionals or flight crew instructed by on-ground physicians are allowed access to the enhanced medical kit, which carries various emergency medications to deal with serious in–flight medical emergencies. The captain of the aircraft has the ultimate authority as to whether or not to divert the aircraft, but they tend to side with caution and what is in the best interest of the stricken passenger.
Individuals with any cardiac, lung or blood diseases, diabetes or cancer, as well as those who have undergone any surgery within a 14-day period prior to travel, must check with their doctor to make sure they are fit for air travel. As a rule of thumb ,one should be able to walk a distance of 150 feet and climb one flight of stairs without developing any chest pain or severe shortness of breath.
Passengers should always notify a flight attendant whenever they are having a health problem. Although the flight crew has only very basic training on responding to medical emergencies, they have the ability to communicate via satellite phones to physicians on the ground, and several tele-medical companies routinely assist flight crews during in-flight medical emergencies by providing instructions on what to do. Many times there are medically trained fellow passengers who also readily volunteer to assist whenever the flight crew broadcasts a call for help.
All U.S–based commercial aircraft that carry more than 85 passengers, and most international air carriers, carry an automated external defibrillator, as well as both a basic and enhanced emergency medical kit. Only medical professionals or flight crew instructed by on-ground physicians are allowed access to the enhanced medical kit, which carries various emergency medications to deal with serious in–flight medical emergencies. The captain of the aircraft has the ultimate authority as to whether or not to divert the aircraft, but they tend to side with caution and what is in the best interest of the stricken passenger.
Individuals with any cardiac, lung or blood diseases, diabetes or cancer, as well as those who have undergone any surgery within a 14-day period prior to travel, must check with their doctor to make sure they are fit for air travel. As a rule of thumb ,one should be able to walk a distance of 150 feet and climb one flight of stairs without developing any chest pain or severe shortness of breath.
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