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Significant Medical (significant + medical)
Selected AbstractsReview article: rifaximin, a minimally absorbed oral antibacterial, for the treatment of travellers' diarrhoeaALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11 2010P. LAYER Aliment Pharmacol Ther,31, 1155,1164 Summary Background, Travellers' diarrhoea, a common problem worldwide with significant medical impact, is generally treated with anti-diarrhoeal agents and fluid replacement. Systemic antibiotics are also used in selected cases, but these may be associated with adverse effects, bacterial resistance and drug,drug interactions. Aim, To review the clinical evidence supporting the efficacy and safety of the minimally absorbed oral antibiotic rifaximin in travellers' diarrhoea. Methods, PubMed and the Cochrane Register of Controlled Clinical Trials (to January 2010) and International Society of Travel Medicine congress abstracts (2003,2009) were searched to identify relevant publications. Results, A total of 10 publications were included in the analysis. When administered three times daily for 3 days, rifaximin is superior to placebo or loperamide; it is at least as effective as ciprofloxacin in reducing duration of illness and restoring wellbeing in patients with travellers' diarrhoea, both with and without identification of a pathogen, as well as in diarrhoea caused by Escherichia coli infection. Rifaximin demonstrates only minimal potential for development of bacterial resistance and for cytochrome P450-mediated drug,drug interactions, and its tolerability profile is similar to that of placebo. Conclusion, When antibiotic therapy is warranted in uncomplicated travellers' diarrhoea, rifaximin may be considered as a first-line treatment option because of its favourable efficacy, tolerability and safety profiles. [source] Health Status of Incarcerated Adolescents: Implications for Juvenile Justice Decision MakingJUVENILE AND FAMILY COURT JOURNAL, Issue 1 2004ROBERT E. MORRIS ABSTRACT Adolescents arriving in detention often bring with them significant medical, dental, and psychological problems. These issues have important implications for courts that must decide the best disposition for offending youths. Appropriate treatment benefits the individual by enhancing his/her well-being and improving his/her chances of successful rehabilitation. Society also benefits by avoiding the higher cost of caring for neglected conditions later in life. A comprehensive health care program for detention facilities involves establishing standardized procedures that address both common adolescent problems plus those more peculiar to detainees. Health care professionals working in a correctional setting have unique duties such as clearing youths for boot camp, monitoring injuries, dealing with resistant patients, monitoring for safe activities, and planning aftercare for youths who may face impediments to accessing care such as poor motivation and poverty. Research concerning issues specific to the needs of incarcerated youths remains infrequent and should be undertaken by health care providers. This article provides an overview of medical issues confronting juvenile offenders that should be considered when a juvenile becomes involved in the juvenile justice system. [source] Skin cancer in liver transplant recipientsLIVER TRANSPLANTATION, Issue 3 2000Clark C. Otley Skin cancer is the most common malignancy arising in the posttransplantation setting. Multiple factors contribute to the high risk for cutaneous carcinoma in immunosuppressed organ-transplant recipients. We review the phenomenon of skin cancer in solid-organ transplant recipients and further delineate the problem in the context of liver transplantation. Skin cancer is a significant medical and surgical problem for organ-transplant recipients. With prolonged allograft function and patient survival, the majority of solid-organ transplant recipients will eventually develop skin cancer. Although squamous cell carcinoma is the most common cutaneous malignancy in this population, basal cell carcinoma, melanoma, and Kaposi's sarcoma, as well as uncommon skin malignancies, may occur. Highly susceptible patients may develop hundreds of squamous cell carcinomas, which may be life threatening. Management strategies focus on regular full-skin and nodal examination, aggressive treatment of established malignancies, and prophylactic measures to reduce the risk for additional photodamage and malignant transformation. Skin cancer is a substantial cause of morbidity and even mortality among solid-organ transplant recipients. As a byproduct of immunosuppression, liver transplant recipients experience a high incidence of skin cancer and should be educated and managed accordingly. [source] Nutritional status in pregnant adolescents: a systematic review of biochemical markersMATERNAL & CHILD NUTRITION, Issue 2 2007Victoria Hall Moran Abstract Adolescent pregnancy is a major public health challenge for many industrialized countries and is associated with significant medical, nutritional, social and economic risk for mothers and their infants. Despite this, relatively little is known about the nutritional status of this population. The aim of this paper was to conduct a systematic review of the current evidence relating to the biochemical markers of nutritional status of pregnant adolescents living in industrialized countries. Six papers were identified that fulfilled the inclusion criteria, the majority of which were conducted in the United States. The studies were of variable quality and most failed to control for potential confounders which may have strongly influenced the findings. Due to limited research, conclusions cannot be drawn about the zinc and calcium status of pregnant adolescents, and data on folate and vitamin B12 status appeared conflicting. There was some consensus among studies, however, to suggest that indicators of anaemia and iron status were compromised in pregnant adolescents, particularly during the third trimester of pregnancy. Chronological age did not appear to influence nutritional status, although there was some evidence to suggest that increasing gynaecologic age may positively influence plasma ferritin levels. Current research is limited by sampling and measurement bias, and research is urgently required to address these limitations. Further consideration should also be made of the influence of the role of socio-economic support on pregnant adolescents' nutritional status. The achievement of improved nutrition in pregnancy among adolescents requires multidisciplinary collaborations of adolescent healthcare providers, academics, professional organizations, policymakers, industry and service users. Only once this is achieved can adolescent nutrition, and adolescent nutrition in pregnancy, be significantly and sustainably optimized. [source] |