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vrijdag 18 augustus 2017

The Lancet: [Comment] Patterns of bacteraemia aetiology

[Comment] Patterns of bacteraemia aetiology
Bloodstream infections are a leading cause of morbidity and mortality in both high-income and lower-income countries, but the causative organisms and risk factors differ. Human beings coexist with diverse bacterial flora on their skin and their nasal, pharyngeal, and gastrointestinal mucosae. Physical barriers and non-specific immune defences keep these bacteria in check. However, various primary pathogens can invade via the respiratory mucosa (eg, some Streptococcus pneumoniae serotypes) or gastrointestinal (Salmonella Typhi) mucosa or integument (Staphylococcus aureus), then enter the bloodstream and provoke clinical syndromes such as sepsis, febrile bacteraemia, meningitis, or enteric fever.
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[Review] Inpatient versus outpatient parenteral antibiotic therapy at home for acute infections in children: a systematic review
Inpatient management is necessary in many situations, but medical and allied-health treatments are increasingly being used on an outpatient basis to allow patients who would traditionally have been admitted to hospital to remain at home. Home-based clinical management has many potential benefits, including reduced hospital-acquired infections, cost savings, and patient and family satisfaction. Studies in adults provide evidence for the benefits of home-based versus hospital-based intravenous antibiotics, but few studies inform practice in home-based intravenous antibiotic therapy for children.
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[Articles] Global yellow fever vaccination coverage from 1970 to 2016: an adjusted retrospective analysis
Our results highlight important gaps in yellow fever vaccination coverage, can contribute to improved quantification of outbreak risk, and help to guide planning of future vaccination efforts and emergency stockpiling.
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[Comment] Yellow fever vaccination: estimating coverage
Recent decades have witnessed an unprecedented emergence of epidemic arbovirus diseases, including yellow fever.1 The yellow fever outbreak that started in Angola in 2016 developed into the largest and most widespread outbreak of yellow fever reported in Africa in more than 20 years, leading to depletion of all yellow fever vaccine stocks.2 The outbreak also resulted in the first documented importation of yellow fever into Asia.3 Furthermore, since late 2016, yellow fever has caused outbreaks in southeastern Brazil close to the most populated areas of South America, with Rio de Janeiro state hosting nearly 16 million people.
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[Articles] The epidemiology of sepsis in Brazilian intensive care units (the Sepsis PREvalence Assessment Database, SPREAD): an observational study
The incidence, prevalence, and mortality of ICU-treated sepsis is high in Brazil. Outcome varies considerably, and is associated with access to adequate resources and treatment. Our results show the burden of sepsis in resource-limited settings, highlighting the need to establish programmes aiming for sepsis prevention, early diagnosis, and adequate treatment.
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