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Ravi A, Shetty PK, Singh P, Wakode D, Modica SF, Kodaganallur Pitchumani P, Thomas DC. Needlestick injuries in dentistry: Time to revisit. J Am Dent Assoc 2023; 154:783-794. [PMID: 37530693 DOI: 10.1016/j.adaj.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Blood-borne pathogens (BBPs) are infectious microorganisms that are found in human blood and can cause diseases in humans. Health care workers such as physicians, surgeons, nurses, dentists, dental students, dental assistants, laboratory technicians, personnel handling infectious waste, and other health care employees are at increased risk of exposure to these pathogens. Percutaneous injuries from needles or other sharp objects are the major sources of BBPs in the workplace. Needlestick injuries (NSIs) have the most potential to transmit and have the easiest mode of transmission of BBPs. TYPES OF STUDIES REVIEWED The authors searched electronic databases (PubMed, Web of Science, Google Scholar, Scopus, Embase, MEDLINE-Ovid) for studies and articles focused on the various aspects of NSIs, their possible causes, prevention, and management protocols. RESULTS There is a lack of literature on the global prevalence of NSIs among dental practitioners and underreporting of NSIs by clinicians. The authors also found that dental students and inexperienced practitioners were the most vulnerable. They found apparent inconsistencies in guidelines and recommendations from various regulatory and statutory agencies in charge of limiting and managing NSIs. CONCLUSION The most significant occupational risks for health care workers globally are NSIs. Dentists are recognized as one of the high-risk groups for exposure to NSIs. Although the reporting rate was noticeably low, the frequency of NSIs among dental students was alarmingly high. PRACTICAL IMPLICATIONS Appropriate and succinct training of dental health care workers is crucial for prevention and management of NSIs. It is recommended that dentists familiarize themselves with recommendations from such agencies and organizations as the Center for Disease Control and Prevention, Occupational Safety and Health Administration, and American Dental Association.
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Ma KJ, Hung JL, Chou MH, Wang JY. Patterns of Systemic Disease Diagnoses among Medical Professionals in Taiwan: Statistical Analysis and Data Mining. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14017. [PMID: 36360897 PMCID: PMC9657375 DOI: 10.3390/ijerph192114017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Although high-risk work environments and heavy workload expose medical professionals to long-term risks of disease, no comprehensive analysis has been conducted on the corresponding risks of diseases to each type of medical professionals. This study pre-analyzed the risks of medical professionals in developing various systemic diseases in Taiwan to provide a comprehensive examination of the differences between each type of systemic disease. METHODS From the secondary databases of 2002-2013, 15,407 medical professionals were selected for analysis. A chi-squared test and logistic regression were performed to identify the relationship between types of medical professionals and systemic diseases. The life trajectories of diagnosis sequence of the medical professionals were illustrated accordingly. RESULTS The physicians were the most vulnerable to infectious, parasitic, and digestive diseases. This was possibly associated with their work characteristics and occupational risks. CONCLUSION According to the life trajectories, all types of the medical professionals exhibited a similar trend in the orders of risks to each type of systemic disease, which suggests that their work environment exposes them to real risks of health hazard.
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Affiliation(s)
- Kai-Jie Ma
- Department of Public Health, China Medical University, Taichung 406040, Taiwan
| | - Jui-Lien Hung
- Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan
| | - Ming-Hsien Chou
- Department of Public Health, China Medical University, Taichung 406040, Taiwan
- Department of Physical Medicine and Rehabilitation, Taichung Armed Forces General Hospital, Taichung 411228, Taiwan
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, Taipei 114202, Taiwan
- Section of Physical Medicine and Rehabilitation, School of Medicine, National Defense Medical Center, Taipei 114201, Taiwan
| | - Jong-Yi Wang
- Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan
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Coelho AC, García Díez J. Biological Risks and Laboratory-Acquired Infections: A Reality That Cannot be Ignored in Health Biotechnology. Front Bioeng Biotechnol 2015; 3:56. [PMID: 25973418 PMCID: PMC4412124 DOI: 10.3389/fbioe.2015.00056] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 04/10/2015] [Indexed: 12/16/2022] Open
Abstract
Advances and research in biotechnology have applications over a wide range of areas, such as microbiology, medicine, the food industry, agriculture, genetically modified organisms, and nanotechnology, among others. However, research with pathogenic agents, such as virus, parasites, fungi, rickettsia, bacterial microorganisms, or genetic modified organisms, has generated concern because of their potential biological risk - not only for people, but also for the environment due to their unpredictable behavior. In addition, concern for biosafety is associated with the emergence of new diseases or re-emergence of diseases that were already under control. Biotechnology laboratories require biosafety measures designed to protect their staff, the population, and the environment, which may be exposed to hazardous organisms and materials. Laboratory staff training and education is essential, not only to acquire a good understanding about the direct handling of hazardous biological agents but also knowledge of the epidemiology, pathogenicity, and human susceptibility to the biological materials used in research. Biological risk can be reduced and controlled by the correct application of internationally recognized procedures such as proper microbiological techniques, proper containment apparatus, adequate facilities, protective barriers, and special training and education of laboratory workers. To avoid occupational infections, knowledge about standardized microbiological procedures and techniques and the use of containment devices, facilities, and protective barriers is necessary. Training and education about the epidemiology, pathogenicity, and biohazards of the microorganisms involved may prevent or decrease the risk. In this way, the scientific community may benefit from the lessons learned in the past to anticipate future problems.
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Affiliation(s)
- Ana Cláudia Coelho
- Department of Veterinary Sciences, Veterinary and Animal Science Center (CECAV), School of Agrarian and Veterinary Sciences, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Juan García Díez
- Department of Veterinary Sciences, Veterinary and Animal Science Center (CECAV), School of Agrarian and Veterinary Sciences, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
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Abstract
Human risks of acquiring a zoonotic disease from animals used in biomedical research have declined over the last decade because higher quality research animals have defined microbiologic profiles. Even with diminished risks, the potential for exposure to infectious agents still exists, especially from larger species such as nonhuman primates, which may be obtained from the wild, and from livestock, dogs, ferrets, and cats, which are generally not raised in barrier facilities and are not subject to the intensive health monitoring performed routinely on laboratory rodents and rabbits. Additionally, when laboratory animals are used as models for infectious disease studies, exposure to microbial pathogens presents a threat to human health. Also, with the recognition of emerging diseases, some of which are zoonotic, constant vigilance and surveillance of laboratory animals for zoonotic diseases are still required.
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Affiliation(s)
- James G. Fox
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Glen Otto
- Animal Resources Ctr University Texas Austin, Austin, TX, USA
| | - Lesley A. Colby
- Department of comparative Medicine University of Washington, Seattle, WA, USA
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Mansueto P, Seidita A, Vitale G, Cascio A. Transfusion transmitted leishmaniasis. What to do with blood donors from endemic areas? Travel Med Infect Dis 2014; 12:617-27. [DOI: 10.1016/j.tmaid.2014.10.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 10/11/2014] [Accepted: 10/13/2014] [Indexed: 10/24/2022]
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Hajilooi M, Lotfi P, Seif F, Bazmani A, Momeni M, Ravary A, Kazemi Arababadi M, Khalilian AR. The Cytotoxic T Lymphocyte Antigen-4 +49A/G Single Nucleotide Polymorphism Association With Visceral Leishmaniasis. Jundishapur J Microbiol 2014; 7:e12143. [PMID: 25632324 PMCID: PMC4295314 DOI: 10.5812/jjm.12143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 08/04/2013] [Accepted: 09/10/2013] [Indexed: 01/26/2023] Open
Abstract
Background: Several lines of evidence approve that innate and adaptive immunity play key roles in the defense against visceral leishmaniasis (VL). The polymorphism within the cytotoxic T lymphocyte antigen 4 (CTLA-4) gene alters its expression. Objectives: The main aim of this study was to evaluate the polymorphism within the +49 position of the CTLA-4 gene of Iranian patients with VL in comparison with healthy controls. Materials and Methods: In this cross-sectional study, 88 patients with clinical presentations of VL, who were seropositive for Leishmania (group 1), 86 patients without clinical presentations but seropositive (group 2), and 115 healthy controls (group 3) were assessed with respect to the CTLA-4 +49A/G polymorphism, using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The anti-Leishmania antibody titration was evaluated using an immunofluorescence method. Results: Our results indicated that both CTLA-4 +49A/G polymorphisms were significantly associated with VL. Conclusions: According to the results, the polymorphisms within the +49 position of CTLA-4 can be associated with VL and may be considered as risk factors for the disease.
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Affiliation(s)
- Mehrdad Hajilooi
- Department of Immunology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Pegah Lotfi
- Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Farhad Seif
- Department of Immunology and Microbiology, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IR Iran
| | - Ahad Bazmani
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Mohammad Momeni
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Ali Ravary
- Occupational Environment Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, IR Iran
| | - Mohammad Kazemi Arababadi
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Ali Reza Khalilian
- Faculty of Medicine, Shahid Beheshti Hospital, Hamadan University of Medical Sciences, Hamadan, IR Iran
- Corresponding author: Ali Reza Khalilian, Shahid Beheshti Hospital, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran. Tel: +98-8118271560, Fax: +98-8118254073, E-mail:
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Abasi M, Lotfi P, Bazmani A, Matini M, Hajilooi M. Evaluation of FcγRIIIB-NA1/NA2 Polymorphism in Visceral Leishmaniasis. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e12437. [PMID: 24910789 PMCID: PMC4028762 DOI: 10.5812/ircmj.12437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 08/06/2013] [Accepted: 09/15/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Several lines of evidence demonstrating that innate and adaptive immunity play important roles in the defense against visceral leishmaniasis (VL). A polymorphism within the FcγRIIIB gene can lead to the expression of three variants of NA1, NA2, and the combined one (NA1/NA2) which alters affinity of IgG to its receptor. OBJECTIVES The main aim of this study was to evaluate the FcγRIIIB-NA1/NA2 polymorphism in the FcγRIIIB gene of VL patients in comparison to healthy controls. PATIENTS AND METHODS In this cross-sectional study, three groups; 54 seropositive patients with clinical presentation of VL (group 1), 104 seropositive patients without clinical presentation (group 2), and 104 healthy controls (group 3) were evaluated with respect to the FcγRIIIB-NA1/NA2 polymorphism using a PCR-SSP method. The titration of anti-leishmania antibodies was analyzed using an immunoflorescence technique. RESULTS Our results indicated that polymorphisms within the FcγRIIIB gene (that lead to the expression of the NA1/NA2 isoforms) are significantly associated with VL. The results demonstrated that the genotype heterozygotic for FcγRIIIB-NA1/NA2 expression was significantly increased in VL patients, group 1 when compared to groups 2 and 3. Conversely, there is a decrease in homozygous NA1 and NA2 genotypes in VL patients; however, the overall frequency of NA1 and NA2 alleles appear similar across the three cohorts examined. CONCLUSIONS According to our results, it is likely that the increased frequency of the FcγRIIIB-NA1/NA2 genotype is associated with impaired immune responses against VL and its subsequent clearance from the patient.
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Affiliation(s)
- Mohammad Abasi
- Faculty of Medicine, Shahid Beheshti Hospital, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Pegah Lotfi
- Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Ahad Bazmani
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Mohamad Matini
- Department of Parasitology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Mehrdad Hajilooi
- Department of Immunology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran
- Corresponding Author: Mehrdad Hajilooi, Department of Immunology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran. Tel: +98-8118250509, Fax: +98-8118254073, E-mail:
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Rapoport AB, Bergeron G, Shipton LK. A 32-Year-Old Man From El Salvador With Fever, Weight Loss, and Splenomegaly. Clin Infect Dis 2014. [DOI: 10.1093/cid/cit702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Karram S, Loya A, Hamam H, Habib RH, Khalifeh I. Transepidermal elimination in cutaneous leishmaniasis: a multiregional study. J Cutan Pathol 2012; 39:406-12. [PMID: 22443392 DOI: 10.1111/j.1600-0560.2012.01890.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Transepidermal elimination has been documented in a myriad of infectious diseases; however, its occurrence in cutaneous leishmaniasis has not been evaluated. METHODS Skin biopsies (n = 212) with cutaneous leishmaniasis in Lebanon (n = 46), Syria (n = 53), Saudi Arabia (n = 45) and Pakistan (n = 68) were evaluated. Clinical data collected included age, gender, eruption type (papule, nodule, verrucous or scar), duration and anatomic location. Histopathologically, multiple parameters were recorded including Ridley's parasitic index and pattern, transepidermal elimination, interface changes, ulceration and necrosis. Transepidermal elimination was defined as the presence of amastigotes in the epidermis in all layers, limited to the basal layer or present in a perforating plug. All cases were confirmed by polymerase chain reaction (PCR) analysis followed by restriction fragment length polymorphism analysis for molecular subspeciation. RESULTS Leishmania tropica was identified in 88.2% and Leishmania major in 11.8% of all cases. Transepidermal elimination was observed in 28.3% of cases (29 perforating plug, 19 all layers and 12 basal layer) with a significant prevalence of L. major in this group (35 vs. 2%, p < 0.001). Cases with transepidermal elimination were associated with interface changes and higher parasitic index (p < 0.001) but not with an increased ulceration rate (p > 0.05). Multivariate analysis showed that transepidermal elimination was independently predicted by L. major [OR (95% confidence interval) = 80 (9-712); p < 0.001], parasitic index [OR = 3.4 (2.1-5.3); p < 0.001], interface changes [OR = 6.24 (2.2-17.8); p < 0.001] and necrosis [OR = 0.2 (0.1-0.8);p = 0.026]. CONCLUSIONS We report the largest multiregional cutaneous leishmaniasis series with a 28.3% documented transepidermal elimination incidence of which 48% were perforating plug; a significant prevalence of L. major was also identified in the transepidermal elimination group. The association of transepidermal elimination with interface changes and a higher parasitic index, without an increased ulceration rate, may reflect a unique biologic alteration in the epidermis, serving to facilitate the extrusion of the parasites through the skin.
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Affiliation(s)
- Sarah Karram
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Zoller T, Naucke TJ, May J, Hoffmeister B, Flick H, Williams CJ, Frank C, Bergmann F, Suttorp N, Mockenhaupt FP. Malaria transmission in non-endemic areas: case report, review of the literature and implications for public health management. Malar J 2009; 8:71. [PMID: 19379496 PMCID: PMC2672952 DOI: 10.1186/1475-2875-8-71] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Accepted: 04/20/2009] [Indexed: 11/10/2022] Open
Abstract
In non-endemic areas, malaria is rare and locally acquired infections, particularly with Plasmodium falciparum, are exceptional events. The diagnosis is, therefore, likely to be delayed or missed in patients without a relevant travel history. This report describes a case of falciparum malaria in Berlin, Germany, in a patient who had not been to an endemic area for more than a decade. Potential routes of vector-related and direct transmission were evaluated, particularly with regard to a possible danger to the public. A review of the literature was conducted regarding possible routes of transmission and their probability assessed. Genotyping of parasite isolates of this and another patient with malaria admitted 16 days before revealed homology between the two strains. In a local entomological survey, anopheline vectors on the hospital grounds as well as in the residential area of both patients were found. Despite intensive investigations, the mode of transmission remained obscure. In this context, possible routes of vector-borne and direct occupational/accidental transmission in a major European city are reviewed and discussed, providing information and guidance in case other similar events occur elsewhere. Examples for investigations and measures to be taken in such a situation are provided. When local malaria transmission within a large non-immune population cannot be ruled out, genotyping of parasite isolates, local entomological surveys, preparedness for secondary cases, expert consultations in a multidisciplinary team and careful information management are essential. Malaria acquired in non-endemic areas remains an unlikely, but possible event for which awareness needs to be maintained.
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Affiliation(s)
- Thomas Zoller
- Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
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Tarantola A, Abiteboul D, Rachline A. Infection risks following accidental exposure to blood or body fluids in health care workers: a review of pathogens transmitted in published cases. Am J Infect Control 2006; 34:367-75. [PMID: 16877106 PMCID: PMC7115312 DOI: 10.1016/j.ajic.2004.11.011] [Citation(s) in RCA: 159] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2004] [Accepted: 11/08/2004] [Indexed: 01/21/2023]
Abstract
Hospital staff and all other human or veterinary health care workers, including laboratory, research, emergency service, or cleaning personnel are exposed to the risk of occupational infection following accidental exposure to blood or body fluids (BBF) contaminated with a virus, a bacteria, a parasite, or a yeast. The human immunodeficiency virus (HIV) or those of hepatitis B (HBV) or C (HCV) account for most of this risk in France and worldwide. Many other pathogens, however, have been responsible for occupational infections in health care workers following exposure to BBF, some with unfavorable prognosis. In developed countries, a growing number of workers are referred to clinicians responsible for the evaluation of occupational infection risks following accidental exposure. Although their principal task remains the evaluation of the risks of HIV, HBV, or HCV transmission and the possible usefulness of postexposure prophylaxis, these experts are also responsible for evaluating risks of occupational infection with other emergent or more rare pathogens and their possible timely prevention. The determinants of the risks of infection and the characteristics of described cases are discussed in this article.
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Affiliation(s)
- Arnaud Tarantola
- International and Tropical Department, National Institute for Public Health Surveillance, InVS, Saint-Maurice, France.
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Woods JP, Decker LS, Meinkoth J, Steurer F. Lymph node aspirate from a 4-month-old Mastiff with weight loss, lymphadenopathy, and pyrexia. Vet Clin Pathol 2002; 29:137-139. [PMID: 12070825 DOI: 10.1111/j.1939-165x.2000.tb00244.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J. Paul Woods
- Department of Veterinary Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1H 6R8, Canada.
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Ferreira MS, Borges AS. Some aspects of protozoan infections in immunocompromised patients- a review. Mem Inst Oswaldo Cruz 2002; 97:443-57. [PMID: 12118272 DOI: 10.1590/s0074-02762002000400001] [Citation(s) in RCA: 117] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Protozoa are among the most important pathogens that can cause infections in immunocompromised hosts. These microorganisms particularly infect individuals with impaired cellular immunity, such as those with hematological neoplasias, renal or heart transplant patients, patients using high doses of corticosteroids, and patients with acquired immunodeficiency syndrome. The protozoa that most frequently cause disease in immunocompromised patients are Toxoplasma gondii, Trypanosoma cruzi, different Leishmania species, and Cryptosporidium parvum; the first two species cause severe acute meningoencephalitis and acute myocarditis, Leishmania sp. causes mucocutaneous or visceral disease, and Cryptosporidium can lead to chronic diarrhea with hepatobiliary involvement. Various serological, parasitological, histological and molecular methods for the diagnosis of these infections are currently available and early institution of specific therapy for each of these organisms is a basic measure to reduce the morbidity and mortality associated with these infections.
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Affiliation(s)
- Marcelo Simão Ferreira
- Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG, 38400-027, Brasil.
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Herwaldt BL. Laboratory-acquired parasitic infections from accidental exposures. Clin Microbiol Rev 2001; 14:659-88, table of contents. [PMID: 11585780 PMCID: PMC88999 DOI: 10.1128/cmr.14.3.659-688.2001] [Citation(s) in RCA: 147] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Parasitic diseases are receiving increasing attention in developed countries in part because of their importance in travelers, immigrants, and immunocompromised persons. The main purpose of this review is to educate laboratorians, the primary readership, and health care workers, the secondary readership, about the potential hazards of handling specimens that contain viable parasites and about the diseases that can result. This is accomplished partly through discussion of the occupationally acquired cases of parasitic infections that have been reported, focusing for each case on the type of accident that resulted in infection, the length of the incubation period, the clinical manifestations that developed, and the means by which infection was detected. The article focuses on the cases of infection with the protozoa that cause leishmaniasis, malaria, toxoplasmosis, Chagas' disease (American trypanosomiasis), and African trypanosomiasis. Data about 164 such cases are discussed, as are data about cases caused by intestinal protozoa and by helminths. Of the 105 case-patients infected with blood and tissue protozoa who either recalled an accident or for whom the likely route of transmission could be presumed, 47 (44.8%) had percutaneous exposure via a contaminated needle or other sharp object. Some accidents were directly linked to poor laboratory practices (e.g., recapping a needle or working barehanded). To decrease the likelihood of accidental exposures, persons who could be exposed to pathogenic parasites must be thoroughly instructed in safety precautions before they begin to work and through ongoing training programs. Protocols should be provided for handling specimens that could contain viable organisms, using protective clothing and equipment, dealing with spills of infectious organisms, and responding to accidents. Special care should be exercised when using needles and other sharp objects.
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Affiliation(s)
- B L Herwaldt
- Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3724, USA.
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Quiroz ES, Castellano CM, Greene JN, Sandin RL, Moscinski LC. Toxoplasmic Lymphadenopathy Clinically Presenting as Lymphoma. Cancer Control 1997; 4:434-439. [PMID: 10763053 DOI: 10.1177/107327489700400510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- ES Quiroz
- Department of Internal Medicine, University of South Florida, College of Medicine, Tampa 33612, USA
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Weigle K, Saravia NG. Natural history, clinical evolution, and the host-parasite interaction in New World cutaneous Leishmaniasis. Clin Dermatol 1996; 14:433-50. [PMID: 8889321 DOI: 10.1016/0738-081x(96)00036-3] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- K Weigle
- Fundacion Centro Internacional de Entrenamiento e Investigaciones Medicas (CIDEIM), Cali, Colombia
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Abstract
Gastrointestinal dysfunction is a major problem for many patients with chronic Chagas' disease, as are cardiac dysrhythmias and cardiomyopathy. The underlying anatomic abnormality in these patients is a denervation of the gastrointestinal tract. This process of nerve destruction usually develops insidiously over many years, and it is highly variable in terms of its extent in individual patients as well as in the segments of the gastrointestinal tract that are most affected. Megaesophagus is the most common manifestation of gastrointestinal Chagas disease, and mechanical dilation of the esophageal sphincter or surgery in advanced cases usually give satisfactory relief of symptoms. Megacolon, particularly of the sigmoid segment, is also common in patients with chronic T. cruzi infections, and its presence can be complicated by fecal impaction or sigmoid volvulus. Patients with advanced megacolon who have resections of the sigmoid colon and most of the rectum generally do well postoperatively.
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Affiliation(s)
- L V Kirchhoff
- Division of Infectious Diseases, University of Iowa, Iowa City, USA
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Daumal M, Verreman V, Daumal F, Manoury B, Colpart E. Paludisme à Plasmodium falciparum consécutif à une piqûre d'aiguille. Med Mal Infect 1996. [DOI: 10.1016/s0399-077x(96)80040-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
An estimated 500,000 laboratory workers in the United States are at risk of exposure to infectious agents that cause disease ranging from inapparent to life-threatening infections, but the precise risk to a given worker unknown. The emergence of human immunodeficiency virus and hantavirus, the continuing problem of hepatitis B virus, and the reemergence of Mycobacterium tuberculosis have renewed interest in biosafety for the employees of laboratories and health care facilities. This review examines the history, the causes, and the methods for prevention of laboratory-associated infections. The initial step in a biosafety program is the assessment of risk to the employee. Risk assessment guidelines include the pathogenicity of the infectious agent, the method of transmission, worker-related risk factors, the source and route of infection, and the design of the laboratory facility. Strategies for the prevention and management of laboratory-associated infections are based on the containment of the infectious agent by physical separation from the laboratory worker and the environment, employee education about the occupational risks, and availability of an employee health program. Adherence to the biosafety guidelines mandated or proposed by various governmental and accrediting agencies reduces the risk of an occupational exposure to infectious agents handled in the workplace.
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Affiliation(s)
- D L Sewell
- Pathology and Laboratory Medicine Service, Veterans Affairs Medical Center, Portland, Oregon 97201, USA
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Bimane cyclic esters, possible stereologues of trypanothione as antitrypanosomal agents. Bimanes 29. Eur J Med Chem 1995. [DOI: 10.1016/0223-5234(96)88283-3] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Affiliation(s)
- L V Kirchhoff
- Department of Internal Medicine, University of Iowa, Iowa City 52242
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