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Reports the revolution of clinical medicine with the discovery of penicillin in London, England. Functions of penicillin in treating infectious diseases; Purification of antibiotics for therapeutic tests; Details on the growth of a penicillium mold on a culture of staphylococci.

Understanding people's concepts of illness and health is key to crafting policies and communications campaigns to address a particular medical concern. This paper gathers cultural knowledge on infectious disease causation, prevention, and treatment the Philippines that are particularly relevant for the COVID-19 pandemic, and analyzes their implications for public health. This paper draws from ethnographic work (e.g. participant observation, interviews, conversations, virtual ethnography) carried out individually by each of the two authors from February to September 2020. The data was analyzed in relation to the anthropological literature on local health knowledge in the Philippines. We find that notions of hawa (contagion) and resistensiya (immunity) inform people's views of illness causation as well as their preventive practices - including the use of face masks and 'vitamins' and other pharmaceuticals, as well as the ways in which they negotiate prescriptions of face mask use and physical distancing. These perceptions and practices go beyond biomedical knowledge and are continuously being shaped by people's everyday experiences and circulations of knowledge in traditional and social media. Our study reveals that people's novel practices reflect recurrent, familiar, and long-held concepts - such as the moral undertones of hawa and experimentation inherent in resistensiya. Policies and communications efforts should acknowledge and anticipate how these notions may serve as either barriers or facilitators to participatory care and improved health outcomes. [ABSTRACT FROM AUTHOR]

Typhoid fever is a highly communicable and infectious disease that can be fatal and causes severe complications if unattended to timely. The infection, at times, can be more complex, challenging, and impossible to treat as antibiotics become less effective. Hence, the effect of limited clinical efficacy of the antibiotics with corresponding relapse response to treatment on infected humans is considered in this paper by formulating a deterministic model for direct and indirect transmission mode of Typhoid infection. The basic reproduction number is analytically derived and used to implement the global sensitivity analysis. Following the sensitivity analysis result, the optimal control analysis is carried out and simulated numerically with four controls: sanitation and hygiene practice and awareness campaign control, sterilisation and disinfection control, the potency of antibiotics control and screening control. Finally, the cost-effectiveness analysis for infected and susceptible humans with four cases that compared fifteen strategies is analysed. The results indicate that the sanitation and hygiene practice and awareness campaign is good to implement for single control implementation, while for double control implementation, Strategy 6, which is the combination of Strategy 1 and the potency of antibiotics administered to typhoid patients, is the best to consider. Combining Strategy 6 and screening control is the most cost-effective for triple controls. Furthermore, the overall computation of cost-effectiveness among all the most cost-effective with all the controls combined suggests that sanitation and hygiene practice and awareness campaign is the most cost-effective strategy to implement for eradicating typhoid infection in the population and for preventing susceptible populations from contracting the bacteria. [ABSTRACT FROM AUTHOR]

(1) Problem: The increasing incidence and prevalence of infectious diseases in Indigenous Australians (Aboriginal groups and Torres Strait Islanders) are concerning. Indigenous Australians experience the burden of infectious diseases disproportionately when compared to non-Indigenous Australians. (2) Aim: Our report aims to describe how to apply Strengths-Based Nursing (SBN) to ameliorate the impact of the most common infectious diseases in Indigenous Australians. Specifically, we aim to describe how nurses can use SBN to partner with Indigenous Australian communities to remediate, control, and mollify the impact of the most common infectious diseases encountered by them using their limited resources. (3) Methods: Meticulous PubMed, Google Scholar, and web searches were conducted pertaining to Strengths-Based Nursing and common infectious diseases in Indigenous Australians. (4) Findings: The two groups of infectious diseases considered are sexually transmitted infections (STIs) and infectious skin diseases (including parasitic infestations). The prevalence of these infectious diseases in Indigenous Australians is deliberated on, with data when possible, or known trends and impacts. Finally, existing, evidence-based, prudent, and possible SBN approaches are discussed towards tackling these infectious diseases judiciously with available local resources, in conjunction with the support of impacted people, their families, and their communities. (5) Discussion and Conclusion: The SBN approach is a relatively new perspective/approach to clinical and nursing care. In contradistinction to the commonly utilised medical model, SBN pits strengths against deficits, available resources against professional judgment, solutions against unavailable items, and collaborations against hierarchy. In light of the current situation/data, several SBN approaches to combat STIs and skin infections in Indigenous Australians were identified and discussed for the first time in the "Results" section of this paper. [ABSTRACT FROM AUTHOR]

Copyright of Tropical Medicine & International Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pharmacogenetics holds great potential for improving the effectiveness of treatment modalities in infectious diseases by taking into account the genetic determinants of both the host and infectious agents' individuality. Better utilization of resources and improved therapeutic efficiency are the expected outcomes of personalized medicine using pharmacogenetic and pharmacogenomics information made available by technological advances. However, there has been growing concern in the clinical community regarding the evaluation of the true benefits of these approaches. This perception is partly due to the limited number and perceived poor quality of economic evaluations in this field, and initiatives aimed at harmonizing and communicating strategies improving the quality of these studies and their acceptance by the clinical community are greatly needed. This paper reviews current literature of economic evaluations of pharmacogenetics interventions guiding pharmacotherapy in infectious diseases. PubMed and the NHS Centre for Reviews and Dissemination databases were searched using a combination of five broad research terms related to pharmacogenetic approaches, and papers relative to economic evaluations of pharmacogenetic interventions in infectious diseases retained for further analysis. Using these criteria, a total of 14 papers were included in this review. The area of economic evaluation of pharmacogenetic interventions in infectious diseases remains understudied and would benefit from greater harmonization. The main weaknesses of evaluations reviewed in this paper seem to be represented by poor evidence of pharmacogenetic marker validation, inconsistencies in the selection of costs and utility included in the economic models and the choice of sensitivity analysis. All these factors limit the overall transparency of the studies, greater acceptance of their results and applicability to diverse and possibly resourcelimited environments where these approaches could be expected to have the greater impact. [ABSTRACT FROM AUTHOR]

The outcome of management of diabetic foot ulcers remains a challenge, and there remains continuing uncertainty concerning optimal approaches to management. It is for these reasons that in 2008 and 2012, the International Working Group of the Diabetic Foot (IWGDF) working group on wound healing published systematic reviews of the evidence to inform protocols for routine care and to highlight areas, which should be considered for further study. The same working group has now updated this review by considering papers on the interventions to improve the healing of chronic ulcers published between June 2010 and June 2014. Methodological quality of selected studies was independently assessed by two reviewers using Scottish Intercollegiate Guidelines Network criteria. Selected studies fell into the following ten categories: sharp debridement and wound bed preparation with larvae or hydrotherapy; wound bed preparation using antiseptics, applications and dressing products; resection of the chronic wound; oxygen and other gases, compression or negative pressure therapy; products designed to correct aspects of wound biochemistry and cell biology associated with impaired wound healing; application of cells, including platelets and stem cells; bioengineered skin and skin grafts; electrical, electromagnetic, lasers, shockwaves and ultrasound and other systemic therapies, which did not fit in the aforementioned categories. Heterogeneity of studies prevented pooled analysis of results. Of the 2161 papers identified, 30 were selected for grading following full text review. The present report is an update of the earlier IWGDF systematic reviews, and the conclusion is similar: that with the possible exception of negative pressure wound therapy in post-operative wounds, there is little published evidence to justify the use of newer therapies. Analysis of the evidence continues to present difficulties in this field as controlled studies remain few and the majority continue to be of poor methodological quality. [ABSTRACT FROM AUTHOR]

Though there is an abundance of information on cutaneous malignancies in transplant recipients, cutaneous infections in solid organ transplant recipients (SOTRs) are underrepresented in the dermatological literature. Our paper provides a comprehensive review of bacterial cutaneous infections within the solid organ transplant population. Cutaneous bacterial infections may lead to significant morbidity and even mortality in this immunosuppressed population. Thus, it is to the benefit of both dermatologists and other transplant care providers to better understand and recognize the features of cutaneous bacterial infections in SOTRs. This paper can aid providers in promptly identifying, diagnosing, and treating bacterial skin infections. This review discusses the diagnosis and treatment of the following bacterial species: Staphylococcus, Streptococcus, Pseudomonas aeruginosa, Escherichia coli, Nocardia, Mycobacteria, and Bartonella henselae. [ABSTRACT FROM AUTHOR]

Background: Antibiotics have played an essential role in decreasing morbidity and mortality from infectious diseases. However, indiscriminate use and unrestricted access is contributing to the emergence of bacterial resistance. This paper reports on a situational analysis of antimicrobial use and resistance in Ghana, with focus on policy and regulation.Methods: Relevant policy documents, reports, regulations and enactments were reviewed. PubMed and Google search engines were used to extract relevant published papers. Websites of stakeholders such as Ministry of Health (MOH) and its agencies were also reviewed. An interview guide was used to elicit responses from selected officials from these sectors.Results: Laws and guidelines to control the use of antimicrobials in humans were available but not for animals. There was no National Antimicrobial Policy (NAP). A health practice regulatory law mandates Physicians, Physician Assistants, Midwives and trained Nurses to prescribe antimicrobials. However, antibiotics are widely prescribed and dispensed by unauthorised persons, suggesting weak enforcement of the laws. Antibiotics were also supplied to and from unapproved medicine outlets. The Standard Treatment Guidelines (STG), Essential Medicines List (EML) and the National Health Insurance Scheme Medicines List (NHISML) provide restrictions regarding levels of prescribing of antimicrobials. However, existing guidelines on antibiotic use are mostly not adhered to. The use of Automatic Stop Orders to avoid wastage in the hospitals is also not practiced. Data on use of antibiotics for individuals are not readily available in most facilities. Again, there are no standards or guidelines on veterinary use of antibiotics. Surveillance systems for consumption of antibiotics and resistance monitoring were not in place in most health facilities. However, there is an ongoing national action to create awareness on bacteria resistance, strengthening knowledge through research and surveillance and development of NAP in line with global action plan on antimicrobial resistance.Conclusion: Absence of national antimicrobial policy, weak regulatory environment and non-adherence to practice standards may have contributed to increased and unregulated access to antimicrobials in Ghana, a catalyst for development and spread of antimicrobial resistance. [ABSTRACT FROM AUTHOR]

Background: Children in lower middle-income countries (LMICs) are more at risk of dying, than those in High Income Countries (HICs), due to highly prevalent deadly yet preventable childhood infections. Alongside concerns about the incidence of these infections, there has been a renewed interest in involving community health workers (CHWs) in various public health programs. However, as CHWs are increasingly asked to take on different tasks there is a risk that their workload may become unmanageable. One solution to help reduce this burden is the use of mobile health (mHealth) technology in the community through behaviour change. Considering there are various CHWs based mHealth approaches on illness management and education, therefore, we aimed to appraise the available literature on effectiveness of these mHealth approaches for caregivers to improve knowledge and management about common under-five childhood infections with respect to behaviour change.Methods: We searched six databases between October to December 2019 using subject heading (Mesh) and free text terms in title or abstract in US English. We included multiple study types of children under-five or their caregivers who have been counselled, educated, or provided any health care service by CHWs for any common paediatric infectious diseases using mHealth. We excluded articles published prior to 1990 and those including mHealth technology not coming under the WHO definition. A data extraction sheet was developed and titles, abstracts, and selected full text were reviewed by two reviewers. Quality assessment was done using JBI tools.Results: We included 23 articles involving around 300 000 individuals with eight types of study designs. 20 studies were conducted in Africa, two in Asia, and one in Latin America mainly on pneumonia or respiratory tract infections followed by malaria and diarrhoea in children. The most common types of Health approaches were mobile applications for decision support, text message reminders and use of electronic health record systems. None of the studies employed the use of any behaviour change model or any theoretical framework for selection of models in their studies.Conclusions: Coupling mhealth with CHWs has the potential to benefit communities in improving management of illnesses in children under-five. High quality evidence on impact of such interventions on behaviour is relatively sparse and further studies should be conducted using theoretically informed behaviour change frameworks/models.Registration: PROPSERO Registration number: CRD42018117679. [ABSTRACT FROM AUTHOR]

When we encounter a malicious rumor or an infectious disease outbreak, immunizing k nodes of the relevant network with limited resources is always treated as an extremely effective method. The key challenge is how we can insulate limited nodes to minimize the propagation of those contagious things. In previous works, the best k immunised nodes are selected by learning the initial status of nodes and their strategies even if there is no feedback in the propagation process, which eventually leads to ineffective performance of their solutions. In this paper, we design a novel vaccines placement strategy for protecting much more healthy nodes from being infected by infectious nodes. The main idea of our solution is that we are not only utilizing the status of changing nodes as auxiliary knowledge to adjust our scheme, but also comparing the performance of vaccines in various transmission slots. Thus, our solution has a better chance to get more benefit from these limited vaccines. Extensive experiments have been conducted on several real-world data sets and the results have shown that our algorithm has a better performance than previous works. [ABSTRACT FROM AUTHOR]

This paper examines one of the most popular remedies in medieval plague medicine, namely theriac, and explores possible reasons for its remarkable continuity in the late medieval and early modern medical tradition. Theriac, reputed as a universal antidote since ancient times, was a complex compound, composed of multiple ingredients, difficult to prepare, and subject to strict manufacturing and commercial controls. The paper centers on the therapeutic applications of theriac and on its relative pharmacologic efficacy in treating the symptoms of plague. The consistent use of theriac in plague medicine attests not only to the conservatism of medieval medical practice, but also to an underlying solidly founded rationale that combined humoral doctrine, empiric observation, and pharmacologic effect. [ABSTRACT FROM AUTHOR]

Data on the epidemiology of serious fungal infections in Greece are scarce. Our aim was to calculate the burden of serious fungal diseases in Greece. A thorough literature search for papers reporting epidemiological data on serious fungal diseases in Greece was performed. Where no Greek data existed, we used a structured set of assumptions to estimate fungal disease burden, based on specific high-risk populations. Of the 10.8 million population, 85.5 % are adults and 27 % are over 60 years of age. The annual fungal disease estimates are as follows: 142,337 Greek women get recurrent vaginal thrush (2,632 cases/100,000 females); there are 889 cases of esophageal candidiasis (8.2 cases/100,000); annual incidence of Pneumocystis pneumonia is 112 cases; chronic pulmonary aspergillosis prevalence is 386 cases; there are 20,843 patients with allergic bronchopulmonary aspergillosis and 27,744 with severe asthma with fungal sensitization; candidaemia incidence is 541 cases (5.0/100,000); there are 81 cases of Candida peritonitis; invasive aspergillosis occurs in 1,125 patients. According to our calculations, 194,067 individuals (1.79 cases/100,000) in Greece suffer from serious fungal diseases each year. This is the first attempt to determine the burden of fungal diseases in Greece, and provides a crude estimate on its impact on public health. [ABSTRACT FROM AUTHOR]

Background: Complexity in medicine needs to be reduced to simple components in a way that is comprehensible to researchers and clinicians. Few studies in the current literature propose a measurement model that addresses both task and patient complexity in medicine.Objective: The objective of this paper is to develop an integrated approach to understand and measure clinical complexity by incorporating both task and patient complexity components focusing on the infectious disease domain. The measurement model was adapted and modified for the healthcare domain.Methods: Three clinical infectious disease teams were observed, audio-recorded and transcribed. Each team included an infectious diseases expert, one infectious diseases fellow, one physician assistant and one pharmacy resident fellow. The transcripts were parsed and the authors independently coded complexity attributes. This baseline measurement model of clinical complexity was modified in an initial set of coding processes and further validated in a consensus-based iterative process that included several meetings and email discussions by three clinical experts from diverse backgrounds from the Department of Biomedical Informatics at the University of Utah. Inter-rater reliability was calculated using Cohen's kappa.Results: The proposed clinical complexity model consists of two separate components. The first is a clinical task complexity model with 13 clinical complexity-contributing factors and 7 dimensions. The second is the patient complexity model with 11 complexity-contributing factors and 5 dimensions.Conclusion: The measurement model for complexity encompassing both task and patient complexity will be a valuable resource for future researchers and industry to measure and understand complexity in healthcare. [ABSTRACT FROM AUTHOR]

In this paper, we study an SIS epidemic model with nonlocal delay based on reaction–diffusion equation. The spatiotemporal distribution of the model solution is studied in detail, and sufficient conditions for the occurrence of the Turing pattern were obtained using the analysis of Turing instability. It was found that the delay not only prohibited the spread of infectious disease, but also had great effects on the spatial steady-state patterns. More specifically, the spatial average density of the infected populations will decrease, as well the width of the stripe pattern will increase as delay increases. When the delay increases to a certain value, the stripe pattern changes to the mixed pattern. The results in this work provide new theoretical guidance for the prevention and treatment of infectious diseases. [ABSTRACT FROM AUTHOR]

Background: In 2015, the World Health Organization (WHO) updated the global methodology for assessing and reducing missed opportunities for vaccination (MOV), when eligible children have contact with the health system but are not vaccinated. This paper presents the results of two pilot assessments conducted in Chad and Malawi. Methods: Using the ten-step global WHO MOV strategy, we purposively selected districts and health facilities, with non-probabilistic sampling of <24 month old children for exit interviews of caregivers and self-administered knowledge, attitudes, and practices (KAP) surveys of health workers. MOV were calculated based on a child’s documented vaccination history (i.e., from a home-based record (HBR) or a health facility vaccination register), including selected vaccines in the national schedule. Results: Respondents included caregivers of 353 children in Chad and of 580 children in Malawi. Among those with documented vaccination history, 82% (195/238) were eligible for vaccination in Chad and 47% (225/483) in Malawi. Among eligible children, 51% (99/195) in Chad, and 66% (149/225) in Malawi had one or more MOV on the survey date. During non-vaccination visits, 77% (24/31) of children eligible for vaccination in Chad and 92% (119/129) in Malawi had a MOV compared to 46% (75/164) and 31% (30/96) during vaccination visits, respectively. Among health workers, 92% in Chad and 88% in Malawi were unable to correctly identify valid contraindications for vaccination. Conclusion: The new MOV tool was able to characterize the type and potential causes of MOV. In both countries, the findings of the assessments point to two major barriers to full vaccination of eligible children—a lack of coordination between vaccination and curative health services and incomplete vaccination during vaccination visits. National immunization programs should explore tailored efforts to improve health worker practices and to increase vaccine delivery by making better use of existing health service contacts. [ABSTRACT FROM AUTHOR]

Summary: This paper presents a detailed mathematical analysis of the role of awareness programs by media and antiviral treatment on the control of infectious diseases. A nonlinear model is proposed in order to control the infectious diseases, and the model is examined under various scenarios of control measures using variety of mathematical techniques including stability, sensitivity, optimal control, and cost‐effectiveness analysis. Considering the constant control parameters, the basic reproduction number is derived and investigated by the existence and stability of equilibria, then the relative impact of each of the constant control parameters are assessed by calculating the sensitivity index of the basic reproduction number. Under the time‐dependent controls, the necessary conditions for the optimal control of the disease are derived using the Pontryagin's maximum principle in order to determine optimal strategies for controlling the spread of the disease. In order to investigate the most cost‐effective control strategy among all the possible strategies, cost‐effectiveness analysis is carried out using numerical simulations and the result reveals that the strategy combination of 3 control measures (the successful campaign of awareness programs by media, controlling effort that alters infectious cases receiving treatment, and strengthening effort made on awareness campaign programs) is the most cost‐effective control strategy and this indicates that implementation of all the 3 control measures is necessary in order to control the disease outbreak. [ABSTRACT FROM AUTHOR]

Eumycetoma is a chronic infectious disease characterized by a large subcutaneous mass, often caused by the fungus Madurella mycetomatis. A combination of surgery and prolonged medication is needed to treat this infection with a success rate of only 30%. There is, therefore, an urgent need to find more effective drugs for the treatment of this disease. In this study, we screened 800 diverse drug-like molecules and identified 215 molecules that were active in vitro. Minimal inhibitory concentrations were determined for the 13 most active compounds. One of the most potent compounds, a fenarimol analogue for which a large analogue library is available, led to the screening of an additional 35 compounds for their in vitro activity against M. mycetomatis hyphae, rendering four further hit compounds. To assess the in vivo potency of these hit compounds, a Galleria mellonella larvae model infected with M. mycetomatis was used. Several of the compounds identified in vitro demonstrated promising efficacy in vivo in terms of prolonged larval survival and/or reduced fungal burden. The results presented in this paper are the starting point of an Open Source Mycetoma (MycetOS) approach in which members of the global scientific community are invited to participate and contribute as equal partners. We hope that this initiative, coupled with the promising new hits we have reported, will lead to progress in drug discovery for this most neglected of neglected tropical diseases. [ABSTRACT FROM AUTHOR]

Despite the double burden of infectious and chronic non-communicable diseases in Africa, health care expenditure disproportionately favours infectious diseases. In this paper, we examine quantitatively the extent of this disproportionate access to diagnoses and treatment of diabetes, hypertension and malaria in Ghana. A total of 220 health facilities was surveyed across the country in 2011. Findings indicate that diagnoses and treatment of infectious diseases were more accessible than NCDs. In terms of treatment, 78% and 87% of health facilities had two of the recommended malaria drugs while less than 35% had essential diabetes and hypertension drugs. There is a significant unmet need for diagnoses and treatment of NCDs in Ghana. These inequities have implications for high morbidity and mortality from NCDs. We recommend the use of task shifting as a model to increase the delivery of NCD services. [ABSTRACT FROM AUTHOR]

Fever may be the only clinical symptom at the onset of infection in neutropenic cancer patients undergoing myelosuppressive chemotherapy. A prompt and evidence-based diagnostic and therapeutic approach is mandatory. A systematic search of current literature was conducted, including only full papers and excluding allogeneic hematopoietic stem cell transplant recipients. Recommendations for diagnosis and therapy were developed by an expert panel and approved after plenary discussion by the AGIHO. Randomized clinical trials were mainly available for therapeutic decisions, and new diagnostic procedures have been introduced into clinical practice in the past decade. Stratification into a high-risk versus low-risk patient population is recommended. In high-risk patients, initial empirical antimicrobial therapy should be active against pathogens most commonly involved in microbiologically documented and most threatening infections, including Pseudomonas aeruginosa, but excluding coagulase-negative staphylococci. In patients whose expected duration of neutropenia is more than 7 days and who do not respond to first-line antibacterial treatment, specifically in the absence of mold-active antifungal prophylaxis, further therapy should be directed also against fungi, in particular Aspergillus species. With regard to antimicrobial stewardship, treatment duration after defervescence in persistently neutropenic patients must be critically reconsidered and the choice of anti-infective agents adjusted to local epidemiology. This guideline updates recommendations for diagnosis and empirical therapy of fever of unknown origin in adult neutropenic cancer patients in light of the challenges of antimicrobial stewardship. [ABSTRACT FROM AUTHOR]

Introduction: Mother-to-child transmission of hepatitis B infection is one of the major routes of hepatitis B virus (HBV) infection in Africa. Amusingly, Africa is the only region yet to meet the World Health Organization's target of reducing the prevalence of HBV infection to less than 1% among children under 5 years of age by 2020. In Ghana, little has been documented about midwives' views on the factors impacting the successful implementation of mother-to-child transmission via HBV prevention programs. Objective: This study explored midwives' views on the challenges associated with the prevention of mother-to-child transmission of HBV infection in the La-Nkwantanang municipality. Methods: The study adopted an exploratory descriptive qualitative design and involved 14 midwives who were purposively recruited from a primary-level health facility in the La-Nkwantanang Municipality, Accra. Individual face-to-face interviews were conducted using an in-depth interview guide. The data were content analyzed using the six steps recommended by Braun and Clark. Results: Three main themes, namely, health professional or midwife factors and patient and health facility factors, negatively impacted the prevention of maternal-to-child transmission program. The five subthemes identified in this study included lack of awareness, financial constraints, and unavailability of logistics and protocols. The study recognized that midwives face many challenges even though they have a strong desire to prevent vertical transmission of HBV. Conclusion: The implementation of a mother-to-child transmission program is negatively impacted by many intrinsic, client, and health facility factors. Midwives who act as major stakeholders need to be periodically trained on the components and protocols for managing pregnant women living with HBV. The necessary logistics and management protocols need to be urgently provided. The skills and education obtained from the training will empower midwives to be knowledgeable about how to deliver quality care and provide education and support for HBV-infected pregnant women. The provision of logistics needed for the successful implementation of the program could avert delays associated with the administration of the hepatitis B birth dose vaccine and immunoglobulin to exposed newborns. [ABSTRACT FROM AUTHOR]

Background: A large proportion of patients receiving antiretroviral therapy (ART) in low and middle income countries (LMICs) have unknown treatment outcomes and are classified as lost to follow-up (LTFU). Physical tracing of patients classified as LTFU is common; however, effects of tracing on outcomes remains unclear. The objective of this systematic review is to compare estimates of LTFU, mortality and retention in LMIC in cohorts of patients with and without physical tracing. Methods and Findings: We systematically identified studies in LMIC programmatic settings using MEDLINE (2003–2011) and HIV conference abstracts (2009–2011). Studies reporting the proportion LTFU 12-months after ART initiation were included. Tracing activities were determined from manuscripts or by contacting study authors. Studies were classified as “tracing studies” if physical tracing was available for the majority of patients. Summary estimates from the 2 groups of studies (tracing and non-tracing) for LTFU, mortality, stop of ART, transfers out, and retention on ART were determined. 261 papers and 616 abstracts were identified of which 39 studies comprising 54 separate cohorts (n = 187,666) met inclusion criteria. Of those, physical tracing was available for 46% of cohorts. Treatment programs with physical tracing activities had lower estimated LTFU (7.6% vs. 15.1%; p<.001), higher estimated mortality (10.5% vs. 6.6%; p = .006), higher retention on ART (80.0 vs. 75.8%; p = .04) and higher retention at the original site (80.0% vs. 72.9%; p = .02). Conclusions: Knowledge of patient tracing is critical when interpreting program outcomes of LTFU, mortality and retention. The reduction of the proportion LTFU in tracing studies was only partially explained by re-classification of unknown outcomes. These data suggest that tracing may lead to increased re-engagement of patients in care, rather than just improved classification of unknown outcomes. [ABSTRACT FROM AUTHOR]

In terms of scientific activities generally and ethnobiological pursuits in particular, North Korea, officially known as the Democratic People's Republic of Korea, is an almost blank entity on the quilt of global research. During a sabbatical semester at Pyongyang University of Science and Technology the author used this opportunity to gather some information on the uses of insect and other terrestrial arthropods as human food and components of traditional healing methods in that country. Despite the widely publicised shortcomings in the supply of food stuffs to the population of North Korea, insects are not generally seen as a source of food worthy of exploitation. However, the therapeutic use of insects, centipedes and scorpions to treat illnesses as diverse as the common cold, skin rashes, constipation, dysentery, nervous prostration, whooping cough, osteomyelitis, tetanus, and various forms of cancer is apparently still popular. The arthropods used therapeutically are credited with anti-inflammatory, immunological and other health-promoting effects, because they are said to contain hormones, steroids, lipids and plant-derived alkaloids, all of which capable of exerting their effects on the human body. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to explore how the TECH Model (testing for and treating infectious diseases and vaccination; environmental modification to prevent disease transmission; chronic disease identification and treatment; and health maintenance and education) can be used for assessing and achieving healthy prisons. Design/methodology/approach – This paper explores the concepts of "health in prison" and "healthy prisons" in the context of recent research and guidance. The paper then considers the TECH Model as an approach to achieving healthy prisons. Findings – Under each of the four TECH Model domains are tasks to achieve a healthy prison. For prisons with poor or no resources, each domain contains steps that will improve prison health and move towards a healthy prison for both prisoners and staff. Implementation can thus be "low-TECH" or "high-TECH" depending on the setting and the available resources and the model is specifically designed to provide options for resource-poor as well as resource-rich correctional settings. Originality/value – The TECH Model is a first step in characterizing the components of a healthy prison and the processes to achieve this. This Model could be implemented in all levels of prisons internationally. [ABSTRACT FROM AUTHOR]

The effectiveness and safety of treatment with ketoconazole and itraconazole were compared in 773 sporotrichosis-infected cats over a four-year period (2002 to 2005). Five hundred and ninety-eight cats received oral ketoconazole and 175 received oral itraconazole. Treatment was successful in 238 (30.8 per cent) cats, of which 171 (28.6 per cent) of 598 received 13.5 to 27.0 mg/kg/day ketoconazole and 67 (38.3 per cent) of 175 received 8.3 to 27.7 mg/kg/day itraconazole. Adverse effects were reported in 306 (39.6 per cent) of the cats, 105 (13.6 per cent) died and 430 (55.6 per cent) dropped out of treatment or were still under treatment at the time of data analysis. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Phaeohyphomycoses are recognized as opportunistic fungal infections caused by several genera of melanin-pigmented moulds (dematiaceous fungi) which are ubiquitous saprophytic agents found in soil, water and decaying vegetable matter. These infections are usually acquired by direct traumatic implantation of fungal elements into tissues or by contamination of open wounds, being invariably associated with an immunosuppressive or debilitated status. Phaeohyphomycoses are rarely reported in dogs, most appearing as focal or multifocal subcutaneous intact or ulcerated/fistulized nodules or plaques usually found in the facial area, the distal part of extremities or the tail, without any systemic signs. According to the literature data, Alternaria spp. were identified on the coat from 20-80% of healthy dogs and cats without any skin lesions. In this paper, we have reported a case of cutaneous phaeohyphomycosis with Alternaria spp. in a 3-year-old unspayed male Cane corso dog with chronic skin lesions, not responding to antibiotherapy. The diagnosis of fungal infection was based on cytology, fungal culture and clinical response to long term oral administration of itraconazole. In our opinion, the infection likely occurred by direct implantation into defective hairs as well as by contamination of ruptured follicular cysts with Alternaria spp.originated from skin colonization and the outdoor habitat. We also considered the inherited follicular dysplasia (color dilution alopecia) to be a promoting factor in acquisition of this opportunistic fungal infection. Finally, complete resolution of lesions under itraconazole therapy and lack of reccurence for 14 months were decisive features for diagnosis. [ABSTRACT FROM AUTHOR]

This paper explores the optimal treatment of an infectious disease in a Susceptible-Infected-Susceptible model, where there are two strains of the disease and one strain is more infectious than the other. The strains are perfectly distinguishable, instantly diagnosed and equally costly in terms of social welfare. Treatment is equally costly and effective for both strains. Eradication is not possible, and there is no superinfection. In this model, we characterise two types of fixed points: coexistence equilibria, where both strains prevail, and boundary equilibria, where one strain is asymptotically eradicated and the other prevails at a positive level. We derive regimes of feasibility that determine which equilibria are feasible for which parameter combinations. Numerically, we show that optimal policy exhibits switch points over time, and that the paths to coexistence equilibria exhibit spirals, suggesting that coexistence equilibria are never the end points of optimal paths. [ABSTRACT FROM AUTHOR]

Background: Conducting clinical trials to assess experimental treatments for potentially pandemic infectious diseases is challenging. Since many outbreaks of infectious diseases last only six to eight weeks, there is a need for trial designs that can be implemented rapidly in the face of uncertainty. Outbreaks are sudden and unpredictable and so it is essential that as much planning as possible takes place in advance. Statistical aspects of such trial designs should be evaluated and discussed in readiness for implementation. Methodology/Principal findings: This paper proposes a generic ordinal sequential trial design (GOST) for a randomised clinical trial comparing an experimental treatment for an emerging infectious disease with standard care. The design is intended as an off-the-shelf, ready-to-use robust and flexible option. The primary endpoint is a categorisation of patient outcome according to an ordinal scale. A sequential approach is adopted, stopping as soon as it is clear that the experimental treatment has an advantage or that sufficient advantage is unlikely to be detected. The properties of the design are evaluated using large-sample theory and verified for moderate sized samples using simulation. The trial is powered to detect a generic clinically relevant difference: namely an odds ratio of 2 for better rather than worse outcomes. Total sample sizes (across both treatments) of between 150 and 300 patients prove to be adequate in many cases, but the precise value depends on both the magnitude of the treatment advantage and the nature of the ordinal scale. An advantage of the approach is that any erroneous assumptions made at the design stage about the proportion of patients falling into each outcome category have little effect on the error probabilities of the study, although they can lead to inaccurate forecasts of sample size. Conclusions/Significance: It is important and feasible to pre-determine many of the statistical aspects of an efficient trial design in advance of a disease outbreak. The design can then be tailored to the specific disease under study once its nature is better understood. [ABSTRACT FROM AUTHOR]

Background The aim of this research paper was to determine the incidence, risk factors, and clinical outcome of solid organ transplant ( SOT) recipients diagnosed and treated for cryptococcosis at our institution. Methods Retrospective analysis of all patients with SOT diagnosed and treated for cryptococcal infection occurring between January 2001 and December 2015. Results Of 102 patients diagnosed with cryptococcal infection, 23 were SOT recipients. Renal transplant accounted for 22/23 cases, of which 13 had meningitis. The annual incidence of infection has risen significantly, and is now greater than 2/1000 prevalent renal transplant recipients. As expected, biochemical factors associated with meningitis include lower glucose on cerebrospinal fluid ( CSF) analysis, median 2.4 vs 4.5 mmol/L ( P=.02); CSF white blood cell median 50 vs 1/μL ( P<.001); CSF protein, median 950 vs 335 mg/L ( P=.04). Serum cryptococcal antigen titers were higher in the meningitis cohort, median 512 vs 32 ( P=.03). Clinically, headache on admission (odds ratio: 9 [1.29-63.03], P=.03) and a prolonged length of stay (median of 36 vs 13 days) in the meningitis cohort ( P=.02) were significant. Conclusion Cryptococcal infection in SOT recipients remains rare; however, there has been a marked increase in cases since 2014. This study reveals a need for increased vigilance for a potential emerging infectious disease. It furthermore highlights the need for ongoing research to further aid early diagnosis, prognostication, management, and screening cost-effectiveness. [ABSTRACT FROM AUTHOR]

An issue that remains challenging in the field of causal inference is how to relax the assumption of no interference between units. Interference occurs when the treatment of one unit can affect the outcome of another, a situation which is likely to arise with outcomes that may depend on social interactions, such as occurrence of infectious disease. Existing methods to accommodate interference largely depend upon an assumption of "partial interference" - interference only within identifiable groups but not among them. There remains a considerable need for development of methods that allow further relaxation of the no-interference assumption. This paper focuses on an estimand that is the difference in the outcome that one would observe if the treatment were provided to all clusters compared to that outcome if treatment were provided to none - referred as the overall treatment effect. In trials of infectious disease prevention, the randomized treatment effect estimate will be attenuated relative to this overall treatment effect if a fraction of the exposures in the treatment clusters come from individuals who are outside these clusters. This source of interference - contacts sufficient for transmission that are with treated clusters - is potentially measurable. In this manuscript, we leverage epidemic models to infer the way in which a given level of interference affects the incidence of infection in clusters. This leads naturally to an estimator of the overall treatment effect that is easily implemented using existing software. [ABSTRACT FROM AUTHOR]

This paper highlights the critical importance of evidence on vector-borne diseases (VBD) prevention and control interventions in urban settings when assessing current and future needs, with a view to setting policy priorities that promote inclusive and equitable urban health services. Research should produce knowledge about policies and interventions that are intended to control and prevent VBDs at the population level and to reduce inequities. Such interventions include policy, program, and resource distribution approaches that address the social determinants of health and exert influence at organizational and system levels. [ABSTRACT FROM AUTHOR]

This paper is an attempt to estimate the risk of infection importation and exportation by travelers. Two countries are considered: one disease-free country and one visited or source country with a running endemic or epidemic infectious disease. Two models are considered. In the first model (disease importation), susceptible individuals travel from their disease-free home country to the endemic country and come back after some weeks. The risk of infection spreading in their home country is then estimated supposing the visitors are submitted to the same force of infection as the local population but do not contribute to it. In the second model (disease exportation), it is calculated the probability that an individual from the endemic (or epidemic) country travels to a disease-free country in the condition of latent infected and eventually introduces the infection there. The input of both models is the force of infection at the visited/source country, assumed known. The models are deterministic, but a preliminary stochastic formulation is presented as an appendix. The models are exemplified with two distinct real situations: the risk of dengue importation from Thailand to Europe and the risk of Ebola exportation from Liberia to the USA. [ABSTRACT FROM AUTHOR]

Background: Rhinoentomophthoromycosis, or rhino-facial conidiobolomycosis, is a rare, grossly disfiguring disease due to an infection with entomophthoralean fungi. We report a case of rhinoentomophthoromycosis from Gabon and suggest a staging system, which provides information on the prognosis and duration of antifungal therapy. Methods: We present a case of rhinoentomophthoromycosis including the histopathology, mycology, and course of disease. For the suggested staging system, all cases on confirmed rhinoentomophthoromycosis published in the literature without language restriction were eligible. Exclusion criteria were missing data on (i) duration of disease before correct diagnosis, (ii) outcome, and (iii) confirmation of entomophthoralean fungus infection by histopathology and/or mycology. We classified cases into atypical (orbital cellulitis, severe pain, fever, dissemination), early, intermediate, and late disease based on the duration of symptoms before diagnosis. The outcome was evaluated for each stage of disease. Findings: The literature search of the Medpilot database was conducted on January 13, 2014, (updated on January 18, 2015). The search yielded 8,333 results including 198 cases from 117 papers; of these, 145 met our inclusion criteria and were included in the final analysis. Median duration of treatment was 4, 3, 4, and 5 months in atypical, early, intermediate, and late disease, respectively. Cure rates were clearly associated with stage of disease and were 57%, 100%, 82%, and 43% in atypical, early, intermediate, and late disease, respectively. Conclusion: We suggest a clinical staging system that underlines the benefit of early case detection and may guide the duration of antifungal treatment. The scientific value of this classification is its capacity to structure and harmonize the clinical and research approach towards rhinoentomophthoromycosis. [ABSTRACT FROM AUTHOR]

Fungal infections have dramatically increased in the last decades in parallel with an increase of populations with impaired immunity, resulting from medical conditions such as cancer, transplantation, or other chronic diseases. Such opportunistic infections result from a complex relationship between fungi and host, and can range from self-limiting to chronic or life-threatening infections. Modern medicine, characterized by a wide use of biomedical devices, offers new niches for fungi to colonize and form biofilm communities. The capability of fungi to form biofilms is well documented and associated with increased drug tolerance and resistance. In addition, biofilm formation facilitates persistence in the host promoting a persistent inflammatory condition. With a limited availability of antifungals within our arsenal, new therapeutic approaches able to address both host and pathogenic factors that promote fungal disease progression, i.e., chronic inflammation and biofilm formation, could represent an advantage in the clinical setting. In this paper we discuss the antifungal properties of myriocin, fulvic acid, and acetylcholine in light of their already known anti-inflammatory activity and as candidate dual action therapeutics to treat opportunistic fungal infections. [ABSTRACT FROM AUTHOR]

This paper investigates consequences of vaccine implementation strategies for infectious diseases by a mathematical model. For an infectious disease, the degree of infection may vary widely among the individuals. Reports show that individuals belonging to certain groups possess considerably higher risk to infection. Incorporating this phenomenon into vaccination strategies, the host is categorized into different groups to measure the outcome of the vaccination. A mathematical model is proposed and analysed to evaluate this measure. Our results suggest that vaccinating a group with certain priority may lead to elimination of the disease effectively. The strategy is cost-effective as well. [ABSTRACT FROM AUTHOR]

The Global Outbreak Alert and Response Network (GOARN) was established in 2000 as a network of technical institutions, research institutes, universities, international health organisations and technical networks willing to contribute and participate in internationally coordinated responses to infectious disease outbreaks. It reflected a recognition of the need to strengthen and coordinate rapid mobilisation of experts in responding to international outbreaks and to overcome the sometimes chaotic and fragmented operations characterising previous responses. The network partners agreed that the World Health Organization would coordinate the network and provide a secretariat, which would also function as the operational support team. The network has evolved to comprise 153 institutions/technical partners and 37 additional networks, the latter encompassing a further 355 members and has been directly involved in 137 missions to 79 countries, territories or areas. Future challenges will include supporting countries to achieve the capacity to detect and respond to outbreaks of international concern, as required by the International Health Regulations (2005). GOARN's increasing regional focus and expanding geographic composition will be central to meeting these challenges. The paper summarises some of network's achievements over the past 13 years and presents some of the future challenges. [ABSTRACT FROM PUBLISHER]

Background: The COVID-19 pandemic has exposed gaps and areas of need in health care systems. General practitioners (GPs) play a crucial role in the response to COVID-19 and other respiratory infectious diseases (e.g., influenza). Knowing the current flow of these patients and the real needs of GPs is necessary to implement new therapeutic and diagnostic strategies. We sought to learn about the flow of COVID-19 and flu patients in Spanish primary health centers and understand the training needs in both the diagnosis and treatment of these diseases. Methods: A total of 451 regionally representative GPs completed an online survey between January and February 2022. Results: Most of the GPs had available infection containment measures (79%) and access to point-of-care (POC) rapid diagnostic testing (81%) in their centers. The availability of on-the-day diagnostic tests for COVID-19 was higher than that for influenza (80% vs. 20%). Most GPs referred 1 of 10 COVID-19 or flu patients with moderate to severe disease to the emergency department (80% and 90%, respectively). Training/knowledge was considered good regarding diagnostic tests and vaccines (85%) but null or low regarding antivirals (60%) and monoclonal antibodies (80%). Conclusions: This survey identified the conditions of Spanish GPs in terms of the diagnosis and treatment of COVID-19 and flu patients. Respondents' comments suggested that quite radical system-level adjustments are needed to allow GPs to capitalize on the potential benefits of POC tests for diagnosis, reduction of referrals, and monitoring of these diseases. [ABSTRACT FROM AUTHOR]

Copyright of Medicina Interna de Mexico is the property of Colegio de Medicina Interna de Mexico and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Malaria remains a major cause of morbidity and mortality in Ghana. Very little attention was paid to community participation in malaria control in the past and this has affected most of the desired outcomes. The recent recognition of the importance of community participation in malaria control had informed the implementation of Intermittent Preventive Treatment of Childhood Malaria (IPTc). The intervention was implemented in the Shime sub-district of the Keta District in Ghana and this paper reports the evaluation of the community involvement aspect of the project. Method: Semi-structured questionnaire were administered to 105 randomly selected caregivers. A focus group discussion was organized for nine Community Assistants (CAs) and 16 in-depth interviews were conducted with opinion leaders. The tools were used to investigate community attitudes towards, level of awareness and acceptance of the intervention. The benefits of the project and the preferred mode of drug delivery were also investigated. Results: Findings indicated that, the people were aware of the project in their communities. They showed high level of participation and have accepted the intervention as their own. There was a reported reduction in hospital attendance from 52.4% to 6.7%, which led to perceived savings for caregivers. The people preferred that community members deliver the drugs because they are more approachable, caring and sensitive to their health needs than the nurses. Conclusion: The approach adopted by entrusting the intervention into the hands of the community members by allowing them to select their own CAs coupled with the observation of necessary community protocols had led to high level of participation, acceptance and successful outcome of the intervention. [ABSTRACT FROM AUTHOR]

Traditionally, biomedical research endeavors in low to middle resources countries have focused on communicable diseases. However, data collected over the past 20 years by the World Health Organization (WHO) show a significant increase in the number of people suffering from non-communicable diseases (e.g. heart disease, diabetes, cancer and pulmonary diseases). Within the coming years, WHO predicts significant decreases in communicable diseases while non-communicable diseases are expected to double in low and middle income countries in sub-Saharan Africa. The predicted increase in the noncommunicable diseases population could be economically burdensome for the basic healthcare infrastructure of countries that lack resources to address this emerging disease burden. Biomedical research could stimulate development of healthcare and biomedical infrastructure. If this development is sustainable, it provides an opportunity to alleviate the burden of both communicable and non-communicable diseases through diagnosis, prevention and treatment. In this paper, we discuss how research using biomedical technology, especially genomics, has produced data that enhances the understanding and treatment of both communicable and non-communicable diseases in sub-Saharan Africa. We further discuss how scientific development can provide opportunities to pursue research areas responsive to the African populations. We limit our discussion to biomedical research in the areas of genomics due to its substantial impact on the scientific community in recent years however, we also recognize that targeted investments in other scientific disciplines could also foster further development in African countries. [ABSTRACT FROM AUTHOR]

Improving the effectiveness of the treatment of critically ill and their longer survival has increased the existence of later complications rarely seen before. Among the hospital-acquired infections such complications include infection of mold fungi. The paper presents difficulties in diagnosing and therapy of Aspergillus mold infections illustrating them with the description of cases when Aspergillus infection occurred during the treatment of critically ill, leading with treatment delay to high mortality. [ABSTRACT FROM AUTHOR]

Copyright of Forum Zakażeń is the property of Evereth Publishing Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The dynamics of infectious diseases that are spread through direct contact have been proven to depend on the strength of community structure or modularity within the underlying network. It has been recently shown that weighted networks with similar modularity values may exhibit different mixing styles regarding the number of connections among communities and their respective weights. However, the effect of mixing style on epidemic behavior was still unclear. In this paper, we simulate the spread of disease within networks with different mixing styles: a dense-weak style (i.e., many edges among the communities with small weights) and a sparse-strong style (i.e., a few edges among the communities with large weights). Simulation results show that, with the same modularity: 1) the mixing style significantly influences the epidemic size, speed, pattern and immunization strategy; 2) the increase of the number of communities amplifies the effect of the mixing style; 3) when the mixing style changes from sparse-strong to dense-weak, there is a ‘saturation point’, after which the epidemic size and pattern become stable. We also provide a mean-field solution of the epidemic threshold and size on weighted community networks with arbitrary external and internal degree distribution. The solution explains the effect of the second moment of the degree distribution, and a symmetric effect of internal and external connections (incl. degree distribution and weight). Our study has both potential significance for designing more accurate metrics for the community structure and exploring diffusion dynamics on metapopulation networks. [ABSTRACT FROM AUTHOR]

Background: Infectious diseases after solid organ transplantation (SOT) are one of the major complications in transplantation medicine. Vaccination-based prevention is desirable, but data on the response to active vaccination after SOT are conflicting. Methods: In this systematic review, we identify the serologic response rate of SOT recipients to post-transplantation vaccination against tetanus, diphtheria, polio, hepatitis A and B, influenza, Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitides, tick-borne encephalitis, rabies, varicella, mumps, measles, and rubella. Results: Of the 2478 papers initially identified, 72 were included in the final review. The most important findings are that (1) most clinical trials conducted and published over more than 30 years have all been small and highly heterogeneous regarding trial design, patient cohorts selected, patient inclusion criteria, dosing and vaccination schemes, follow up periods and outcomes assessed, (2) the individual vaccines investigated have been studied predominately only in one group of SOT recipients, i.e. tetanus, diphtheria and polio in RTX recipients, hepatitis A exclusively in adult LTX recipients and mumps, measles and rubella in paediatric LTX recipients, (3) SOT recipients mount an immune response which is for most vaccines lower than in healthy controls. The degree to which this response is impaired varies with the type of vaccine, age and organ transplanted and (4) for some vaccines antibodies decline rapidly. Conclusion: Vaccine-based prevention of infectious diseases is far from satisfactory in SOT recipients. Despite the large number of vaccination studies preformed over the past decades, knowledge on vaccination response is still limited. Even though the protection, which can be achieved in SOT recipients through vaccination, appears encouraging on the basis of available data, current vaccination guidelines and recommendations for post-SOT recipients remain poorly supported by evidence. There is an urgent need to conduct appropriately powered vaccination trials in well-defined SOT recipient cohorts. [ABSTRACT FROM AUTHOR]

Invasive fungal infections (IFIs) are responsible for significant morbidity and mortality, especially in immunocompromised patients and in those requiring admission to an intensive care unit. The epidemiology of IFI is changing, and an increment in non- Aspergillus filamentous fungi and non- Candida albicans species has been observed. The present paper reviews the epidemiology and diagnosis of IFIs. Regarding the treatment of IFIs, it focuses primarily on the role of liposomal amphotericin B in this setting. The main recommendations put forth by expert societies and groups are discussed. [ABSTRACT FROM AUTHOR]

Abstract: In this paper, we propose and analyze an epidemic problem which can be controlled by vaccination as well as treatment. In the first part of our analysis we study the dynamical behavior of the system with fixed control for both vaccination and treatment. Basic reproduction number is obtained in all possible cases and it is observed that the simultaneous use of vaccination and treatment control is the most favorable case to prevent the disease from being epidemic. In the second part, we take the controls as time dependent and obtain the optimal control strategy to minimize both the infected populations and the associated costs. All the analytical results are verified by simulation works. Some important conclusions are given at the end of the paper. [Copyright &y& Elsevier]

Febrile episodes and infections represent important complications during antineoplastic chemotherapy for pediatric neoplastic diseases. In the last years many international association published guidelines for the management of these complications in adults, but no document of this type was prepared for children. One of the major causes of this situation is probably the very low number of pediatric clinical trials with adequate power and design. The paper summarizes guidelines provided for the management of infectious complications in adults with cancer by different international and will comment on how much they may be translated in the management of pediatric patients. [ABSTRACT FROM AUTHOR]