Items in AFP with MESH term: Antiviral Agents
Nongenital Herpes Simplex Virus - Article
ABSTRACT: Nongenital herpes simplex virus type 1 is a common infection usually transmitted during childhood via nonsexual contact. Most of these infections involve the oral mucosa or lips (herpes labialis). The diagnosis of an infection with herpes simplex virus type 1 is usually made by the appearance of the lesions (grouped vesicles or ulcers on an erythematous base) and patient history. However, if uncertain, the diagnosis of herpes labialis can be made by viral culture, polymerase chain reaction, serology, direct fluorescent antibody testing, or Tzanck test. Other nonoral herpes simplex virus type 1 infections include herpetic keratitis, herpetic whitlow, herpes gladiatorum, and herpetic sycosis of the beard area. The differential diagnosis of nongenital herpes simplex virus infection includes aphthous ulcers, acute paronychia, varicella-zoster virus infection, herpangina, herpes gestationis (pemphigoid gestationis), pemphigus vulgaris, and Behçet syndrome. Oral acyclovir suspension is an effective treatment for children with primary herpetic gingivostomatitis. Oral acyclovir, valacyclovir, and famciclovir are effective in treating acute recurrence of herpes labialis (cold sores). Recurrences of herpes labialis may be diminished with daily oral acyclovir or valacyclovir. Topical acyclovir, penciclovir, and docosanol are optional treatments for recurrent herpes labialis, but they are less effective than oral treatment.
ABSTRACT: Family physicians encounter diagnostic and treatment issues when caring for pregnant women with hepatitis B or C and their newborns. When hepatitis B virus is perinatally acquired, an infant has approximately a 90 percent chance of becoming a chronic carrier and, when chronically infected, has a 15 to 25 percent risk of dying in adulthood from cirrhosis or liver cancer. However, early identification and prophylaxis is 85 to 95 percent effective in reducing the acquisition of perinatal infection. Communication among members of the health care team is important to ensure proper preventive techniques are implemented, and standing hospital orders for hepatitis B testing and prophylaxis can reduce missed opportunities for prevention. All pregnant women should be screened for hepatitis B as part of their routine prenatal evaluation; those with ongoing risk factors should be evaluated again when in labor. Infants of mothers who are positive for hepatitis B surface antigen should receive hepatitis B immune globulin and hepatitis B vaccination within 12 hours of birth, and other infants should receive hepatitis B vaccination before hospital dis- charge. There are no effective measures for preventing perinatal hepatitis C transmission, but transmission rates are less than 10 percent. Perinatally acquired hepatitis C can be diagnosed by detecting hepatitis C virus RNA on two separate occasions between two and six months of age, or by detecting hepatitis C virus antibodies after 15 months of age.
Neuraminidase Inhibitors for Influenza Treatment and Prevention in Healthy Adults - Cochrane for Clinicians
Acute Onset Vesicular Rash - Photo Quiz
Management of Influenza - Article
ABSTRACT: Influenza is a contagious airborne viral illness characterized by abrupt onset of symptoms. Fever, myalgia, headache, rhinitis, sore throat, and cough are commonly reported symptoms. The diagnosis should be made clinically, and the decision to begin antiviral therapy should not be delayed for laboratory confirmation of influenza. The 2009 pandemic influenza A (H1N1) virus is expected to continue to circulate during the 2010-2011 season, but it is not certain whether it will replace or cocirculate with seasonal influenza A subtypes that have been circulating since 1977. The 2009 H1N1 virus is largely resistant to adamantanes, but it is sensitive to neuraminidase inhibitors such as oseltamivir. Neuraminidase inhibitors have modest effectiveness in reducing influenza-related symptoms in patients at low risk of complications. Patients at high risk of complications, including pregnant women, should be treated with antiviral agents, preferably within 48 hours of symptom onset. Family physicians should follow guidelines from the World Health Organization and the Centers for Disease Control and Prevention when treating patients with influenza or influenza-like symptoms.
Influenza Management Guide 2010-2011 - Editorials
Treatment of Nongenital Cutaneous Warts - Article
ABSTRACT: Numerous treatments for nongenital cutaneous warts are available, although no single therapy has been established as completely curative. Watchful waiting is an option for new warts because many resolve spontaneously. However, patients often request treatment because of social stigma or discomfort. Ideally, treatment should be simple and inexpensive with low risk of adverse effects. Salicylic acid has the best evidence to support its effectiveness, but it is slow to work and requires frequent application for up to 12 weeks. Cryotherapy with liquid nitrogen is a favorable option for many patients, with cure rates of 50 to 70 percent after three or four treatments. For recalcitrant warts, Candida or mumps skin antigen can be injected into the wart every three to four weeks for up to three treatments. More expensive treatments for recalcitrant warts are offered in many dermatology offices. Photodynamic therapy with aminolevulinic acid has the best evidence of effectiveness compared with pulsed dye laser, intralesional bleomycin, and surgical removal using curettage or cautery.
Advisory Committee on Immunization Practices Issues Recommendations for the 1998-99 Influenza Season - Special Medical Reports
Hepatitis C: Who Should We Be Treating? - Editorials
Advisory Committee on Immunization Practices Issues Recommendations for the 1999-2000 Influenza Season - Special Medical Reports