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Infectious diseases are caused by microorganisms that release toxins or invade body tissues. The most common pathogenic organisms are bacteria, viruses, fungi, protozoa, and helminths. Systemic infections usually cause fevers, chills, sweats, malaise, and occasionally headache, muscle and joint pain, or changes in mental status, and even septic shock-MODS. Infectious diseases have always threatened populations and caused great loss of life in history, but since the last century, with the discovery of antibiotics, historical trends have been reversed. It is reported that between 1990 and 2017, age-standardized disability-adjusted life year (DALY) rates decreased by 41.3% (38.8-43.5) for infectious diseases. However, in 2017, lower respiratory infections are still ranked as the third cause of DALYs. Drug therapy is the one of most critical management strategies for infectious diseases. Efficacy and safety of drug therapy should always be considered, especially in elders, neonates and immunosuppressed patients. Off-label drug therapy has been performed for complex infectious diseases, especially for new emerging infectious diseases. However, off-label drug therapy can be extremely complex: some are prone to rational use, while others are more susceptible to the issues of irrational use. With the increasing rate of publication of data in this area, new evidence for the efficacy and safety of different treatment approaches is constantly developing. Thus, rigorous analysis of such data is imperative, which will guide future clinical practice and guidelines.
Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.
All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.
Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.
According to the Centers for Disease Control and Prevention (CDC), 115 Americans die each day from an opioid overdose, which averages one death every 12.5 minutes. Between 1999 and 2016, the number of drug overdoses catapulted by 300 percent, with injection drug use increasing by 93 percent between 2004 and 2014 and opioid-related hospital admissions increasing by 58 percent over the past decade. And an inexorable sequela of the opioid epidemic is the spread of infectious diseases. To address these infectious disease consequences of the opioid crisis, a public workshop titled Integrating Infectious Disease Considerations with Response to the Opioid Epidemic was convened on March 12 and 13, 2018, by the National Academies of Sciences, Engineering, and Medicine. Participants discussed strategies to prevent and treat infections in people who inject drugs, especially ways to work efficiently though the existing public health and medical systems. This publication summarizes the presentations and discussions from the workshop.
Severe Community Acquired Pneumonia is a book in which chapters are authored and the same topics discussed by North American and European experts. This approach provides a unique opportunity to view the different perspectives and points of view on this subject. Severe CAP is a common clinical problem encountered in the ICU setting. This book reviews topics concerning the pathogenesis, diagnosis and management of SCAP. The discussions on the role of alcohol in severe CAP and adjunctive therapies are important topics that further our understanding of this severe respiratory infection.
The 29 papers contained in this volume look closely at various aspects of what is termed, "The Maternal-Fetal Interface," as it relates to the latest research in placental science. A substantial section of the book is devoted to the troublesome question of vertical transmission of infectious agents: namely, the HIV-1 virus. However, other sections of the volume examine related issues such as drug and toxin transfer across the term placenta and the diversity of placental types and how this can affect a placenta's effectiveness as a barrier. Anthony Carter is at the University of Odense, Denmark Vibeke Dantzer is at the University of Copenhagen, DenmarkThomas Jansson is at the University of Gothenburg, Sweden
Now in its thoroughly revised, updated Fifth Edition, this handbook is a practical, easily accessible, and authoritative guide to the diagnosis and treatment of infectious diseases. Leading experts present realistic clinical approaches to infectious disease problems seen in hospital and outpatient settings and offer up-to-the-minute advice on antimicrobial use--including specific recommendations on dosages, routes of administration, and duration of therapy. Chapters are written in a user-friendly outline format that is ideal for quick reference.This edition includes complete information on new diseases, new antibiotics, and HIV antiviral agents.