Prophylaxis detection

First, the protocol may induce the detection of extra cases - cases that would have gone undetected if no protocol were used in the usual care of patients. These cases may be detected earlier than they would have been in usual care. In the prophylaxis example above, repeated testing of all patients is likely to increase the number of deep vein thromboses that are detected, especially if, in usual care, patients are only tested when they develop clinical signs of deep vein thromboses. This extra or early detection may also reduce the average costs for each case detected, because subclinical cases or those detected early may be less costly to treat than clinically detected cases. However, because these two potential biases - more cases, each of which may cost less -work in opposite directions, the total costs of care for patients in the trial may or may not exceed those that would occur in usual care. 

A single dose of IV cefazolin will provide adeqnate prophylaxis for most cases. Oral ciprofloxacin may be used for patients with j8-lactam hypersensitivity. Postoperative therapeutic antibiotics may be indicated if perforation is detected during surgery, depending on whether an established infection is present. 

Van der Schans, M.J., Noort, D., Fidder, A., Degenhardt, C.E.A.M., Benschop, H.P., Langenberg, J.P. (2002). Retrospective detection of exposure to organophosphorus anticholinesterases fluoride reactivation and mass spectrometric analysis of phosphylated human butyrylcholinesterase. The meeting of NATO TG 004 Task Group on Prophylaxis and Therapy of Chemical Agents. November 4-7, 2002, Oslo, Norway. 

The principal reason against recommending amodiaquine for malaria prophylaxis is the reporting of agranulocytosis, occasionally associated with hepatitis (SEDA-12, 241) (SED-12, 692). Since specific IgG antibodies, which lead to leukopenia, can be detected, aU this suggests that the agranulocytosis is immune-mediated. 

If health officials fail to detect the release until people start becoming ill, physicians should instruct their patients to begin a fever watch. Those who develop an unexplained fever or flu-like illness within 14 days of exposure should begin treatment as outlined in Tables 2.15 and 2.16, depending on whether the outbreak involves a contained or mass casualty scenario. Patients with tularemia do not require isolation, and close contacts of cases do not require prophylaxis because person-to-person transmission does not occur (43). 

Important measures in prevention of military casualties include adequate detection measures, physical protection, chemical prophylaxis and proper treatment. In the terrorist context, proper emergency planning is key. Treatment of poisoning by organophosphorus nerve agents is dealt with in other chapters in this volume. 

C. Classification of Biological Agents. Taxonomic classification of biological agents is important in terms of detection, identification, prophylaxis, and treatment. Biological agents which may be used as weapons can be classified as follows ... 

Raynaud s phenomenon secondary to systemic sclerosis Cardiac transplants Juvenile rheumatoid arfliritis polymyositis/dermatomyositis infection prophylaxis in pediatric patients with HIV acute myocarditis Tumor detection Diagnosis of myocarditis... 

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