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The only documented justifications for colon cleansing are preparation for surgery or prior to barium contrast x-rays or colonoscopy.

Background: Rabies causes 55,000 deaths annually, half of which are in children less than 15 years of age, and has the highest mortality rate of any infectious disease. It is both preventable and controllable. Economic impact of rabies in developing countries in Asia and Africa, where over 98% of all human rabies deaths occur from exposure to canine rabies, rises each year. Estimated annual human rabies prevention costs are about $800 million U.S. Even so, continuing vaccine and RIG shortages in countries with the highest incidence of rabies continue unabated, leaving the most vulnerable at greatest risk. New lyssavirus genotypes continue to be discovered in bats in Asia and Africa-needing continuing widespread surveillance globally. Burden of disease and suffering cannot be over-stated. Rabies victims in developing countries are often sent home to die, due to lack of treatment facilities and fear of the disease. Additionally, lack of surveillance and adequate control measures have enabled rabies spread to previously rabies-free areas (e.g recent outbreak in Bali leading to human rabies deaths). Methods: Literature review-MesH rabies, monoclonals, vaccine, epidemiology, surveillance Meeting abstracts 2008-09. Results: Recent advances in rabies prevention and control strategies: 1. New vaccine both for humans and animals. Molecular biology has brought new understanding to lyssavirus evolution, to possible new reduced vaccine schedules, and to an effective substitute for equine or human rabies immunoglobulin through the development of promising monoclonal antibodies now in clinical trials. Oral animal vaccines have been developed using human adenovirus as the rabies G-Protein carrier. 2. Diagnosis of rabies in the field has been made posible via the dRIT light microscope immunohistochemical test. 3. GIS systems and computer modeling have improved rabies surveillance. 4.Partners for Rabies Control has developed an action blueprint for controlling rabies in developing countries. 5. Substantial funding from Bill and Melinda Gates Foundation is targeted to studues if dog rabies elimination in Tanzania,Kuazulu-Natal, and the Philippines. 6. A registered charity in the U.K. and U.S., the Alliance for Rabies Control, has become a beacon for rabies education and prevention. Conclusion: Rabies is both preventable and controllable-many challenges, but brighter future! Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive

1st Ed , (xiv) + 485 pp , hardcover, USD 167.00 , ISBN 978‐1‐405‐18441‐0 . Wiley‐Blackwell, Chichester, UK : Eli Schwartz , 2009 . With a record number of international tourist arrivals expected in 2010 1 and with a myriad of health and safety risks confronting travelers today, those health professionals in the frontline of travel medicine need access to a definitive reference textbook of tropical diseases. The first edition of Tropical Diseases in Travelers is well positioned to respond to this challenge to inform both the pre‐travel and post‐travel health consultation. The first edition of Tropical Diseases in Travelers has a dedication, a table of contents, a list of contributors, a foreword by Alan Magill (ISTM President 2009–2011), acknowledgments, 43 chapters organized into three main parts, two appendices, and a comprehensive index. There are …

Sciendo provides publishing services and solutions to academic and professional organizations and individual authors. We publish journals, books, conference proceedings and a variety of other publications.

Bartonella henselae is implicated as the main etiologic agent of Cat scratch disease (CSD, Cat-scratch fever). A majority of domestic cats may harbor the intra-erythrocytic agent for extended periods without apparent disease. In humans, B. henselae most commonly results in a subacute, bacterial infection that presents with one or more reddish papules which may progress to pustules and regional lymph node enlargement. Usual features include fever, malaise, and a granulomatous lymphadenitis on biopsy. However, atypical clinical presentations occur, albeit with infrequence, and may result in a difficult and protracted diagnostic process. The infection in susceptible hosts such as immunocompromised or elderly patients may result in endocarditis, encephalitis, fever of unknown origin, and general malaise. It is not transmitted from person to person and quarantine is not necessary. The arthropod vector, Ctenocephalides felis, or the cat flea, plays a major role in transmission among cats and to humans. The transmission risk to humans can be substantially reduced through elimination of flea infestations in companion animals. There are numerous recent reviews and case reports in the veterinary and medical literature reflecting increased recognition of this zoonotic agent. All this notwithstanding, many physicians and other providers may not be familiar with this agent and the potential spectrum of human disease; this may lead to delays in diagnosis and unnecessary diagnostic procedures. This article emphasizes the aspects of B. henselae infection, including a typical case report and a table with selected human case reports of unusual clinical manifestations from the published literature.

In spite of a number of advances in rabies research and education, rabies remains a serious global threat and causes 55,000 deaths annually. About half of these deaths occur in children under 15 years of age, and in areas where awareness, public and private support, and rabies vaccines and immunoglobulin (RIG) are unavailable or too expensive. Until rabies biologics become more readily available, public and professional education remain of critical importance toward efforts to eliminate this dreadful scourge.

There are no passengers on spaceship earth. We are all crew ! (Marshall Mcluhan). Understanding the emergence of new zoonotic agents requires knowledge of pathogen biodiversity in wildlife, human-wildlife interactions, anthropogenic pressures on wildlife populations, and changes in society and human behavior [1].

Stem cell tourism, an unscrupulous form of medical tourism, has become the huckster's new brand of "snake oil". Rogue clinics in Europe, LatinAmerica, Asia, and other locations are advertising unproven stern cell treatments for a variety of diseases such as heart disease, diabetes, and neurological disorders (ALS, MS, Parkinson's etc). If you Google stem cell therapy, a deluge of ads for these charlatans pops up, complete with testimonials from former patients. They do not report medical outcomes based on careful follow-up, but they do prey on vulnerable and desperate people seeking a magical cure for their ailment. The cost varies, but is usually over $20,000 US per treatment [1]. And these procedures are risky. For example, authorities in the Netherlands closed a stem cell clinic after a British patient had a severe adverse reaction [2, 3]. Furthermore, a recent report from Tel Aviv [4] describes the first case of brain and spinal cord tumors in a young boy with a rare neurological disorder (ataxia-telangiectasia), who developed a glioneuronal benign neoplasms four years after intracerebellar and intrathecal injection of human fetal neural stem cells in a Russian clinic. Careful genetic analysis suggested that the cells came from two different donors.

In its first two years of implementation, (2007 and 2008), the World Rabies Day initiative has proven to be an extremely effective focal point around which to increase global educational awareness about how to prevent rabies. World Rabies Day has been endorsed by a multinational group of global stakeholders including international health organizations, national governments, educational institutions, NGOs and industry, as well as those individuals living at daily risk of exposure. In 2007, 75% of all reported participants in World Rabies Day activities came from Asian countries. In 2008, 22 Asian countries participated in World Rabies' Day activities and the number of animals reported to be vaccinated in association with World Rabies Day reached nearly 617,000 in Asia alone. Personal accounts from individual event coordinators demonstrated the dimensions of the growing campaign throughout Asia. The manuscript will provide a review of outreach conducted to the continent of Asia for the first two World Rabies Day initiatives.

Background. Primary care physicians are in short supply worldwide, and Thailand is no exception. The current economic crisis contributes further to this situation. Thailand does not yet have a formally defined and certifying family practice board. In addition, there are two opposing trends in Thailand which stress an adequate supply of providers: 1) Inadequate formal training for primary care doctors; and 2) The 'brain drain' caused by the higher salaries in the private sector and the effort to make Thailand a key hub for 'Medical Tourism'. From one perspective of primary care, Thailand is a developing or transitional country rooted in hospital/specialist care, yet seeking ways to improve overall quality and cost-effectiveness for its people.Objectives: To ascertain the current and future potential for increasing the number of primary care providers in Thailand, and to encourage further research on this question in the context of economic reality and the cultural background of medical care in Thailand.Methods: Literature search of Thai and other international medical journals for 'Primary care Thailand'; Google Scholar search for 'Primary care Thailand'; Pubmed search using MeSH terms 'Primary care' AND 'Thailand'. In addition, physicians and administrative staff in Bangkok from private general-travel medicine practice, an academic medical center, two non-profit facilities, and four investor-owned institutions were interviewed. The literature review was completed 13 March 2009, and the interviews were conducted in person during the author's visit to Bangkok in January 2009.Results: Although there is some interest in promoting primary care more effectively, the majority of medical practice is still hospital-specialist oriented, at least in Bangkok. One exception was in one of the smaller private hospitals, where several well-trained primary care physicians practiced. In addition, some of the larger hospitals noted for medical tourism are developing sections for local Thai patients, and this may encourage recruitment of fully trained family doctors or specialists in general internal medicine.Conclusions: The future of primary care in Thailand remains in question. It needs the change by the political establishment and medical leadership to define formally primary care or a recognized and certified medical specialty. Furthermore, careful research of both national and regional health needs and practices is a critical factor for success.

Clinicians, researchers, public health officials, infection control officers, travel medicine practitioners and many other medical professionals are constantly being bombarded with information about new journals and web sites. The array of new information is overwhelming. The National Library of Medicine catalogs contain approximately 5000 medical journals from the USA alone with another 80:from other countries. In order to provide focus for those interested in and responsible for global public health, this report summarizes some of the more reliable reference resources in these areas. Biomedical, technical, climate, and travel issues are constantly challenging our knowledge, experience, and judgment. Infectious diseases are spreading ever more rapidly; microbes are becoming increasingly resistant to medical interventions. Evidence-based medicine has entered our lexicon and is a work-in-progress. The health professional needs both the best and most timely information available.Freedman [1] in 2004 published a comprehensive list of resources in travel medicine, including international authorities such as the World Health Organization (WHO) and the Centers for Disease Control, USA (CDC), along with a detailed list of journals, textbooks, societies, web sites, listservs, and government resources. These information resources are highly recommended to those interested in travel medicine, especially for those new to the field.This letter gives a brief focus on key resources. New International Health Regulations (IHR's) came into effect in June 2007 [2]. Their importance to travel medicine practitioners have been discussed by Hardiman and Wilder-Smith [3]. The revised International Certificate of Vaccination can be ordered in packets of 50 or more from WHO (www.who.int, available in English, French, and Arabic) and are also available, but only in English and French from the US Government Printing Office (Tel: 1-202-512-1800; or toll-free at 1-866-512-1800).

The US health care delivery system is a dysfunctional mess [1], lacks a cohesive and affordable national plan, is addicted to technology and gadgets, has a fee-for-service reimbursement structure which discourages medical students from going into primary care specialties, and suffers under the weight of an iron quadrangle: the health insurance industry, politicians, hospitals, and the pharmaceutical industry.This quadrangle, while giving lip service to health care reform, is fighting to maintain the status quo and its own bottom line. While the medical profession may be losing the 'war', it has its own shortcomings, such as overspecialization, and the emphasis on 'half-way' technologies [2] rather than those interventions that were proven effective by randomized clinical trials [3]. In addition, the proliferation of subspecialty societies, largely dedicated to promoting their own interests, has added to the challenge of meaningful reform. This situation is another example of the 'Tragedy of the Commons': finite resources vs unlimited demand [4]; a concept also described earlier by Thucydides and Aristotle [5].Although there is a long history of reform efforts [6], the current 'non-system' has been remarkably resilient and resistant to change [7]. During the 2008 election campaign, neither candidate proposed a meaningful major reform plan. The American congress is beholden to too many special interests, has lost the respect of the American public and has so far proven inept and inert.The United States cannot afford to continue with this $2 trillion dinosaur without major reform. Patchwork fixes, such as electronic medical records and tort reform [8, 9], will not suffice. Health maintenance organizations (HMO's) and managed-care organizations have not had significant impact in spite of early successes. Health care has been transformed from a public service into a business commodity, paying obscene salaries to greedy senior executives [10].The US system is tilted highly to the expensive delivery of health services at personal and public expense in the form of reduced pay and benefits and high-cost insurance and taxes [11], when common sense should dictate otherwise. As Emmanuel and Fuchs have described, we in the U.S. have produced 'A Perfect Storm of Overutilization' [12]. The pendulum must move back to the center, with a balance of affordable insurance for all, primary care as the underpinning for people, reimbursement systems which reward primary care givers fairly, and 'Taming the Technology Beast' [13]. No amount of effort at cost control, primary care, electronic medical records, etc. will succeed unless a more rational system of technology development and distribution is implemented, including the study of safety and other unintended consequences [13].The implications for Asian health care delivery seem clear. "Do not follow the US example". Work toward a rational balance (diagonal) of primary (horizontal) and speciality (vertical) care [14-17]. And remember that without proper use of effective technologies (immunization, safe drinking water and sanitation), you will fail. Here, 'vertical' applies to aiming for disease-specific results (specialization), 'horizontal' applies to broader improvement in health systems, 'diagonal' applies to improving the broader health system to achieve disease-specific results [14-17].

span style="font-size: 10.0pt; font-family: ";Microsoft Sans Serif";,";sans-serif";; mso-fareast-font-family: ";Times New Roman";; color: #003300; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: TH;"World Rabies Day (WRD) 2008 is scheduled for September 28, 2008. Sponsors include The Centers for Disease Prevention and Control, USA (CDC), the Alliance for Rabies Control (ARC), The World Health Organization (WHO), and several others mentioned below. The principal web site is: www.worldrabiesday.org. WRD 2007 reached over 54 million individuals, about 400,000 people from 74 countries participated in various activities to increase awareness and raise financial support, and approximately 600,000 animal vaccinations were given. Government and community agencies, volunteers, and a number of veterinary organizations and schools supported this global effort. Much work remains in order ultimately to ‘Make Rabies History’. Educational efforts, resources, and recent developments are reviewed./span

Although many advances have been made, rabies remains a neglected, preventable, under-reported, and untreatable disease with the highest case fatality rate of any infectious disease. To help counter this, the Alliance for Rabies Control (ARC) and the US Centers for Disease Control and Prevention (CDC) jointly inaugurated the first World Rabies Day (WRD) on September 8, 2007. A number of veterinary organizations and schools, volunteers, and the World Health Organization (WHO) joined in supporting this effort designed to increase awareness and education of both the lay public and health professionals. This report summarizes volunteer experience in this effort in a Midwestern US community. Approximately 280 adult, middle- , high school, lay and health professional individuals attended these programs between August 26 and November 4, 2007. The questions and comments from participants at all levels reinforce the need for continuing and expanded efforts in rabies education. Sample teaching-discussion materials will also be described.

Dedmon, Robert E. (Presbyterian-St. Luke's Hospital, Chicago, Ill.), Albert W. Holmes, and Friedrich Deinhardt . Preparation of fluorescein isothiocyanate-labeled γ-globulin by dialysis, gel filtration, and ion-exchange chromatography in combination. J. Bacteriol. 89: 734–739. 1965.—Antiviral immune γ-globulins isolated from rabbit and guinea pig sera were labeled through dialysis membranes with fluorescein isothiocyanate and purified in several ways to eliminate nonspecific staining. Gel filtration of the conjugate with Sephadex G-25 coarse beads followed by column fractionation with diethylaminoethyl-Sephadex yielded consistently highly specific staining materials. Fluorescein-protein ratios varied between 1.0 and 4.0. This technique has proved to be simple and reliable, and is less time-consuming than previous techniques.