Хомосексуалците во нашата држава

maria_magdalena напиша: Зошто ступидни, Quentin?

 Zatoa sto koza e koza, digitalen kontakt e digitalen, bakterija e bakterija, i nemoze edna bakterija da napagja lugje samo zaradi toa sto se homoseksualci, lezbejki, crnci, belci, katolici, evrei , protestanti.Toa e masinerija na Mr. Bush administration a znaeme kakva e nivnata efikasnost, osobeno koga sakaat da kazat deka nekoj see teror megju narodot(Irak, Iran i slicni gluposti)

 Taa bakterija e nisto drugo tuku klon na MRSA podvid narecen USA 300, rezistentention strafilokok, koj porano go imase samo na klinikite i bolnicite,Megjutoa blagodarenie na negrizata na tie institucii nekoj nesoodveten personal" dozvoli da se rasiri i pomegju normalnata populacija kade sto lugjeto se vo sekojdneven kontakt bilo da e seksualen ili samo digitalen(guskanje, dopiri, igranje fudbal,kontakt so mnogu lugje vklucitelno digitalen kontakt pri interakcija na rabotnoto mesto).

 Megjutoa vo NY times, kade sto bese za prv pat objavena ovaa statija koja A1 ja objavi vo manirot "rekla-kazala" nimalku ne se osvrnuvaat na  sustinata na problemot, tuku kako vesnikot polesno da im se prodava(osobeno pomegju Republikancite" ako eve "losite gay lugje" bile napadnati od nekoja bakterija pa sega moze i nam da ni ja prenesat taa bakterija(neli se izbori vo USA, a gay lugjeto tradicionalno glasaat za Demokratite?)

 Inaku za tie sto podlaboko sakaat da se zapoznaat so USA 300 strafilokokot i kako se prenesuva, i koi se rizicni grupi, eve podolu vo tekstot
 -Lugje so niska higiena
 -Deca
 -Vojnici
 -Sportski timovi
 -Homoseksualci
 -Boraci
 -Lugje koi doagjaaat vo frekfenten digitalen kontakt so ostanati lugje na rabota ili doma

 ili celata studija na Angliski:

 

Printer-Friendly Email This

     Next Article

Management of Serious Bacterial Infections  CME

Introduction

The 45th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) featured a broad display of topics, but the dominant themes regarding bacterial infections were methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile, and resistance to antibiotics, particularly by Gram-negative bacilli. The fluoroquinolones took many hits, primarily due to escalating resistance by a vast array of pathogens and because of their potential role in promoting the new epidemic strain of C difficile. Top billing goes to S aureus, which was the subject of 11 symposia and 120 abstracts. C difficile was the second most common topic with 3 symposia and 34 abstracts.

Methicillin-Resistant S aureus

Although the topic densely populated the entire meeting, there were relatively sparse new findings. The following summary highlights the current state of the art with a few new observations.

Microbiology

The prevalent community-acquired MRSA (CA-MRSA) in the United States appears to have evolved from the methicillin-susceptible S aureus (MSSA) strain ST8. The US Centers for Disease Control and Prevention (CDC) designates the most common of these strains as USA 300 and the less frequent one USA 400 strain on the basis of sequence similarity. Both the USA 300 and USA 400 strains are characterized by the genes for the Panton-Valentine Leukocidin (PVL) and by the SCCmec IV element that confers resistance to all beta-lactam antibiotics. The USA 400 strains, which were first noted in the Midwest United States in 1996, are also designated ST1, and usually have more S aureus toxins than the USA 300 strains. The current epidemic of CA-MRSA is predominantly caused by USA 300 strains, which are clonal ST8 strains, were first reported in 2001, and are now widely distributed through the United States. It should be noted that CA-MRSA is also prominent in other countries, but may involve different clones such as the ST80 clone that is epidemic in The Netherlands,^[1] the ST8 clone in France, and ST5 clone in Japan. These clonal distinctions may not be clinically important because the organisms appear to cause the same diseases, have the same marker of virulence (PVL), the same element for methicillin-resistance, and similar susceptibility to multiple other drugs other than beta-lactam antibiotics.

Epidemiology

Infections with CA-MRSA in outpatients tend to reflect crowding and poor hygiene with epidemics described in children, prison inmates, military recruits, gay men, football players, wrestlers, gymnasts, fencers, injection-drug users, and homeless people.^[2-4] In terms of colonization, nasal carriage of MSSA in healthy persons was about 32% in a national sampling of over 9000 individuals broadly representative of the US population.^[4] However, nasal colonization with MRSA is only about 1%; similar results have been reported by others.^[5]

In an unusual presentation, Scott Weese,^[6] a Canadian veterinarian, reported the problem of MRSA in household pets (birds, dogs, cats, and rabbits) and horses. There have been outbreaks of MRSA infections involving animals, veterinary personnel, and horse handlers where nasal colonization is common in both the animals and the handlers. However, most of these outbreaks are the historic hospital-acquired MRSA strain, USA 100.

Types of Infections

No new types of infections were reported. As noted previously, the great majority of infections in outpatients involve skin and soft tissue. A concern often expressed in the past has been the fear that this CA-MRSA would "get in the hospital." It appears to have done that. Henry Chambers, MD,^[3] San Francisco General Hospital, San Francisco, California, reported that the majority of strains of MRSA recovered from inpatients at San Francisco General Hospital are now PVL-positive USA 300 strains. Similar observations were made by others. For example, Maree and coworkers^[7] reported 6 years of experience at Harbor-UCLA Medical Center which showed that the "CA-MRSA phenotype" (PVL-positive plus SCCmec IV with sensitivity to gentamicin and clindamycin) increased from 17% in 1999 to 56% in 2000. Of particular interest was the observation of Dr. Chambers that infections caused by USA 300 when acquired in the hospital reflected the usual pattern seen with nosocomial MRSA infections as historically described.^[3] Thus, it appeared that the clinical expression of this strain reflected the site of acquisition (outpatient vs inpatient) rather than any of the special virulence factors attributed to the USA 300 strain.

New and Existing Treatment

Parenteral drugs that are active against both types of MRSA include several newer drugs: linezolid, tigecycline, and daptomycin. Oral agents that are usually active include trimethoprim-sulfamethoxazole (TMP-SMX), tetracyclines, fluoroquinolones, and clindamycin.

A few observations from Dr. Chambers:

• TMP-SMX: This is active against 95% of strains, but a major concern is lack of good activity against most beta-hemolytic streptococci, which will confound empiric treatment of soft tissue infections. For serious infections, TMP-SMX was previously found inferior to vancomycin.^[8] This is off-label use.
  
  
• Tetracycline: 90% are sensitive. The most active is minocycline, then doxycycline, and the least active is tetracycline. Group A streptococci are often resistant. This is off-label use, and tetracyclines are contraindicated in children and pregnant women.
  
  
• Clindamycin: Dr. Chambers' personal favorite. It is FDA-approved for this indication, has good activity against streptococci, and inhibits toxin production at subinhibitory concentrations. The major concern is inducible resistance as indicated by the D test.^[2]

In a subsequent presentation.^[3] Dr. Chambers noted that these drugs were not necessary for most soft tissue infections that require drainage. This was demonstrated in a randomized trial of 160 patients requiring incision and drainage of soft tissue abscesses who were randomized to cephalexin or placebo.^[3] Results showed the best outcome (92% cure rate) in the placebo group. The obvious question was why cephalexin was selected for infections where the dominant pathogen was CA-MRSA, which is resistant to all beta-lactam antibiotics. The answer was that no antibiotic would beat a 92% cure rate in the placebo group. It might be noted that no special insight was provided for 2 of the most important questions in the management of CA-MRSA:

• First, in treatment of serious infections such as necrotizing fasciitis or necrotizing pneumonia, is there any advantage to drugs that inhibit toxin formation (clindamycin, linezolid, etc.) compared with vancomycin?
  
  
• Second, is there any novel method to deal with recurrent infections or transmitted infections, such as interfamily spread beyond the obvious interventions of mupirocin, pHisoHex washes, and antibiotics? As it should be, the importance of simple hygiene in controlling CA-MRSA was emphasized by many speakers.

Controlling Pathogens Resistant to Antibiotics

The following are miscellaneous papers/topics selected based on importance in the context of resistance, treatment and control.

"Search and Destroy": The Netherlands Program

This was the most important topic in the field of infection control in terms of interest, controversy, attendance, and showmanship. The extraordinary presentation by Dr. Margarett Vos from Erasmus Medical Center, Rotterdam, The Netherlands ^[9] was augmented by several abstracts to show the time and intensity of effort that would be required to rid US hospitals of MRSA.^[10-12] As background, The Netherlands has maintained hospital environments with MRSA rates less than 1% for many years. They also sport the lowest rates of penicillin-resistant Streptococcus pneumoniae, Pseudomonas aeruginosa, and extended-spectrum beta-lactamase -producing strains of Klebsiella in the European Union. How do they do it? With regard to MRSA (and resistant Gram-negative bacilli), the national policy is "search and destroy" according to the following principles:

1. Isolation of all MRSA carriers.
   
   
2. Preventive isolation of patients considered to be at high risk. This includes patients admitted from neighboring countries.
   
   
3. In the event of unexpected MRSA carriage, patients and healthcare workers who have been in contact with the patient are screened.
   
   
4. Healthcare workers with MRSA carriage are sent home for decolonization and are not allowed to work until cultures (nose, axilla, and groin are negative). Decolonization includes nasal mupirocin, pHisoHex bathing, and antibiotics.
   
   
5. If isolation facilities are inadequate, the affected ward is closed to new admissions.

With these procedures, the prevalence of MRSA in Dutch hospitals has been maintained at less than 0.5%. Nuances of the program include (1) the requirement of 6 negative cultures prior to transfer to the general ward after colonization or infection was detected, (2) required culturing of healthcare workers, and (3) full pay when they are sent home. Family members of affected healthcare workers are also screened and decolonized if necessary. The "search and destroy" policy is mandated nationwide so that hospital administrators cannot interfere. Dr. Voss confessed that the efficacy of the program was never studied in a randomized, controlled trial, but such a trial in the face of a rate of < 0.5% would clearly be unethical.

Others from The Netherlands^[10-12] provided mathematical modeling studies to determine effectiveness of these methods if applied to the United States and other countries with high rates of MRSA, . If the transmission rate is 1.2-1.3 (meaning transmission to 0.2-0.3 patients) the implementation of Step 1 above, which is the method recommended by the Society for Healthcare Epidemiology of America (SHEA), will never be effective. However, nationwide implementation of the full program could reduce MRSA carriage in hospitals to < 1% within 4 years.^[10]

Controlling MRSA and Other Resistant Bacteria in the United States

The US perspective on this topic was presented by Michele Pearson^[13] from the CDC. It was noted that US policy for infection control was based on recommendations from the Healthcare Infection Control Practices Advisory Committee (HICPAC), which is a multidisciplinary panel with representation from multiple professional societies. The challenges of infection control in the United States were viewed as particularly complicated for several reasons:

• Nosocomial infections are no longer limited to "hospital infections" but now include "healthcare-associated infections," such as infections acquired in the outpatient department, long-term-care facilities and home care, as well as hospital wards and intensive care units (ICUs). These isolation practices have substantial negative impact on patients in terms of depression, anxiety, and dissatisfaction. Reduced patient contact in these settings increases the rate of preventable adverse outcomes.
  
  
• The emergence of CA-MRSA means that now large numbers of patients who have no direct contact with healthcare facilities may harbor MRSA.
  
  
• The issues are not limited to MRSA, but also include vancomycin-resistant enterococci (VRE), extended-spectrum beta-lactamase -producing Gram-negative bacilli, and other potentially difficult-to-treat multidrug-resistant pathogens
  
  
• There are substantial limitations in the data, which are largely limited to academic centers reporting relatively short-duration studies. The data that are available support: contact precautions, active surveillance, healthcare worker education, formulary restrictions on antibiotic use, and hand hygiene. For surveillance cultures, key questions concern who (all patients or selected patients) and what (nares with or without axilla and groin) to culture. A high priority has been placed on hand hygiene, but studies show compliance of only 30% to 40% in most facilities. Does this indicate that the guidelines have failed or that the healthcare worker has failed?

   Izvor http://www.medscape.com/viewarticle/522429?rss

аџија напиша: Нова смртоносна болест се шири меѓу хомосексуалцитеlign Хомосексуалците во САД и во Велика Британија се во паника поради ширењето на новата болест предизвикана од бактеријата USA 300, која е отпорна на вообичаените антибиотици. Бактеријата најлесно се шири преку анален однос, но може да се шири и преку поинтимен контакт. Откако бактеријата USA 300 влезе во организмот предизвикува чирови на кожата, труење на крвта, запаление на белите дробови, оштетување на срцето, но и смрт. Бактеријата засега не може да се излекува, отпорна е на сите антибиотици. Експертите стравуваат дека новата болест може да биде пострашна и од СИДА. Првите истражувања во САД и во Велика Британија покажаа дека болеста е најраспространета меѓу хомосексуалците.

Колку некој се интересира за хомосексуалците... Нашол нова сламка давеникот и сега мисли кој знае што направил. Сакаш јас да почнам да барам и набројувам болести кои се шират со хетеросексуален однос?

Изменето од doriangray - 18.Јануари.2008 во 21:39

Drlja напиша: Го претеравте со овие ХОМО-теми и една е премногу

Не се премногу темите, тука може секој да си пишува што сака, но нивото на култура треба да биде на повисоко ниво, исто како и толеранцијата! Затоа викам наместо да пишуваат тука глупости нека напишат нешто корисно за нашиот Тошка!

И наместо да се плукате тука кој е поголем хомосексуалец, а кој поголем хомофоб, одете потпишете се за Тоше да биде на Oprah show! Барем ќе направите нешто корисно

А факти има дека тоа е и вештачки продуциран вирус...ама денес никој не ја обвинува геј популацијата за наводно ИЗМИСЛУВАЊЕ на сидата...нон-сенс е тоа да се тврди. Па хомосексуалци имало и во Стара Грција и во Стар Рим, зошто тогаш не заболеле, ако сето тоа се продуцира од аналната хомосексуална копулација???
И ти не го земаш хомосексуализмот во својата целина, туку алудираш само на машкиот хомосексуализам, тоа ти е како болна точка...Изоставаш еден голем дел...

Како да ти објаснам...Тоа не е прашање на избор...Немој да шириш хомофобични бљувотини, не станува збор за идеологија, туку за природна детерминираност, исто како што ти си ориентирана кон спротивниот пол...

И немој да генерализираш, не се сите хомосексуалци промискуитетни, исто како што не се ни сите хетеросексуалци светци...

Изменето од Quentin - 18.Јануари.2008 во 17:13

Па затоа што ступидни беа и оние кои во хистерија веруваа дека СИДА е болест која се шири само меѓу хомосексуалците...