Assuntos
Alérgenos/imunologia , Anti-Hipertensivos/imunologia , Clortalidona/imunologia , Toxidermias/diagnóstico , Pálpebras/patologia , Hipertensão/tratamento farmacológico , Rinite Alérgica Sazonal/diagnóstico , Anti-Hipertensivos/uso terapêutico , Vesícula , Clortalidona/uso terapêutico , Feminino , Humanos , Hipersensibilidade Tardia , Hipertensão/diagnóstico , Anamnese , Pessoa de Meia-Idade , Testes CutâneosRESUMO
Allergic and hypersensitivity reactions such as anaphylaxis and asthma exacerbations may occur during air travel. Although the exact incidence of in-flight asthma and allergic emergencies is not known, we have concerns that this subject has not received the attention it warrants. There is a need to provide passengers at risk and airlines with the necessary measures to prevent and manage these emergencies. A review of the epidemiology, management and approaches to prevention of allergic and asthma emergencies during air travel is presented with the goal of increasing awareness about these important, potentially preventable medical events.
RESUMO
BACKGROUND: Rifaximin has been shown to be effective in treating and preventing travelers' diarrhea (TD) during the summer season. METHODS: The goal of this double-blinded multicenter trial was to assess the efficacy and safety of rifaximin 550 mg administered once daily for 14 days compared with placebo in the prevention of TD during the dry season in Mexico. RESULTS: There were 101 participants randomized. Overall, 25 participants developed TD during the 3 weeks of the study: 22% from the rifaximin group and 29% from the placebo group (p = 0.4). Mild diarrhea (defined as only one or two unformed stools during a 24-h period plus at least one abdominal symptoms) developed in only 3 (6%) participants taking rifaximin compared with 10 (21%) taking placebo during the first week of study (p = 0.03). No clinically significant or serious adverse events were reported. CONCLUSIONS: Antibiotic prophylaxis of TD in Mexico during the dry season needs to be further studied and its benefits weighed against the benefits of self-treatment.
Assuntos
Diarreia/prevenção & controle , Rifamicinas/administração & dosagem , Viagem , Administração Oral , Anti-Infecciosos/administração & dosagem , Diarreia/etnologia , Relação Dose-Resposta a Droga , Método Duplo-Cego , Humanos , Incidência , México/epidemiologia , Projetos Piloto , Estudos Retrospectivos , Rifaximina , Estações do Ano , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Up to 60% of the US visitors to Mexico develop travelers' diarrhea (TD). In Mexico, rates of diarrhea have been associated with the rainy season and increase in ambient temperature. However, the seasonality of the various diarrheagenic Escherichia coli pathotypes in travelers has not been well described. OBJECTIVE: A study was undertaken to determine if ambient temperature and rainfall have an impact on the acquisition of TD due to different diarrheagenic E coli pathotypes in Mexico. METHODS: We conducted a cohort study of the US adult students traveling to Cuernavaca, Mexico, who were followed during their stay and provided a stool sample with the onset of TD. The presence of E coli was analyzed by a direct fecal multiplex polymerase chain reaction for common E coli pathotypes including enterotoxigenic, enteropathogenic, enteroinvasive, shiga toxin-producing, and enteroaggregative E coli (ETEC, EPEC, EIEC, STEC, and EAEC respectively). The presence of pathotypes was correlated with daily rainfall, average, maximum, and minimum temperatures. RESULTS: A total of 515 adults were enrolled from January 2006 to February 2007. The weekly attack rate of TD for newly arrived travelers was lower in the winter months (range 6.8%-16.3%) than in summer months (range 11.5%-25%; p = 0.05). The rate of ETEC infection increased by 7% for each degree centigrade increase in weekly ambient temperature (p = 0.003). In contrast, EPEC and EAEC were identified in similar proportions during the winter and summer seasons. CONCLUSIONS: Temperature variations in central Mexico influenced the rate of ETEC but not EAEC-associated diarrhea in the US visitors. This epidemiological finding could influence seasonal recommendations for the use of ETEC vaccines in Mexico.