References markers for Chikungunya (Machine translation from France Report)

[Snowy Owl]

References markers for Chikungunya
(Machine & Human translation from France Report)
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<table style="width: 754px; height: 283px;" border="0" cellpadding="0" cellspacing="0"><tbody><tr><td valign="top"></td> </tr><tr> <td class="s" bgcolor="white">Utility of a biological assessment?

• Positive diagnosis and differential

• Impact of fever and anorexia (electrolytes, renal function)

• Impact on co-morbidity

• Impact of an exceptional form or at the evolutionary risk (hepatitis, renal insufficiency, myocarditis)

• Assistance with the therapeutic choices

• Surveillance if initial anomaly (BH, renal function)

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http://www.chikungunya.fr/IMG/ppt/CHIK_REPERES_POUR_LA_PRATIQUE.ppt

 

[Snowy Owl]

Re: References markers for Chikungunya (Machine translation from France Report)

Part 2<nobr><!--[endif]--></nobr>

A biological assessment systematic minimalist:

• Blood Ionogram and renal function (repercussion of the dehydration induced by the fever and the anorexia sometimes raised by the continuation of diuretic).

• Hepatic assessment: transaminases (moderate increase X 2 to 3 N, risks evolutionary clean or on pre-existing hepatopathy).

• Ignition: Crp (generally < 50 mg/l)

• NFS and plates lymphopenia, thrombopenia moderate

• According to clinical orientation: Lipasemy (pancréatite?), troponine (myocarditis?)

• Viral serology, RT-PCR: useless in a typical form.

http://www.chikungunya.fr/IMG/ppt/CH...A_PRATIQUE.ppt

 

[Snowy Owl]

Re: References markers for Chikungunya (Machine translation from France Report)

Part 3

General measures:

• Hydration: to use the structures relay, to mobilize the SIAD (way SC)

• Food adapted to the tastes and the difficulties of swallowing (mouth ulcers).

• Care of mouth (mouth ulcers)

• Mobilization/kinesiotherapy

• Relay Structures: families, association, assistances to residence, intervention of the social services (assistance-housewives, bearing of meal), SIAD

• Revaluation of the chronic treatments (diuretic, hypogly-cémiants, antihypertenseurs): stop, continuation, brought closer monitoring?

http://www.chikungunya.fr/IMG/ppt/CHIK_REPERES_POUR_LA_PRATIQUE.ppt

 

[Snowy Owl]

Re: References markers for Chikungunya (Machine translation from France Report)

Chikungunya: Therapeutic reference marks​

Part 4

Symptomatic treatments:

• Poor literature on this subject within the framework of the chikungunya:

• Absence of study of troops and controlled studies.

• Some in vitro studies in very specialized fields (antiviral, vaccine, passive immunization...)

• The therapeutic risk is the development of a major iatrogenia (medicamentous hepatitis, Lyell syndrome, immuno induced depression...) in a context where an immunizing factor seems important and unfavourable.

• To hold account of the possibilities of self medication or abuse consumption.

http://www.chikungunya.fr/IMG/ppt/CHIK_REPERES_POUR_LA_PRATIQUE.ppt



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[Snowy Owl]

Re: References markers for Chikungunya (Machine translation from France Report)

Chikungunya: Therapeutic reference marks​

Part 5


Analgesics of level 1 (nonmorphine)

• Paracetamol: few adverse effects, but the risk of hepatitis imposes the prudence in particular in the event of preexistent alcoholic hepatopathy or of excessive alcohol consumption.

• Anti-inflammatory drugs not stéroïds (quoted in the report/ratio of the mission of support to the fight against the chikungunya with the Island of Réunion, meeting 2006). Many and varied adverse effects imposing an extreme prudence in this context:

• Acute renal insufficiency, hepatotoxicity Reached cutaneous (immuno-allergic, toxidermies...)
• Increase of the hemorrhagic risk (thrombopenia), digestive haemorrhage
• Risks serious sepsis

• Salicylés: same remarks as for the AINS.

http://www.chikungunya.fr/IMG/ppt/CHIK_REPERES_POUR_LA_PRATIQUE.ppt

 

[Snowy Owl]

Re: References markers for Chikungunya (Machine translation from France Report)

Chikungunya: Therapeutic reference marks
Part 6a & 6b
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Analgesics of level 2 (morphine weak)

• For associations with paracetamol: cf paracetamol.

• Codeine: in association with paracetamol, effectiveness higher than paracetamol alone, with its own opiated side effects (somnolence, giddinesses, nauseas, vomiting, constipation).

• Dextropropoxyphene: the effectiveness of association to paracetamol does not seem higher than paracetamol alone, with in more of the side effects dependent on the opiated properties and direct cardiac purposes of the DPX.

• Tramadol: side effects of opiates.

• Nefopam: usable PO, poor tolerance.

Part 6b

Analgesics of level the 3 (strong morphine)

• Effects of opiates on the operation of the respiratory centers have a clinical translation at insufficient the respiratory chronicle or in the event of overdose.

• To disadvise at the subject presenting a bronchial hyperreactivity.

• Greater sensitivity at the old people.

• Adverse effects: digestive (nauseas, vomiting, constipation), somnolence, confusion, histaminoliberation, urinary (reten-tion, dysurie)...

• Analgesics association: to decrease the adverse effects and for an additive action.

http://www.chikungunya.fr/IMG/ppt/CHIK_REPERES_POUR_LA_PRATIQUE.ppt

 

[Snowy Owl]

Re: References markers for Chikungunya (Machine translation from France Report)

Chikungunya: Therapeutic reference marks
Part 7
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The antipalud?ans ( antiinflammatory actions made profitable in the rhumato?de polyarthritis)

Nivaquine (chloroquine sulphate): 1 study controls open on 10 patients of which 5 are moderately improved, amounts compatible with the side effects.

Brighton SW. Chloroquine phosphates of chronic Chikungunya arthritis treatment. Open year pile study. S Afr Med J. 1984; 66(6): 217-8.

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Hexaquine (quinine, thiamin): use in the island, effectiveness?

Plaquenil (hydrochloroquine): use in the island, effectiveness?

Side effects: cutaneous, digestive, hepatic, psychic, ocular, auditive, blood, neurosensory...

http://www.chikungunya.fr/IMG/ppt/CH...A_PRATIQUE.ppt​

 

[Snowy Owl]

Re: References markers for Chikungunya (Machine translation from France Report)

Chikungunya: Therapeutic reference marks
Part 8
​

Corticotherapy

• Effective on the inflammatory pains.

• Which incidence of a corticothérapie in viremic phase (the first 7 days)?

• Immunodepressor effect added again to the immunodepression presumedly related to the infection by chikungunya?

• Rebound effect with the stop?

• Decompensation of preexistent tares: diabetes, cardiac insufficiency... Myorelaxants

<input name="kls" value="0" type="hidden"> <input name="ienc" value="utf8" type="hidden">http://www.chikungunya.fr/IMG/ppt/CH...A_PRATIQUE.ppt

 

[Snowy Owl]

Re: References markers for Chikungunya (Machine translation from France Report)

Chikungunya: Therapeutic reference marks
Part 9
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Antiviral: no therapeutic currently recognized in vivo (in vitro activity)

Briolant S Al. In vitro inhibition of Chikungunya and Semliki Forest viruses replication by antiviral compounds: synergistic effect of interferon has and ribavirin combination. Antiviral LMBO 2004; 61(2): 111-7.

Andrei G, De Clercq E Molecular approaches for the treatment of hemorrhagic fever virus infections. Antiviral LMBO. 1993 Sep;22(1):45-75.

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Vaccine: at the experimental and "confidential stage defense"
Levitt NH et al.. Development of year attenuated strain of Chikungunya virus for uses in vaccinates production. Vaccinate 1986; 4 (3). : 157-62.

Edelan et al.. Phase II safety and imunogenicity study of life cikugunya virus vaccinates TST-GSD-218. Am J Too much Med Hyg 200; 62(6): 681-5

http://www.chikungunya.fr/IMG/ppt/CH...A_PRATIQUE.ppt

 

[Snowy Owl]

Re: References markers for Chikungunya (Machine translation from France Report)

Chikungunya: Therapeutic reference marks
Part 10
​

Immunization passivates starting from the serum of a convalescent: an idea to be dug?

Igarashi A et al.. Passivate immunization of mice with rabbit antisera against Chikungunya virus and its components. Biken J. 1971; 14(3): 353-5.

Phytotherapy Possibility of induction enzymatic with fall of the effectiveness of the usual drugs and increase of the risk of hepatitis with paracetamol.

Physiotherapy

http://www.chikungunya.fr/IMG/ppt/CH...A_PRATIQUE.ppt

 

[Snowy Owl]

Re: References markers for Chikungunya (Machine translation from France Report)

Chikungunya: Therapeutic reference marks
Part 11​

When to hospitalize?

• Doubts diagnosis on another infectious pathology (another arbo-virus disease, leptospirosis, infection of the urinary tracts, paludism...)

• Suspicion of complicated forms general state

Deterioration in conjunction with fever, dehydration, functional impotence. Exceptional forms (meningoencephalitis, hepatitis, cutaneous attack, myocarditis).
Decompensation of a Co-morbidity (cardiac: coronary insufficiency, IVG; renal; hepatic; diabetic...). Iatrogenic complications.
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• Maintenance is impossible in residence by absence of family recourse and in spite of the installation or the reinforcement of assistances to residence.

http://www.chikungunya.fr/IMG/ppt/CH...A_PRATIQUE.ppt

 

[Snowy Owl]

Re: References markers for Chikungunya (Machine translation from France Report)

Chikungunya: Therapeutic reference marks
Part 12​

Which monitoring in residence?

Hydration and mobility;

• reinforcement of hours as assistance-housewives, more frequent passages of the satisfactory IDE
• Antalgie Complications suitable for the disease: strong fever, forms cutaneous v?siculo-bulleuse or extensive...
• Increased monitoring of Co-morbidity: cardiac insufficiency, coronary insufficiency, diabetes, chronic renal insufficiency...
• Monitoring of the tolerance and the iatrogenic effects related to the therapeutic startups.

http://www.chikungunya.fr/IMG/ppt/CH...A_PRATIQUE.ppt​

 

[Snowy Owl]

Re: References markers for Chikungunya (Machine translation from France Report)

All thanks to;

Mausy for his site of the Chickungunya Outbreaks in La R?union Island


</p:colorscheme> Dr F Staikowsky (SAU-SMUR, GHSR)
Dr A Bourd? (SAMU-SMUR-SAU, CHD)
Dr P Morbidelli (Urgences-SMUR, HGM)

Dr M Weber ( Urgences, ASE)


And all the perseverant doctors at La R?union and around.

 

[Sonny]

Re: References markers for Chikungunya (Machine translation from France Report)

Gosh Sonwy Owl, What's going on?
Like most people, I can't post in the breaking news fourm,
and, I only speak one language but I'm sure we'd all like to help. Whats going on?



..( What's going on? is American for, How can I help? )

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http://www.flutrackers.com/forum/showthread.php?t=7381
""We need professional help please""
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