BOOK
The Travel and Tropical Medicine Manual E-Book
Christopher A. Sanford | Elaine C. Jong | Paul S. Pottinger
(2016)
Additional Information
Book Details
Abstract
Prevent, evaluate, and manage diseases that can be acquired in tropical environments and foreign countries with The Travel and Tropical Medicine Manual. This pragmatic resource equips medical providers with the knowledge they need to offer effective aid, covering key topics in pre- and post-travel medicine, caring for immigrants and refugees, and working in low-resource settings. It's also the perfect source for travelers seeking quick, easy access to the latest travel medicine information.
- Dynamic images illustrate key concepts for an enhanced visual understanding.
- Evidence-based treatment recommendations enable you to manage diseases confidently.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Expert Consult page | IFC1 | ||
| The Travel and Tropical Medicine Manual | i | ||
| Copyright Page | iv | ||
| Table Of Contents | v | ||
| Preface | viii | ||
| List of Contributors | ix | ||
| 1 Pre-Travel Advice | 1 | ||
| 1 Approach to Travel Medicine and Contents of a Personal Travel Medicine Kit | 1 | ||
| Approach to Travel Medicine | 2 | ||
| Immunizations for Travel | 3 | ||
| Malaria Chemoprophylaxis | 4 | ||
| Traveler’s Diarrhea | 5 | ||
| Medical Emergencies during Travel | 9 | ||
| Finding a Physician in a Foreign Country | 9 | ||
| Emergency Information Needed | 9 | ||
| Payment for Services | 10 | ||
| Emergency Medical Care en Route | 10 | ||
| Emergency Evacuation Home | 10 | ||
| Emergency Blood Transfusion | 11 | ||
| Wilderness and Adventure Travel | 11 | ||
| The Traveler’s Medical Kit | 11 | ||
| Prescription Medications | 11 | ||
| Summary of Considerations for Health and Travel | 11 | ||
| Further Reading | 15 | ||
| 2 Urban Medicine: Threats to Travelers to Cities in Low-Income Nations | 17 | ||
| Infectious Diseases | 18 | ||
| Trauma | 18 | ||
| Air Pollution | 20 | ||
| Heat Illness | 22 | ||
| Crime and Security | 23 | ||
| Illicit Drug Use | 24 | ||
| Conclusion | 25 | ||
| Further Reading | 25 | ||
| 3 Emerging Infectious Diseases and the International Traveler | 27 | ||
| Approach to International Travelers | 27 | ||
| Emerging and Reemerging Zoonoses | 29 | ||
| Vector-Borne Diseases | 29 | ||
| West Nile Virus | 29 | ||
| Chikungunya Virus | 29 | ||
| Zika Virus | 31 | ||
| Dengue Virus | 31 | ||
| P. knowlesi Malaria | 31 | ||
| Artemisinin-Resistant P. falciparum Malaria | 32 | ||
| Lyme Borreliosis | 32 | ||
| Air-Borne Diseases | 32 | ||
| SARS-CoV | 32 | ||
| MERS-CoV | 32 | ||
| Food- and Water-Borne Diseases | 33 | ||
| Sarcocystosis | 33 | ||
| Other | 33 | ||
| S. haematobium Urinary Schistosomiasis | 33 | ||
| Ebola Virus | 33 | ||
| Information Resources for Emerging Infectious Diseases | 34 | ||
| REFERENCES AND FURTHER READING | 34 | ||
| 4 Jet Health | 36 | ||
| Cabin Air Quality | 36 | ||
| Pressurization | 36 | ||
| Ventilation | 37 | ||
| Contamination | 38 | ||
| Humidity and Temperature | 39 | ||
| Transmission of Communicable Diseases on Aircraft | 39 | ||
| Supplemental Oxygen during Air Travel | 40 | ||
| The Air Carrier Access Act of 1986: Denial of Boarding/Passenger Acceptance | 41 | ||
| Deep Venous Thrombosis and Air Travel | 41 | ||
| Turbulence-Related Injuries | 42 | ||
| In-Flight Medical Emergencies | 43 | ||
| Automatic External Defibrillators | 44 | ||
| Behavioral Problems during Air Travel | 44 | ||
| Acknowledgments | 45 | ||
| Further Reading | 45 | ||
| 5 Immunizations for Travelers | 47 | ||
| Routine Immunizations | 47 | ||
| Hepatitis A Vaccine as a Routine Immunization | 48 | ||
| Hepatitis B Vaccine as a Routine Immunization | 50 | ||
| Influenza Vaccine | 50 | ||
| Pneumococcal Vaccine | 50 | ||
| Required Travel Immunizations | 50 | ||
| Yellow Fever Vaccine | 51 | ||
| Yellow Fever (YF) Vaccine | 51 | ||
| YF Vaccine Booster Doses | 51 | ||
| YF Vaccine Precautions and Contraindications | 51 | ||
| YF Vaccine-Associated Viscerotropic Disease (YEL-AVD) | 53 | ||
| YF Vaccine Letter of Waiver | 55 | ||
| Meningococcal ACWY Vaccines | 55 | ||
| Meningococcal ACWY-Diphtheria Toxin Protein Conjugate (MenACWY-D) Vaccine | 57 | ||
| Meningococcal ACWY-CRM Conjugate (MenACWY-CRM) Vaccine | 57 | ||
| Meningococcal Polysaccharide A/C/Y/W-135 Vaccine (MPSV4) | 57 | ||
| Polio Vaccine | 57 | ||
| Cholera Vaccine | 58 | ||
| Smallpox Vaccine | 58 | ||
| Recommended Travel Vaccines | 58 | ||
| Hepatitis A Vaccine | 58 | ||
| Hepatitis A Virus (HAV) Vaccine | 58 | ||
| Delayed Hepatitis A Vaccine Booster Dose | 59 | ||
| Hepatitis A Vaccine Interchangeability | 59 | ||
| Immune Globulin (IG) | 59 | ||
| Concurrent Administration of Hepatitis A Vaccine with Immune Globulin | 59 | ||
| Hepatitis B Virus (HBV) Vaccine | 59 | ||
| Hepatitis B Vaccine Low-Responders or Nonresponders | 60 | ||
| Accelerated Hepatitis B Vaccine Schedules | 60 | ||
| Hepatitis A/B Combination Vaccine | 60 | ||
| Accelerated Hepatitis A/B Vaccine Schedule | 60 | ||
| Typhoid Vaccine | 61 | ||
| Ty21A Oral Typhoid Vaccine | 61 | ||
| Ty21A Typhoid Vaccine and Concomitant Drugs | 61 | ||
| Ty21A Oral Typhoid Vaccine and Other Vaccines | 61 | ||
| Vi Capsular Polysaccharide (ViCPS) Typhoid Vaccine | 61 | ||
| ViCPS Typhoid Vaccine Combined with Hepatitis A Vaccine | 62 | ||
| Cholera Vaccine | 62 | ||
| Killed Whole-Cell B Subunit Oral Cholera Vaccine (WC/rBS OCV) | 62 | ||
| Killed Whole-Cell Bivalent (O1 and O139 Serogroups) Oral Cholera Vaccine (BivWC OCV) | 62 | ||
| Meningococcal Serogroup B Vaccine | 62 | ||
| Meningococcal B-4C Vaccine (MenB-4C) | 63 | ||
| Meningococcal B-FHbp Vaccine (MenB-FHbp) | 63 | ||
| Rabies Vaccine | 63 | ||
| Pre-Exposure Rabies Vaccines | 63 | ||
| Rabies Vaccine Booster Doses | 64 | ||
| Rabies Post-Exposure Vaccine and Rabies Immune Globulin (RIG) | 64 | ||
| Japanese Encephalitis Virus Vaccine | 64 | ||
| Japanese Encephalitis Purified Inactivated Virus Vaccine (JE-PIV) | 66 | ||
| Tick-Borne Encephalitis Vaccine | 66 | ||
| FSME-Immuno TBE Vaccine | 66 | ||
| Tuberculosis (BCG) Vaccine | 68 | ||
| Bacillus Calmette-Guérin Vaccine (BCG) | 68 | ||
| Conclusion | 69 | ||
| Further Reading | 69 | ||
| 6 Malaria Prevention | 71 | ||
| Approach to Malaria Prevention | 71 | ||
| 1. Assessing Individual Risk | 72 | ||
| 2. Preventing Mosquito Bites (Personal Protection Measures) | 72 | ||
| 3. Use of Chemoprophylactic Drugs Where Appropriate | 73 | ||
| 4. Seeking Early Diagnosis and Treatment If Fever Develops during or after Travel | 74 | ||
| Current Chemoprophylactic Drug Regimens | 74 | ||
| Chloroquine-Sensitive Zones | 75 | ||
| Chloroquine-Resistant Zones | 80 | ||
| Atovaquone Plus Proguanil (Malarone) | 80 | ||
| Doxycycline | 82 | ||
| Mefloquine | 83 | ||
| Primaquine | 84 | ||
| Chloroquine and Mefloquine-Resistant Zones | 84 | ||
| Contrasts in Prophylaxis Recommendations among Health Organizations | 84 | ||
| Frequent Short-Term Travel to High-Risk Areas | 84 | ||
| Summary | 85 | ||
| Other Drugs | 85 | ||
| Drug Regimens to Avoid for Chemoprophylaxis | 85 | ||
| Amodiaquine | 85 | ||
| Artemisinin Derivatives, Alone or in Combination with Other Antimalarials | 85 | ||
| Chloroquine plus Proguanil | 85 | ||
| Halofantrine | 85 | ||
| Pyrimethamine plus Sulfadoxine (Fansidar) | 86 | ||
| Pyrimethamine plus Dapsone | 86 | ||
| Quinine | 86 | ||
| Standby Emergency Malaria Therapy (SBET) | 86 | ||
| Atovaquone plus Proguanil (Malarone™) | 87 | ||
| Artemether/Lumefantrin (Coartem™, Riamet™) | 87 | ||
| Special Therapeutic Considerations | 87 | ||
| The Pregnant Traveler | 87 | ||
| The Infant Traveler | 88 | ||
| The Immunocompromised Traveler | 88 | ||
| The Traveler without a Spleen | 89 | ||
| Long-Term Travelers | 89 | ||
| Primaquine for Relapse Prevention | 89 | ||
| Primaquine-Resistant or Tolerant P. vivax | 89 | ||
| Further Reading | 90 | ||
| 7 Water Disinfection | 91 | ||
| Risk of Water-Borne Infection | 91 | ||
| Field Techniques for Water Treatment | 92 | ||
| Definitions | 93 | ||
| Heat | 93 | ||
| Filtration | 95 | ||
| Clarification | 97 | ||
| Granular Activated Charcoal | 97 | ||
| Chemicals | 97 | ||
| Choice of Halogen | 102 | ||
| Superchlorination-Dechlorination | 105 | ||
| Iodine Resins | 105 | ||
| Chlorine Dioxide | 106 | ||
| Other Chemical Disinfectants | 106 | ||
| Mixed Species Disinfection (Electrolysis) | 106 | ||
| Potassium Permanganate | 106 | ||
| Hydrogen Peroxide | 106 | ||
| Silver | 107 | ||
| Citrus | 107 | ||
| Ultraviolet Light | 107 | ||
| Solar Irradiation (SODIS) | 107 | ||
| Nanoparticles: Solar Photocatalytic Disinfection | 108 | ||
| Summary of Preferred Techniques | 108 | ||
| Further Reading | 110 | ||
| 8 Traveler’s Diarrhea: Prevention and Self-Treatment | 112 | ||
| Etiology | 113 | ||
| Prevention of Traveler’s Diarrhea | 114 | ||
| Dietary Precautions | 114 | ||
| Immunizations | 114 | ||
| Chemoprophylaxis | 115 | ||
| Bismuth Subsalicylate | 115 | ||
| Antibiotic Prophylaxis | 115 | ||
| Probiotics | 116 | ||
| Empiric Self-Treatment | 116 | ||
| Oral Rehydration | 116 | ||
| Symptomatic Treatment | 117 | ||
| Empiric Antibiotic Treatment | 118 | ||
| Fluoroquinolone Antibiotics | 118 | ||
| Azithromycin | 118 | ||
| Rifaximin | 119 | ||
| Special Considerations | 119 | ||
| Further Reading | 119 | ||
| 9 Disequilibrium: Jet Lag, Motion Sickness, Cold Exposure, and Heat Illness | 121 | ||
| Jet Lag | 121 | ||
| Prevention and Treatment | 122 | ||
| Melatonin | 122 | ||
| Nonbenzodiazepine Benzodiazepine-Receptor Agonists (NBRAs) | 122 | ||
| Ramelteon | 123 | ||
| Armodafinil | 124 | ||
| Agomelatine | 124 | ||
| Sleep Schedule Adjustment | 124 | ||
| Bright Light Exposure | 125 | ||
| Jet Lag Diet and Other Remedies | 125 | ||
| Motion Sickness | 126 | ||
| Prevention | 126 | ||
| Antihistamines | 127 | ||
| Scopolamine Patch | 127 | ||
| Sympathomimetics | 128 | ||
| Phenytoin | 128 | ||
| Other Drugs | 128 | ||
| Treatment | 128 | ||
| Cold Exposure | 129 | ||
| Nonfreezing Cold Injuries | 130 | ||
| Pernio | 130 | ||
| Trench Foot | 130 | ||
| Freezing Injuries | 130 | ||
| Hypothermia | 131 | ||
| Heat Illness | 132 | ||
| Acclimatization | 133 | ||
| Environmental Heat Illness | 133 | ||
| Heat Syncope | 133 | ||
| Heat Edema | 133 | ||
| Heat Tetany | 134 | ||
| Heat Cramps | 134 | ||
| Heat Exhaustion | 134 | ||
| Treatment of Heat Exhaustion | 134 | ||
| Heat Stroke | 135 | ||
| Classic Heat Stroke | 135 | ||
| Exertional Heat Stroke | 135 | ||
| Differential Diagnosis of Heat Stroke in Travelers | 135 | ||
| Treatment of Heat Stroke | 136 | ||
| Cool the Patient | 136 | ||
| Support the Vital Signs | 136 | ||
| Prevention of Heat Stroke | 136 | ||
| Further Reading | 136 | ||
| 2 Advice for Special Travelers | 138 | ||
| 10 High-Altitude Travel | 138 | ||
| What Constitutes “High Altitude”? | 138 | ||
| The Environment at High Altitude | 138 | ||
| Physiologic Responses to Hypobaric Hypoxia | 139 | ||
| The Altitude-Naïve Traveler | 140 | ||
| Normal Responses to High Altitude | 140 | ||
| Recognition of Acute Altitude Illness | 140 | ||
| Risk Factors for Acute Altitude Illness | 141 | ||
| Prevention of Acute Altitude Illness | 141 | ||
| Nonpharmacologic Measures | 141 | ||
| Pharmacologic Measures | 143 | ||
| Treatment of Acute Altitude Illness | 143 | ||
| The Returning Traveler | 143 | ||
| Determining What Happened | 144 | ||
| Further Evaluation | 145 | ||
| Risk Mitigation for Future Trips | 146 | ||
| The Potentially At-Risk Traveler | 146 | ||
| A Framework for Assessing Risk | 146 | ||
| Question 1: Is the Individual at Risk for Severe Hypoxemia or Impaired Tissue Oxygen Delivery? | 146 | ||
| Question 2: Is the Individual at Risk for Impaired Ventilatory Responses to Hypoxia? | 146 | ||
| Question 3: Is the Individual at Risk Due to the Expected Pulmonary Vascular Responses to Hypobaric Hypoxia? | 147 | ||
| Question 4: Will Environmental Features of High Altitude or the Expected Physiologic Responses to Hypobaric Worsen the Underlying Medical Condition? | 147 | ||
| Further Evaluation | 147 | ||
| Risk Mitigation Strategies | 149 | ||
| Return Travel to High Altitude | 149 | ||
| Further Reading | 150 | ||
| General High-Altitude Medicine | 150 | ||
| Travelers with Underlying Medical Conditions | 151 | ||
| 11 Dive Medicine | 152 | ||
| Preparation for Dive Travel | 152 | ||
| Decompression Sickness | 154 | ||
| Prevention of Swimmer’s Ear (Otitis Externa) | 157 | ||
| Recreational Diving | 157 | ||
| Barotrauma | 158 | ||
| After the Trip | 162 | ||
| Further Reading | 162 | ||
| 12 Travel Advice for Pediatric Travelers | 165 | ||
| Developmental Aspects and Travel | 165 | ||
| Airline Travel | 166 | ||
| Motion Sickness | 167 | ||
| Vaccine Schedules for Infants and Children | 167 | ||
| Malaria Prevention | 173 | ||
| Personal Protective Measures | 173 | ||
| Chemoprophylaxis | 175 | ||
| Diarrhea Prevention and Treatment | 177 | ||
| General Safety for Traveling Children and Adolescents | 180 | ||
| Altitude | 180 | ||
| Miscellaneous Issues for Young Travelers | 181 | ||
| Further Reading | 182 | ||
| 13 Students Traveling Abroad | 184 | ||
| The Pre-University Student | 185 | ||
| University Students | 185 | ||
| Health Science Students Abroad | 185 | ||
| Vaccines for Students | 186 | ||
| Medications for Traveling Students | 186 | ||
| The Role of the Chaperone | 187 | ||
| Traveling with Chronic Illness | 187 | ||
| Mental Health | 188 | ||
| Social Issues | 189 | ||
| Personal Safety | 189 | ||
| Contingency Planning for Emergencies | 190 | ||
| Summary | 190 | ||
| Further Reading | 190 | ||
| General Travel | 190 | ||
| Pre-University Adolescent Student Traveler | 190 | ||
| University Student Travelers | 191 | ||
| Health Science Student Travelers | 191 | ||
| 14 Advice for Women Travelers | 192 | ||
| Gender-Based Medicine | 192 | ||
| Gender-Related Issues in Tropical Disease | 192 | ||
| General Health Issues of Women Travelers | 193 | ||
| Women’s Travel Medicine Kit | 193 | ||
| Menstruation | 193 | ||
| Urinary Tract Infections | 194 | ||
| Vaginitis | 198 | ||
| Contraception | 198 | ||
| Special Considerations for Women on Oral Contraceptives | 198 | ||
| Drug Interactions That May Affect Oral Contraceptive Efficacy | 199 | ||
| Contraceptive Failure: Emergency Contraception | 199 | ||
| Sexually Transmitted Infections | 200 | ||
| Gynecologic Concerns at Altitude | 201 | ||
| Travel during Pregnancy | 201 | ||
| Basic Questions to Answer When Counseling Pregnant Women | 201 | ||
| Transportation Risks during Pregnancy | 203 | ||
| Airlines | 203 | ||
| Automobile Travel | 204 | ||
| Sea Travel | 204 | ||
| FDA Use-in-Pregnancy Ratings | 204 | ||
| Travel Vaccines for Women | 205 | ||
| Vaccination during Pregnancy | 205 | ||
| Cholera | 206 | ||
| Hepatitis A Vaccine | 206 | ||
| Hepatitis B Vaccine | 206 | ||
| Hepatitis A/B Combination Vaccine | 206 | ||
| HPV Vaccine | 206 | ||
| Japanese Encephalitis Vaccine | 206 | ||
| Meningococcal Vaccines | 207 | ||
| Polio | 207 | ||
| Rabies Vaccines (Diploid Cell Culture) | 207 | ||
| Tetanus, Diphtheria (Td) and Tetanus, Diphtheria, and Pertussis (Tdap) Vaccines | 207 | ||
| Typhoid Vaccines | 208 | ||
| Varicella | 208 | ||
| Yellow Fever | 208 | ||
| Vector-Borne Diseases during Pregnancy | 208 | ||
| Malaria Chemoprophylaxis in Pregnancy | 209 | ||
| Prevention of Traveler’s Diarrhea during Pregnancy | 209 | ||
| Other Parasitic Diseases | 210 | ||
| Other Infections | 210 | ||
| Exercise | 211 | ||
| Medical Service Available in the Area of Destination | 212 | ||
| Health Insurance Coverage When Out of Area | 212 | ||
| Signs of Serious Pregnancy-Related Illness for Which Emergency Medical Help Should be Sought | 212 | ||
| Travel Issues and Breast Feeding | 212 | ||
| Older Women Travelers | 213 | ||
| Personal Security and Safety Issues | 214 | ||
| Summary | 214 | ||
| 15 The Immunocompromised Traveler | 215 | ||
| The Immunocompromised Traveler | 215 | ||
| Infectious Disease Risks | 215 | ||
| Enteric Infections | 216 | ||
| Respiratory Infections | 217 | ||
| Vector-Borne Infections | 218 | ||
| Preparation of the Immunocompromised Traveler | 219 | ||
| Infection Prevention Strategies | 221 | ||
| Vaccinations | 221 | ||
| Vaccines for Travel to Developing Countries | 223 | ||
| Special Vaccines for Specific Destinations or Activities | 224 | ||
| Chemoprophylaxis for Traveler’s Diarrhea | 224 | ||
| Antimalarial Prophylaxis | 225 | ||
| Sexual Precautions | 225 | ||
| Further Reading | 225 | ||
| 16 Travel with Chronic Medical Conditions | 228 | ||
| Chronic Obstructive Pulmonary Disease, Asthma, and Other Respiratory Conditions | 229 | ||
| Supplemental Oxygen | 231 | ||
| Travelers with Asthma | 232 | ||
| Cardiovascular Disease | 233 | ||
| Cardiac Pacemakers and Implantable Cardiac Defibrillators | 235 | ||
| Diabetes Mellitus | 235 | ||
| Diabetes and High Altitude | 237 | ||
| Traveling East across Six or More Time Zones | 237 | ||
| Traveling West Across Six or More Time Zones | 238 | ||
| Prevention of Hypoglycemia | 240 | ||
| Artificial Hip Joints and Other Orthopedic Hardware | 241 | ||
| Internet Resources | 241 | ||
| References and Further Reading | 241 | ||
| 17 Travel and Mental Health | 243 | ||
| Medevac Statistics | 243 | ||
| Pre-departure Assessment and Advice: Risk Factors | 243 | ||
| Pre-travel Evaluation of Resilience | 244 | ||
| Common Mental Health Problems among Travelers and How They Arise | 246 | ||
| Sleep, Travel, and Psychiatric Problems | 246 | ||
| Alcohol-Use Disorders and Their Consequences | 246 | ||
| Trauma- and Stressor-Related Disorders | 247 | ||
| The Psychological Sequelae of Exposure to Traumatic Events | 247 | ||
| Psychosis | 247 | ||
| The Role of the Clinician: Organizing Support | 248 | ||
| Mental Health Support for Humanitarian and Other Overseas Workers | 248 | ||
| Internet Resources | 248 | ||
| Further Reading | 249 | ||
| 18 Pre-Travel Assessment and Advice for Expatriates and Volunteers | 250 | ||
| Expatriates | 250 | ||
| Definitions | 250 | ||
| Type of Expatriate | 250 | ||
| Destination | 250 | ||
| Duration | 250 | ||
| Emerging Trends | 250 | ||
| Pre-Travel Care | 251 | ||
| History | 251 | ||
| Physical Exam | 251 | ||
| Laboratory Tests | 251 | ||
| Assessing Fitness for Travel | 252 | ||
| Vaccine-Preventable Diseases (VPD) | 252 | ||
| Typhoid Vaccine | 253 | ||
| Hepatitis B | 253 | ||
| Japanese Encephalitis (JE) Vaccine | 254 | ||
| JE-MB Vaccine | 254 | ||
| JE-VC Vaccine | 254 | ||
| JE-CV Vaccine | 254 | ||
| JE SA-14-14-2 Vaccine | 254 | ||
| Rabies | 254 | ||
| Yellow Fever | 254 | ||
| On the Horizon | 255 | ||
| Other Health Problems: Infectious | 255 | ||
| Malaria | 255 | ||
| Dengue | 255 | ||
| Gastrointestinal (GI) Infections | 255 | ||
| Sexually Transmitted Infections | 256 | ||
| Tuberculosis (TB) | 256 | ||
| Viral Hemorrhagic Fevers | 256 | ||
| Other Health Problems: Non-Infectious | 256 | ||
| Safety and Security | 256 | ||
| Traffic and Trauma | 256 | ||
| Mental and Emotional Health | 256 | ||
| Dental Problems | 257 | ||
| Cardiovascular | 257 | ||
| Medical Care Abroad | 257 | ||
| Post-Travel Care | 257 | ||
| Further Reading | 258 | ||
| 19 Health Screening in Immigrants, Refugees, and International Adoptees | 260 | ||
| Mandatory Immigration Screening in the United States: Medical Component | 260 | ||
| Summary | 264 | ||
| Medical Screening of New Arrivals in the United States | 265 | ||
| Summary | 266 | ||
| Further Reading and Salient References | 269 | ||
| 3 Fever | 271 | ||
| 20 Travel-Acquired Illnesses Associated with Fever | 271 | ||
| Epidemiology | 271 | ||
| Medical History | 274 | ||
| Vaccinations and Prophylaxis | 274 | ||
| Exposures | 274 | ||
| Clinical Characteristics | 275 | ||
| Incubation Period | 275 | ||
| Fever Patterns | 275 | ||
| Specific Symptoms | 275 | ||
| Approach to the Traveler with Fever | 282 | ||
| Infectious Diseases in the Traveler with Fever | 284 | ||
| Malaria | 284 | ||
| Typhoid and Paratyphoid Fever (Enteric Fevers) | 284 | ||
| Arboviral Diseases | 285 | ||
| Dengue Fever | 285 | ||
| Chikungunya | 287 | ||
| Zika | 287 | ||
| Yellow Fever | 288 | ||
| Hemorrhagic Syndromes | 288 | ||
| Rickettsial Diseases | 288 | ||
| Helminths | 293 | ||
| Schistosomiasis (Bilharziasis) | 293 | ||
| Filariasis | 293 | ||
| Strongyloidiasis | 293 | ||
| Trichinosis | 293 | ||
| Paragonimiasis | 293 | ||
| Echinococcosis | 294 | ||
| Protozoa | 294 | ||
| Amebiasis | 294 | ||
| Chagas Disease | 294 | ||
| African Trypanosomiasis | 294 | ||
| Visceral Leishmaniasis | 294 | ||
| Toxoplasmosis | 295 | ||
| Bacteria | 295 | ||
| Tuberculosis | 295 | ||
| Meningococcal Meningitis | 295 | ||
| Leptospirosis | 295 | ||
| Brucellosis | 295 | ||
| Plague | 296 | ||
| Melioidosis | 296 | ||
| Relapsing Fever | 296 | ||
| Bartonellosis (Oroya Fever) | 296 | ||
| Anthrax | 296 | ||
| Sexually Transmitted Infections | 296 | ||
| Viruses | 296 | ||
| Respiratory and Enteric Viruses | 296 | ||
| Hepatitis | 297 | ||
| Human Immunodeficiency Virus (HIV) | 297 | ||
| Infectious Mononucleosis | 297 | ||
| Measles | 297 | ||
| Fungi | 297 | ||
| Further Reading | 297 | ||
| 21 Malaria Diagnosis and Treatment | 300 | ||
| General Considerations | 300 | ||
| Etiology | 300 | ||
| Presentation | 300 | ||
| Epidemiology | 300 | ||
| Pathogenesis | 301 | ||
| Natural Life Cycle | 301 | ||
| Pathophysiology | 303 | ||
| Immunity to Malaria | 303 | ||
| Clinical Features | 304 | ||
| Laboratory Diagnosis | 305 | ||
| Rapid Diagnostic Test (RDT) | 306 | ||
| Polymerase Chain Reaction (PCR) | 306 | ||
| Serology | 306 | ||
| Treatment | 306 | ||
| Uncomplicated Malaria | 306 | ||
| Antimalarial Drugs for Uncomplicated Malaria | 307 | ||
| Artemisinin-Based Combination Therapies (ACTs) | 307 | ||
| Atovaquone-Proguanil | 307 | ||
| Chloroquine | 307 | ||
| Mefloquine | 307 | ||
| Primaquine | 307 | ||
| Drugs No Longer Recommended | 307 | ||
| Severe Malaria | 309 | ||
| Radical Cure of P. vivax or P. ovale Malaria | 310 | ||
| Prevention of Malaria in Travelers | 310 | ||
| Special Therapeutic Considerations | 311 | ||
| Malaria during Pregnancy | 311 | ||
| Malaria in Infancy and Childhood | 311 | ||
| Malaria in Patients with Chronic Diseases | 312 | ||
| General Points | 312 | ||
| Commonly Encountered Practical Problems | 312 | ||
| Errors of Diagnosis | 312 | ||
| Errors of Management | 313 | ||
| Therapeutic Dilemmas (Always Seek Expert Advice) | 313 | ||
| Further Reading | 314 | ||
| Diagnosis of Malaria | 314 | ||
| Treatment of Malaria | 314 | ||
| Management Issues in Severe Malaria | 314 | ||
| 22 Viral Hepatitis in Travelers and Immigrants | 315 | ||
| Epidemiology and Etiology | 316 | ||
| Hepatitis A Virus (HAV) | 316 | ||
| Hepatitis B Virus (HBV) | 318 | ||
| HBV Infection in Pregnancy | 320 | ||
| Hepatitis C Virus (HCV) | 320 | ||
| Hepatitis D Virus (HDV) | 321 | ||
| Hepatitis E Virus (HEV) | 321 | ||
| Clinical Syndromes | 324 | ||
| Prodrome | 324 | ||
| Icteric Phase | 324 | ||
| Convalescent Phase | 325 | ||
| Acute Liver Failure | 325 | ||
| Chronic Hepatitis | 325 | ||
| Viral Hepatitis Co-Infections | 325 | ||
| Differential Diagnosis | 326 | ||
| Viral Diseases | 326 | ||
| Yellow Fever | 326 | ||
| Epstein-Barr Virus (EBV) | 326 | ||
| Cytomegalovirus (CMV) | 326 | ||
| Herpes Simplex | 326 | ||
| Coxsackievirus | 326 | ||
| Nonviral Infections | 326 | ||
| Typhoid | 326 | ||
| Malaria | 326 | ||
| Liver Abscess | 326 | ||
| Q Fever | 326 | ||
| Secondary Syphilis | 326 | ||
| Leptospirosis | 327 | ||
| Toxoplasmosis | 327 | ||
| Helminthic Infestations | 327 | ||
| Ascariasis | 327 | ||
| Schistosomiasis | 327 | ||
| Flukes | 327 | ||
| Toxic Hepatitis | 327 | ||
| Biliary Tract Disease | 327 | ||
| Gilbert Syndrome | 327 | ||
| Pregnancy | 327 | ||
| Diagnosis | 327 | ||
| Hepatitis A | 328 | ||
| Hepatitis B | 328 | ||
| Hepatitis C | 330 | ||
| Hepatitis D | 330 | ||
| Hepatitis E | 332 | ||
| Epstein-Barr Virus and Cytomegalovirus | 332 | ||
| Treatment | 332 | ||
| Prevention | 333 | ||
| Hepatitis A Vaccine | 333 | ||
| HAV Vaccine in Compromised Hosts | 333 | ||
| Immune Globulin | 333 | ||
| Hepatitis B | 333 | ||
| HBV Vaccine in Compromised Hosts | 334 | ||
| Hepatitis C | 334 | ||
| Hepatitis D | 334 | ||
| Hepatitis E | 334 | ||
| Further Reading | 334 | ||
| 23 Leptospirosis | 336 | ||
| Etiology | 336 | ||
| Epidemiology | 336 | ||
| Clinical | 338 | ||
| Anicteric Leptospirosis | 339 | ||
| Severe (Icteric) Leptospirosis (Weil Syndrome) | 340 | ||
| Pulmonary Leptospirosis | 340 | ||
| Differential Diagnosis | 340 | ||
| Diagnosis | 340 | ||
| Cultures | 340 | ||
| Immunodiagnosis | 342 | ||
| Laboratory and Radiologic Findings | 342 | ||
| Treatment | 342 | ||
| Prevention | 343 | ||
| Further Reading | 343 | ||
| 24 Lyme Disease | 345 | ||
| Causative Organism | 345 | ||
| Transmission | 346 | ||
| Epidemiology | 347 | ||
| Clinical Manifestations | 348 | ||
| Diagnosis | 349 | ||
| Therapy | 351 | ||
| Prevention | 353 | ||
| Tick Bite Prevention | 353 | ||
| Post-Exposure Antibiotic Prophylaxis | 353 | ||
| Lyme Disease Vaccine | 353 | ||
| Further Reading | 354 | ||
| 25 Tuberculosis in Travelers and Immigrants | 356 | ||
| Transmission and Pathogenesis | 356 | ||
| Epidemiology | 357 | ||
| Conditions Mimicking Tuberculosis | 357 | ||
| Mycobacterium bovis and Nontuberculous Mycobacterial Infection | 358 | ||
| Tuberculosis in Tourists | 358 | ||
| Clinical Features | 359 | ||
| Pulmonary Tuberculosis | 359 | ||
| Extrapulmonary Tuberculosis | 359 | ||
| Tuberculosis in Children | 359 | ||
| Tuberculosis in Persons with HIV Infection | 360 | ||
| Diagnosis | 360 | ||
| Radiographic Findings | 360 | ||
| Tuberculin Skin Testing | 360 | ||
| Interferon-γ Release Assays | 361 | ||
| AFB Smear and Culture | 362 | ||
| Nucleic Acid Amplification Testing | 362 | ||
| Treatment of Active Tuberculosis | 362 | ||
| Drug-Resistant TB | 364 | ||
| Treatment Precautions | 365 | ||
| Adherence to TB Treatment | 365 | ||
| Prevention | 366 | ||
| TB Risk Assessment | 367 | ||
| Evaluation of Immigrants for TB | 368 | ||
| Evaluation of Travelers Who Visit TB-Endemic Countries | 368 | ||
| Pre-Travel | 368 | ||
| Post-Travel | 369 | ||
| References and Further Reading | 369 | ||
| 26 Chagas Disease | 371 | ||
| Epidemiology | 371 | ||
| Parasite Distribution versus Disease Distribution | 371 | ||
| Vectors | 372 | ||
| Reservoir Hosts | 373 | ||
| Transmission by Vector | 373 | ||
| Transmission Related to Transfusions and Organ Transplants | 374 | ||
| Congenital Transmission | 374 | ||
| Clinical Features | 375 | ||
| Acute Disease | 375 | ||
| Chronic Disease | 376 | ||
| Chronic T. cruzi Infection in Immunosuppressed Patients | 376 | ||
| Diagnosis | 378 | ||
| Serologic Detection Methods | 378 | ||
| Parasite Detection Methods | 378 | ||
| Blood Cultures | 378 | ||
| Polymerase Chain Reaction | 378 | ||
| Evaluation and Treatment | 378 | ||
| Evaluation | 378 | ||
| Antitrypanosomal Agents | 379 | ||
| Symptomatic Treatment | 380 | ||
| Prognosis | 380 | ||
| Prevention | 380 | ||
| For Persons Living in Endemic Areas | 380 | ||
| For Persons Traveling to Endemic Areas | 380 | ||
| References and Further Reading | 381 | ||
| 27 Human African Trypanosomiasis (Sleeping Sickness) | 382 | ||
| Epidemiology | 382 | ||
| Pathogen/Lifecycle | 383 | ||
| Clinical Manifestations | 383 | ||
| Testing and Diagnosis | 385 | ||
| Treatment | 386 | ||
| Treatment of T.b. gambiense Trypanosomiasis | 387 | ||
| Stage 1 | 387 | ||
| 4 Diarrhea | 415 | ||
| 31 Approach to Diarrhea in Returned Travelers | 415 | ||
| Exposure History and Risk Factors | 415 | ||
| Clinical Presentation and Evaluation | 416 | ||
| Diagnostic Studies | 417 | ||
| Infectious Diarrhea Syndromes | 422 | ||
| Salmonella | 422 | ||
| Shigella | 423 | ||
| Campylobacter | 424 | ||
| Vibrio | 425 | ||
| Other Notable Bacterial Pathogens | 425 | ||
| Emerging Bacterial Pathogens | 426 | ||
| Viral Agents | 427 | ||
| Further Reading | 427 | ||
| 32 Amebiasis, Giardiasis, and Other Intestinal Protozoan Infections | 429 | ||
| Entamoeba histolytica | 429 | ||
| Pathogenesis | 429 | ||
| Intestinal Amebiasis | 429 | ||
| Extraintestinal Amebiasis | 430 | ||
| Immunity | 430 | ||
| Epidemiology | 430 | ||
| Clinical Features | 430 | ||
| Intestinal Amebiasis | 430 | ||
| Extraintestinal Amebiasis | 431 | ||
| Diagnosis | 431 | ||
| Intestinal Amebiasis | 431 | ||
| Examination of the stool | 431 | ||
| Colonoscopy | 431 | ||
| 5 Dermatology | 457 | ||
| 35 Approach to Tropical Dermatology | 457 | ||
| Clinical Approach | 457 | ||
| General Dermatologic Treatments | 458 | ||
| Further Reading | 459 | ||
| 36 Acute Skin Reactions and Bacterial Infections | 460 | ||
| Sunburn and Other Ultraviolet Light Reactions | 460 | ||
| Etiology | 460 | ||
| Prevention | 460 | ||
| Treatment | 461 | ||
| Dermatitis in Travelers | 462 | ||
| Etiology | 463 | ||
| Clinical Features | 463 | ||
| Diagnosis | 463 | ||
| Treatment | 463 | ||
| Drug Eruptions | 464 | ||
| Clinical Features | 464 | ||
| Diagnosis | 464 | ||
| Treatment | 464 | ||
| Arthropod Bites and Stings | 464 | ||
| Etiology and Clinical Features | 464 | ||
| Diagnosis | 465 | ||
| Treatment | 465 | ||
| Prevention | 466 | ||
| Bacterial Skin Infections | 466 | ||
| Pyoderma | 466 | ||
| Etiology | 466 | ||
| Clinical Features | 467 | ||
| Diagnosis | 468 | ||
| Treatment | 468 | ||
| Pyomyositis | 470 | ||
| Etiology | 470 | ||
| 6 Sexually Transmitted Diseases | 524 | ||
| 41 Sexually Transmitted Infections and Foreign Travel | 524 | ||
| Casual Sexual Activity and Travel | 524 | ||
| Sexual Tourism | 525 | ||
| The International Spread of HIV | 525 | ||
| Risks for Acquisition of STIs and HIV during Travel | 526 | ||
| Prevention of STIs and HIV | 526 | ||
| Barrier Protection | 526 | ||
| HIV Pre-Exposure Prophylaxis | 527 | ||
| Vaccines | 527 | ||
| Advice to Travelers | 527 | ||
| Further Reading | 528 | ||
| 42 Gonococcal and Chlamydial Genital Infections and Pelvic Inflammatory Disease | 529 | ||
| Epidemiology | 529 | ||
| Urethritis | 530 | ||
| Cervicitis | 531 | ||
| Pelvic Inflammatory Disease | 531 | ||
| Treatment of Gonorrhea and Chlamydia | 532 | ||
| Further Reading | 533 | ||
| 43 Syphilis | 535 | ||
| Epidemiology | 535 | ||
| Clinical Presentation | 535 | ||
| Primary Syphilis | 536 | ||
| Secondary Syphilis | 536 | ||
| Latent and Tertiary Syphilis | 537 | ||
| Neurosyphilis | 537 | ||
| Diagnosis | 537 | ||
| Diagnosis of Central Nervous System Syphilis | 540 | ||
| Treatment | 541 | ||
| Assessing Therapeutic Response | 543 | ||
| Management of Sex Partners | 543 | ||
| HIV and Syphilis | 543 | ||
| Further Reading | 543 | ||
| 44 Genital Ulcer Disease | 545 | ||
| Herpes Simplex Virus (HSV) | 547 | ||
| Epidemiology | 547 | ||
| Pathogenesis | 548 | ||
| Clinical Manifestations and Diagnosis | 548 | ||
| Treatment and Prevention | 549 | ||
| Chancroid | 550 | ||
| Epidemiology | 550 | ||
| Pathogenesis | 550 | ||
| Clinical Manifestations and Diagnosis | 550 | ||
| Treatment and Prevention | 551 | ||
| Lymphogranuloma Venereum (LGV) | 551 | ||
| Epidemiology | 551 | ||
| Pathogenesis | 551 | ||
| 7 Helminths | 554 | ||
| 45 Common Intestinal Roundworms | 554 | ||
| General Considerations | 554 | ||
| Etiology | 555 | ||
| Clinical Features | 555 | ||
| Prevention | 555 | ||
| Diagnosis | 555 | ||
| Hematology | 555 | ||
| Microbiology | 557 | ||
| Serology | 557 | ||
| The String Test | 557 | ||
| Adhesive Tape Test | 557 | ||
| Baermann Funnel Gauze Method | 557 | ||
| Treatment | 557 | ||
| Special Therapeutic Considerations | 558 | ||
| Intestinal Obstruction Due to Ascaris | 558 | ||
| Surgery | 558 | ||
| Pregnant and Lactating Women | 558 | ||
| Infants | 559 | ||
| Altered Immune States | 559 | ||
| Chronic Strongyloides Infections | 559 | ||
| Pinworm | 559 | ||
| Other Roundworms | 560 | ||
| Other Hookworm Species | 560 | ||
| Mass Drug Administration | 560 | ||
| Anisakiasis | 560 | ||
| Epidemiology | 561 | ||
| Clinical Presentation | 561 | ||
| Diagnosis | 561 | ||
| Treatment | 561 | ||
| Prevention | 561 | ||
| Further Reading | 562 | ||
| 46 Cestodes | 564 | ||
| Epidemiology and Demographics of Human Tapeworm Infections in Developed Nations | 564 | ||
| Intestinal Tapeworms | 564 | ||
| Tissue Tapeworms | 568 | ||
| Clinical Presentation of Tapeworm Infections | 569 | ||
| Diagnosis | 569 | ||
| Parasitologic Testing | 569 | ||
| Radiology | 570 | ||
| Pathology | 570 | ||
| Clinical Management | 570 | ||
| Treatment | 570 | ||
| Public Health and the Role of Screening | 572 | ||
| Prognosis | 572 | ||
| Further Reading | 572 | ||
| 47 Filarial Infections | 574 | ||
| Lymphatic Filariasis | 574 | ||
| Epidemiology | 574 | ||
| B. malayi and B. timori | 574 | ||
| W. bancrofti | 575 | ||
| Pathology | 575 | ||
| Clinical Manifestations in Those Native to the Endemic Region | 576 | ||
| Clinical Manifestations in New Arrivals to Endemic Areas | 576 | ||
| Diagnosis | 577 | ||
| Direct Examination | 578 | ||
| Nuclepore™ filtration | 578 | ||
| Knott’s concentration technique | 578 | ||
| Indirect Measures | 578 | ||
| Detection of circulating parasite antigen | 578 | ||
| Serodiagnosis using parasite extract | 578 | ||
| Molecular diagnostics | 578 | ||
| Imaging studies | 578 | ||
| Differential Diagnosis | 579 | ||
| Treatment | 579 | ||
| Microfilaria-Positive Individuals | 579 | ||
| Microfilaria-negative antigen-positive individuals | 579 | ||
| Acute Manifestations of Lymphatic Filariasis | 579 | ||
| Filarial Adenolymphangitis (ADL) | 579 | ||
| Chronic Manifestations of Lymphatic Filariasis | 579 | ||
| Lymphedema | 579 | ||
| Treatment Options and Dosage | 580 | ||
| Prevention and Control | 580 | ||
| Tropical Eosinophilia Syndrome | 580 | ||
| Clinical Features | 581 | ||
| Pathology | 581 | ||
| Differential Diagnosis | 581 | ||
| Treatment | 581 | ||
| Onchocerciasis | 581 | ||
| Epidemiology | 581 | ||
| Pathology | 582 | ||
| Evidence Synopsis | e1 | ||
| Title: | e1 | ||
| Date completed: | e1 | ||
| Authors: | e1 | ||
| Clinical question: | e1 | ||
| Author recommendations: | e1 | ||
| Evidence and recommendations: | e1 | ||
| PICO: | e2 | ||
| What are the parameters of our evidence search? Refer to the following tables (Tables 1 and 2) | e2 | ||
| Guidelines: | e5 | ||
| Author commentary: | e6 | ||
| Update alerts: | e6 | ||
| Glossary: | e6 | ||
| References | e6 | ||
| Recommended citation: | e7 | ||
| Evidence Synopsis | e8 | ||
| Title: | e8 | ||
| Date completed: | e8 | ||
| Authors: | e8 | ||
| Clinical question: | e8 | ||
| Author recommendations: | e8 | ||
| Evidence and recommendations: | e8 | ||
| PICO: | e8 | ||
| What are the parameters of our evidence search? | e8 | ||
| Patients or population: | e8 | ||
| Settings: | e8 | ||
| Intervention: | e8 | ||
| Comparison: | e8 | ||
| Guidelines and performance measures: | e11 | ||
| American Heart Association: | e11 | ||
| Author commentary: | e11 | ||
| Update alerts: | e11 | ||
| Glossary: | e11 | ||
| References | e11 | ||
| Recommended citation: | e12 | ||
| Evidence Synopsis | e13 | ||
| Title: | e13 | ||
| Date completed: | e13 | ||
| Authors: | e13 | ||
| Clinical question: | e13 | ||
| Author recommendations: | e13 | ||
| Evidence and recommendations: | e13 | ||
| PICO: | e13 | ||
| Basis for and determinants of the strength of recommendations | e14 | ||
| Patients or population: | e14 | ||
| Setting: | e14 | ||
| Intervention: | e14 | ||
| Comparison: | e14 | ||
| Guidelines and performance measures: | e14 | ||
| Author commentary: | e15 | ||
| Update alerts: | e15 | ||
| Glossary: | e15 | ||
| References | e15 | ||
| Recommended citation: | e16 | ||
| Evidence Synopsis | e17 | ||
| Title: | e17 | ||
| Date completed: | e17 | ||
| Authors: | e17 | ||
| Clinical question: | e17 | ||
| Author recommendations: | e17 | ||
| Evidence and recommendations: | e17 | ||
| PICO: | e18 | ||
| What are the parameters of our evidence search? | e18 | ||
| Population: | e18 | ||
| Setting: | e18 | ||
| Intervention: | e18 | ||
| Comparator: | e18 | ||
| Outcome: | e18 | ||
| Guidelines: | e21 | ||
| Author commentary: | e22 | ||
| Update alerts: | e24 | ||
| Glossary: | e24 | ||
| References | e24 | ||
| Appendix: | e25 | ||
| Patients or population: | e25 | ||
| Exposure: | e25 | ||
| Comparison: | e25 | ||
| Outcome: | e25 | ||
| Recommended citation: | e25 | ||
| Evidence Synopsis | e26 | ||
| Title: | e26 | ||
| Date completed: | e26 | ||
| Authors: | e26 | ||
| Clinical question: | e26 | ||
| Author recommendations: | e26 | ||
| Evidence and recommendations: | e26 | ||
| What are the parameters of our evidence search? | e26 | ||
| What is the basis for our conclusion(s)? | e27 | ||
| Patients or population: | e27 | ||
| Intervention: | e27 | ||
| Comparison: | e27 | ||
| Outcome: | e27 | ||
| Setting: | e27 | ||
| Outcome: | e30 | ||
| Outcome: | e32 | ||
| Guidelines: | e35 | ||
| Author commentary: | e36 | ||
| Update alerts: | e37 | ||
| Glossary: | e37 | ||
| References | e37 | ||
| Recommended citation: | e37 | ||
| Quick Evidence Synopsis | e38 | ||
| Title: | e38 | ||
| Date completed: | e38 | ||
| Authors: | e38 | ||
| Clinical question: | e38 | ||
| What does the evidence conclude? | e38 | ||
| What are the parameters of our evidence search? | e38 | ||
| PICO: | e38 | ||
| What is the basis for the conclusion(s)? | e39 | ||
| Population: | e39 | ||
| Setting: | e39 | ||
| Intervention: | e39 | ||
| Comparator: | e39 | ||
| What do clinical guidelines say? | e39 | ||
| Author commentary: | e39 | ||
| FDA Black Box warning | e39 | ||
| FDA precautions and warnings: | e39 | ||
| Glossary: | e39 | ||
| Next scheduled update: | e39 | ||
| References | e41 | ||
| Recommended citation: | e41 | ||
| Evidence Synopsis | e42 | ||
| Title: | e42 | ||
| Date completed: | e42 | ||
| Authors: | e42 | ||
| Clinical question: | e42 | ||
| Author recommendations: | e42 | ||
| Evidence and recommendations: | e42 | ||
| PICO: | e42 | ||
| What are the parameters of our evidence search? | e43 | ||
| Patients or population: | e43 | ||
| Intervention: | e43 | ||
| Comparison: | e43 | ||
| Outcome: | e43 | ||
| Settings: | e43 | ||
| Guidelines: | e49 | ||
| Author commentary: | e49 | ||
| Update Alerts: | e50 | ||
| Glossary: | e50 | ||
| References | e50 | ||
| Recommended citation: | e51 | ||
| Evidence Synopsis | e52 | ||
| Title: | e52 | ||
| Date completed: | e52 | ||
| Authors: | e52 | ||
| Clinical question: | e52 | ||
| Author recommendations: | e52 | ||
| Evidence and recommendations: | e52 | ||
| PICO: | e52 | ||
| What are the parameters of our evidence search? | e53 | ||
| Patients or population: | e53 | ||
| Intervention: | e53 | ||
| Comparison: | e53 | ||
| Outcome: | e53 | ||
| Setting: | e53 | ||
| Guidelines: | e55 | ||
| Author commentary: | e55 | ||
| Update alerts: | e55 | ||
| Glossary: | e55 | ||
| References | e56 | ||
| Recommended citation: | e56 | ||
| Appendix | 610 | ||
| Index | 615 | ||
| A | 615 | ||
| B | 618 | ||
| C | 619 | ||
| D | 622 | ||
| E | 623 | ||
| F | 625 | ||
| G | 626 | ||
| H | 627 | ||
| I | 630 | ||
| J | 631 | ||
| K | 631 | ||
| L | 631 | ||
| M | 633 | ||
| N | 635 | ||
| O | 636 | ||
| P | 636 | ||
| Q | 639 | ||
| R | 639 | ||
| S | 639 | ||
| T | 642 | ||
| U | 644 | ||
| V | 645 | ||
| W | 645 | ||
| X | 646 | ||
| Y | 646 | ||
| Z | 646 |