Q fever is caused by the bacteria Coxiella burnetii. It can infect both humans and animals. In humans, it often causes flu-like symptoms but can also result in atypical pneumonia or hepatitis. Animals can experience reproductive issues like abortions. The bacteria is transmitted through airborne particles from animal birth products and milk, as well as through direct contact with infected animals or ticks. Prevention focuses on good animal husbandry like vaccination and disposal of birth products to control transmission.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
2. Overview
• Organism
• History
• Epidemiology
• Transmission
• Disease in Humans
• Disease in Animals
• Prevention and Control
• Actions to Take
Center for Food Security and Public Health, Iowa State University, 2011
4. The Organism
• Coxiella burnetii
– Obligate intracellular pathogen
– Proteobacteria
– Stable and resistant
– Killed by pasteurization
– Two antigenic phases
• Phase 1: virulent
• Phase 2: less pathogenic
Center for Food Security and Public Health, Iowa State University, 2011
6. History
• 1935
– Queensland, Australia (abattoir worker)
– Montana, USA (ticks)
• Outbreaks
– Military troops
• When present in areas
with infected animals
– Cities and towns
• Downwind from farms
• By roads traveled by animals
Center for Food Security and Public Health, Iowa State University, 2011
8. Transmission
• Aerosol
– Parturient fluids
• 109 bacteria released
per gram of placenta
– Urine, feces, milk
• Direct contact
• Fomites
• Ingestion
• Arthropods (ticks)
Center for Food Security and Public Health, Iowa State University, 2011
9. Transmission
• Person-to-person (rare)
– Transplacental (congenital)
– Blood transfusions
– Bone marrow transplants
– Intradermal inoculation
– Possibly sexually transmitted
Center for Food Security and Public Health, Iowa State University, 2011
11. Epidemiology
• Worldwide
– Except New Zealand
• Reservoirs
– Domestic animals
• Sheep, cattle, goats, dogs, cats
– Birds
– Reptiles
– Wildlife
Center for Food Security and Public Health, Iowa State University, 2011
12. Epidemiology
• Occupational and
environmental hazard
– Farmers
– Livestock producers
– Veterinarians
and technicians
– Meat processors/
abattoir workers
– Laboratory workers
Center for Food Security and Public Health, Iowa State University, 2011
13. Center for Food Security and Public Health, Iowa State University, 2011
14. Q Fever in the U.S., 2010
Center for Food Security and Public Health, Iowa State University, 2011
16. Human Disease
• Incubation: 2 to 5 weeks
• One organism may cause disease
• Humans are dead-end hosts
• Disease
– Asymptomatic (50%)
– Acute
– Chronic
Center for Food Security and Public Health, Iowa State University, 2011
17. Acute Infection
• Flu-like, self limiting
• Atypical pneumonia (30 to 50%)
• Hepatitis
• Skin rash (10%)
• Other signs (< 1%)
– Myocarditis, meningoencephalitis,
pericarditis
• Death: 1 to 2%
Center for Food Security and Public Health, Iowa State University, 2011
18. Chronic Disease
• 1 to 5% of those infected
– Prior heart disease, pregnant women,
immunocompromised
• Endocarditis
• Other
– Granulomatous hepatitis
– Cirrhosis
– Osteomyelitis
• 50% relapse rate after antibiotic therapy
Center for Food Security and Public Health, Iowa State University, 2011
19. Risk to Pregnant Women
• Most asymptomatic
• Transplacental transmission
• Reported complications
– In-utero death
– Premature birth
– Low birth weight
– Placentitis
Center for Food Security and Public Health, Iowa State University, 2011
20. Prognosis
• Usually self-limiting
• Only 2% develop severe disease
• Active chronic disease
– Usually fatal if left untreated
– Fatality for endocarditis: 45 to 65%
– 50 to 60% need valve replacement
• Case-fatality rate: <1 to 2.4%
Center for Food Security and Public Health, Iowa State University, 2011
21. Diagnosis
• Serology (rise in titer)
– IFA, CF, ELISA, microagglutination
• DNA detection methods
– PCR
• Isolation of organism
– Risk to laboratory personnel
– Rarely done
Center for Food Security and Public Health, Iowa State University, 2011
22. Treatment
• Treatment
– Doxycycline
– Chronic disease – long course
• 2 to 3 years of medication
• Immunity
– Long lasting (possibly lifelong)
Center for Food Security and Public Health, Iowa State University, 2011
23. Dairy Farmer Case
• Male dairy farmer
– Age 46
– Sudden onset of fever,
chills, cough
– Initially diagnosed as influenza
– Symptoms persisted for 2 weeks
– Presented to emergency room
– Again diagnosed as influenza
Center for Food Security and Public Health, Iowa State University, 2011
24. Dairy Farmer Case
• Referral to infectious disease specialist
– Tested positive for Q fever
– Antibiotics for 5 days
– Resolved in 2 weeks
• Epidemiology
– No recent calvings on his farm
– Two beef cattle herds across the road
• 2 out of 14 tested positive for Q fever
Center for Food Security and Public Health, Iowa State University, 2011
25. Urban Outbreak Case
• 1985, Nova Scotia, Canada
– 33 cases of Q fever
• 25 were exposed to cat
• 17 developed cough
• 14 developed pneumonia
– Symptoms
• Fever, sweats, chills, fatigue,
myalgia, headache
– Cat tested positive for C. burnetii
Center for Food Security and Public Health, Iowa State University, 2011
27. Animal Disease
• Sheep, cattle, goats
– May be asymptomatic
– Reproductive failure
• Abortions
• Stillbirths
• Retained placenta
• Infertility
• Weak newborns
• Low birth weights
– Carrier state
Center for Food Security and Public Health, Iowa State University, 2011
28. Animal Disease
• Other animal species
– Dogs, cats, horses, pigs
– Most other mammals
– Fowl species
• Often asymptomatic
• Reproductive failure may occur
Center for Food Security and Public Health, Iowa State University, 2011
29. Post Mortem Lesions
• Placentitis
– Leathery and thickened
– Purulent exudate
• Edges of cotyledons
• Intercotyledonary areas
• Aborted fetus
– Non-specific
Center for Food Security and Public Health, Iowa State University, 2011
30. Diagnosis and Treatment
• Diagnosis
– Identification of organism
– PCR
– Serologic tests: IFA, ELISA, CF
– Isolation of organism
• Hazardous - Biosafety level 3
• Treatment
– Tetracycline prior to parturition
Center for Food Security and Public Health, Iowa State University, 2011
31. Morbidity and Mortality
• Prevalence unknown
• Endemic areas
– 18 to 55% of sheep with antibodies
– 82% of dairy cattle
• Morbidity in sheep: 5 to 50%
• Death is rare
Center for Food Security and Public Health, Iowa State University, 2011
33. Prevention and Control
• Good husbandry
– Tick prevention
– Disposal of birth products
• Separate new or sick animals
• Vaccination
– Human and animal
– Not available in U.S.
Center for Food Security and Public Health, Iowa State University, 2011
34. Prevention and Control
• Pasteurization
• Disinfection
– 10% bleach
• Eradication not practical
– Too many reservoirs
– Constant exposure
– Stability of agent in environment
Center for Food Security and Public Health, Iowa State University, 2011
35. Q Fever as a Biological Weapon
• Accessibility
• Low infectious dose
• Stable in the environment
• Aerosol transmission
• WHO estimate
– 5 kg agent released on 5 million persons
• 125,000 ill - 150 deaths
• Could travel downwind for over 20 km
Center for Food Security and Public Health, Iowa State University, 2011
36. Additional Resources
• World Organization for Animal Health (OIE)
– www.oie.int
• U.S. Department of Agriculture (USDA)
– www.aphis.usda.gov
• Center for Food Security and Public Health
– www.cfsph.iastate.edu
• USAHA Foreign Animal Diseases
(“The Gray Book”)
– www.usaha.org/Portals/6/Publications/FAD.pdf
Center for Food Security and Public Health, Iowa State University, 2011
37. Acknowledgments
Development of this presentation was made possible
through grants provided to
the Center for Food Security and Public Health at Iowa
State University, College of Veterinary Medicine from
the Centers for Disease Control and Prevention,
the U.S. Department of Agriculture,
the Iowa Homeland Security and
Emergency Management Division, and the
Multi-State Partnership for Security in Agriculture.
Authors: Radford Davis, DVM, MPH; Glenda Dvorak, DVM, MS, MPH, DACVPM;
Ann Peters, DVM, MPH
Reviewers: Kerry Leedom Larson, DVM, MPH, PhD
Center for Food Security and Public Health, Iowa State University, 2011