Many clinicians routinely prescribe sulfamethoxazole-trimethoprim (SMX-TMP) or another agent to prevent the development of Pneumocystis jirovecii pneumonia (PCP) in patients receiving immunosuppressive medications, with the assumption that the risks are same as some one who is immunosuppressed from HIV. Evidence justifying such a policy is sparse.
A recent study published in J Am Acad Dermatology tried to find the right way to do this. The authors of this retrospective study examined the frequency of PCP in 198 HIV-negative patients who received immunomodulatory medications for dermatologic disorders, such as psoriasis, dermatomyositis, vasculitis, and pemphigoid.
Systemic corticosteroids, methotrexate, antimalarials, and azathioprine were the most common immunosuppressive medications used by these patients; approximately 25% received a biologic agent, such as etanercept. About 25% were concurrently receiving a prophylactic medication to prevent PCP. During an average follow-up of 8 years, PCP developed in only one patient (94 years old) not receiving PCP prophylaxis (0.7% incidence). Serious reactions to the PCP-preventive medication developed in 6% of SMX-TMP recipients and 37% of dapsone recipients.
The very low risk for PCP is too small to justify routine prophylaxis. In addition to their expense, these medications are frequently associated with adverse effects. The authors sensibly recommend that clinicians avoid routine prophylaxis in patients receiving immunosuppressive agents and that we remain alert to the uncommon possibility of PCP, especially in those with apparent risk factors, which include age >60, concurrent pulmonary disease, leukopenia, hypoalbuminemia, and CD4 counts <300/dL.
This above issue was brought on by one of my colleagues, Dr.Dioverti.. during a friendly chat ...as she had a patient on bactrim prophylaxis due to chronic steroid use. This study will help those questions for now.
What's up i am kavin, its my first time to commenting anyplace, when i read this article i thought i could also create comment due to this brilliant paragraph.
ReplyDeleteLook into my website; same day cash advance loans
It is no secret that I have a very deep and personal relationship with God. I have pushed and resisted that relationship this past year through all the bullshit I have had to go through living with Herpes but once again, God is bigger than my stubbornness and broke through that outbreak cold sore and all I had Genital Herpes. For me personally, hearing over and over how I am not good enough has really invaded my mind in the worst way possible. I completely shut down and I was just waking up like is this how life going to end this temporary herpes outbreak “fuck everybody with herpes if you know what I mean” but let's be honest here...It is a cowardly to say no to herbal medicine. It is fear based. And it is dishonest to what my heart wants. Don't build a wall around yourself because you are afraid of herbals made or taking a bold step especially when it's come to health issues and getting cure. So many young men/ women tell me over and over that Dr Itua is going to scam me but I give him a try to today I feel like no one will ever convince me about herbal medicine I accept Dr Itua herbal medicine because it's cure my herpes just two weeks of drinking it and i have been living for a year and months now I experience outbreak no more, You can contact him if you need his herbal medicine for any such diseases like, Herpes, Hepatitis, HIV, Epilepsy, Infertility, Love Spell,. Email..drituaherbalcenter@gmail.com then what's app.+2348149277967.... My advice to any sick men/women out there is simple... Be Always an open book. Be gut wrenching honest about yourself, your situation, and what you are all about. Don't hold anything back. Holding back will get you nowhere...maybe a one way ticket to lonelyville and that is NOT somewhere you want to be. So my final truth...and I'm just starting to grasp this one..
ReplyDelete, WOW WHO WILL EVE BELIEVE THAT I WILL BE THIS HAPPY TODAY, AFTER MANY YEARS OF PAIN LIVING WITH HIV VIRUS. MY NAME IS STEPHEN LIVE IN UNITED KINGDOM. IT ALL HAPPEN FEW YEARS BACK WHEN I DISCOVERED THAT MY SYSTEM IS NO LONGER FUNCTIONING WELL, SO I DECIDED TO GO FOR MEDICAL CHECKUP ALL TO DISCOVERED THAT I HAVE BEEN LIVING WITH HIV POSITIVE VIRUS AND I NEVER NOTICE IT FOR A VERY LONG TIME. AT THIS PARTICULAR POINT OF TIME I WANTED TO GIVE UP MY LIFE, BUT WHEN I WENT THROUGH THE INTERNET TO READ MORE ABOUT HIV VIRUS, I FOUND OUT THAT THIS VIRUS IS DISGUSTING BOTH INTERNAL AND EXTERNAL. GOD SO HAVE IT THAT I HARD ABOUT THIS SIMPLE WONDERFUL AND GOD SENT HERBAL DR CALLED DR AKHIGBE THE SAME DAY I WANTED TO GIVE UP EVERYTHING BECAUSE I FEEL LIFE WAS NO LONGER IMPORTANT TO ME, MANY THINGS HAPPENED BUT TO CUT THE STORY SHORT, I AM HIV NEGATIVE NOW, AND EVER SINCE I WAS CURED THERE IS NO OUTBREAK EVERYTHING HAS GONE BACK TO NORMAL AND I BELIEVE AM THE HAPPIEST PERSON ON EARTH TODAY. DR AKHIGBE NEVER ASK ME TO TESTIFY FOR HIM, I DECIDED TO DO THIS MY WAY SO THAT AS MANY THAT WILL BELIEVE AND CONTACT HIM WILL BE FREE FROM THIS DEADLY DISEASE. THIS VIRUS IS SPREADING EVERYDAY SO LET PUT OUR HANDS TOGETHER TO SAVE LIFE. BUT I KNOW MANY ARE YET TO DISCOVERED THAT THEY ARE LIVING WITH THIS VIRUS. I BELIEVE THIS IS THE MOST CRITICAL VIRUS, YOU CAN LIVE WITH IT FOR MANY YEARS AND YOU WILL NEVER NOTICE IT. WELL AM SO HAPPY TODAY ESPECIALLY WHEN MY LOST LOVE IS BACK AND WE ARE GETTING MARRIED SOON. SO MY DEAR LADIES AND GENTLEMEN LET PUT OUR HANDS TOGETHER TO SAVE AS MANY WE CAN BY SHARING THIS TESTIMONY SO THAT THOSE THAT DONT HAVE THE OPPORTUNITY TO CURE THEIR DISEASE WILL BE CURED AND BE HAPPY FOREVER, SO YOU CAN CONTACT HIM THROUGH HIS EMAIL ADDRESS, WHATSAPP NUMBER AND WEBSITE AS FOLLOWED. drrealakhigbe@gmail.com +2348142454860. http:drrealakhigbe.weebly.com
ReplyDeleteHE CAN ALSO CURE THE FOLLOWING AND AM A LIVING TESTIMONY TO IT.
DIABETES
HIV
PREGNANCY PROBLEM
HERPES
ALS
CANCER
CONTACT HIM TODAY AND YOUR LIFE WILL NEVER REMAIN THE SAME AGAIN, AM PROUD OF YOU DR AKHIGBE
Hello everyone, i am here today on this forum giving a life testimony on how I was cured from HIV Virus while this may sound discouraging and people may not be-live that HIV CURE has be found,while i was once an HIV positive i live with this disease for more than years now, i have been to so many places for help including hospitals wasted money and times hoping that i was going to get cure but nor was able, until God use someone to cure me from this disease (HIV) true the help of a man called Dr osemu with his herbal root herbs medicine. while i don’t have much to say but to give thanks and praise to God almighty who use Sir Dr osemu to extend my life for what you have done for me DR, i will not stop thanking you because you put a smile on my face again.thanks once again if you are into similar problem or with any kind of diseases you can contact Sir Dr osemu on his mail drosemusolutionhome@gmail.com or call him or whatsapp on +2348108356068and i will not stop thanking you DR osemu for what you have done for me in my life, i will keep posting to the world for them to no that you are in existence , thanks for your audience and i hope you find help like i did for what he has done for me, if you are into similar problem like HERPES,HEPATITIS B,CANCER,DIABETICS.do not wast time to contact him now his WhatsApp +2348108356068 and his email drosemusolutionhome@gmail.com.
ReplyDelete
ReplyDeleteFINALLY FREE FROM HERPES VIRUS
I thought my life had nothing to offer anymore because life became meaningless to me because I had HERPES virus, the symptoms became very severe and bold and made my family run from and abandoned me so they won't get infected. I gave up everything, my hope, dreams,vision and job because the doctor told me there's no cure. I consumed so many drugs but they never cured me but hid the symptoms inside me making it worse. I was doing some research online someday when I came across testimonies of some people of how DR PAUL ODUKU cured them from HERPES virus, I never believed at first and thought it was a joke but later decided to contact him on the details provided and when I messaged him we talked and he sent me his herbal medicine and told me to go for a test after 21 days. Within 21 days of medication the symptoms disappeared and when I went for a test Lo and behold I was NEGATIVE by the Doctor Who tested me earlier. Thank you DR PAUL ODUKU because I forever owe you my life and I'll keep on telling the world about you. If you are going through same situation worry no more and contact DR PAUL ODUKU via odukuherbalremedies@gmail.com or through his WhatsApp +2349064430408 https://naturalherbalremedyblog.wordpress.com
I have been suffering from (HERPES) disease for the last four years and had constant pain, especially in my knees. During the first year, I had faith in God that I would be healed someday.This disease started to circulate all over my body and I have been taking treatment from my doctor, a few weeks ago I came on search on the internet if I could get any information concerning the prevention of this disease, on my search I saw a testimony of someone who has been healed from (Hepatitis B and Cancer) by this Man Dr. Silver and she also gave the email address of this man and advise we should contact him for any sickness that he would be of help, so I wrote to Dr. Silver telling him about my (HERPES Virus) he told me not to worry that I was going to be cured!! hmm i never believed it,, well after all the procedures and remedy given to me by this man few weeks later I started experiencing changes all over me as the Dr. assured me that I have cured, after some time i went to my doctor to confirmed if I have been finally healed behold it was TRUE, So friends my advice is if you have such sickness or any other at all you can email Dr. Silver (drsilverhealingtemple@gmail.com) sir I am indeed grateful for the help I will forever recommend you to my friends!!! with your lovely Email Address ( drsilverhealingtemple@gmail.com you can contact him also on whatsapp +2347032474849
ReplyDeleteTestimony about Dr David the great Herbalist, he has the cure to all manner of diseases, he cured my herpes disease, though I went through different website I saw different testimonies about different spell casters and herbalist, I was like Many people have the herpes disease cure why are people still suffering from it?' I though of it, then I contact Dr. David via email, davidherbalcure519@gmail.com I didn't believe him that much, I just wanted to give him a try, he replied my mail and Needed some Information about me, then I sent them to him, he prepared it (CURE) and sent it to Fedex Online Service delivery, he gave my details to the Fedex Office, they told me that 2-3 days I will receive the package and i took the medicine as prescribed by him and I went for check-up 1 week after finishing the medicine, I was tested herpes disease negative, if you are herpes disease patient do me a favor for you to contact him and I will try my possible best to make sure you get cured, when you contact him, make sure you tell him that I referenced you.. contact him via: davidherbalcure519@gmail.com. Dr DAVID CAN AS WELL CURE THE FOLLOWING DISEASE- HIV/AIDS,HERPES,CANCER,ALS,WARTS,ANCE,HIRE BLOOD PRESSURES,YEAST,HEPATITIES A B C. Or on his Whatsapp number: +13656594152
ReplyDeletethis is real take it serious, who will believe that a herb can cure ten
ReplyDeleteyears HIV in my body, i never believe that this will work i have spend a
lot when getting drugs from the hospital to keep me healthy, what i was
waiting for is death because i was broke, one day i hard about this great
man who is well know of HIV and cancer cure, i decided to email him,
unknowingly to me that this will be the end of the HIV aids in my body, he
prepare the herb for me, and give me instruction on how to take it, at the
end of the two week, he told me to go to the hospital for a check up, and i
went, surprisingly after the test the doctor confirm me negative, i thought
it was a joke, i went to other hospital was also negative, then i took my
friend who was also HIV positive to the Dr voodoo after the treatment she
was also confirm negative . He also have the herb to cure cancer please i
want every one with this virus to be free, that is why am dropping his
email address, voodoospelltemple66@gmail.com i want you to email him he
is a great man. the government is also interested in this Dr voodoo
thank you for saving my life, and I promise I will always testify
for your good work you can also add him on whatsApp
+2348140120719