Community-acquired pneumonia is a leading cause of death in the world and the sixth most common cause of death in the United States. It is the number one cause of death from infectious diseases in the United States. This article reviews the latest available guidelines from two leading organizations--the Infectious Diseases Society of America and the American Thoracic Society.
Most sexually transmitted infections (STIs) are asymptomatic--contributing to underdiagnosis estimated at 50% or more. Diagnosis of an STI signals sexual health risk because an STI facilitates the transmission and acquisition of other STIs, including human immunodeficiency virus. Undiagnosed and untreated STIs can have particularly devastating consequences for women, potentially causing significant long-term damage to women's reproductive health. The authors discuss common clinical presentations, screening, diagnosis, and treatment for trichomoniasis, chlamydia, gonorrhea, syphilis, and herpes simplex virus.
The authors retrospectively evaluated maternal and fetal outcomes of 73 consecutive singleton pregnancies complicated by preterm premature rupture of amniotic membranes. When preterm labor occurred and fetuses were at a viable gestational age, pregnant patients were managed aggressively with tocolytic therapy, antenatal corticosteroid injections, and antenatal fetal testing. Among the 73 pregnant patients, there were 22 (30.1%) stillbirths and 13 (17.8%) neonatal deaths, resulting in a perinatal death rate of 47.9%. Thirty-eight liveborn neonates survived and were subsequently released from the hospital; all surviving newborns had significant morbidity and comorbidity, however. Maternal morbidity was minimal. Pregnancy outcomes remain dismal when the fetal membrane ruptures before 23 weeks of gestation.
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