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1. Jamieson DJ, Theiler RN & Rasmussen SA, Emerging Infections and Pregnancy. Emerging Infectious Diseases, 2006; Vol 12, N0 11: 1638-43.
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parvovirus and human immunodeficiency virus. Pediatr Infect Dis J.1989;8:459-468.
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40. Patra S, Kumar A, Trivedi SS et al. Maternal and fetal outcomes in pregnant women with acute hepatitis E virus infection. Ann Intern Med. 2007;147(1):28.

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1. Raz R. Hormone replacement therapy or prophylaxis in postmenopausal women with recurrent urinary tract infection, J Infect Dis 2001; 183 (Suppl 1): S74-6.
2. Foxman B, Somsel P, Tallman P, Gillespie B, Raz R, Colodner R, Kandula D, Sobel JD. Urinary tract infection among women aged 40-65: behavioral and sexual risk factors.J of
Clin Epidemiol 2001; 54:710-718
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4. Jackson SL, Boyko EJ, Scholes D, Abraham L, Gupta K, Fihn SD. Predictors of urinary tract infections after menopause: A prospective study. Am J Med 2004; 117: 903-911
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Med 2008; 23(5): 595-9.
6. Nicolle LE , Asymptomatic bacteriuria in the elderly. Infect Dis Clin North Am 1997; 11:647-662
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8. Dontas A, Kasviki-Charvati P, Papanayiotou P, Marketos S. Bacteriuria and survival in old age. N Engl J Med 1981; 304: 939-943.
9. Nordenstam G, Brandberg A, Oden A, Svanborg-Eden C, Svanborg A. Bacteriuria and mortality in an elderly population. N Engl J Med 1986; 314: 1152-1156.
10. Platt R, Polk B, Murdock B, Rosner B. Mortality associated with nosocomial urinary tract infection. N Engl J Med 1982; 307: 637-642.
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1186.
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Maturitas 1981; 3:321-7
14. Thomas TM, Plymat KR, Blannin J et al. Prevalence of urinary incontinence. Br Med J 1980; 281: 1243-5
15. Raz R, Intravaginal estriol and the bladder. JAMA 1999; Chapter 24 pages 1-3, The millennium review 2000. The management of the menopause.]
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safety aspects. Maturitas 1980; 2: 275-82
17. Raz R, Stamm WE. A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections. N Engl J Med. 329(11): 753-6, 1993.
18. Eriksen BC. A randomized, open, parallel-group study on the preventive effect of an estradiol-releasing vaginal ring (Estring) on recurrent urinary tract infections in postmenopausal women. Am J Obstet Gynecol 1999; 180: 1072-9
19. Raz R, Colodner R, Rohana Y, Batino S, Rottensterich E, Wasser I, Stamm W Effectiveness of estriol-containing vaginal pessaries and nitrofurantoin macrocrystal therapy in
the prevention of recurrent urinary tract infection in postmenopausal women. CID 2003; 36:1362-8
20. Brown JS, Vittinghoff E, Kanaya AM, Agarwal SK, Hulley S, Foxman B. Urinary tract infections in postmenopausal women: Effect of hormone therapy and risk factors.
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trial in older women. J of Antimicrob Chemot. 2009; 63: 389-395.
24. Avorn J, Monane M, Gurwitz JH, Glynn RJ, Choodnovskiy I, Lipsitz LA. Reduction of bacteriuria and pyuria after ingestion of cranberry juice. JAMA 1994; 271:7514.

17


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23

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1. Methicillin Resistant Staphylococcus aureus : An evolving clinical challenge. Clinical Infect Dis 2008; 46: S342-S343
2. Battouli Said-Salim PhD; Barun Mathema, MPH; Barry N. Kreiswirth, PhD. community-acquired Methicillin Resistant Staphylococcus aureus: An Emerging pathogen. Infect
control Hosp Epidemiol 2003;24:451-455
3. Nicola Zetola; John S Francis; Eric L Neumberger; William R Bishai Community- acquired Methicillin Resistant Staphylococcus aureus: An Emerging threat Lancet Infect Dis
2005;5; 257- 286
4. Helen W Boucher and G. Ralph Corey. Epidemiology of Methicillin Resistant Staphylococcus aureus. Clinical Infect Dis 2008; 46: S344-S349
5. Mark D King MD, MS; Bianca J. Humphrey, BS; Yun F Wang, PhD; Ekaterina V. Kourbatova, MD, MPH; Susan M. Ray and Henry M. Blumbeg MD. Emergence of communityacquired Methicillin Resistant Staphylococcus aureus USA 300 Clone as the predominant Cause of Skin and soft tissue infections Ann Intern Med 2006; 144: 309-317
6. Jacob Kuint; Asher Barzilai; Gilli Regev- Yochay; Ethan Rubinstein; Nati Keller; Ayala Maayan- Metzger Comparison of community-acquired Methicillin Resistant
Staphylococcus aureus bacteremia to other staphylococcal species in a neonatal intensive care unit Eur J Pediatr 2007;166: 319-325
7. Schlesinger Y, Yahalom S, Raveh D,Yinnon AM, Segel R, Erlichman M, Attias D, Rudensky B. Isr Med Assoc J. 2003 Dec; 5(12); 847-851
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Cardiology 1997; 30:1072- 1078
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with Methicillin Resistant Staphylococcus aureus (MRSA) in Patients admitted to an urban hospital. Emergence of community associated MRSA. Clinical Infect Dis 2005; 41:
159-166
13. Muto CA, Jernigan JA, Ostrowsky BE et al. SHEA guidelines for preventing nosocomial transmission of multi drug resistant Staphylococcus aureus and enterococcus. Infect
control Hosp Epidemiol 2003; 24: 362-386

27

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5. Fowler VG, Boucher HW, Corey GR etal. S.aureus Endocarditis and Bacteremia Study Group. Daptomycin versus standard therapy for bacteremia and endocarditis caused
by Staphylococcus aureus. N Engl J Med 2006; 355: 653665.
6. Silverman JA, Mortin LI, Vanpraagh AD, Li T, Alder J. Inhibition of daptomycin by pulmonary surfactant: invitro modeling and clinical impact. J Infect Dis 2005; 191:
21492152.
7. Hidron AI, Schuetz AN, Nolte FS, Gould CV, Osborn MK. Daptomycin resistance in Enterococcus faecalis prosthetic valve endocarditis. J Antimicrob Chemother.
2008;61(6):1394-6.
8. Moellering RC, Linden PK, Reinhardt J, Blumberg EA, Bompart F, Talbot GH. The efficacy and safety of quinupristin/dalfopristin for the treatment of infections caused by
vancomycin-resistant Enterococcus faecium. Synercid Emergency-Use Study Group. J Antimicrob Chemother 1999; 44: 251261.
9. Stamatakis MK, Richards JG. Interaction between quinupristin/dalfopristin and cyclosporine. Ann Pharmacother 1997; 31: 576578.
10. Guay DR. Oritavancin and tigecyline: investigational antimicrobials for multi-drug resistant bacteria. Pharmacotherapy 2004;24: 5868.
11. Van Bambeke F. Glycopeptides in clinical development: pharmacological profile and clinical perspectives. Curr Opin Pharmacol 2004;4: 471478.
12. Pace JL, Yang G. Glycopeptides: update on an old successful antibiotic class. Biochem Pharmacol 2006;71: 968980.
13. Dorr MB, Jabes D, Cavaleri M etal. Human pharmacokinetics and rationale for once-weekly dosing of dalbavancin, a semisynthetic glycopeptide. J Antimicrob Chemother
2005;55 (suppl 2): 2530.
14. French G.L. What's new and not so new on the antimicrobial horizon? Clinical Microbiol and Infection 2008;14(Suppl. 6) 19-29.
15. Kohloff SA, Robin PM, Reznik T, Hawser S, Islam K, Hammershlag MR. In vitro activity of a novel diamino-pyrimidine compound, iclaprim, against Chlamydia trachomatis
and C. Pneumoniae. Antimicrobial Agents Chemotherapy 2004;48: 1885-1886.
16. Pankey GA. Tigecyline. J Antimicrob Chemother 2005; 56: 470480.
17. Abbanat D, Morrow B, Bush K. New agents in development for the treatment of bacterial infections. Curr Opin Pharmacol. 2008;8(5):582-92.

30

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1. Lazzarin A, et-al: NEJM 2003:348 (22): 2186-2195
2. Clotet B, et-al: Lancet 2007: 369: 1169-1178
3. Murri R, et-al: Aids patient care STDs 2009: 23 (1): 35-39
4. Grossman Z, et-al: CID 2005: 40 (2): 294-302
5. Lundgren J, et-al: CROI 2009, Feb: Abs 44LB
6. DeMeyer S, et al. 15th CROI; Boston, MA (2008); Abst. 874.
7. Hardy D, et al. 15th CROI; Boston, MA (2008); Abst. 792.
)8. Demarest J, et-al: 11th CROI; SF, USA (2004
9. Wilkin TJ, et-al: Antimicrob. Agents. Chemotherapy 2005: 49: 4721-4732
10. Haubrich R and Johnson M, et al. 15th CROI; Boston, MA (2008); Absts. 790 and 791.
11. Cooper D and Steigbigel R, et al. 15th CROI; Boston, MA (2008); Absts. 788 and 789.

36

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Saharan
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39

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Incubation Time

Parasites
)Malaria (all species
Viruses
Dengue Fever
Viral hemorrhagic fever
Bacteria
Bacterial diarrhea
Typhoid & Paratyphoid fever
Rickettsia
Leptospira
Brucella
Meningococcemia

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Viral hepatitis A, E
Typhoid & Paratyphoid fever
)Acute Schistosomiasis (katayama Fever

)Medium (15-60 days

)Malaria (non falciparum

Amebic liver abscess
Viral hepatitis B
Tuberculosis
Visceral leishmaniasis

)Long (> 60 days

:3 ( )% . 3
Country of Origin
]Israel [3

Australia
][9

Canada
][10

]England [7

163

232

587

195

Number of patients

1999-2003

1997-1999

1981-1988

1992-1993

Study years

33

27

32

42

Malaria

24

11

2.6

RTI

14

4.5

6.7

Febrile diarrheal
diseases

17

6.2

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1.5

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2.6

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0.5

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0.4

1.6

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21

25

24

Undetermined fever

Destination:

38

15

NA

60

Africa

53

61

NA

Asia

NA

Latin America

20

NA

NA

Pacific

.

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} {
1. Berko-Ball J: A Profile of Israeli Travelers to Endemic Countries: A National Survey Israel Society for Parasitology, Protozoology and Tropical Medicine Annnual Meeting,
Ramat Gan, Israel, December 10-11, 2007, 2007.
2. Wilson ME, Weld LH, Boggild A, et al.: Fever in returned travelers: results from the GeoSentinel Surveillance Network. Clin Infect Dis 2007; 44(12): 1560-8.
3. Stienlauf S, Segal G, Sidi Y, Schwartz E: Epidemiology of travel-related hospitalization. J Travel Med 2005; 12(3): 136-41.
4. Meltzer E, Sadik C, Schwartz E: Enteric fever in Israeli travelers: a nationwide study. J Travel Med 2005; 12(5): 275-81.
5. Leshem E, Maor Y, Meltzer E, Assous M, Schwartz E: Acute schistosomiasis outbreak: clinical features and economic impact. Clinical Infectious Diseases 2008; 47(12):
1499-506.
6. Sejvar J, Bancroft E, Winthrop K, et al.: Leptospirosis in "Eco-Challenge" athletes, Malaysian Borneo, 2000. Emerg Infect Dis 2003; 9(6): 702-7.
7. Doherty JF, Grant AD, Bryceson AD: Fever as the presenting complaint of travellers returning from the tropics. Qjm 1995; 88(4): 277-81.
8. Bottieau E, Clerinx J, Van den Enden E, et al.: Fever after a stay in the tropics: diagnostic predictors of the leading tropical conditions. Medicine (Baltimore) 2007; 86(1): 18-25.
9 O'Brien D, Tobin S, Brown GV, Torresi J: Fever in returned travelers: review of hospital admissions for a 3-year period. Clin Infect Dis 2001; 33(5): 603-9.
10. MacLean J, Lalonde R, Ward B: Fever from the tropics. Travel Medicine Advisor 1994; 5(27): 2-14.
11. Wilder-Smith A, Schwartz E: Dengue in travelers. N Engl J Med 2005; 353(9): 924-32.
12. Connor BA, Schwartz E: Typhoid and paratyphoid fever in travellers. Lancet Infect Dis 2005; 5(10): 623-8.
13. Meltzer E, Artom G, Marva E, Assous MV, Rahav G, Schwartzt E: Schistosomiasis among travelers: new aspects of an old disease. Emerging Infectious Diseases 2006; 12(11):
1696-700.
14. van Crevel R, Speelman P, Gravekamp C, Terpstra WJ: Leptospirosis in travelers. Clin Infect Dis 1994; 19(1): 132-4.

41

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} {
1. Bialek SR, Terrault NA. The changing epidemiology and natural history of hepatitis C virus infection. Clin Liver Dis 2006;10(4):697-715.
2. Zeuzem S. Interferon-based therapy for chronic hepatitis C: current and future perspectives. Nat Clin Pract Gastroenterol Hepatol 2008;5(11):610-22.
3. McHutchison JG, et al. Adherence to combination therapy enhances sustained response in genotype-1-infected patients with chronic hepatitis C. Gastroenterology. 2002
Oct;123(4):1061-9.
4. Reddy KR, et al. Impact of ribavirin dose reductions in hepatitis C virus genotype 1 patients completing peginterferon alfa-2a/ribavirin treatment. Clin Gastroenterol Hepatol 2007 ;5(1):124-9.
5. Fried MW et al. Peginterferon alpha-2a plus ribavirin for chronic hepatitis C virus infection. N Engl J Med 2002;347: 975982.
6. Zeuzem S et al. Efficacy of 24 weeks treatment with peginterferon alfa-2b plus ribavirin in patients with chronic hepatitis C infected with genotype 1 and low pretreatment
viremia. J Hepatol 2006;44: 97103.
7. Pearlman BL et al. Treatment extension to 72 weeks of peginterferon and ribavirin in hepatitis C genotype 1-infected slow responders. Hepatology 2007;46:16881694.
8. Yuan HJ, Lee WM. Nonresponse to treatment for hepatitis C: current management strategies. Drugs. 2008;68(1):27-42.

43

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ALT

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20,000 IU/ml

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Antiviral and

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)??Long term (for life

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Yes

No

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Oral

Subcutaneous

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Few

Many

Side effects

Decrease in disease
progression
)(Lamivudine

Unknown

Long term effects

Tenofovir
48wk

Telbuvidine
52wk

Entecavir
48wk

Adefovi
48wk

Lamivudine
48wk

Peginterferon
Alfa-2

Parameter

76%

60%

67%

21%

44%

25%

HBVDNA loss

21%

22%

21%

12%

16%

27%

HBeAg seroconversion

69%

77%

68%

48%

41%

39%

ALT normalization

N/A

80%

69%

90%

50%

N/A

Durability of response

0%

5% at 1y, 25%
at 2y

0.2% at 1y
1.2% at 5y

0% at 1y, 29%
at 5y

19% at 1 y 69%
at 5 y

no

Resistance

93%

88%

90%

51%

60%

63%

HBVDNA loss

77%

74%

78%

72%

63%

38%

ALT normalization

.3 B
HBeAg positive

HBeAg negative

45

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} {
1. Lai CL, Yuen MF. Chronic hepatitis B--new goals, new treatment. N Engl J Med. 2008 ;359(23):2488-91.
2. Lok AS, McMahon BJ. Chronic hepatitis B. Hepatology 2007 ;45(2):507-39
3. Lai M, Hyatt BJ, Nasser I, Curry M, Afdhal NH. The clinical significance of persistently normal ALT in chronic hepatitis B infection. J Hepatol 2007;47(6):760-7 4. Chen CJ, Yang
HI, Su J, Jen CL, You SL, Lu SN, Huang GT, Iloeje UH; REVEAL-HBV Study Group. Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA
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5. Keeffe E, Dieterich D, Han SH, Jacobson I, Martin P, Schiff E, Tobias H. A. Treatment Algorithm for the Management of Chronic Hepatitis B Virus Infection in the United States:
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6. Liaw YF, Sung JJ, Chow WC, et al. Lamivudine for patients with chronic hepatitis B and advanced liver disease. N Engl J Med 2004;351:15211531.
7. Ben-Ari Z, Mor E, Tur-Kaspa R. Experience with lamivudine therapy for hepatitis B virus infection before and after liver transplantation, and review of the literature. J Intern
Med. 2003 May;253(5):544-52.
8. Dusheiko G. Adefovir dipivoxil for the treatment of HBeAg-positive chronic hepatitis B: a review of the major clinical studies. J Hepatol. 2003;39 Suppl 1:S116-23.
9. Marcellin P, Heathcote EJ, Buti M, et al. Tenofovir disoproxil fumarate versus adefovir dipivoxil for chronic hepatitis B. N Engl Med. 2008 Dec 4;359(23):2442-55.
10. Chang TT, Gish RG, de Man R, et al. A comparison of entecavir and lamivudine for HBeAg-positive chronic hepatitis B. N Engl J Med 2006;354:10011010
11. Lai CL, Gane E, Liaw YF, et al. Telbivudine versus lamivudine in patients with chronic hepatitis B. N Engl J Med 2007;357:25762588.
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