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1.
Emerg Infect Dis ; 29(3): 1-9, 2023 03.
Article in English | MEDLINE | ID: mdl-36823026

ABSTRACT

The pathogens that cause most emerging infectious diseases in humans originate in animals, particularly wildlife, and then spill over into humans. The accelerating frequency with which humans and domestic animals encounter wildlife because of activities such as land-use change, animal husbandry, and markets and trade in live wildlife has created growing opportunities for pathogen spillover. The risk of pathogen spillover and early disease spread among domestic animals and humans, however, can be reduced by stopping the clearing and degradation of tropical and subtropical forests, improving health and economic security of communities living in emerging infectious disease hotspots, enhancing biosecurity in animal husbandry, shutting down or strictly regulating wildlife markets and trade, and expanding pathogen surveillance. We summarize expert opinions on how to implement these goals to prevent outbreaks, epidemics, and pandemics.


Subject(s)
Communicable Diseases, Emerging , Zoonoses , Animals , Humans , Zoonoses/epidemiology , Pandemics , Animals, Wild , Animals, Domestic , Communicable Diseases, Emerging/epidemiology , Disease Outbreaks
2.
Proc Natl Acad Sci U S A ; 117(45): 28515-28524, 2020 11 10.
Article in English | MEDLINE | ID: mdl-33106399

ABSTRACT

Tropical forest loss currently exceeds forest gain, leading to a net greenhouse gas emission that exacerbates global climate change. This has sparked scientific debate on how to achieve natural climate solutions. Central to this debate is whether sustainably managing forests and protected areas will deliver global climate mitigation benefits, while ensuring local peoples' health and well-being. Here, we evaluate the 10-y impact of a human-centered solution to achieve natural climate mitigation through reductions in illegal logging in rural Borneo: an intervention aimed at expanding health care access and use for communities living near a national park, with clinic discounts offsetting costs historically met through illegal logging. Conservation, education, and alternative livelihood programs were also offered. We hypothesized that this would lead to improved health and well-being, while also alleviating illegal logging activity within the protected forest. We estimated that 27.4 km2 of deforestation was averted in the national park over a decade (∼70% reduction in deforestation compared to a synthetic control, permuted P = 0.038). Concurrently, the intervention provided health care access to more than 28,400 unique patients, with clinic usage and patient visitation frequency highest in communities participating in the intervention. Finally, we observed a dose-response in forest change rate to intervention engagement (person-contacts with intervention activities) across communities bordering the park: The greatest logging reductions were adjacent to the most highly engaged villages. Results suggest that this community-derived solution simultaneously improved health care access for local and indigenous communities and sustainably conserved carbon stocks in a protected tropical forest.


Subject(s)
Carbon , Conservation of Natural Resources , Delivery of Health Care , Forests , Rural Health , Adult , Climate Change , Diagnosis , Disease , Female , Forestry , Health Impact Assessment , Humans , Male , Middle Aged , Trees , Tropical Climate
3.
Arch Pathol Lab Med ; 143(8): 919-942, 2019 08.
Article in English | MEDLINE | ID: mdl-30785787

ABSTRACT

CONTEXT.­: Fatal dermatologic diseases and ones with high morbidity can occur in the inpatient setting. In such cases, prompt and accurate assessment of a bedside skin biopsy is required. This may be challenging for many pathologists who are not familiar with the complexity of skin pathology and skin terminology within the fields of dermatopathology and dermatology. OBJECTIVE.­: To provide the pathologist with a practical, up-to-date, and "must-know" reference guide on dermatologic urgencies and emergencies from a real-world perspective, highlighting diagnostic pearls, diagnostic pitfalls, and commonly encountered practice gaps. This review will focus on key diseases with which every pathologist should be familiar, including angioinvasive fungal infections, Stevens-Johnson syndrome/toxic epidermal necrolysis, staph-scalded-skin syndrome, acute graft-versus-host disease, bullous pemphigoid, calciphylaxis, Sweet syndrome and its histiocytoid variant, pyoderma gangrenosum, and leukocytoclastic vasculitis, as well as those in their clinical and histopathologic differential. DATA SOURCES.­: This review is based on peer-reviewed literature and our personal experiences with these diseases at major academic institutions, including one where a large number of stem cell transplants are performed. This review is unique as it represents collaborative expert opinion from both a dermatopathology and a dermatology standpoint. CONCLUSIONS.­: This review outlines the critical role that the pathologist plays in the outcomes of patients with dermatologic urgencies and emergencies. Improved patient care will result from prompt and accurate histopathologic diagnoses as well as an open line of communication with the dermatologist.


Subject(s)
Dermatology/statistics & numerical data , Pathologists/statistics & numerical data , Skin Diseases/diagnosis , Skin/pathology , Acute Disease , Biopsy , Dermatology/standards , Graft vs Host Disease/diagnosis , Graft vs Host Disease/etiology , Hematopoietic Stem Cell Transplantation/adverse effects , Humans , Pathologists/standards , Pathology, Clinical/standards , Pathology, Clinical/statistics & numerical data
5.
Dermatol Online J ; 23(7)2017 Jul 15.
Article in English | MEDLINE | ID: mdl-29469710

ABSTRACT

Congenital leukonychia is a rare nail disorder that may occur in isolation or in association with a number of syndromic disorders. In the following letter, we describe a case of isolated congenital true leukonychia to add to the current literature. This case is particularly unique in that it does not appear to be inherited in an autosomal dominant fashion, in contrast to the majority of reported cases.


Subject(s)
Hypopigmentation/congenital , Nail Diseases/congenital , Adolescent , Female , Fingers , Humans
6.
J Drugs Dermatol ; 13(9): 1153-4, 2014 Sep.
Article in English | MEDLINE | ID: mdl-25362747

ABSTRACT

Diaper dermatitis is the most common dermatologic disorder of infancy. Its cause can often be determined clinically based on the clinical presentation. Primary diaper dermatitis is associated with irritants and spares the deep skin folds. Secondary diaper dermatitis is most often caused by Candida yeast overgrowth and typically presents as a well-defined area of beefy red erythema covering the diaper area and including the deep folds of skin with hallmark satellite pustules. Other causes include seborrheic dermatitis, psoriasis, acrodermatitis enteropathica, allergic contact dermatitis, Langerhans cell histiocytosis, and, in the setting of a primarily pustular eruption, bacterial folliculitis. A simple potassium hydroxide preparation (KOH) can confirm the diagnosis of candida diaper dermatitis and guide proper treatment.


Subject(s)
Candidiasis, Cutaneous/complications , Candidiasis, Cutaneous/diagnosis , Diaper Rash/complications , Diaper Rash/diagnosis , Antifungal Agents/administration & dosage , Candidiasis, Cutaneous/drug therapy , Diaper Rash/drug therapy , Humans , Infant , Male
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