Animals amusing and assisting humans
Clive R. Hollin in An Introduction to Human–Animal Relationships, 2021
Another use of detection dogs lies in finding animals we see as problematic. The small oval, reddish insect Cimex lectularius, better known as the bed bug, has plagued humans for millennia (Panagiotakopulu & Buckland, 1999). An adult nocturnal bed bug is typically between 5 and 7 mm in size and does not fly, but it can move rapidly within a room. The female can lay hundreds of eggs, each about the size of a speck of dust, over a lifetime. The bed bug lives on the blood of animals or humans and their bites can leave small red bumps surrounded by blisters in a tell-tale line or zigzag pattern. Needless to say, bed bugs are unwanted and if they infest a hotel, they are a major problem. However, their size and secretiveness makes them difficult to detect, making eradication extremely difficult (Figure 6.4).
Clinician’s Guide to Common Arthropod Bites and Stings *
Gail Miriam Moraru, Jerome Goddard in The Goddard Guide to Arthropods of Medical Importance, Seventh Edition, 2019
Bed bugs produce a mostly painless bite on exposed areas of the head, neck, face, and arms during the night, which is helpful information when performing a history and physical. Not all persons react to bed bug bites; perhaps as many as 50% do not.3,4 Lesions sometimes occur in a line, but this is not due to a single bug biting and then moving a few millimeters to bite again. Instead, the linear nature of bed bug bites, often referred to as “breakfast, lunch, dinner bites”, is due to numerous bugs feeding at the skin interface where they line up to feed. At the bite site, hemorrhagic puncta may be seen. Lesions may be macular, papular (Figure 9.2), nodular, urticarial, bullous, indurated plaques, or eczematous patches depending on the host’s immune sensitivity to the bite and the length of exposure to the bug infestation. There is considerable evidence that the time-to-lesion development decreases upon subsequent biting events.5,6
Bed Bugs
Jerome Goddard in Public Health Entomology, 2022
Houses heavily infested with bed bugs may contain literally thousands of specimens under and within the bed and in the mattress seams. There may be black layers of bed bug excrement on the mattress, thousands of cast skins, and eggs several millimeters thick. Infestations like this can lead to anemia in affected individuals due to blood loss.11 The most common bite reactions are pruritic maculopapular, erythematous lesions at bed bug feeding sites, one per insect (Figure 16.4). Bite lesions may be intensely itchy, but if not abraded, and usually resolve within a week or so.12–14 Due to hyper-sensitization, the size and pruritis associated with these common reactions may increase in some individuals who experience repeated bites.15–17 Some people display more complex cutaneous reactions, including pruritic wheals (local urticaria), papular urticaria, diffuse urticaria,18–22 and even bullous lesions.22–25 There are a few reports of systemic reactions from bed bug bites, including asthma, generalized urticaria, and anaphylaxis.24,26,27 One patient staying in a hotel awakened during the night with severe itching and urticaria on his arm and neck; bed bugs were found in the room.28 He developed angioedema and hypotension, was hospitalized, and showed transient anterolateral ischemia on electrocardiogram. Eight months later, after an experimental bed bug bite, he developed a wheal at the bite site and generalized itching that required epinephrine to resolve his symptoms.
There’s No Harm in Talking: Re-Establishing the Relationship Between Theological and Secular Bioethics
Published in The American Journal of Bioethics, 2020
Michael McCarthy, Mary Homan, Michael Rozier
For example, imagine a clinical ethics consultation centered on the question of an organization’s obligation to continue treatment of an oncology patient. Simple respect for autonomy might say there is an obligation to honor the patient’s wishes, or raising other questions about payment and reimbursement. However, this consultation was not whether or not a patient should be treated, but how to remediate an ongoing bed bug problem, in particular, how to transport them to treatment when transportation services previously declined to assist because of the bed bugs and how to provide the patient clothes without them feeling insulted. What a patient wants/needs is immediately confronted by complex social structures. The question shifts from what ought we do, to what is our responsibility to bring about a good outcome for both the individual and the common good. The common good, becomes a more urgent question and requires special consideration from the perspective of those pushed to the margins of society (and our clinics).
Cutaneous side effects of hydroxychloroquine in health care workers in a COVID referral hospital – implications for clinical practice
Published in Journal of Dermatological Treatment, 2022
Kabir Sardana, Sinu Rose Mathachan, Desh Deepak, Ananta Khurana, Surabhi Sinha
All four HCWs (Table 1) had presented to the Dermatology outpatients department with pruritic rash following intake of prophylactic doses of HCQ. Our hospital is a COVID referral hospital that has doctors posted in various areas, including the COVID screening center, triage area, ward, and ICU. All HCWs posted in these areas are advised a prophylactic regimen of HCQ, wherein 400 mg twice a day is giving as a loading dose on day 1 followed by 400 mg weekly dose for 7 weeks. Out of six cases that presented, four were diagnosed as HCQ induced rash, and in three cases (Cases 1, 2, and 3) the skin rash appeared within 2–7 days of initiation of the therapy. Of the remaining two one had bed bug infestation and the second had a acneiform eruption unrelated to HCQ. On examination the lesions were diagnosed as urticaria (n = 3) maculopapular rash (n = 1) and palmoplantar itching (n = 2). There was no history of preceding intake of food, drugs including aspirin, physical causes, dental caries, sore throat, urinary tract infection, or gastrointestinal infection. Blood biochemical and hematological profile did not reveal any relevant abnormalities except raised AEC and eosinophilia in one case (case 1). The Naranjo score for causality assessment varied from 4 to 5 (probable). While all four HCWs were administered oral antihistamines, oral methylprednisolone (16 mg) was added for 1 week in the case who presented with maculopapular rash & severe pruritus (Case 1) which was not relieved on antihistamines. In two cases (Cases 1 and 3) who had palmoplantar pruritus, the symptom persisted even after 14 days use of antihistamines.
Diverting homeless substance users from hospitalization and incarceration: an innovative agency collaboration
Published in Journal of Social Work Practice in the Addictions, 2022
Once a client agrees to the program, he/she is provided transportation by law enforcement to SCDC which admits new clients from 8am–6pm, Monday-Friday. Upon arrival, law enforcement officers perform a pat down for contraband items. Law enforcement is responsible for the removal and destruction of contraband. Clients are screened for medical stability by the emergency medical technician (EMT) Lead. Once medically cleared for admission, clients take a urinary analysis test and complete the intake while staff runs clients’ belongings through the laundry and a bed bug oven. During the intake process, the EMT Lead discusses referral to Medication Assisted Treatment (MAT) which is provided onsite through a local medical provider.
Related Knowledge Centers
- Blister
- Fever
- Necrosis
- Parasitism
- Rash
- Vasculitis
- Allergy
- Infection
- Hematophagy
- Itch