Books on the topic 'Pup mortality'
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1
Phillips, Andrew. Rural, regional and remote health: A study on mortality. 2nd ed. Canberra: Australian Institute of Health and Welfare, 2007.
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2
Lemieux, Donald R. Mortality and morbidity among Maine pulp and paper industry workers, 1984-1986. [Augusta, Maine]: Dept. of Human Services, Office of Data, Research, and Vital Statistics, 1988.
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3
(Editor), W. Zatonski, M. Smans (Editor), J. Tyczynski (Editor), and Peter Boyle (Editor), eds. Atlas of Cancer Mortality in Central Europe (DISCONTINUED (IARC Scient Pub)). IARC Scientific Publications, 1996.
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4
(Editor), Michel Smans, Calum S. Mair (Editor), and Peter Boyle (Editor), eds. Atlas of Cancer Mortality in the European Economic Community (DISCONTINUED (IARC Scient Pub)). IARC Scientific Publications, 1993.
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(Editor), F. Berrino, R. Capocaccia (Editor), J. Esteve (Editor), G. Gatta (Editor), A. Micheli (Editor), M. Sant (Editor), and A. Verdecchia (Editor), eds. Eurocare-2 Survival of Cancer Patients: In Europe in the Late Eighties (DISCONTINUED (IARC Scient Pub)). IARC Scientific Publications, 2000.
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6
E, Filipy R., Pacific Northwest Laboratory, and U.S. Nuclear Regulatory Commission. Office of Nuclear Regulatory Research. Division of Regulatory Applications., eds. Inhaled PuO nd/or total-body gamma radiation: Early mortality and morbidity in rats and dogs. Washington, DC: Division of Regulatory Applications, Office of Nuclear Regulatory Research, U.S. Nuclear Regulatory Commission, 1988.
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7
E, Filipy R., Pacific Northwest Laboratory, and U.S. Nuclear Regulatory Commission. Office of Nuclear Regulatory Research. Division of Regulatory Applications., eds. Inhaled PuO nd/or total-body gamma radiation: Early mortality and morbidity in rats and dogs. Washington, DC: Division of Regulatory Applications, Office of Nuclear Regulatory Research, U.S. Nuclear Regulatory Commission, 1988.
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8
E, Filipy R., Pacific Northwest Laboratory, and U.S. Nuclear Regulatory Commission. Office of Nuclear Regulatory Research. Division of Regulatory Applications., eds. Inhaled ²³⁹PuO₂ nd/or total-body gamma radiation: Early mortality and morbidity in rats and dogs. Washington, DC: Division of Regulatory Applications, Office of Nuclear Regulatory Research, U.S. Nuclear Regulatory Commission, 1988.
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9
(Editor), R. Sankaranarayanan, R. J. Black (Editor), and D. M. Parkin (Editor), eds. Cancer Survival in Developing Countries (DISCONTINUED (IARC Scient Pub)). IARC Scientific Publications, 1999.
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10
Nava, Stefano, and Luca Fasano. Ventilator Liberation Strategies. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199653461.003.0039.
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The weaning process should ideally begin as soon as the patient is intubated and continue through the treatment of the cause inducing acute respiratory failure. Weaning includes the assessment of readiness to extubate, extubation, and post-extubation monitoring; it also includes consideration of non-invasive ventilation which has been shown to reduce the duration of invasive mechanical ventilation in selected patients. Weaning accounts for approximately 40% of the total time spent on mechanical ventilation and should be achieved rapidly, since prolonged mechanical ventilation is associated with increased risk of complications and mortality and with increased costs. During mechanical ventilation, medical management should seek to correct the imbalance between respiratory load and ventilatory capacity (reducing the respiratory and cardiac workload, improving gas exchange and the ventilatory pump power). Ventilator settings delivering partial ventilatory pump support may help prevent ventilator-induced respiratory muscles dysfunction. Daily interruption of sedation has been associated with earlier extubation. Critically ill patients should be repeatedly and carefully screened for readiness to wean and readiness to extubate, and objective screening variables should be fully integrated in clinical decision making.
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Schröder, Fritz H. Screening for prostate cancer. Edited by James W. F. Catto. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199659579.003.0062.
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Screening for a disease must be clearly defined and differentiated from early detection. ‘Screening’ refers to the application of tests to the whole population or to defined segments such as males within certain defined high risk age groups. If applied in such a fashion ‘screening’ for prostate cancer may also be described epidemiologically as ‘secondary prevention’. While high-quality randomized studies show that screening reduces prostate cancer mortality by 21–44%, there is wide agreement that the introduction of population-based screening is at present premature because harms, mainly the high rate of overdiagnosis seen currently outweighs the benefits. This chapter attempts to put current knowledge into perspective with a set of recognized prerequirements for the application of screening, established by Wilson and Jungner in 1968.
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Alhazzani, Waleed, and Deborah J. Cook. Stress ulcer prophylaxis and treatment drugs in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0041.
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Many changes have occurred over the last three decades in the field of stress ulcer gastrointestinal bleeding and its prevention. The topic is controversial, fuelled by disparate data, studies at risk of bias, and the impression that the problem is not as serious as it once was. Indeed, compared with over four decades ago when mucosal ulceration of the stomach causing serious bleeding was first described, a relatively small proportion of critically-ill patients now develop clinically important bleeding. Acid suppression is commonly prescribed for stress ulcer prophylaxis (SUP), targeting subgroups of patients at high risk in the intensive care unit (ICU), rather than universal prevention. The randomized clinical trials to date suggest a significant reduction in CIB with use of histamine-2-receptor antagonists (H2RAs) compared with no SUP, with no impact on pneumonia, ICU mortality, or length of stay. However, these trials are of moderate quality. More recent RCTs suggest proton pump inhibitors compared with H2RAs may significantly reduce the risk of CIB without influencing the risk of pneumonia, ICU mortality, or length of stay. These trials are also of moderate quality. Today, the decision whether to use SUP, and which agent to use, is complex. Clinical considerations include local epidemiological data (for centres documenting these outcomes), and patient-specific risks of gastrointestinal bleeding and infection, indexed to case mix.
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Henggeller, Michelle. Infections in the HIV Patient. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199976805.003.0055.
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The hallmark of the human immunodeficiency virus (HIV) patient with a cluster of differentiation 4 (CD4) T lymphocyte count below 200 is the development of opportunistic infections. Although the use of antiretroviral therapy (ART) has decreased the incidence of these infections, they continue to be a major case of morbidity and mortality in the patient with HIV. These infections can be respiratory in nature and present with cough or shortness of breath: Pneumocystis pneumonia (PCP), tuberculosis (TB), aspergillosis, and coccidioidomycosis. Neurological infections, which can present with change in mental status, include toxoplasmosis encephalitis (TE), meningoencephalitis, John Cunningham (JC) virus, and progressive multifocal leukoencephalopathy (PML). Gastrointestinal infections, such as Cryptosporidium, present with abdominal pain and diarrhea. Viral changes can result from cytomegalovirus retinitis. Fever or nonspecific symptoms can result from disseminated Mycobacterium Avium complex disease, histoplasmosis, bartonellosis, and cytomegalovirus.
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Shepherd, Gillian. Where Are the Children? Locating Children in Funerary Space in the Ancient Greek World. Edited by Sally Crawford, Dawn M. Hadley, and Gillian Shepherd. Oxford University Press, 2018. http://dx.doi.org/10.1093/oxfordhb/9780199670697.013.28.
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Children are often underrepresented in ancient Greek cemeteries in terms of retrievable burials, and their visibility in major formal city cemeteries can vary considerably with time and space. However, given that child mortality—especially perinatal death—must always have been high, there remain questions regarding the nature and location of the disposal of deceased children in periods and places where it is clear they did not receive formal burial alongside adults in city cemeteries. This chapter seeks to gather and analyse in a more systematic manner the evidence for child burials outside city cemeteries and to put forward some suggestions regarding the disposal of children where their burials continue to elude us; it also examines more specifically the locations of retrieved child burials and highlights the considerable variations in acceptable destinations for deceased children in the ancient Greek world.
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Pajnkihar, Majda, and Dominika Vrbnjak, eds. Advanced Nursing Practice: International Experiences and Future Direction for Nursing in Slovenia, Book of Abstracts. University of Maribor Press, 2021. http://dx.doi.org/10.18690/978-961-286-499-6.
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First international Advanced Nursing Practice conference in Slovenia brought world leading academic scholars to exchange and share their experiences on Advance Nursing Practice (ANP) education and practice. Special emphasis will be put on presentation of competencies, roles and scope of practice. Aim of our conference was to bring ANP education and especially the nature of ANP practice closer to an academic and clinical environment as well to decision making bodies in government and other professional groups in Slovenia. Numerous studies have shown that advanced practice nurses can provide quality patient care by role extension or expansion, contribute to efficacy, cost efficiency, patient satisfaction, reduced (re)hospitalizations, and reduced mortality. Experts from countries where ANP is well established and experts from countries where ANP is in the beginning stages of development participated in round table discussion. Conclusions of the round table discussion produced future direction for development of ANP in Slovenia.
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Taggart, David, and Yasir Abu-Omar. Heart surgery. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0098.
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Cardiac surgery is still a relatively young specialty, having been developed only in the latter half of the twentieth century with the introduction of extracorporeal circulation or ‘cardiopulmonary bypass’ (CPB). This initiated the era of open heart surgery, initially allowing the repair of congenital heart defects, then valve replacements, coronary artery bypass grafting (CABG), and, finally, heart transplantation. Over the last two decades, improvements in medical, anaesthetic, and surgical management of patients, allied to refinements in extracorporeal perfusion technology, have resulted in a decreasing mortality and morbidity from heart surgery despite the advanced age and significant comorbidity of many patients. Today, heart surgery continues to improve the prognosis and quality of lives of patients around the world. Surgical techniques and technologies continue to evolve and recent years have witnessed the emergence of, amongst others, the use of long-lasting conduits for CABG procedures, beating-heart (‘off-pump’) surgery, the use of minimally invasive and robotic techniques, and long-term mechanical circulatory support.
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Taggart, David P., and John D. Puskas, eds. State of the Art Surgical Coronary Revascularization. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198758785.001.0001.
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State of the Art Surgical Coronary Revascularization is an authoritative textbook dedicated to the art and science of surgical coronary revascularization, with 71 chapters, organized in nine sections, and written by over 100 recognized world experts. The textbook covers every aspect of the surgical management of coronary artery pathology and ischaemic heart disease. It provides extensive sections detailing pathophysiology, evaluation, and medical and percutaneous management of ischaemic heart disease as well as general outcomes and quality assessment for coronary artery bypass grafting. Pre-, intra- and postoperative management of coronary artery bypass graft patients is emphasized in detail as are the core surgical principles in the conduct of coronary artery bypass grafting, with special focus on the selection of conduits and how to optimize the performance of both on- and off-pump surgery to reduce morbidity and mortality. There are detailed sections on how to improve outcomes with both arterial and venous bypass grafts.
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van Hooijdonk, Roosmarijn T. M., and Marcus J. Schultz. Insulin and oral anti-hyperglycaemic agents in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0050.
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Dysglycaemia is frequently seen in the intensive care unit (ICU). Hyperglycaemia, hypoglycaemia and glycaemic variability are all independently associated with mortality and morbidity in critically-ill patients. It is common practice to treat hypergycaemia in these patients, while at the same time preventing hypoglycaemia and glycaemic variability. Insulin infusion is preferred over oral anti–hyperglycaemic agents for glucose control in the ICU because of the highly unpredictable biological availability of oral anti-hyperglycaemic agents during critical illness. Many oral anti–hyperglycaemic agents are relatively contraindicated in critically-ill patients. Intravenously-administered insulin has a predictable effect on blood glucose levels, in particular because of its short half-life. Notably, effective and safe insulin titration requires frequent blood glucose measurements, a dedicated lumen of a central venous catheter for infusion of insulin, an accurate syringe pump, and trained nurses for delicate adoptions of the infusion rate. Insulin infusion increases the risk of hypoglycaemia, which should be prevented at all times. In addition, precautions should be taken against overcorrection of hypoglycaemia, using only small amounts of glucose. Whether glycaemic variability can be kept minimal is uncertain. Use of continuous glucose measuring devices has the potential to improve glycaemic control in critically-ill patients.
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Cheong, Adrian, Gabriel Steg, and Stefan K. James. ST-segment elevation myocardial infarction. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0043.
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Acute myocardial infarction with ST-segment elevation is a common and dramatic manifestation of coronary artery disease. It is caused by the rupture of an atherosclerotic plaque in a coronary artery, leading to its total thrombotic occlusion and resultant ischaemia and necrosis of downstream myocardium. The diagnosis of ST-segment elevation myocardial infarction is based on a syndrome of ischaemic chest pain symptoms, associated with typical ST-segment elevation on the electrocardiogram and an eventual rise in biomarkers of myocardial necrosis. The treatment of ST-segment elevation myocardial infarction is focused on re-establishing blood flow in the coronary artery involved, preferably by percutaneous coronary intervention, or by pharmacological thrombolysis in the case of expected lengthy time delays or lack of availability of facilities. Early mortality from ST-segment elevation myocardial infarction can be attributed to the sequelae or complications of myocardial ischaemia, or complications related to therapy. The former include arrhythmias (such as ventricular tachycardia or fibrillation), mechanical complications (such as ventricular free wall, septal, and mitral chordal rupture), and pump failure leading to cardiogenic shock. The latter includes haemorrhagic complications and coronary stent thrombosis. Given that myocardial necrosis is a critically time-dependent process, the organization of an ST-segment elevation myocardial infarction care system and adherence to the latest clinical trial evidence and guidelines are crucial to ensure that patients are treated in an optimal manner.
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Cheong, Adrian P., Gabriel Steg, and Stefan K. James. ST-segment elevation MI. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0043_update_001.
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Acute myocardial infarction with ST-segment elevation is a common and dramatic manifestation of coronary artery disease. It is caused by the rupture of an atherosclerotic plaque in a coronary artery, leading to its total thrombotic occlusion and resultant ischaemia and necrosis of downstream myocardium. The diagnosis of ST-segment elevation myocardial infarction is based on a syndrome of ischaemic chest pain symptoms, associated with typical ST-segment elevation on the electrocardiogram and an eventual rise in biomarkers of myocardial necrosis. The treatment of ST-segment elevation myocardial infarction is focused on re-establishing blood flow in the coronary artery involved, preferably by percutaneous coronary intervention, or by pharmacological thrombolysis in the case of expected lengthy time delays or lack of availability of facilities. Early mortality from ST-segment elevation myocardial infarction can be attributed to the sequelae or complications of myocardial ischaemia, or complications related to therapy. The former include arrhythmias (such as ventricular tachycardia or fibrillation), mechanical complications (such as ventricular free wall, septal, and mitral chordal rupture), and pump failure leading to cardiogenic shock. The latter includes haemorrhagic complications and coronary stent thrombosis. Given that myocardial necrosis is a critically time-dependent process, the organization of an ST-segment elevation myocardial infarction care system and adherence to the latest clinical trial evidence and guidelines are crucial to ensure that patients are treated in an optimal manner.
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Castle, David J., Peter F. Buckley, and Fiona P. Gaughran. Physical Health and Schizophrenia (Oxford Psychiatry Library). Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198811688.001.0001.
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The association between mental health and physical health forms the core of this book. While it is recognized that serious mental illnesses such as schizophrenia carry a reduced life expectancy, it is often assumed that suicide is the main cause of this disparity. But in actuality, suicide accounts for no more than a third of the early mortality associated with schizophrenia: the vast majority is due to cardiovascular factors. This book seeks to put this stark fact in context, detailing the extent of cardiovascular risk, sharing information regarding reasons for this excess, and outlining approved approaches for screening for and treatment of such risk factors in people with schizophrenia. As such, this book seeks to inform those caring for people with schizophrenia of these parameters and suggests ways in which they may be addressed, using a holistic model which embraces shared decision-making and which is compatible with the recovery framework. It provides guidance regarding monitoring as well as information about focused interventions that can help ameliorate risk. It also addresses those physical health factors apart from cardiovascular, that add to the burden of ill health amongst people with schizophrenia: pulmonary health, bone health, sexual health, and cancer risk are just some of these. In addition, the book provides patient and carer information material that can be used to try to ensure that all involved have a truly informed role in decision-making about their treatment and that both psychiatric and physical health issues are taken seriously.
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Scarpa, Raffaele, Francesco Caso, Luisa Costa, Rosario Peluso, Nicola Matteo Dario Di Minno, and Antonio Del Puente. Peripheral arthritis. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198737582.003.0010.
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Clinical presentation of peripheral arthritis in patients with psoriatic arthritis (PsA), has been described by Moll and Wright who classified it into four subsets: symmetrical polyarthritis, asymmetrical oligoarthritis, distal interphalangeal (DIP) arthritis and arthritis mutilans. In the symmetrical polyarthritis subset, the distribution of articular involvement is similar to rheumatoid arthritis and this has for many years justified the inappropriate use of the terminology ‘rheumatoid-like form’, at present completely abandoned. Oligoarthritis is characterized by asymmetrical involvement of few joints (less than four), which include scattered DIP or proximal interphalangeal (PIP) joints and/or metatarsophalangeal joints. DIP arthritis may occur with symmetrical or asymmetrical features, and it is often in strict association with onycopathy. The arthritis mutilans pattern is characterized by osteolysis of phalanx and metacarpals and it is very rare, occurring in less than 1% of patients with established form of arthritis. In 15-20% of the cases the arthritis may precede the onset of the psoriatic skin rash. Consequently, psoriatic arthritis ‘sine psoriasis’ should not be considered a rare clinical finding. In this subset articular involvement is clinically expressed, while cutaneous is apparently absent. Laboratory tests and imaging are relevant for differential diagnosis which in some presentations may represent a diagnostic challenge. The outcome of peripheral patterns of PsA patients is related not only to the spectrum of peripheral phenotypes, but also to early diagnosis, and metabolic aspects, which may affect excess in morbidity and mortality.
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Marshik, Celia. At the Mercy of Their Clothes. Columbia University Press, 2017. http://dx.doi.org/10.7312/columbia/9780231175043.001.0001.
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In much of modern fiction, it is the clothes that make the character. Garments embody personal and national histories. They convey wealth, status, aspiration, and morality (or a lack thereof). They suggest where characters have been and where they might be headed, as well as whether or not they are aware of their fate. This study explores the agency of fashion in modern literature. Celia Marshik’s study combines close readings of modernist and middlebrow works, a history of Britain in the early twentieth century, and the insights of thing theory. She focuses on four distinct categories of modern clothing: the evening gown, the mackintosh, the fancy dress costume, and secondhand attire. In their use of these clothes, we see authors negotiate shifting gender roles, weigh the value of individuality during national conflict, work through mortality, and depict changing class structures. Marshik’s dynamic comparisons put Ulysses in conversation with Rebecca, Punch cartoons, articles in Vogue, and letters from consumers, illuminating opinions about specific garments and a widespread anxiety that people were no more than what they wore. Throughout her readings, Marshik emphasizes the persistent animation of clothing—and objectification of individuals—in early-twentieth-century literature and society. She argues that while artists and intellectuals celebrated the ability of modern individuals to remake themselves, a range of literary works and popular publications points to a lingering anxiety about how political, social, and economic conditions continued to constrain the individual.
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Cohen, Mary Ann, Jack M. Gorman, and Scott L. Letendre, eds. Comprehensive Textbook of AIDS Psychiatry. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.001.0001.
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Psychiatric factors play a significant role in the ongoing human immunodeficiency virus (HIV) pandemic. In less than four decades, advances in HIV medical care and research have transformed acquired immune deficiency syndrome (AIDS) from a rapidly fatal illness of unknown cause into a chronic, manageable illness. Vast strides have been made in clinical care and pathogenesis research in the fields of HIV prevention and psychiatric care, including pre- (PreP) and and post-exposure (PEP) prophylaxis. Although AIDS is an entirely preventable infectious illness, HIV transmission continues throughout the world. Transmission of HIV continues to be fueled by many factors, including stigma of HIV and mental illness as well as discrimination, criminalization, and risky behaviors. A comprehensive biopsychosocial approach to sexual health and mental health and diminution of stigma are key to both HIV prevention and HIV care. Integration of psychiatric care into HIV prevention and treatment entails use of a biopsychosocial approach that maintains a view of each individual with HIV as a member of a family, community, and society who deserves to be treated with dignity and compassion. This textbook provides an update on HIV medicine and psychiatry; introduces the concept of HIV/AIDS as “the great magnifier of maladies”; explores the paradoxes and disparities of HIV care; explains how HIV psychiatry is a paradigm for the psychiatric care of the medically ill (psychosomatic medicine); and sets the stage for an understanding of how integrated care can prevent transmission of HIV and reduce morbidity and mortality in persons with HIV.
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Ryff, Carol D., and Robert F. Krueger, eds. The Oxford Handbook of Integrative Health Science. Oxford University Press, 2018. http://dx.doi.org/10.1093/oxfordhb/9780190676384.001.0001.
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This handbook signals a paradigm shift in health research. Population-based disciplines have employed large national samples to examine how sociodemographic factors contour rates of morbidity and mortality. Behavioral and psychosocial disciplines have studied the factors that influence these domains using small, nonrepresentative samples in experimental or longitudinal contexts. Biomedical disciplines, drawing on diverse fields, have examined mechanistic processes implicated in disease outcomes. The collection of chapters in this handbook embraces all such prior approaches and, via targeted questions, illustrates how they can be woven together. Diverse contributions showcase how social structural influences work together with psychosocial influences or experiential factors to impact differing health outcomes, including profiles of biological risk across distinct physiological systems. These varied biopsychosocial advances have grown up around the Midlife in the United States (MIDUS) national study of health, begun over 20 years ago and now encompassing over 12,000 Americans followed through time. The overarching principle behind the MIDUS enterprise is that deeper understanding of why some individuals remain healthy and well as they move across the decades of adult life, while others succumb to differing varieties of disease, dysfunction, or disability, requires a commitment to comprehensiveness that attends to the interplay of multiple interacting influences. Put another way, all of the disciplines mentioned have reliably documented influences on health, but in and of themselves, each is inherently limited because it neglects factors known to matter for health outside the discipline’s purview. Integrative health science is the alternative seeking to overcome these limitations.
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Stewart, Dustin D. Futures of Enlightenment Poetry. Oxford University Press, 2020. http://dx.doi.org/10.1093/oso/9780198857792.001.0001.
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This book offers a revisionist account of poetry and embodiment from Milton to Romanticism. Scholars have made much of the period's theories of matter, with some studies equating the eighteenth century's modernity with its materialism. Yet the Enlightenment in Britain also brought bold new arguments for the immateriality of spirit and evocative claims about a coming spirit realm. Protestant religious writing was of two minds about futurity, swinging back and forth between patience for the resurrected body and desire for the released soul. This ancient pattern carried over, the book argues, into understandings of poetry as a modern devotional practice. A range of authors agreed that poems can provide a foretaste of the afterlife, but they disagreed about what kind of future state the imagination should seek. The mortalist impulse-exemplified by John Milton and by Romantic poets Anna Letitia Barbauld and William Wordsworth-is to overcome the temptation of disembodiment and to restore spirit to its rightful home in matter. The spiritualist impulse-driving eighteenth-century verse by Mark Akenside, Elizabeth Singer Rowe, and Edward Young-is to break out of bodily repetition and enjoy the detached soul's freedom in advance. Although the study isolates these two tendencies, each needed the other as a source in the Enlightenment, and their productive opposition didn't end with Romanticism. The final chapter identifies an alternative Romantic vision that keeps open the possibility of a disembodied poetics, and the introduction considers present-day Anglophone writers who continue to put it to work.
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Guideline for the Treatment of Leishmaniasis in the Americas. Second Edition. Pan American Health Organization, 2022. http://dx.doi.org/10.37774/9789275125038.
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Leishmaniasis is a neglected infectious disease of great importance in the Region of the Americas because of its prevalence, wide geographical distribution, morbidity and mortality. Several species of Leishmania can cause disease, and the resulting presentations differ in their clinical manifestations, diagnostic signs, severity, and treatment responses. The three main forms of leishmaniasis disease are: cutaneous, mucosal or visceral, of which cutaneous leishmaniasis is the most common. Visceral leishmaniasis (caused by L. infantum) is the most severe form and can cause death in up to 90% of untreated people. In 2013, PAHO, with the support of the Spanish Agency for International Development Cooperation, developed recommendations for the treatment of leishmaniasis in the Americas using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Since that time, new evidence has accumulated necessitating a revision of these recommendations. This publication, the second edition of the treatment guidelines for the Americas, has been put together with the leadership of PAHO’s Regional Program for Leishmaniasis with the support of the World Health Organization. It presents updated therapeutic recommendations for all three major forms of leishmaniasis disease, detailing the schemes and criteria for indication of treatment in the regional context. There are several notable changes from the first edition. For cutaneous disease, ketoconazole has been removed from the list of treatment options. Evidence for thermotherapy and pentamidine isethionate has been upgraded to “conditional” from “weak” in the previous edition. The number of Leishmania species for which there is strong evidence of the effectiveness of miltefosine has increased from two to four. And the evidence for intralesional antimonials in this disease form is now strong, whereas previously it was considered weak. The evidence for treatments for mucosal leishmaniasis – which is now considered separately to cutaneous disease – has become stronger since the first analysis, with the recommendation for use of pentavalent antimonials with or without oral pentoxifylline now strong. For visceral disease, the evidence has moved in the other direction. Whereas in the first edition, the evidence was considered strong for pentavalent antimonials, amphotericina B deoxycholate, it is now conditional. For miltefosine, there is now strong evidence against its useage. Further changes include the division of recommendations by adult and pediatric populations and the addition of new specific recommendations for immunocompromised patients that were not available in the first edition, including a strong recommendation against the use of pentavalent antimonials.