Cimex lectularius (the "bedbug") is an insect that feeds nocturnally, taking a requisite blood meal from a sleeping human or other parasitized host. Immunological reactions to bedbug saliva vary, but typically, bites yield erythematous and pruritic papules. The face and distal extremities, areas uncovered by sleeping clothes or blankets, are preferentially involved. Until the late 1990s, bedbug infestations in the United States were declining. Resurgence is attributed to increased travel and resistance to insecticides. Although hepatitis or human immunodeficiency virus is not effectively transmitted by the bedbug, pruritus and the fear and perceived violation of an infestation can be debilitating. Bedbugs are small but robust, and their ability to remain ensconced in crevices within the bedroom makes eradication difficult. As more patients present with bedbug bites, physicians must possess the knowledge to diagnose, treat, and educate with regard to bedbug bites and bedbug infestations.
Comorbidity was not significantly associated with treatment selection or pretreatment QOL scores in patients with HNSCC. Location of the primary tumor and disease stage were significantly associated with treatment selection. Further studies are required to determine the effect of comorbidity on patient and tumor responses to treatment.
Alcohol withdrawal is associated with a significantly greater incidence of postoperative complications and duration of hospitalization. Benzodiazepine prophylaxis does not prevent postoperative alcohol withdrawal symptoms in all patients at risk. Alternate methods of prophylaxis should be explored.
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