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6,600 |
Asthma and Microbes: A New Paradigm
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Asthma is worldwide at pandemic levels for the past 30 years but is increasing at a greater rate in more affluent societies. It is a heterogeneous disorder caused by interaction between genetic predisposition, atopy, and environmental factors, including allergens, air pollution, and respiratory infections. The pathological aspects and pathophysiological mechanisms are reviewed in this chapter. Allergens or infectious agents may stimulate Th-2 inflammation which causes activation of IL-13, eosinophils, and increase IgE levels, subsequently leading to bronchial smooth muscle hypercontraction. Respiratory viral infections are well-known causes of precipitation of acute asthma exacerbations in 50–60 % of attacks. There is also increasing evidence that bacterial infections, Chlamydia pneumoniae, and Mycoplasma pneumoniae, may contribute to the onset and course of asthma. The two main hypothesis of microbial genesis of asthma that has arisen in the past 20–30 years appears to be incongruous, but are not, are the hygiene hypothesis of asthma, and the virus-related asthma, early onset of viral bronchiolitis in the susceptible hosts being responsible for later development of asthma. The clinical and experimental evidences to support these contentions are reviewed and critiqued.
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6,601 |
Diagnostic Knowledge in the Genetic Economy and Commerce
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On 5 December 2002 the Australian Senate passed the Research Involving Embryos and Prohibition of Human Cloning Bill 2002, which regulates stem cell research. The bill introduces some restrictions with regard to the use of stored frozen embryos, which are not destined to be implanted. The bill states that only frozen embryos created before April 2002 can be used for research purposes, provided that the individuals whom these embryos relate to give their consent. The alternative to this restriction would have been no research at all, and this would have happened if the law had been stopped. The Australian scientists regarded the new law as a compromise that would undoubtedly slow down research, but not entirely stop it.
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6,602 |
High Capacity Vectors
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Since the construction of the first generation of general cloning vectors in the early 1970s, a large number of cloning vectors have been developed. Despite the bewildering choice of commercial and other available vectors, the selection of cloning vector to be used can be decided by applying a small number of criteria: insert size, copy number, incompatibility, selectable marker cloning sites, and specialized vector functions. Several of these criteria are dependent on each other. Most general cloning plasmids can carry a DNA insert up to around 15 kb in size. Several types of vectors are available for cloning large fragments of DNA too. This chapter presents a consolidated account of some new generation of high-capacity vectors such as cosmid, yeast artificial chromosome (YAC) , bacterial artificial chromosome (BAC), P1 phage artificial chromosome (PAC), and human artificial chromosome (HAC).
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6,603 |
Vector-based antiviral therapy
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6,604 |
Heparan Sulfate Proteoglycans in Infection
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To cause infections, microbial pathogens elaborate a multitude of factors that interact with host components. Using these host–pathogen interactions to their advantage, pathogens attach, invade, disseminate, and evade host defense mechanisms to promote their survival in the hostile host environment. Many viruses, bacteria, and parasites express adhesins that bind to cell surface heparan sulfate proteoglycans (HSPGs) to facilitate their initial attachment and subsequent cellular entry. Some pathogens also secrete virulence factors that modify HSPG expression. HSPGs are ubiquitously expressed on the cell surface of adherent cells and in the extracellular matrix. HSPGs are composed of one or several heparan sulfate (HS) glycosaminoglycan chains attached covalently to specific core proteins. For most intracellular pathogens, cell surface HSPGs serve as a scaffold that facilitates the interaction of microbes with secondary receptors that mediate host cell entry. Consistent with this mechanism, addition of HS or its pharmaceutical functional mimic, heparin, inhibits microbial attachment and entry into cultured host cells, and HS-binding pathogens can no longer attach or enter cultured host cells whose HS expression has been reduced by enzymatic treatment or chemical mutagenesis. In pathogens where the specific HS adhesin has been identified, mutant strains lacking HS adhesins are viable and show normal growth rates, suggesting that the capacity to interact with HSPGs is strictly a virulence activity. The goal of this chapter is to provide a mechanistic overview of our current understanding of how certain microbial pathogens subvert HSPGs to promote their infection, using specific HSPG–pathogen interactions as representative examples.
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6,605 |
Angiotensin-(1-7), Angiotensin-Converting Enzyme 2, and New Components of the Renin Angiotensin System
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The discovery of angiotensin-(1-7) [Ang-(1-7)] in 1988 represented the first deviation from the traditional biochemical cascade of forming bioactive angiotensin peptides. Prior to that time, the biological actions of angiotensin II (Ang II) were being investigated as it relates to cardiovascular function, including hypertension, cardiac hypertrophy and failure, as well as biological actions in the brain and kidney. We now know that Ang II elicits a whole host of actions both within and outside of the cardiovascular system. Furthermore, the discovery of Ang-(1-7) by our laboratory was also the first indication of a biologically active angiotensin peptide that further studies revealed served to counter-balance the actions of Ang II. This chapter reviews the data demonstrating the role of the vasodepressor axis of the renin angiotensin system in the regulation of cardiovascular function and the new data that shows the existence of angiotensin-(1-12) as a novel alternate substrate for the production of angiotensin peptides. The ultimate role of this discovery, as well as the continuing elucidation of mechanisms pertaining to RAS physiology, will likely be clarified in the coming years, in hopes of improving the treatment of cardiovascular disease.
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6,606 |
Epidemiologie und Prävention von nosokomialen Infektionen
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Eine nosokomiale Infektion (griechisch: nosokomeion = Krankenhaus) ist laut Infektionsschutzgesetz definiert als eine „Infektion mit lokalen oder systemischen Infektionszeichen als Reaktion auf das Vorhandensein von Erregern oder ihrer Toxine, die im zeitlichen Zusammenhang mit einer stationären oder einer ambulanten medizinischen Maßnahme steht, soweit die Infektion nicht bereits vorher bestand“. Das Risiko, eine Infektion zu entwickeln, ist für Patienten im Krankenhaus höher als für Menschen außerhalb des Krankenhauses. Grund dafür ist, dass bei vielen Patienten durch ihre Grunderkrankung eine Schwächung des Immunsystems besteht und/oder invasive Maßnahmen durchgeführt werden, die das Eindringen von Erregern in das Körperinnere und das Entstehen einer Infektion erleichtern. Besonders gefährdet sind deshalb im Bereich der Pädiatrie Frühoder Mangelgeborene, pädiatrische Intensivpatienten, Patienten mit chronischen Erkrankungen wie der zystischen Fibröse oder Dialysepflicht und onkologisch-pädiatrische Patienten. Dabei können auch fakultativ pathogene Mikroorganismen zu einer Infektion führen. Außerdem kommt es im Krankenhaus durch häufige durchgeführte Antibiotikatherapien zu einer Selektion von Keimen mit problematischem Resistenzspektrum, was die Therapie erschwert und die Übertragung dieser Keime erleichtert.
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6,607 |
Spezielle Erreger und Infektionen
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Durch das konsequente Einhalten und Anwenden der Standardhygienemaßnahmen lassen sich die meisten Transmissionen zwischen Patienten, aber auch Übertragungen auf das Personal vermeiden. Das folgende Kapitel widmet sich den Besonderheiten einzelner Erreger und Infektionskrankheiten und den ggf. erforderlichen zusätzlichen Schutzmaßnahmen. Es hilft bei der individuellen Risikoanalyse hinsichtlich Erregertyp, Übertragungsweg, Streupotenzial und exponierter Personen. Eine erregerspezifische Übersicht zum Nachschlagen ermöglicht eine schnelle Orientierung.
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6,608 |
The Global Threat of Emergent/Re-emergent Vector-Borne Diseases
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The past 30 years has witnessed a dramatic re-emergence of epidemic vector-borne diseases throughout much of the world. Factors contributing to this are many, but the principal drivers have been complacency and de-emphasis of infectious diseases in pubic health policy, increased population growth, uncontrolled urbanization without concomitant attention to water and waste management, increased globalization and the ease with which modern air transport can quickly spread pathogens and their vectors. The re-emergence of parasitic, bacterial and viral vector-borne pathogens is described. This re-emergence increases the current and future need for preventative measures to contain disease outbreaks and for international cooperation and collaboration to constantly monitor the outbreak of these debilitating and deadly diseases.
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6,609 |
Virus-Like Particles-Based Mucosal Nanovaccines
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Virus-like particles (VLPs) are protein complexes that resemble a virus and constitute highly immunogenic entities as they mimic the pathogen at an important degree. Among nanovaccines, those based on VLPs are the most successful thus far with some formulations already commercialized (e.g., those against hepatitis B and E viruses and human papillomavirus). This chapter highlights the advantages of VLPs-based vaccines, describing approaches for their design and transmittance of the state of the art for mucosal VLPs-based vaccines development. Several candidates have been produced in insect cells, plants, and E. coli and mammalian cells; they have been mainly evaluated in i.n. and oral immunization schemes. i.n. vaccines against the influenza virus and the Norwalk virus are the most advanced applications. For the latter, i.n. formulations are under clinical evaluation. Perspectives for the field comprise the expansion of the use of low-cost platforms such as plants and bacteria, the development of multiepitopic/multivalent vaccines, and computationally designed VLPs. Mucosal VLPs-based vaccines stand as a major promising approach in vaccinology and the initiation of more clinical trials is envisaged in a short time.
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6,610 |
Managing the Negotiation Process
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In global public health negotiations, the stakes are usually high and often time is of the essence. The outbreak of the SARS epidemic in late 2002, for example, illustrated how rapidly crises can occur and how immediate action may be required. Negotiations on immediate and short-term issues such as SARS, and even on long-term policies not triggered by a crisis, can be made all the more complex by diverse interests, conflicting understandings of underlying facts and linkages among the multitude of issues. Specific obstacles to joint problem-solving may include disagreement on the existence, certainty or severity of the problem; on the best way to tackle the problem or the likelihood of success; or on who bears responsibility to act, who will pay costs and who will manage the response. In the health sector, national leaders in key countries may be reluctant to acknowledge the urgent need to address the spread of a disease, either because they question the facts or because they fear that taking action will have negative impacts on their international image and/or domestic political support.
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6,611 |
Imaging of Pulmonary Infections
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Pulmonary infections have always been a cause of high morbidity and mortality, particularly in the pediatric and geriatric population and in immunocompromised hosts [1]. Pulmonary infections have various etiologies and have variegated patterns on radiographs and computed tomography (CT). Imaging plays an important role in the initial diagnosis and follow-up of various lung infections. Radiographs can be normal or non-specific during the initial evaluation, and CT findings may be more definitive. CT not only helps with the diagnosis but can also aid in management by guiding the diagnostic and therapeutic procedure. The pulmonary infections spread by direct or indirect contact with the infected host, droplet transmission, or an airborne spread. In rare cases, some infections can also be transmitted by vectors, namely, insect or animal hosts, and rarely by direct invasion from nearby infected organs. Pulmonary infections may have typical imaging patterns and distribution based on the mode of spread. There are a number of well-described imaging patterns of alveolar infections. The localization and morphological features on imaging may help in the diagnosis of infection and identification of mode of infection and, in certain cases, the microorganism responsible for the infection.
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6,612 |
Porcine Epidemic Diarrhea Virus
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Porcine epidemic diarrhea virus (PEDv) causes disease and mortality to piglets worldwide. Most vaccines used to combat the disease have been ineffective live attenuated virus vaccines. Research has emerged showing both the spike (S) and membrane (M) proteins of the virus have potential for use as subunit vaccines. This research has been largely undertaken using plants as expression platforms, with some promising candidates having emerged.
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6,613 |
Summary of Infection Control in the Dental Office: A Global Prospective
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During the delivery of dental care, there is the potential for the dissemination and/or exposure to blood and other body fluids as well as numerous microorganisms that colonize the mouth and/or oral, nasal, and respiratory fluids/secretions. Dentists, dental staff, and patients can be exposed to a variety of pathogenic microorganisms from these sources within the dental office. Contamination from any of these organisms may result in disease transmission which may occur from direct contact with infected body fluids and tissues, or indirectly by contacting surfaces and/or devices that have been contaminated. This phenomenon can occur anywhere in the world where dental care is provided. The principles of infection control must be employed to ensure that dental care is delivered in as safe a manner as possible for both the dental providers and the patients.
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6,614 |
Technical and Clinical Niches for Point of Care Molecular Devices
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A point of care (POC) device is one that is used outside of a central laboratory environment; generally near , or at the site of the patient/client. Point of care testing (POCT) varies from tests performed in physician’s office labs, or “satellite” or “stat” labs, to tests performed on tabletop instruments in a clinic area, to testing performed with hand-held instruments at the bedside. In peripheral lab settings, POCT may be performed by trained laboratory staff, but clinic and bedside POCT is frequently performed by staff who lack specialized laboratory training and whose primary job is something other than doing lab tests.
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6,615 |
Science
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Science today studies phenomena lasting less than 10(−21) s and phenomena which occurred more than 13 billion years ago; science also studies phenomena occurring over distances greater than 10(28) cm and shorter than 10(−13) cm; that is, science studies phenomena occurring over times and distances varying by a factor of about 10(40) (Fig. 3.1). In those incomprehensible ranges of time and space, the description of the physical world presented by science is most impressive. Based on what we know today everything in this enormous cosmos everywhere is made up of the same microscopic particles, the atoms and their constituents; their behavior is governed by the same physical laws everywhere.
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6,616 |
Asthma
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6,617 |
Virtual Screening and Molecular Design Based on Hierarchical Qsar Technology
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This chapter is devoted to the hierarchical QSAR technology (HiT QSAR) based on simplex representation of molecular structure (SiRMS) and its application to different QSAR/QSPR tasks. The essence of this technology is a sequential solution (with the use of the information obtained on the previous steps) of the QSAR paradigm by a series of enhanced models based on molecular structure description (in a specific order from 1D to 4D). Actually, it’s a system of permanently improved solutions. Different approaches for domain applicability estimation are implemented in HiT QSAR. In the SiRMS approach every molecule is represented as a system of different simplexes (tetratomic fragments with fixed composition, structure, chirality, and symmetry). The level of simplex descriptors detailed increases consecutively from the 1D to 4D representation of the molecular structure. The advantages of the approach presented are an ability to solve QSAR/QSPR tasks for mixtures of compounds, the absence of the “molecular alignment” problem, consideration of different physical–chemical properties of atoms (e.g., charge, lipophilicity), and the high adequacy and good interpretability of obtained models and clear ways for molecular design. The efficiency of HiT QSAR was demonstrated by its comparison with the most popular modern QSAR approaches on two representative examination sets. The examples of successful application of the HiT QSAR for various QSAR/QSPR investigations on the different levels (1D–4D) of the molecular structure description are also highlighted. The reliability of developed QSAR models as the predictive virtual screening tools and their ability to serve as the basis of directed drug design was validated by subsequent synthetic, biological, etc. experiments. The HiT QSAR is realized as the suite of computer programs termed the “HiT QSAR” software that so includes powerful statistical capabilities and a number of useful utilities.
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6,618 |
Anemia and RBC Transfusion
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Anemia is common in critically ill patients. More than 90% of patients have subnormal hemoglobin by the third day of ICU admission. Despite the fact that blood transfusions have not been shown to improve the outcome of ICU patients (see below) and that the current guidelines recommend blood transfusion only when the hemoglobin falls below 7.0 g/dl, almost half of all patients admitted to an ICU receive a blood transfusion.(1,2) The etiology of anemia of critical illness is multi-factorial and complex. Repeated phlebotomy, gastrointestinal blood loss, and other surgical procedures contribute significantly to the development of anemia. Red cell production in critically ill patients is often abnormal and is involved in the development and maintenance of anemia. The pathophysiology of this anemia includes decreased production of erythropoietin (EPO), impaired bone marrow response to erythropoietin, and reduced red cell survival.
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6,619 |
Automatic Question Generation for Learning Evaluation in Medicine
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An approach of automatic question generation from given learning material of medical text is presented in this paper. The main idea is to generate the questions automatically based on question templates which are created by training on many medical articles. In order to provide interesting questions, our research focuses on medical related concepts. This method can be used for evaluation of learner’s comprehension after he/she finished a reading material. Different from traditional learning system the articles and questions are all prepared beforehand; participants can learn whatever new input medical articles with the help of automatic question generation.
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6,620 |
Wich tige Gesetze, Verordnungen und Richtlinien
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6,621 |
Epidemiologia e scenari globali
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L’epidemiologia è lo studio dinamico dello stato di salute delle popolazioni. Naturalmente, la complessità delle malattie e dei fenomeni di diversa natura a esse correlati (biologici, ecologici, antropologici eccetera) richiede un approccio che può essere solo multidisciplinare. Per i medici e i veterinari, lo studio della diffusione e della frequenza delle malattie nelle popolazioni umane e animali rappresenta uno strumento essenziale, sia per la prevenzione e il controllo, sia per la diagnosi e la cura.
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6,622 |
Hidden Silent Codes in Viral Genomes
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Viruses are small infectious agents that replicate only inside the living cells of other organisms and comprise approximately 94% of the nucleic acid-containing particles in the oceans. They are believed to play a central role in evolution, are responsible for various human diseases, and have important contributions to biotechnology and nanotechnology. Viruses undergo evolutionary selection for efficient transmission from host to host by exploiting the host’s gene expression machinery (e.g., ribosomes) for the expression of the genes encoded in their genomes. As a result, viral genes tend to be expressed via non-canonical mechanisms that are very rare in living organisms. Many of the gene expression stages and other aspects of the viral life cycle are encoded in the viral transcripts via ‘silent codes’, and are induced by mutations that are synonymous to the viral amino acid content. In a series of studies that included the analyses of dozens of organisms from the three domains of life, it was shown that there are overlapping ‘silent codes’ in the genetic code that are related to all stages of gene expression regulation. The aim of this chapter is to summarize the current knowledge related to the silent codes in viral genomes and the open questions in the field.
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6,623 |
Long Non-coding RNA
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Rapid development in genome-wide transcriptional analyses has led to the discovery of a large number of non-coding transcripts, also called long non-coding RNA (lncRNA). LncRNAs harbor biological activities including regulation of protein-coding gene expression at epigenetic, transcriptional and post-transcriptional levels. They also take a part in various physiological and pathological processes, participating in cell development, immunity, disease processes and oncogenesis. Here I discuss and summarize, current knowledge about lncRNA origin, function and involvement in human disease.
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6,624 |
Introduction to Human-Environment Interactions Research
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Contemporary theories about the reciprocal interactions of human beings with the environment are only fully intelligible in the light of the historical roots of such theories. In this introduction we provide an overview of the major Western intellectual currents up to those that are commonly used today. Three main themes help organize this broad array of theories and approaches: environmental determinism, cultural determinism, and human-environment interaction concerned with the processual relationships between people and environment as grounded in historical, social, and ecological contexts. This chapter also provides an overview of the four parts of the book and discusses the coverage, diversity, and parallels in themes and approaches across all chapters.
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6,625 |
World Health Organization
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The World Health Organization (WHO) is a specialized agency of the United Nations (UN) that is concerned with international public health. It was established on April 7, 1948, with headquarters in Geneva, Switzerland and is a member of the UN Development Group. The membership of the WHP includes 193 countries and 2 associate members. Six regional committees, located in the Americas, Europe, the Eastern Mediterranean, South-East Asia, the Western Pacific, and Africa, focus on regional health concerns.
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6,626 |
Viruses and the Nucleolus
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The nucleolus is a dynamic sub-nuclear structure integral to the function of a eukaryotic cell. Some of its major roles involve ribosome subunit biogenesis, RNA processing, cell cycle control and responding to cellular stress, such as infection. Our understanding of the relationship between viruses and the nucleolus has moved from a phenomenological approach describing protein localisation to functional studies involving genetic analysis and proteomic approaches. These advances have provided fundamental insights as to how and why the nucleolus is targeted by many different viruses both to usurp normal functioning and to recruit nucleolar proteins to facilitate virus replication. This knowledge has been exploited for therapeutic strategies involving targeted inhibition of virus replication and live-attenuated recombinant vaccines.
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6,627 |
Infections
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Even if heart transplantation is an undisputed source of medical progress, several complications still hamper the outcome of transplanted patients. Among them, infections are associated with significant morbidity, mortality, and economic burden. Depending on clinical and radiological signs and based on the time interval after transplantation, a broad spectrum of microbial pathogens can be responsible for these infections. This microbiological diversity, associated with altered clinical signs due to immunosuppressive drugs, is a cause of delayed diagnosis and treatment. The objective of this overview is to provide a structured procedure to explore fever and specific symptoms that can be suggestive of infection in heart-transplanted patients. Furthermore, main preventive and curative strategies will be described.
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6,628 |
Cordylobia spp.
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6,629 |
Strategies of Preparedness Response to Biological Warfare and Bioterrorism Threats
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Risks associated with deliberate use of biological agents against population and the needs for a strong public health system are well recognized. The potential use of biological agents is mounting every day, especially with growing political dissidence as well as social and economical conflicts in several countries. Countries in Eastern Europe have considerable vulnerability because of economical, social and political difficulties they are facing, along with inadequate response capacity and large number of outfits having continuous low intensity conflicts with established administrative system. There are no doubts that preparedness against biological weapons must be integrated in national disaster preparedness plan, as well as strengthen the core competencies of public health and other national and local authorities to respond to biological crisis, along with strong collaboration with other national agencies, like intelligence, defense and police.
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6,630 |
Kann das Immunsystem unterwandert werden?
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Infektionserreger haben sich in ihrer Evolution darauf spezialisiert, in einem immunkompetenten Wirt zu leben und ein breites Repertoire origineller Tricks entwickelt, das Immunsystem zu unterwandern. Die Tabelle 20.1 zeigt Beispiele.
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6,631 |
Geographic Medicine
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This chapter uses a sub-discipline of medicine, known as geographic medicine, to describe how human movements contribute to the transmission of parasites on spatial scales that exceed the limits of its natural habitat. Traditionally, public health programs have focused on the health of populations, whereas the practice of medicine has focused on the health of individuals. It should be noted, however, that the population health management owes much to the effective delivery of clinical care. This chapter demonstrates how public health is intimately linked to patient care through human movement. Nearly a century ago, people typically did not develop a disease where it is contracted or even close to that place. Today, daily travel is a common way of life in modern metropolitan areas. Large, localized mosquito populations in areas that people visit regularly may be both reservoirs and hubs of infection, even if people only pass through those locations briefly. By examining of the role of human movement across different scales, this chapter examines how public health communities can use information on pathogen transmission to increase the effectiveness of disease prevention programs and clinical care.
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6,632 |
Therapieversagen
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Eine allgemein anerkannte Definition des Therapieversagens ist nicht verfügbar. Zu unterscheiden sind klinische Kriterien des Therapieansprechens (Entfieberung, Rückgang inflammatorischer Parameter, Stabilisierung oder Rückgang der Beatmungsintensität, hämodynamische Stabilisierung) sowie der Rückbildung der akuten Pneumonie; erstere können nach 72 h erstmals beurteilt werden, letztere erst innerhalb von 8–10 Tagen. Das Therapieversagen der nosokomialen Pneumonie ist mit annähernd 30 % ein häufiges Ereignis. Es ist mit einer ernsten Prognose verbunden und sollte daher eine umfangreiche Differentialdiagnostik erfahren. Muster des Therapieversagens umfassen die rasche Progredienz innerhalb der ersten 72 h (progressive pneumonia), das fehlende Ansprechen nach 72 h (nonresolving pneumonia) sowie das Therapieversagen nach initialem Ansprechen (sekundäres Therapieversagen). Ursachen können sein eine inadäquate kalkulierte antimikrobielle Therapie, gleichzeitig vorliegende andere Infektionsfoci oder nichtinfektiöse Ursachen sowie Ursachen, die mit der Immunantwort des Wirts in Zusammenhang stehen. Ursächliche Erreger entsprechen weitgehend dem für die jeweilige Behandlungseinheit gegebenen Spektrum; aber auch Fadenpilze und Herpesviren sind mögliche Erreger. Die diagnostische Evaluation sollte primär bronchoskopisch und durch Gewinnung einer bronchoalveolären Lavage (BAL) erfolgen. Transbronchiale Biopsien oder offene Lungenbiopsien können im Einzelfall erwogen werden. Histologisch ergeben sich am häufigsten eine Pneumonitis bzw. Fibrose und ein diffuser Alveolarschaden (DAD).
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6,633 |
Influenza
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Influenza, abbreviated as flu, is an acute respiratory infectious disease caused by influenza virus, which is mainly spread along with droplets with strong infectivity. The influenza virus may cause epidemics or pandemics of influenza and its incidence ranks the first among legally listed infectious diseases. The prevalence of influenza peaks in autumns and winters, with short illness course and self limitation. However, influenza can be complicated by pneumonia or other serious complications that may cause death in populations of infants, young children, the elderly, those with underlying heart and lung disease and those with compromised immunity.
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6,634 |
Role of Fibrinolysis in the Nasal System
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In this chapter, we show the presence of tissue-type plasminogen activator (t-PA), urokinase-type plasminogen activator (u-PA), and plasminogen activator inhibitor-1 (PAI-1) in nasal mucosa. It is suggested that t-PA synthesized in mucous cells is promptly secreted and modifies the watery nasal discharge in allergic rhinitis and that u-PA activity may help with the passage of large amounts of rhinorrhea by reducing its viscosity. Furthermore, we clarify the relation between fibrinolytic components and the pathology of allergy, particularly during the development of nasal allergy and nasal tissue changes. Wild-type (WT) mice can develop nasal allergy for ovalbumin (OVA) sensitization, but PAI-1-deficient mice (PAI-1(-/-)) cannot. The production of specific immunoglobulins IgG1 and IgE in the serum and production of interleukins IL-4 and IL-5 in splenocyte culture supernatant increased significantly in WT-OVA mice. In PAI-1(-/-) mice, these reactions were absent, and specific IgG2a in serum and interferon-γ in splenocyte culture medium increased significantly. Histopathologically, there was marked goblet cell hyperplasia and eosinophil infiltration into the nasal mucosa in WT-OVA mice, but these were absent in PAI-1(-/-) mice. These results indicate that the immune response in WT-OVA mice can be classified as a dominant Th2 response, which would promote collagen deposition. In contrast, the Th2 response in PAI-1(-/-) mice was down-regulated and the immune response shifted from Th2-dominant reaction to a Th1-dominant one. Taken together, these findings suggest that PAI-1 plays an important role not only in thrombolysis but also in the immune response.
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6,635 |
Predictive Dynamics: Modeling for Virological Surveillance and Clinical Management of Dengue
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Dengue fever is a flu-like illness spread by the bite of an infected mosquito and is fast emerging as a major public health concern. Timely and cost-effective diagnosis would reduce the mortality rates besides providing better grounds for clinical management and disease surveillance. Identifying the clinical features for early diagnosis of dengue would be useful in reducing the virus transmission in a community. In addition to the clinical features, obtaining the influential laboratory attributes and their range would aid in quick identification of disease severity in the suspected individuals. In this chapter a new alternating decision tree methodology which generates more accurate and simplified decision tree structures with simplified classification rules is discussed. This approach helps one to obtain the influential clinical and laboratory features which would aid in identifying the suspected dengue individuals and assess the severity of infection in them.
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6,636 |
Infections After High-Dose Chemotherapy and Autologous Hematopoietic Stem Cell Transplantation
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Infection represents an important cause of morbidity after autologous hematopoietic stem cell transplantation (HSCT). Immunodeficiency is the key risk factor and results from interplay between the underlying disease and its therapy. Various defects in the immune system coexist in HSCT recipients. In the early post-transplant period, neutropenia, oral and gastrointestinal mucositis, and the presence of central venous catheters are the main risk factors. Bacterial infections predominate, and the agents and antibiotic susceptibility profiles vary widely in different regions. Invasive candidiasis is infrequent with fluconazole use, but the incidence of invasive aspergillosis is on the rise, mainly in patients receiving purine analogues or intensive chemotherapy before transplant. In the post-engraftment period, infections are less frequent, but may contribute to significant non-relapse mortality. The dynamics of immune reconstitution drives the risk for infection in this period. The most frequent infections are varicella-zoster virus disease and respiratory tract infections. Assessment of the risk of infection in each period and the identification of patients at higher risk of specific infections are critical to the appropriate management of infectious complications after autologous hematopoietic stem cell transplantation.
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6,637 |
Medical Words Linked to Places
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Many medical terms come from places: towns, rivers, islands, forests, mountains, valleys, countries, and continents. These toponymous diseases, syndromes, descriptors, and other entities bring us colorful names that help us recall some of their history. Today we have Zika virus, its name coming from the Zika Forest in Ghana. Caucasian comes from the Caucasus Mountains, lesbian from the island of Lesbos, and Epsom salts from a mineral spring in Epsom, Surrey, England. Chapter 10.1007/978-3-319-50328-8_5 tells the stories behind these place-named diseases and how many of them affect us today.
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6,638 |
Social Problems: A Cost-Effective Psychosocial Prevention Paradigm
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This introductory chapter provides a discussion about the need for prevention. As justification for prevention, the chapter highlights the costs of social problems discussed in the book, including academic problems, violence in schools, child maltreatment, HIV/AIDS, and substance abuse.
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6,639 |
MHC Class I Expression and CD8 T Cell Function: Towards the Cell Biology of T-APC Interactions in the Infected Brain
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Antigen presentation by major histocompatibility complex class I (MHC-I) and class II (MHC-II) molecules is a prerequisite for T cell engagement during the activation as well as the effector phase. The central nervous system (CNS) is unique in that cells resident in the parenchyma, glia and neurons, do not constitutively (or very sparsely at best) express MHC molecules (Aloisi et al., 2000; Sedgwick and Hickey, 1997; Xiao and Link, 1998), making them invisible to T cells. Additional restrictions on T cell surveillance are imposed by the absence of classical lymphatic drainage, the blood—brain barrier (BBB), and the unique anatomy of the brain microvasculature (Bechmann et al., 2007; Galea et al., 2007; Hickey, 2001; Xiao and Link, 1998; Lowenstein, 2002). Infiltrating cells not only have to cross the vascular wall to penetrate into the perivascular space, but more importantly overcome the barrier formed by the glia limitans to access the CNS parenchyma. While the first step is generally not associated with pathology, penetration from the perivascular space of postcapillary venules into the parenchyma is more restricted and once overcome, associated with clinical consequences (Bechmann et al., 2007). In the resting state, perivascular macrophages are maintained by replacement with circulating monocytes. However the glial limitans is not breached, and thus, these cells are considered to be located outside the confines of the BBB. While diffusion of soluble factors and antibodies is restricted by the BBB, especially by the tight, continuous, unfenestrated capillary epithelium, leukocyte infiltration preferentially occurs at distal sites in postcapillary venules (Bechmann et al., 2007). BBB permeability and leukocyte infiltration are thus not necessarily functionally nor physically linked. The barriers separating CNS parenchyma from the circulation explains the rare presence of T cells in the normal CNS parenchyma, despite the ability of peripherally activated and memory T cells to traffic to non lymphoid tissues independent of antigen presentation (Masopust et al., 2004). Nevertheless, T cells activated during an infection or auto-immune response, are able to enter into, and migrate within the brain parenchyma, even in the presence of an intact, non-inflamed BBB (Cabarrocas et al., 2003; Chen et al., 2005; Evans et al., 1996; Hickey, 2001). However, although entry of activated T cells into the CNS is independent of their antigen specificity, only those T cells that recognize antigen are retained. Thus, barriers limiting T cell surveillance of the brain are rapidly overcome following CNS infections and other inflammatory conditions (Griffin, 2003; Ransohoff et al., 2003). Under such conditions, it is also likely that a number of non-activated, bystander T cells, as well as other leukocytes, including B cells are able to penetrate into the brain parenchyma. Mechanisms propagating protective versus pathogenic potential of T cells in varying disease models are complex and require more in depth exploration. This chapter highlights recent advances relating to antigen presentation functions by resident CNS cells and effects exerted by CD8 T cells in vivo with an emphasis on anti-viral functions.
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6,640 |
Human Infected H5N6 Avian Influenza
|
Human infected H5N6 avian influenza is an acute respiratory infectious disease caused by H5N6 subtype of avian influenza virus.
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6,641 |
Lychee Biology and Biotechnology
|
Lychee (Litchi chinensis Sonn.) is one of the revered members of the soapberry family Sapindaceae which includes 150 genera and 2000 species. It is a tropical and subtropical fruit tree which is native to Fujian and Guangdong regions of China and is cultivated as an important commercial fruit crop in many parts of the world. It is famous for its fragrant and sugary flavour. After China, India is at the second position in the production of lychee in the world. The varieties with large pulp, small seeds and noteworthy flavour are of great interest among the consumers and farmers. Lychee fruit took tremendous attention of scientists as it contains ample amounts of anti-oxidants, vitamins and fibre. Moreover, the plant parts possess considerable anti-pyretic, anti-inflammatory, anti-cancer, anti-diabetic, anti-tumour and anti-oxidant properties. Propagation of lychee from seeds is difficult and not practicable because of longer juvenile period and non-viable, abortive and genetically diverse nature of the seedlings. However, the techniques such as cell, tissue and organ culture (micropropagation) can overcome the difficulties of lychee propagation. Very limited efforts have been made in its varietal improvement through hybridization and modern breeding techniques. In a nutshell, lychee is an important commercial fruit crop, and there is a need to develop technical research so as to sustain and enhance its yield, postharvest management, medicinal value and marketing. This chapter comprises of botanical description, cultivation, medicinal uses, micropropagation and trading of Litchi chinensis.
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6,642 |
Testing the Donor
|
The transplantation of tissues from donor to recipient is a fundamental part of medicine today. A range of tissues including bone, skin, tendons, heart valves, corneas etc. are collected from suitable donors and transplanted into those patients for whom tissue transplant would have clinical benefit.
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6,643 |
Update in Pediatric Hospital Medicine
|
Pediatric Hospital Medicine has significantly developed as a field over the past two decades. With the goal of improving care for hospitalized children, much of the research in this field has focused on reducing unnecessary interventions, optimizing necessary treatments, and reducing variability for common inpatient conditions. While this is far from an exhaustive chapter on the vast diversity and advances in this field, it focuses on the updates for some of the top diagnoses in hospital medicine and the major trends in the field. Updated management of acute viral bronchiolitis, urinary tract infections, neonatal infections, brief resolved unexplained events (formerly, apparent life-threatening events), and osteomyelitis are highlighted with emphasis on major management changes. In addition, and distinct to pediatric hospital medicine, the topics of overuse and high value care are discussed as they have gained momentum in influencing the way hospitalists think and practice.
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6,644 |
Intensivtherapie nach Organtransplantation
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Nach langen Diskussionen bietet das Transplantationsgesetz, das seit 01.12.1997 in Kraft ist, Rechtssicherheit. Das Gesetz dient dem Schutz des Spenders und des Empfängers, und es bietet Rechtssicherheit für alle in der Transplantationsmedizin Tätigen. Das Gesetz legt die Rechte und Verpflichtungen der Beteiligten und die Wege der Organspende und -vermittlung fest. Das Gesetz unterscheidet zwischen der Organentnahme bei Lebenden und bei Verstorbenen und legt die Rahmenbedingungen fest. Die Umsetzung der Todesbestimmung soll nach den Erkenntnissen der medizinischen Wissenschaft erfolgen und ist in den Richtlinien der Bundesärztekammer (3. Fortschreibung 1997) festgelegt worden.
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6,645 |
Surgical Complications of Childhood Tumors
|
Most childhood tumors will first present to a physician; some tumors will present in an atypical manner and may mimic a surgical condition. The diagnosis may be missed if the surgeon is not aware of the possibility of cancer. A very great number of rare presentations of childhood cancer have been described in the literature. It is important that the surgeon who is not experienced in the management of childhood cancer is aware that an apparently benign condition could be a manifestation of an underlying malignancy.
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Influenza in the Elderly
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Pneumocystis jiroveci Pneumonia
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Pneumocystis pneumonia (PCP) is one of the most common pulmonary infections in persons with impaired cell-mediated immunity, and particularly those infected with human immunodeficiency virus (HIV).1–7 Pneumocystis was first described in the lungs of guinea pigs, during experiments on American trypanosomiasis by Carlos Chagas8 in 1909 and by Antonio Carinii9 in 1910. Both considered the cysts of Pneumocystis as part of the trypanosome’s life cycle. Shortly afterward the Delanoes10 found identical forms in the lungs of rats that had not been infected with trypanosomes and recognized the organism as a separate species. The name Pneumocystis carinii, was given to this organism as a generic name (Greek:pneumon, “lung”; kystis, “cyst”), honoring Carinii.11
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6,648 |
Recombinant IgA Antibodies
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The production of monoclonal antibodies and the development of recombinant antibody technology have made antibodies one of the largest classes of drugs in development for prophylactic, therapeutic and diagnostic purposes. Currently, all of the Food and Drug Administration (FDA)- approved antibodies are immunoglobulin Gs (IgGs). However, more than 95%of the infections are initiated at the mucosal surfaces, where IgA is the primary immune effector antibody.
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6,649 |
4 Respiratoire spoedgevallen
|
Het gebruik van de term ‘status asthmaticus’ voor een ernstige, levensbedreigende astma-aanval schept veel onduidelijkheid. De ene auteur geeft hiermee een bepaalde ernst van bronchusobstructie aan, de andere verdisconteert in dit begrip de duur van een aanval, eventuele complicaties of een zekere mate van therapieresistentie.
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6,650 |
Development of Mucosal Vaccines Based on Lactic Acid Bacteria
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Today, sufficient data are available to support the use of lactic acid bacteria (LAB), notably lactococci and lactobacilli, as delivery vehicles for the development of new mucosal vaccines. These non-pathogenic Gram-positive bacteria have been safely consumed by humans for centuries in fermented foods. They thus constitute an attractive alternative to the attenuated pathogens (most popular live vectors actually studied) which could recover their pathogenic potential and are thus not totally safe for use in humans. This chapter reviews the current research and advances in the use of LAB as live delivery vectors of proteins of interest for the development of new safe mucosal vaccines. The use of LAB as DNA vaccine vehicles to deliver DNA directly to antigen-presenting cells of the immune system is also discussed.
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6,651 |
Concepts and Theories of Longevity
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This chapter is concerned with the concepts, statistics, theories, and future levels of human longevity, particularly extreme longevity. The term, extreme longevity or superlongevity, is used here to refer to centenarians, that is, persons with a verified age of 100 years or more. Among these we identify for special attention a subgroup known as supercentenarians, that is, persons with a verified age of 110 years or more. In both popular and scientific reporting, people aged 85 years and over have often been considered as extreme aged, but the rapid increase in the number of people in these older age groups suggests a redefinition of the notion of extreme aged. Persons in the broad age group 85 years and over are also referred to as persons of advanced age and the oldest-old. The former description now seems appropriate but the latter one does not. Preferences vary among demographers and gerontologists as to the choice of designations for these groups.
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6,652 |
Virus–Platelet Associations
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Virus–platelet interplay is complex. Diverse virus types have been shown to associate with numerous distinct platelet receptors. This association can benefit the virus or the host, and thus the platelet is somewhat of a renegade. Evidence is accumulating to suggest that viruses are capable of entering platelets. For at least one type of RNA virus (dengue virus), the platelet has the necessary post-translational and packaging machinery required for production of replicative viral progeny. As a facilitator of immunity, the platelet also participates in eradicating the virus by direct and indirect mechanisms involving presentation of the pathogen to the innate and adaptive immune systems, thus enhancing inflammation by release of cytokines and other agonists. Virus-induced thrombocytopenia is caused by tangential imbalance of thrombopoeisis, autoimmunity, and loss of platelet function and integrity.
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6,653 |
11 Longziekten
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Deze aandoeningen, die soms met ‘verkoudheid’ of ‘griep’ betiteld worden, doen zich regelmatig – en vaak epidemisch – voor; bij kinderen (drie- tot viermaal per jaar) vaker dan bij volwassenen (een- tot tweemaal per jaar).
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6,654 |
Biomedicines as Adverse Event Inducers
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Biomedicines are new agents with old roots. Products of biological origin, such as vaccines, blood and serum components, human proteins, hormones, and immunoglobulins, are used from long time in human therapy.
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6,655 |
Behavioural and Medical Differentials of Cognitive Decline and Dementia in Dogs and Cats
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Cognitive dysfunction syndrome (CDS) is a diagnosis of exclusion given that there is no specific diagnostic test or tool and that medical disorders can cause the same set of signs. The veterinary surgeon must first identify that signs are present, collect a full history and then perform a full physical examination and relevant diagnostic tests to rule out medical causes for the signs including blood and urine analysis, radiographs and diagnostic imaging such as magnetic resonance imaging (MRI) where indicated.
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6,656 |
Air Pollution and Disasters
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Many disasters lead to air pollution and vice versa. This chapter elaborates major air pollution issues due to earthquake, tsunami, volcanic eruption, epidemics, extreme temperature, insect infestation, mass movement, wars, and fire accidents.
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6,657 |
Mycobacterial Sepsis and Multiorgan Failure Syndrome
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Tuberculosis (TB) is a global disease with high prevalence in developing countries. According to the World Health Organization (WHO) fact sheet 2009, more than 2 billion (equal to one third of world’s population) people are infected with TB bacilli. Of the cases detected, 5 % were cases of multi-drug resistant TB. Admission to a critical care unit is not required in the majority of cases. However, TB sepsis is a rapidly fatal disease that requires intensive care unit (ICU) admission and management and represents a big diagnostic and therapeutic challenge.
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6,658 |
Temporal Features in Biological Warfare
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No matter how prepared a population may be, bioterrorism cannot be prevented: the first clues will always be given by ill people. Temporal analysis applied to this type of scenarios could be an additional tool for limiting disruption among civilians allowing for recognizing typical temporal progression and duration of symptoms in first infected people. We propose the application of a fuzzy temporal reasoning system we have developed for biomedical temporal data analysis in different scenarios after a hypothetical attack. The system is able to handle both qualitative and metric temporal knowledge affected by vagueness and uncertainty, taking into account in this way the vagueness of patients reports expressed in natural language.
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6,659 |
Cough, Cold, and Congestion
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The common cold is a benign, self-limited, acute viral infection with associated symptoms of sneezing, rhinorrhea, nasal congestion, cough, and malaise. It is the most frequent acute illness in the industrialized world. Adults typically have two to three episodes of illness yearly while children can have up to five. The common cold is typically caused by viruses (including rhinovirus, RSV, coronavirus, and others), and often, no infecting organism is detected. Treatment is usually targeted at symptomatic relief. The differential diagnosis for cough, cold, and congestion is broad: ranging from non-emergent causes such as rhinitis to life-threatening illnesses such as pulmonary embolism. Careful assessment is necessary as misidentification can lead to inappropriate discharge of potentially lethal conditions.
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6,660 |
Infection Control Methods
| null |
6,661 |
Ontology Evolution: MEDLINE Case Study
|
With the rising importance of knowledge interchange, many industrial and academic applications have adopted ontologies as their conceptual backbone. Business dynamics and changes in the operating environment often give rise to continuous changes in application requirements that may be fulfilled only by changing the underlying ontologies. This is especially true for Semantic Web applications, which are based on heterogeneous and highly distributed information resources and therefore need efficient mechanisms to cope with changes in the environment. In our previous work we have developed the KAON ontology evolution framework that (i) enables handling the required ontology changes; (ii) ensures the consistency of the underlying ontology and all dependent artefacts; (iii) supports the user to manage changes more easily; and (iv) offers advice to the user for continual ontology reengineering. In this paper we apply the proposed approach on the MEDLINE system and discuss its benefits. First, we translated the MeSH/MEDLINE into a set of the ontologies by enriching the MeSH vocabulary with the set of rules and by eliminating some inconsistencies. Second, we showed that ontology evolution ensures the consistency between all related data. Third, we indicated how formal semantics provided by an ontology might be useful to improve the indexing in the existing MEDLINE system.
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6,662 |
Immunosenescence Modulation by Vaccination
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A decline in immune function is a hallmark of aging that leads to complicated illness from a variety of infectious diseases, cancer and other immune-mediated disorders, and may limit the ability to appropriately respond to vaccination. How vaccines might alter the senescent immune response and what are the immune correlates of protection will be addressed from the perspective of (1) stimulating a previously primed response as in the case of vaccines for seasonal influenza and herpes zoster, (2) priming the response to novel antigens such as pandemic influenza or West Nile virus, (3) vaccination against bacterial pathogens such as pneumococcus and pertussis, (4) vaccines against bacterial toxins such as tetanus and Clostridium difficile, and (5) vaccine approaches to mitigate effects of cytomegalovirus on immune senescence. New or improved vaccines developed over recent years demonstrate the considerable opportunity to improve current vaccines and develop new vaccines as a preventive approach to a variety of diseases in older adults. Strategies for selecting appropriate immunologic targets for new vaccine development and evaluating how vaccines may alter the senescent immune response in terms of potential benefits and risks in the preclinical and clinical trial phases of vaccine development will be discussed.
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6,663 |
Document Re-ranking by Generality in Bio-medical Information Retrieval
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Document ranking is an important process in information retrieval (IR). It presents retrieved documents in an order of their estimated degrees of relevance to query. Traditional document ranking methods are mostly based on the similarity computations between documents and query. In this paper we argue that the similarity-based document ranking is insufficient in some cases. There are two reasons. Firstly it is about the increased information variety. There are far too many different types documents available now for user to search. The second is about the users variety. In many cases user may want to retrieve documents that are not only similar but also general or broad regarding a certain topic. This is particularly the case in some domains such as bio-medical IR. In this paper we propose a novel approach to re-rank the retrieved documents by incorporating the similarity with their generality. By an ontology-based analysis on the semantic cohesion of text, document generality can be quantified. The retrieved documents are then re-ranked by their combined scores of similarity and the closeness of documents’ generality to the query’s. Our experiments have shown an encouraging performance on a large bio-medical document collection, OHSUMED, containing 348,566 medical journal references and 101 test queries.
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6,664 |
HIV/AIDS Related Respiratory Diseases
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Lungs are the most commonly involved organ by HIV/AIDS related diseases, and pulmonary infections are the main reasons for the increasing death rate from AIDS. Pathogens of HIV related pulmonary infections include parasites, fungi, mycobacteria, viruses, bacteria and toxoplasma gondii. According to international reports, pathogens have different geographical distribution, which is also closely related to the socioeconomic status of the region to produce varied AIDS related diseases spectra. For instance, in the United States, pneumocystis carnii pneumonia (PCP), tuberculosis and recurrent bacterial pneumonia (at least twice within 1 year) occur frequently in HIV infected patients. An international report published 10 years ago indicated that PCP is the most common and serious pulmonary opportunistic infections in HIV infected patients. Now its incidence has dropped with the application of antiretroviral treatment and preventive measures. PCP will continue to occur initially in patients who are aware of their HIV infection. In addition, HIV related viral and parasitic infections have been reported both domestically and internationally. In this section, the clinical manifestations and imaging findings of HIV related pulmonary infections are analyzed and discussed, which provide effective diagnosis basis, so as to reduce the incidence of HIV-related pulmonary infections.
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6,665 |
Immune Tolerance in Autoimmune Central Nervous System Disorders
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Multiple sclerosis (MS) afflicts genetically predisposed individuals and is associated with T lymphocyte-mediated damage to the myelin sheath of neurons in the central nervous system, resulting in severely impaired signal transmission. The mechanisms of the induction and manifestation of MS are not entirely understood. The control of autoimmune disorders is accomplished by both central tolerance in which autoreactive T lymphocytes are eliminated in the thymus and by tolerance mechanisms that operate in the periphery. Among the many mechanisms described, T regulatory (Treg) cells derived from the thymus (tTregs) and induced (iTregs) in the periphery as well as T regulatory type 1 cells (Tr1) are involved in many disease models. However, the precise details of the generation and perpetuation of these various Treg subsets and their relevance to the regulation of autoimmune diseases remain elusive. In this review, we critically analyze the current knowledge of the tolerance mechanisms involved in the regulation of MS and its animal model, experimental autoimmune encephalomyelitis.
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6,666 |
Step 3 of EBP: Part 1—Evaluating Research Designs
|
Step 3 of the EBP process involves evaluating the quality and client relevance of research results you have located to inform treatment planning. While some useful clinical resources include careful appraisals of research quality, clinicians must critically evaluate the content both included in these summaries and what is excluded or omitted from them. For individual research studies, clinicians must first identify and evaluate the research designs and methods reported. The terminology used to describe research designs in EBM/EBP may not always be consistent with that used in most social work research courses. This chapter provides a review of the key research designs used in EBM and EBP in order to orient clinicians to core terminology found in EBP summaries and reports.
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6,667 |
A Comparison of Evolutionary Approaches to the Shortest Common Supersequence Problem
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The Shortest Common Supersequence problem is a hard combinatorial optimization problem with numerous practical applications. Several evolutionary approaches are proposed for this problem, considering the utilization of penalty functions, GRASP-based decoders, or repairing mechanisms. An empirical comparison is conducted, using an extensive benchmark comprising problem instances of different size and structure. The empirical results indicate that there is no single best approach, and that the size of the alphabet, and the structure of strings are crucial factors for determining performance. Nevertheless, the repair-based EA seems to provide the best performance tradeoff.
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6,668 |
Prevention and Therapy from Contact Dermatitis (with Special Reference to Occupational Dermatology)
| null |
6,669 |
RNA Interference and MicroRNA Modulation for the Treatment of Cardiac Disorders: Status and Challenges
|
The current status and challenges of RNA interference (RNAi) and microRNA modulation strategies for the treatment of myocardial disorders are discussed and related to the classical gene therapeutic approaches of the past decade. Section 2 summarizes the key issues of current vector technologies which determine if they may be suitable for clinical translation of experimental RNAi or microRNA therapeutic protocols. We then present and discuss examples dealing with the potential of cardiac RNAi therapy. First, an approach to block a key early step in the pathogenesis of a virus-induced cardiomyopathy by RNAi targeting of a cellular receptor for cardiopathogenic viruses (Section 3). Second, an approach to improve cardiac function by RNAi targeting of late pathway of heart failure pathogenesis common to myocardial disorders of multiple etiologies. This strategy is directed at myocardial Ca(2+) homeostasis which is disturbed in heart failure due to coronary heart disease, heart valve dysfunction, cardiac inflammation, or genetic defects (Section 4). Whereas the first type of strategies (directed at early pathogenesis) need to be tailor-made for each different type of pathomechanism, the second type (targeting late common pathways) has a much broader range of application. This advantage of the second type of approaches is of key importance since enormous efforts need to be undertaken before any regulatory RNA therapy enters the stage of possible clinical translation. If then the number of patients eligible for this protocol is large, the actual transformation of the experimental therapy into a new therapeutic option of clinical importance is far more likely to occur.
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6,670 |
Nanomicrobiology
|
Microbiology plays an important role in practice of medicine. Nanodiagnostics have refined the detection of infectious diseases and many new nanotechnology-based therapies, particularly of viral diseases, are in development.
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6,671 |
Dark scenarios
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In this chapter, we present four “dark scenarios” that highlight the key socio-economic, legal, technological and ethical risks to privacy, identity, trust, security and inclusiveness posed by new AmI technologies. We call them dark scenarios, because they show things that could go wrong in an AmI world, because they present visions of the future that we do not want to become reality. The scenarios expose threats and vulnerabilities as a way to inform policy-makers and planners about issues they need to take into account in developing new policies or updating existing legislation. Before presenting the four scenarios and our analysis of each, we describe the process of how we created the scenarios as well as the elements in our methodology for analysing the scenarios.
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6,672 |
Preparation Without Panic: A Comprehensive Social Marketing Approach to Planning for a Potential Pandemic
|
In recent times the world has faced several potential pandemics – SARS, avian (bird) flu, swine flu, and most recently Ebola. The risk of a disease pandemic presents an important challenge for social marketing –to this point, health-related social marketing has focused on chronic diseases (such as cancer, asthma, obesity) and their risk factors (such as tobacco use, physical inactivity, and dietary intake). In the communicable disease field, most of the challenges we have addressed have had simple and proven preventive strategies (such as immunisation and the use of condoms). However, emerging pandemic diseases pose new challenges – notably in the global scale of the threat, the rapid nature of transmission, and (often) the absence of a known cure or vaccine. In this context, people’s quality of life has scope to be shaped by immense physical and social influences. This chapter reports on a comprehensive study undertaken to inform government policy and practice in the event of an avian influenza pandemic – specifically how to prepare (but not panic) the general public. The research phases included: a media analysis of coverage of a potential pandemic; extensive qualitative formative research; two population CATI surveys; two airport intercept surveys; message development; and message testing. While this research was undertaken in the context of a specific disease, the findings and recommendations are equally relevant to current and future pandemic threats.
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Bacterial Biowarfare Agents
| null |
6,674 |
Theories of Biodiversity Value
|
The discussion of the calculus of biodiversity values in Chap. 5 is the final requisite prop for the stage across which this chapter parades accounts of how biodiversity is supposed to be valuable. The selection of these accounts is generous and represents a great majority of discussions on this topic, though it is not all-inclusive. It does include, among other theories, the theory that biodiversity is valuable for “unspecified moral reasons” (Sect. 6.1), that it is valuable as a resource (Sect. 6.2), as a service provider (Sect. 6.3), as a sustainer of human life (Sect. 6.4), as a key to human health, both as pharmacopoeia and as an inoculation against infection (Sect. 6.5), as the progenitor of human biophilic tendencies (Sect. 6.6), as a generator of (more) value (Sect. 6.7), as font of knowledge (Sect. 6.8), as having option (and quasi-option) value (Sect. 6.9), as transformative (Sect. 6.10), as having experiential value (Sect. 6.11), and as an expression of the natural order (Sect. 6.12). The chapter concludes (Sect. 6.13) with some proposals that are not customarily offered as self-contained theories of biodiversity value, but that are often suggested as still heavily influencing evaluation. These include what conservation biologists call “viability” and “endangerment” as well as conservation “efficiency”. Section 6.13 concludes with an extended discussion of the significance for biodiversity’s value of the history of human impingements on the natural world.
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6,675 |
Pharmacogenomics and Molecular Diagnostics
|
To develop new Polymerase Chain Reaction (PCR)-based assays for nucleic acid detection for infectious diseases. Development of new assays on demand for emerging infectious diseases. For example, no proper nucleic acid-based tests exist for detection of H1N1 influenza virus. My lab, being the parasitology research unit aims to fill this gap by developing this ability.
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6,676 |
Molecular Mechanisms of Flaviviral Membrane Fusion
|
Enveloped viruses rely on transmembrane fusion proteins to fuse the viral membrane to the host-cell membrane and deliver the viral genome into the cytoplasm for replication. Although the structures and evolutionary origins of viral fusion proteins vary widely, all fusion proteins use the same physical principles and topology to drive membrane fusion. First, exposure of a hydrophobic fusion anchor allows them to insert into the host-cell membrane. Conserved hydrophobic residues in the fusion anchor penetrate part way into the outer bilayer leaflet of the host-cell membrane. The fusion protein then folds back on itself, directing the C-terminal viral transmembrane anchor toward the fusion loop. This fold-back forces the host-cell membrane (held by the fusion loop) and the viral membrane (held by the C-terminal transmembrane anchor) against one another until they fuse. In West Nile virus and other flaviviruses this fold-back in the fusion protein, E, is triggered by the reduced pH of an endosome, is accompanied by the assembly of E monomers into trimers, and occurs by domain rearrangement rather than by an extensive refolding of secondary structure. The rearrangement releases a large amount of energy, which is used to exert a bending force on the apposed viral and cellular membranes, propelling them toward each other and, eventually, causing them to fuse. The conserved regions of E that are responsible for driving membrane fusion are attractive targets for antiviral therapies.
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Traumatologie und gewaltsamer Tod
|
Vorgeschichte: Eine 39 Jahre alt gewordene, alkoholabhängige Frau habe von ihrem Hausarzt eine Packung Distraneurinkapseln (25 Stück) verschrieben bekommen; sie solle morgens und mittags je 1, abends 2 Kapseln einnehmen. Aus der Apotheke zurück gekehrt, begann sie zu Hause, mit ihrem Ehemann Alkohol zu trinken. Es sei zu einem Streit gekommen, in dessen Verlauf die Frau die Polizei angerufen habe. Der Ehemann sei daraufhin gegen 17.00 Uhr in Gewahrsam genommen und zur Wache verbracht worden. Ein Atemalkoholtest habe einen Atemalkoholwert von 1,29 mg/l ergeben. Gegen 04.00 Uhr morgens sei der Ehemann wieder entlassen worden (!). Er selbst habe angegeben, seine Ehefrau schlafend auf dem Sofa angetroffen zu haben; er habe sie geweckt, sie habe u.a. zu ihm gesagt, dass sie die Distraneurintabletten eingenommen habe. Ihr Zustand habe sich deutlich von dem bei sonstiger Alkoholisierung unterschieden. Gegen 05.30 Uhr habe er den Notarzt verständigt, der nur noch den Tod feststellen konnte.
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6,678 |
Infectious Diseases: The Role of the Forensic Physician
|
Infections have plagued doctors for centuries, in both the diagnosis of the specific diseases and the identification and subsequent management of the causative agents. There is a constant need for information as new organisms emerge, existing ones develop resistance to current drugs or vaccines, and changes in epidemiology and prevalence occur. In the 21st century, obtaining this information has never been more important. Population migration and the relatively low cost of flying means that unfamiliar infectious diseases may be brought into industrialized countries. An example of this was an outbreak of severe acute respiratory syndrome (SARS), which was first recognized in 2003. Despite modern technology and a huge input of money, it took months for the agent to be identified, a diagnostic test to be produced, and a strategy for disease reporting and isolation to be established. There is no doubt that other new and fascinating diseases will continue to emerge.
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6,679 |
(13)C Chemical Shifts in Proteins: A Rich Source of Encoded Structural Information
|
Despite the formidable progress in Nuclear Magnetic Resonance (NMR) spectroscopy, quality assessment of NMR-derived structures remains as an important problem. Thus, validation of protein structures is essential for the spectroscopists, since it could enable them to detect structural flaws and potentially guide their efforts in further refinement. Moreover, availability of accurate and efficient validation tools would help molecular biologists and computational chemists to evaluate quality of available experimental structures and to select a protein model which is the most suitable for a given scientific problem. The (13)C(α) nuclei are ubiquitous in proteins, moreover, their shieldings are easily obtainable from NMR experiments and represent a rich source of encoded structural information that makes (13)C(α) chemical shifts an attractive candidate for use in computational methods aimed at determination and validation of protein structures. In this chapter, the basis of a novel methodology of computing, at the quantum chemical level of theory, the (13)C(α) shielding for the amino acid residues in proteins is described. We also identify and examine the main factors affecting the (13)C(α)-shielding computation. Finally, we illustrate how the information encoded in the (13)C chemical shifts can be used for a number of applications, viz., from protein structure prediction of both α-helical and β-sheet conformations, to determination of the fraction of the tautomeric forms of the imidazole ring of histidine in proteins as a function of pH or to accurate detection of structural flaws, at a residue-level, in NMR-determined protein models.
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6,680 |
Era of Intelligent Systems in Healthcare
|
The aim of this chapter is to prepare the reader for the outstanding trip that she/he embarked when starting reading this book. At first, we shall try to look for answers to some of the most important questions regarding the connection between intelligent systems and healthcare. What are intelligent systems? How can they be used in healthcare? Have they got benefits and prospects? Let us highlight some of the decisive factors for a successful deployment of intelligent systems in healthcare, including intelligent clinical support and intelligent patient management.
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6,681 |
Behavioral Epidemiology of Infectious Diseases: An Overview
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The focus of the growing discipline of behavioral epidemiology (BE) of infectious diseases is on individual behavior as a key determinant of infection trajectories. This overview departs from the central, but static, role of human behavior in traditional mathematical models of infection to motivate the importance of including behavior into epidemiological models. Our aim is threefold. First, we attempt to motivate the historical and cultural background underpinning the BE revolution, focusing on the issue of rational opposition to vaccines as a natural endpoint of the changed relation between man and disease in modern industrialized countries. Second, we review those contributions, from both mathematical epidemiology and economics, that forerun the current “epidemic” of studies on BE. Last, we offer a more detailed overview of the current epidemic phase of BE studies and, still motivated by the issue of immunization choices, introduce some baseline ideas and models.
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6,682 |
Market Trends in Lateral Flow Immunoassays
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6,683 |
Quantitative Performance Monitoring of China’s HIV Response
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China has made tremendous progress in advancing its national HIV program. Key to this progress was setting targets to motivate implementers to work effectively. Indicators were established using an iterative process with national stakeholders while also meeting international pressures. A plethora of demands may have distracted from ownership of the initial national program but, in the end, strengthened a focus on marginalized groups. China gradually relied less on donors and developed a uniquely Chinese HIV control program. The result was remarkable enlargement of prevention and treatment services that led to a reduction in mortality. Setting targets, and measuring performance against those targets, was vital to gauge continued progress and identify gaps in programing and implementation.
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6,684 |
Grundlagen der systemischen Therapie
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Die Möglichkeiten einer systemischen Therapie maligner Erkrankungen - außerhalb der zytostatischen Chemotherapie - sind in den letzten Jahren deutlich erweitert worden. Dazu haben insbesondere neue Erkenntnisse zur molekularen Pathogenese von Tumorerkrankungen beigetragen. Von besonderem Interesse sind Strategien, die in Prozesse der tumorassoziierten Neoangiogenese oder der neoplastischen Wachstumsregulation eingreifen.
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6,685 |
Bronchite acuta
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La bronchite acuta è una infiammazione dei bronchi primari e secondari ed è una delle patologie relativamente più frequenti nella pratica clinica, anche se la sua definizione rimane, per certi aspetti, non sempre ben definita. La localizzazione del processo infiammatorio spesso coinvolge tratti respiratori limitrofi (faringe, laringe, trachea, bronchi, bronchioli) determinando un interessamento progressivo dell’albero bronchiale.
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6,686 |
Nanomolecular Diagnostics
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Clinical application of molecular technologies to elucidate, diagnose and monitor human diseases is referred to as molecular diagnosis. It is a broader term than DNA (deoxyribonucleic acid) diagnostics and refers to the use of technologies that use DNA, RNA (ribonucleic acid), genes or proteins as bases for diagnostic tests. The scope of the subject is much wider and includes in vivo imaging and diagnosis at single molecule level. A more detailed description of molecular diagnostics is presented elsewhere (Jain 2017a).
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6,687 |
Nanotechnological Approaches for Genetic Immunization
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Genetic immunization is one of the important findings that provide multifaceted immunological response against infectious diseases. With the advent of r-DNA technology, it is possible to construct vector with immunologically active genes against specific pathogens. Nevertheless, site-specific delivery of constructed genetic material is an important contributory factor for eliciting specific cellular and humoral immune response. Nanotechnology has demonstrated immense potential for the site-specific delivery of biomolecules. Several polymeric and lipidic nanocarriers have been utilized for the delivery of genetic materials. These systems seem to have better compatibility, low toxicity, economical and capable to delivering biomolecules to intracellular site for the better expression of desired antigens. Further, surface engineering of nanocarriers and targeting approaches have an ability to offer better presentation of antigenic material to immunological cells. This chapter gives an overview of existing and emerging nanotechnological approaches for the delivery of genetic materials.
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6,688 |
The Successes and Failures of Global Health Organizations: The World Health Organization, UNAIDS, Médicins sans Frontières and PEPFAR
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Chapter 7 examined the operations of multilateral, bilateral and private donors in financing the fight against HIV/AIDS. This chapter examines the operations of five organizations that focus more directly on addressing HIV/AIDS health issues on the ground: the World Health Organization; UNAIDS; Médicins sans Frontières (Doctors without Borders); the US President’s Emergency Plan for AIDS Relief (PEPFAR); and the US Centers for Disease Control and Prevention. The first two form part of the United Nations (UN) system, the third is a private, non-profit non-governmental organization that relies on volunteers to deliver medical services and products in developing countries that are facing health crises and the fourth and fifth are a US government program and agency, respectively. The UN has won the Nobel Peace Prize a number of times: UN Middle East mediator (1950); UNHCR, the UN refugee agency (1954); UN Secretary-General (1961); UNICEF (1965); ILO, the UN labor agency (1969); UNHCR, the UN refugee agency (1981); UN peacekeeping (1988); and UN Secretary-General and the UN, jointly (2001). There are several bodies inside the UN that also have won the Nobel Peace Prize, such as the International Atomic Energy Agency (2005) and Director Mohamed El-Baradei and the Intergovernmental Panel on Climate Change (2007). In addition, the prime minister of Canada, Lester Bowles Pearson, won Nobel Peace Prize for his work with the UN (1957). Médicins sans Frontières has won the Nobel Peace Prize once (1999)
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6,689 |
The Impact of Disease on Welfare
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Welfare is usually defined in terms either of an animal’s ability to cope (Broom, 1986) or of health and behavioural needs. Indeed the very word “dis-ease” implies a state lacking “ease” or well-being. We feel it is important to consider disease holistically: that is to consider the animal’s ability to resist stress and the environmental challenges it faces. Whereas the outcome of poor welfare is expressed as disease, the relative contributions of various stressors will vary with each individual. The other chapters consider genetics, nutrition and environment in terms of the welfare of poultry. However, given the same housing, air, feed and water, some birds may become diseased and some remain healthy. Intrinsic biological variation results in a range of nutrient reserves and immune status at hatching, plus differences in genetic make up, social status and behaviour that interact with each other and further factors to provide different outcomes for the individual. In the pragmatic world of farming, flock health status may be frequently chosen as the index of welfare, but it is important not to lose sight of the health and well-being of each individual, even in flocks numbering tens of thousands of birds.
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6,690 |
Myzetom
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6,691 |
How Does Biodiversity Influence the Ecology of Infectious Disease?
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Over the past years, biodiversity has been reduced on an unprecedented scale, while new infectious diseases are emerging at an increasing rate. Greater overall biodiversity could lead to a greater diversity of hosts and thus of pathogens. Yet disease regulation – due to the buffering role of host diversity – is considered to be one of the services provided by biodiversity. In this chapter, we ask how biodiversity is linked to infectious disease. First, we investigate the influence of the biodiversity of pathogens. We highlight that the number of pathogen species is not well known but that new findings are facilitated by the rapid expansion of molecular techniques. We show that, although there is a trend to find higher pathogen richness toward the equator, identifying a global pattern between the richness of all pathogen species and their latitudinal distribution is challenging. We emphasize that pathogen intraspecific diversity is a crucial factor in disease emergence and allows pathogens to adapt to the selective pressures they face. In addition, the selective pressure acting on hosts due to parasite, and reinforced by parasite diversity within hosts seems to be a major evolutionary and ecological force shaping hosts biodiversity. Second, we investigate how the diversity of hosts influences infectious disease ecology. For multi-host diseases, a change in host species richness or abundance can modify the dynamics of local infectious diseases by either reducing (“dilution effect”) or increasing (“amplification effect”) the risk of transmission to the targeted host species. The underlying hypothesis is that, the competence of reservoirs varies according to the host species. The dilution effect has been demonstrated mainly through theoretical work and there have been only few case studies. Regarding the genetic diversity of host, an important issue is: to what extent does a reduction of this diversity impact the ability of the host population to response to infectious diseases? Third, we rapidly examine the role of biodiversity in the treatment of infectious diseases. To conclude, we consider that the consequences of the loss of species biodiversity on infectious diseases is still largely unknown, notably due to the lack of knowledge on the dynamics of host-pathogen relationships, especially at the population and at the community level.. We highlight that work on multi-host/ ulti-pathogen systems should be fostered and that new approaches, such as metagenomic investigations that does not require a priori assumptions, are promising to describe a community of pathogens and their interactions.
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6,692 |
Performing Interventions: The Politics and Theatre of China’s AIDS Crisis in the Early Twenty-First Century
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Theatrical productions attest to a radical shift in Chinese governmental policy and public awareness of the AIDS epidemic at the dawn of the twenty-first century; state-subsidised theatre worked directly with the government to contain the transmission of HIV. Produced by two of the country’s most elite cultural institutions, the Shanghai Dramatic Arts Center and the Beijing People’s Art Theatre respectively, The Dying Kiss (Shengsi Zhiwen) in 2003 and Student Zhao Ping (Zhao Ping Tongxue) in 2005 represented a sea change in the political response to the epidemic while documenting public perceptions towards people living with HIV and AIDS in China. Marking policy change, they reflect experiences that capture a society transitioning from denial to confrontation at the dawn of the twenty-first century.
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6,693 |
The Ubiquitin-Proteasome System (UPS) as a Cancer Drug Target: Emerging Mechanisms and Therapeutics
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The Ubiquitin-Proteasome System (UPS) plays an important role in the setting of the cellular response to multiple stress signals. Although the primary function of ubiquitin was initially associated with proteolysis, it is now considered as a key regulator of protein function controlling, among other functions, signalling cascades, transcription, apoptosis or oncogenesis. Failure at any level of the UPS is associated with the development of multiple pathologies including metabolic problems, immune diseases, inflammation and cancer. The successful use of the proteasome inhibitor Bortezomib (Velcade) in the treatment of multiple myeloma (MM) and mantle cell lymphoma (MCL) revealed the potential of the UPS as pharmacological target. Ten years later, new inhibitors tackling not only the proteasome but also different subsets of enzymes which conjugate or de-conjugate ubiquitin or ubiquitin-like molecules, have been developed. Most of them are excellent tools to characterize better the emerging molecular mechanisms regulating distinct critical cellular processes. Some of them have been launched already while many others are still in pre-clinical development. This chapter updates some of the most successful efforts to develop and characterize inhibitors of the UPS which tackle mechanisms involved in cancer. Particular attention has been dedicated to updating the status of the clinical trials of these inhibitors.
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6,694 |
Disruptive Behaviors: Should We Foster or Prevent Resiliency?
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6,695 |
Emerging Issues in Environmental and Occupational Lung Diseases
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Humans continue to introduce new or greatly modified agents and techniques into the workplace and environment. These new agents and altered practices lead to evolving patterns of established diseases as well as entirely novel conditions never experienced before in medical history. Although many of these emerging conditions appear in the literature as case reports or case series, these sentinel cases frequently raise the public awareness that drives social movements or, in some situations, represent a warning sign for subsequent outbreaks. The emerging environmental and occupational lung diseases (EOLD) may be grouped arbitrarily into two categories: (1) conditions caused by novel utilization or routes of exposure to agents known to cause EOLD and (2) conditions caused by novel agents not known to cause specific EOLD in the past. Conditions in the first category may include those caused by new exposure scenarios in nonindustrial settings and thus a large population may be at risk. The second category includes new risk factor(s) that were not known to be associated with a specific EOLD, and thus the association between the agent and the new condition could be easily missed. Clinicians should remain astute and vigilant when evaluating the potential role of environmental risk factors in any lung diseases and especially pay attention to the identification of clusters of cases of disease of unknown etiology.
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6,696 |
Sexual Dysfunction
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Female sexual dysfunction or dissatisfaction is a common complaint among obstetric-gynecology patients. These complaints may result from medical treatments and procedures, or may secondarily complicate the management and patient compliance of treatment for other medical issues. Therefore, it is important that clinicians treating females obtain basic information regarding human sexual function and dysfunction. This chapter presents an integration of the clinical research as well as the author’s experience regarding sexual function and the management of sexual problems often presented in an obstetricgynecology practice.
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6,697 |
Common Colds and Respiratory Viruses: Impact on Allergy and Asthma
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6,698 |
Acute Respiratory Failure After Hematopoietic Stem Cell Transplantation
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Infectious and noninfectious pulmonary complications are common among HSCT recipients and are the leading cause for respiratory failure requiring mechanical ventilation and ICU admission. Unique pulmonary syndromes include peri-engraftment respiratory distress syndrome, diffuse alveolar hemorrhage, and idiopathic pneumonia syndrome. Respiratory failure requiring mechanical ventilation after HSCT continues to be associated with a poor prognosis.
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6,699 |
Engineering Control of Airborne Disease Transmission in Health Care Facilities
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Hospital acquired illness or “nosocomial” illness is of increasing concern to public health administrators, hospitals, physicians and patients. Engineering infection control measures are used to reduce the concentration and prevent the spread of these particles throughout a building in order to decrease exposure to and risk of illness from infectious pathogens. The engineer who attempts to deal with microbial indoor air quality finds that pertinent microbiological information exists in abundance but not in easily digestible forms. This paper will provide a brief review of the problem of controlling airborne disease transmission in healthcare facilities with emphasis on medical microbiology and aerobiology in order to offer some conclusions regarding the potential for engineering control of infectious diseases.
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