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8,400 |
Antibody Phage Display
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8,401 |
Pneumologie
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8,402 |
Secondary Metabolite Production in Transgenic Hairy Root Cultures of Cucurbits
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Cucurbits are important group of vegetables due to their nutritional significance and are also used for valuable traditional medicine. The infection of plants by Agrobacterium rhizogenes results in a hairy root (HR) phenotype characterized by rapid growth in hormone-free medium, an unusual ageotropism and extensive lateral branching. These genetically transformed root cultures (hairy roots) can produce levels of secondary metabolites comparable to that of intact plants. Hairy root cultures offer promise for high production and productivity of valuable secondary metabolites in many plants. High stability and productivity features allow the exploitation of HRs as valuable biotechnological tool for the production of plant secondary metabolites. While these chemical compounds are employed by plants for interactions with their environment, humans have long since explored and exploited plant secondary metabolites for medicinal and practical uses. The main constraint for commercial exploitation of hairy root cultivations is the development and scaling up of appropriate reactor vessels (bioreactors) that permit the growth of interconnected tissues normally unevenly distributed throughout the vessel. Emphasis has focused on designing appropriate bioreactors suitable to culture the delicate and sensitive plant hairy roots. To this end, hairy root culture presents an excellent platform for producing valuable secondary metabolites. For these reasons, this chapter describes the establishment of hairy roots and production of secondary metabolites from hairy roots of cucurbits and also phytochemicals uses for biological activity.
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8,403 |
Biological and Chemical Weapons
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The five anthrax letters put in the US mail in 2001 greatly raised concerns about BW and CW. In general, chemical weapons are considered about as lethal per unit mass as conventional explosives and much less lethal than either nuclear or biological weapons (dirty bombs are much less lethal, Chap. 10.1007/978-3-319-25367-1_13). Biological weapons can be as lethal as nuclear weapons if dispersed effectively, but that is not easy to do. For BW to be effective, the bio-materials must be chemically robust, remaining stable, not decaying in sunlight, moisture and rain. This can be accomplished with spores and aerosols. BW material must be dispersed widely, not clumping in few locations. BW can be delivered by cluster bomblets from small missiles. BW can be delivered by helicopter or low-flying crop-duster, or BW can be released in many locations in many small spray cans.
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8,404 |
Myocarditis
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Viruses are the most common cause of myocarditis in economically advanced countries. Enteroviruses and adenoviruses are the most common etiologic agents. Viral myocarditis is a triphasic process. Phase 1 is the period of active viral replication in the myocardium during which the symptoms of myocardial damage range from none to cardiogenic shock. If the disease process continues, it enters phase 2, which is characterized by autoimmunity triggered by viral and myocardial proteins. Heart failure often appears for the first time in phase 2. Phase 3, dilated cardiomyopathy, is the end result in some patients. Diagnostic procedures and treatment should be tailored to the phase of disease. Viral myocarditis is a significant cause of dilated cardiomyopathy, as proved by the frequent presence of viral genomic material in the myocardium, and by improvement in ventricular function by immunomodulatory therapy. Myocarditis of any etiology usually presents with heart failure, but the second most common presentation is ventricular arrhythmia. As a result, myocarditis is one of the most common causes of sudden death in young people and others without preexisting structural heart disease. Myocarditis can be definitively diagnosed by endomyocardial biopsy. However, it is clear that existing criteria for the histologic diagnosis need to be refined, and that a variety of molecular markers in the myocardium and the circulation can be used to establish the diagnosis. Treatment of myocarditis has been generally disappointing. Accurate staging of the disease will undoubtedly improve treatment in the future. It is clear that immunosuppression and immunomodulation are effective in some patients, especially during phase 2, but may not be as useful in phases 1 and 3. Since myocarditis is often selflimited, bridging and recovery therapy with circulatory assistance may be effective. Prevention by immunization or receptor blocking strategies is under development. Giant cell myocarditis is an unusually fulminant form of the disease that progresses rapidly to heart failure or sudden death. Rapid onset of disease in young people, especially those with other autoimmune manifestations, accompanied by heart failure or ventricular arrhythmias, suggests giant cell myocarditis. Peripartum cardiomyopathy in economically developed countries is usually the result of myocarditis.
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8,405 |
Misguided Responses to Public Health Emergencies
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This chapter considers some misguided responses to public health emergencies, or perceived emergencies. At one extreme was the arrest and lifetime confinement in Hawaii and elsewhere of sufferers from leprosy, or Hansen’s disease. This, of course, was not an example of presidential policy, but is included as an example of horrible overreach. An opposite approach was the refusal of the Eisenhower administration to mount a vaccination program to deal with the Asian flu pandemic of 1957. President Eisenhower was devoted to private solutions to such emergencies, and these were manifestly inadequate. There was yet another extreme example of a misguided approach, and that was President Woodrow Wilson’s militant passivity to the 1918 influenza pandemic. Disregarding advice from medical consultants, he refused to discontinue the shipment of troops abroad to fight in the Great War, which resulted in an even greater spread of the contagion because of the great numbers of men confined to small quarters aboard ships. Incompetence can always be a danger in public health emergencies. Although this was not a pandemic, the George W. Bush administration handled the health crisis caused by Hurricane Katrina so poorly that it became a national scandal. On the other hand, President Bush did move to plan wisely for a possible influenza pandemic when he ordered the creation of national stockpiles of antiviral medication.
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8,406 |
Laboratory Diagnosis of Viral Disease
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8,407 |
Infectious Diseases Prevention and Control
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China is a big country with huge regional differences in social economic development. The large population, high population density and mobility, as well as significant regional differences in life style make infectious diseases a major threat to China. With strong outburst and fast spread, infectious diseases are also more difficult to control in China. So China has to stick to a strategy which emphasizes both prevention and therapy in infectious disease control.
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8,408 |
DLI Induced by Herbal Medicine: What Are the Characteristics of DLI due to Herbal Medicines?
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In many countries, herbal medicine has been developed and is currently practiced. Herbal medicine involves the use of the stalks, roots, leaves, flowers, and berries of several different plant species for medical treatment. Many practitioners believe that herbal medication has no side effects because of its natural origin. Thus, herbal medication has been used for a long time with little awareness of its side effects. However, there is an increasing incidence of interstitial pneumonia due to a drug-induced lung injury (DLI), which could be induced by common drugs. Moreover, increasing cases of bronchiolitis obliterans and pulmonary hypertension are being reported; further, these are drug-induced conditions. Clinicians should be more aware of DLI symptoms caused by herbal medication and interrogate patients regarding their use of herbal medication and supplements as well as prescription drugs.
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8,409 |
Collectivism–Individualism, Family Ties, and Philopatry
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As predicted by the parasite-stress theory of values, variation in parasite stress correlated with collectivism–individualism across nations, USA states, and indigenous societies. In regions with high adversity of infectious diseases, human cultures are characterized by high collectivism, whereas in regions of low parasite stress cultures are highly individualistic. The prediction from the parasite-stress theory of values that infectious disease transmissible among humans (nonzoonotics) will be more important in predicting collectivism–individualism than those that humans can contract only from nonhuman animals (zoonotics) was supported. Evidence in human movement patterns for nations, states of the USA, and indigenous societies supports the hypothesis that the absence of dispersal (high philopatry) is a defense against contact with novel parasites in out-groups and their habitats. We show that human cultures with high degrees of collectivism have high degrees of cooperative breeding, and propose that the parasite-stress theory of sociality offers a general theory of family structure across humans as well as nonhuman animal taxa. We propose that a major context for the evolution of human reciprocity was in gaining benefits from out-group interactions during periods of relatively low disease threat. The parasite-stress theory of values offers a novel perspective to explain the evolution of reciprocity and human unique cognitive abilities. The parasite-stress theory suggests useful new research directions for the study of the demographic transition, patriotism, xenophobia, ethnocentrism, and moral foundations theory. We include discussion of ecological correlations and the ecological fallacy. The fact that all scientific findings are correlational is explained.
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8,410 |
Selective and Dual Targeting of CCR2 and CCR5 Receptors: A Current Overview
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The chemokine receptor 2 (CCR2) and chemokine receptor 5 (CCR5) are important mediators of leukocyte trafficking in inflammatory processes. The emerging evidence for a role of CCR2 and CCR5 receptors in human inflammatory diseases led to a growing interest in CCR2- and CCR5-selective antagonists. In this review, we focus on the recent development of selective CCR2/CCR5 receptor ligands and dual antagonists. Several compounds targeting CCR2, e.g., INCB8761 and MK0812, were developed as promising candidates for clinical trials, but failed to show clinical efficacy as presumed from preclinical models. The role of CCR5 receptors as the second co-receptor for the HIV-host cell fusion led to the development of various CCR5-selective ligands. Maraviroc is the first CCR5-targeting drug for the treatment of HIV-1 infections on the market. The role of CCR5 receptors in the progression of inflammatory processes fueled the use of CCR5 antagonists for the treatment of rheumatoid arthritis. Unfortunately, the use of maraviroc for the treatment of rheumatoid arthritis failed due to its inefficacy. Some of the ligands, e.g., TAK-779 and TAK-652, were also found to be dual antagonists of CCR2 and CCR5 receptors. The fact that CCR2 and CCR5 receptor antagonists contribute to the treatment of inflammatory diseases renders the development of dual antagonists as promising novel therapeutic strategy.
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8,411 |
Taxonomy
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This chapter addresses the classification and taxonomy of viruses with special attention to viruses that show pneumotropic properties. Information provided in this chapter supplements that provided in other chapters in Parts II–V of this volume that discuss individual viral pathogens.
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8,412 |
Searching for Superspreaders: Identifying Epidemic Patterns Associated with Superspreading Events in Stochastic Models
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The importance of host transmissibility in disease emergence has been demonstrated in historical and recent pandemics that involve infectious individuals, known as superspreaders, who are capable of transmitting the infection to a large number of susceptible individuals. To investigate the impact of superspreaders on epidemic dynamics, we formulate deterministic and stochastic models that incorporate differences in superspreaders versus nonsuperspreaders. In particular, continuous-time Markov chain models are used to investigate epidemic features associated with the presence of superspreaders in a population. We parameterize the models for two case studies, Middle East respiratory syndrome (MERS) and Ebola. Through mathematical analysis and numerical simulations, we find that the probability of outbreaks increases and time to outbreaks decreases as the prevalence of superspreaders increases in the population. In particular, as disease outbreaks occur more rapidly and more frequently when initiated by superspreaders, our results emphasize the need for expeditious public health interventions.
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8,413 |
Pathogenesis of COPD (Persistence of Airway Inflammation): Why Does Airway Inflammation Persist After Cessation of Smoking?
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The structural features of airways in patients with COPD are airway wall inflammation, fibrosis, muscle hypertrophy, and goblet cell metaplasia. These structural cellular changes contribute to mucus hypersecretion and destruction of the alveolar walls and a decline in forced expiratory volume in one second (FEV(1)). At the cellular level, macrophages, T lymphocytes, and neutrophils, driven by cytokines including interleukin-8 (IL-8), gather on the airways. The main cause of COPD inflammation is cigarette smoke. Smoke causes an increase in the secretion of matrix metalloproteinase (MMPs) and neutrophilic elastase from epithelial cells and neutrophils, which are responsible for mucin production and destruction of the lung. Initially, cigarette smoke influences the expression of pattern recognition receptors (PRRs) including Toll-like receptors (TLRs), the intracellularly located nucleotide-binding oligomerization domain (NOD)-like receptors (NLRs), retinoic acid-inducible gene I (RIG-I)-like receptors (RLRs), and receptors for advanced glycation end products (RAGE) on lung epithelial cells, endothelial cells, and leukocytes in the lung. These actions bring about the production of cytokines and activation of inflammatory cells, leading to production of MMPs and neutrophilic elastase. The inflammatory changes persist for several months and years after smoking cessation and are sometimes irreversible. Damage-associated molecular patterns (DAMPs) released from dying cells after cigarette smoking increase the number of apoptotic cells, suppress efferocytosis, induce hypoxia and oxidative stress, and prolong the inflammatory changes, even after smoking cessation. Viral and bacterial infections of the respiratory tract then fortify these inflammatory responses. Exacerbations of COPD then worsen the deterioration of COPD.
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8,414 |
When a Diagnosis Is Reportable
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8,415 |
Emerging Viruses
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Emerging viruses are viruses that appear suddenly in the human population. These are viruses to which man has no history of exposure and thus no or limited immunity; they are not new evolutionary creations, but are viruses than man meets due to environmental changes, such as deforestation, entering into new habitats, or viruses that are transmitted from one species of animal to humans. Most of these viruses are terrifying, and cause hemorrhagic fever, a complete destruction of the circulation system; they include Lassa fever, Nipah virus, Ebola, HIV, Severe acute respiratory syndrome (SARS), and, recently, Middle East respiratory syndrome (MERS), which is the latest in a series of “new” respiratory viruses infecting man. It is possible that unknown emerging viruses are the cause of death, often listed as “death due to an unknown cause,” as in the retrospective cases of HIV. Emerging viruses might also include poliovirus and influenza, since their introduction into the human population is (was) often sudden and due to changes in the environment or due to contact with other animal species. For examples, polio was a result of changes in sanitation in the countries of North America and Western Europe, and influenza is constantly jumping from aquatic birds to man and other animal species where genomic reassortment occurs.
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8,416 |
Die medizinische Mikrobiologie im 21. Jahrhundert
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Die medizinische Mikrobiologie befasst sich mit der ursächlichen Rolle pathogener (d. h. krankheitserzeugender) Mikroorganismen bei der Entstehung von Störungen im Funktionsablauf des menschlichen Organismus. Störungen dieser Art entstehen durch Ansiedlung und Vermehrung von Mikroorganismen im Sinne des Parasitismus; sie treten als Infektionskrankheit in Erscheinung. Demgemäß betrachtet man die parasitierenden Mikroorganismen als Krankheitserreger; das befallene Individuum wird als »Wirt« oder »Makroorganismus« bezeichnet. Da bei der Betrachtung von Infektionen sowohl der Wirt mit seinen Reaktionen als auch die krankheitserzeugenden Eigenschaften eines Mikroorganismus (d. h. seine Pathogenität) im Vordergrund stehen, lässt sich die medizinische Mikrobiologie am ehesten als Infektionslehre begreifen – als Lehre von der Auseinandersetzung des Wirtes mit den krankheitserzeugenden Eigenschaften des Erregers.
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8,417 |
Severe Sepsis in the Elderly
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8,418 |
The Role of Bats as Reservoir Hosts of Emerging Neuroviruses
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Recent studies have clearly shown that bats are the reservoir hosts of a wide diversity of novel viruses with representatives from most of the known animal virus families. In many respects bats make ideal reservoir hosts for viruses: they are the only mammals that fly, thus assisting in virus dispersal; they roost in large numbers, thus aiding transmission cycles; some bats hibernate over winter, thus providing a mechanism for viruses to persist between seasons; and genetic factors may play a role in the ability of bats to host viruses without resulting in clinical disease. Within the broad diversity of viruses found in bats are some important neurological pathogens, including rabies and other lyssaviruses, and Hendra and Nipah viruses, two recently described viruses that have been placed in a new genus, Henipaviruses in the family Paramyxoviridae. In addition, bats can also act as alternative hosts for the flaviviruses Japanese encephalitis and St Louis encephalitis viruses, two important mosquito-borne encephalitogenic viruses, and bats can assist in the dispersal and over-wintering of these viruses. Bats are also the reservoir hosts of progenitors of SARS and MERS coronaviruses, although other animals act as spillover hosts. This chapter presents the physiological and ecological factors affecting the ability of bats to act as reservoirs of neurotropic viruses, and describes the major transmission cycles leading to human infection.
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8,419 |
Pulmonary Complications Associated with HSCT
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While outcomes for patients who undergo allogeneic hematopoietic stem cell transplantation (HSCT) have improved over the past 10–20 years, pulmonary complications after allogeneic HSCT remain a leading cause of morbidity and mortality. Overall, 25–50% of pediatric HSCT patients will develop pulmonary complications. Thus, prevention, early detection, and intervention are key to minimizing the sequelae from HSCT-associated pulmonary complications. HSCT-associated pulmonary complications can be classified as infectious or noninfectious, and they often follow a predictable timeline, occurring during discrete phases of HSCT (pre-engraftment, early post-engraftment, late post-engraftment). However, certain post-HSCT pulmonary complications span the entire post-HSCT course. The most common causes of noninfectious pulmonary complications are related to the conditioning regimen used which can result in varying degrees of acute or delayed lung injury, the degree of recipient–donor HLA histoincompatibility, the hematopoietic stem cell (HSC) source, the degree of graft manipulation, and the development of graft-versus-host disease (GvHD), both acute and chronic. Infectious etiologies can be caused by any class of pathogen including bacterial, viral, fungal, and protozoan. They usually occur during periods of profound and/or prolonged neutropenia and/or impaired or delayed cellular and humoral immune recovery. Immunosuppression used to prevent or treat GvHD also places a HSCT recipient at high risk for developing pulmonary infections that can be life-threatening. This chapter discusses the most common pulmonary complications associated with HSCT by time period post-HSCT.
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8,420 |
Public Health in Africa: Theoretical Framework
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These are examined as parts of the health or medical systems from an historical perspective that enables the reader to link the present to the past and vice-versa.
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8,421 |
Antiphospholipid (Hughes) Syndrome: An Overview
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In conclusion, the following observations can be made. aPL are present in approximately 2% to 4% of the normal population and the prevalence increases with age. There is a high prevalence among patients with autoimmune connective tissue disorders, especially SLE. There is an association with both venous and arterial thrombosis as well as with pregnancy morbidity, but the strength of association varies amongst studies. This probably reflects different populations, study designs, and different assays and definitions used. In several studies the risk of thrombosis appears to be higher with LA and the data suggests a true association rather than epiphenomenon. In a given patient, both aCL and LA should be measured. A significant impact on long-term survival has been noted and aPL also contribute significantly to accumulated damage in diseases such as SLE. The clinical spectrum of APS features is enormous and continues to expand. It behoves us all as clinicians and health care professionals to consider an early diagnosis of Hughes syndrome, with its distinct clinical and serological features, to reduce the risk of morbidity and mortality in our patients.
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8,422 |
Kardiologie
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8,423 |
How Disease Affected the End of the Bronze Age
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Dr. Norrie provides a summary of the fifteen currently accepted causes for the end of the Bronze Age in the Near East and then goes on to discuss the sixteenth reason—infectious disease epidemics. These are the real reason that the end of the Bronze Age in the Near East was called either the “catastrophe” or the “collapse” due to its short time frame of 50 years, the mass migration of the general population and the “Sea Peoples” plus the abandonment of cities such as Hattusa, the capital of the Hittite Empire c.1200 bce. The diseases most likely to cause this collapse are smallpox, bubonic plague and tularemia.
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8,424 |
Contagio cine qua non oder wie Al Gore die Zukunft in Brand steckte: Zukunftswissen im Filmszenario
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Die Antwort eines Handbuchs der Szenariotechnik auf die Frage, was ein Szenario ist, lautet wie folgt.
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8,425 |
Evolution of the BCL-2-Regulated Apoptotic Pathway
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The mitochondrion descends from a bacterium that, about two billion years ago, became endosymbiotic. This organelle represents a Pandora’s box whose opening triggers cytochrome-c release and apoptosis of cells from multicellular animals, which evolved much later, about six hundred million years ago. BCL-2 proteins, which are critical apoptosis regulators, were recruited at a certain time point in evolution to either lock or unlock this mitochondrial Pandora’s box. Hence, particularly intriguing is the issue of when and how the “BCL-2 proteins–mitochondria–apoptosis” triptych emerged. This chapter explains what it takes from an evolutionary perspective to evolve a BCL-2-regulated apoptotic pathway, by focusing on the events occurring upstream of mitochondria.
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8,426 |
Pathophysiologic Role of Autophagy in Human Airways
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Lung diseases are among the most common and widespread disorders worldwide. They refer to many different pathological conditions affecting the pulmonary system in acute or chronic forms, such as asthma, chronic obstructive pulmonary disease, infections, cystic fibrosis, lung cancer and many other breath complications. Environmental, epigenetic and genetic co-factors are responsible for these pathologies that can lead to respiratory failure, and, even, ultimately death. Increasing evidences have highlighted the implication of the autophagic pathways in the pathogenesis of lung diseases and, in some cases, the deregulated molecular mechanisms underlying autophagy may be considered as potential new therapeutic targets. This chapter summarizes recent advances in understanding the pathophysiological functions of autophagy and its possible roles in the causation and/or prevention of human lung diseases.
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8,427 |
Exam 3 Questions
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1. Which of thefollowing is true regarding the Barrow classification system for carotid cavernous fistulae? A. Type A shunts are indirect shunts between branches of the internal carotid artery (ICA) and cavernous sinus. B. Type B shunts are direct shunts between the ICA and cavernous sinus. C. Type C shunts are indirect shunts between branches of the external carotid artery (ECA) and cavernous sinus. D. Type D shunts are high-flow shunts. E. All of the above. 2. A 80-year-old male with an intracranial neoplasm presents to the emergency department with weight loss, drowsiness, and tachypnea for 1 month. On examination, his respiratory rate is 28 breaths/minute with a normal oxygen saturation. His lungs are clear to auscultation. An arterial blood gas reveals the following: pH 7.60, PCO(2) 14 mmHg, PaO(2) A. Central neurogenic hyperventilation. B. Cheyne-Stokes respirations. C. Apneustic breathing. D. Ataxic breathing. E. Cluster breathing. 3. A 48-year-old female is admitted to the ICU with a Hunt-Hess 2 modified Fisher 2 subarachnoid hemorrhage (SAH). She remains intact neuro-cognitively, but has transcranial doppler (TCD) mean flow velocities up to 150 cm/s, and a serum platelet count twice her baseline. You are worried about vasospasm and impending delayed cerebral ischemia. Which of the following should be performed next? A. An additional 100 mL/h of normal saline should be given on top of maintenance fluids. B. CT perfusion scan to assess for any ongoing hypoperfusion. C. Evaluate volume status with hemodynamic monitoring and give fluid boluses accordingly. D. Induce hypertension to a systolic pressure of 160 mmHg. E. Conventional angiography. 4. A 25-year-old male is currently in the ICU with an anoxic brain injury after diving into shallow waters and suffering a high cervical cord transection. Two weeks after his injury, he remains comatose, has diffuse loss of gray-white differentiation on noncontrast head CT, and exhibits myoclonic status epilepticus. The family is devastated by his poor prognosis, and distraught by his uncontrollable shaking. What is your rationale behind your decision about starting an antiepileptic regimen? A. Phenytoin and propofol will be used, and escalated until eradication of his myoclonus to assess his underlying brain damage. B. Levetiracetam and lacosamide will be used, and escalated until eradication of his myoclonus to assess his underlying brain damage. C. If EEG reveals dyssynchronous spikes on a severely slow background, myoclonus invariably portends death or a vegetative state, and midazolam should only be used for palliative purposes. D. Regardless of EEG or clinical exam, half of patients in myoclonic status epilepticus will have a good neurologic recovery by 90 days. E. Regardless of EEG or clinical exam, myoclonic status epilepticus is always ominous, not amenable to treatment. and should lead to immediate withdrawal of life-support. 5. An 18-year-old female presents to the emergency department with several months of progressive left-sided hearing loss and tinnitus. An MRI of the brain is performed, demonstrating bilateral enhancing dumbbell shaped lesions extending from the auditory canal to the cerebellopontine angle. Which of the following genetic disorders is associated with this finding? A. Von Hippel-Lindau syndrome. B. Neurofibromatosis type II. C. Tuberous sclerosis. D. Schwannomatosis. E. Alport syndrome. 6. A 23-year-old female is brought to the emergency department by her boyfriend with difficulty breathing. She cannot provide her history, but her boyfriend states that she has asthma, although he is unsure of her medications. On physical exam the woman is noted to have nasal flaring, is diaphoretic, cannot lie flat, and is breathing at a rate of 40 breaths/minute. She is given short acting ß(2) agonist treatments with no obvious relief of her symptoms. Serial arterial blood gases are done and show a pCO(2) A. Continue short-acting ß(2) agonist treatment, as her pCO(2) is normalizing, and continue observation in the emergency department. B. Intubate the patient and admit to the ICU. C. Administer intravenous corticosteroids and admit to the general medical ward. D. Place the patient on non-invasive positive pressure ventilation and admit to the general medical ward. E. Administer a long-acting ß(2) agonist agent and admit to the general medical ward. 7. Cerebellar hypoplasia without displacement through the foramen magnum is best described as a: A. Chiari I malformation. B. Chiari II malformation. C. Chiari III malformation. D. Chiari IV malformation. E. Chiari V malformation. 8. A 77-year-old female with a history of hypertension, atrial fibrillation, and diabetes mellitus has recently been taken off of warfarin due to frequent falls and gait instability. She has not had any prior significant bleeding or ischemic events. A recent echocardiogram demonstrates moderate aortic regurgitation with grossly preserved systolic and diastolic function. Which of the following elements is not a stroke risk factor in this patient? A. Age. B. Female gender. C. Hypertension. D. Diabetes mellitus. E. Aortic regurgitation. 9. Which of the following is the most effective measure to prevent aspiration in an intubated patient? A. Elevation of the head of the bed. B. Subglottic drainage. C. Gastric volume monitoring. D. Nasogastric tube placement. E. Percutaneous endoscopic gastrotomy. 10. Which of the following is a unique feature of Comprehensive Stroke Centers? A. Dedicated stroke unit availability. B. 24/7 ability to administer tPA. C. 24/7 interventional neuroradiology availability. D. 24/7 CT angiography availability. E. Ambulance receiving capability. 11. Which of the following segments of the internal carotid artery is farthest from it’s origin? A. Ophthalmic segment. B. Petrous segment. C. Cavernous segment. D. Clinoid segment. E. Lacerum segment. 12. A 44-year-old male is intubated secondary to a high-grade subarachnoid hemorrhage, and is admitted to the ICU. On the sixth postoperative day, he develops worsening hypoxemia and bilateral interstitial infiltrates on his chest x-ray, consistent with acute respiratory distress syndrome (ARDS). Which of the following interventions has not been demonstrated to improve outcomes in ARDS in a prospective randomized trial? A. Prone positioning. B. Lung-protective ventilation. C. Extracorporeal membrane oxygenation (ECMO). D. Neuromuscular blocking agents. E. High-frequency oscillatory ventilation (HFOV). 13. A 56-year-old female is currently intubated in the ICU following a left basal ganglia hemorrhage. The nurse reports the patient is having copious thick secretions, and you are considering initiating inhaled N-acetylcysteine therapy. What element of the patient’s past medical history may serve as a relative contraindication to this treatment? A. Amiodarine-induced pulmonary fibrosis. B. Newly diagnosed metastatic adenocarcinoma of the lung. C. Recent course of outpatient antibiotics for community-acquired pneumonia. D. Poorly controlled asthma. E. All of the above. 14. An 18-year-old female is currently being evaluated for amenorrhea. In addition, she endorses fatigue, cold intolerance, polyuria and dizziness upon standing. On examination, she is thin but appears well hydrated. Blood pressure and heart rate when supine are 90/60 mmHg and 80 beats/minute, respectively. When standing, they are 60/40 mmHg and 120 beats/minute, respectively. Pubic and axillary hair growth is sparse. Eye examination reveals an asymmetric bitemporal hemianopsia. Imaging reveals a cystic, calcified suprasellar mass. Which of the following statements is true regarding the most likely diagnosis? A. Medical management is the mainstay of treatment. B. Recovery of pituitary function is common. C. This patient likely has the papillary subtype of this neoplasm. D. This neoplasm has a bimodal age distribution. E. This neoplasm arises from modified glial cells that reside in the infundibular neurohypophysis. 15. A 55-year-old female presents to the emergency department after collapsing at home. The patient was arguing with her husband before she suddenly became unresponsive. The patient is intubated, and a non-contrast head CT is performed (see Image 1). The patient then undergoes conventional angiography, revealing occlusion of the proximal bilateral middle cerebral and anterior cerebral arteries with extensive collateral vessels noted. All of the following are true regarding the most likely diagnosis except: A. The disease can be either congenital or acquired. B. Patients may suffer recurrent infarcts, or remain completely asymptomatic. C. There are no effective surgical interventions available. D. It is more commonly seen in women than in men. E. Patients may initially present with persistent headaches;
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8,428 |
Adult-Onset Still’s Disease
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Adult-onset Still’s disease (AoSD) is a rare but clinically well-known, polygenic, systemic autoinflammatory disease. It is typically characterized by four main (cardinal) symptoms: spiking fever ≥39 °C, arthralgia or arthritis, skin rash, and hyperleukocytosis (≥10,000 cells/mm(3)). However, many other clinical features are possible, and it can appear in all age groups with potentially severe inflammatory onset accompanied by a broad spectrum of disease manifestation and complications. Hence, it remains a diagnostic challenge, and the clinician should first rule out infectious, tumoral, or inflammatory differential diagnoses. Determination of the total and glycosylated ferritin levels, although not pathognomonic, can help in diagnosis. New biomarkers have recently been described, but they need to be validated. The disease evolution of AoSD can be monocyclic, polycyclic, or chronic. In chronic disease, a joint involvement is often predominant, and erosions are noted in one-third of patients. Many progresses have been made in the understanding of the pathogenesis over the last decades. This chapter provides a comprehensive insight into the complex and heterogeneous nature of AoSD describing the identified cytokine signaling pathways and biomarkers. It also discusses the current evidence for the usage of biologics in AoSD to provide guidance for treatment decisions, taking into account both the efficacy and the safety of the different therapeutic options.
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8,429 |
The Chemical and Biological Properties of Propolis
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The term propolis comes from two Greek words, pro (which means for or in defence of) and polis (which means the city); thus, propolis means in defence of the city or beehive. Propolis is a sticky resinous substance, which is gathered from buds and the bark of trees. It is also known as “bee glue” as bees use it to cover surfaces, seal holes and close gaps in their hives, thus providing a sterile environment that protects them from microbes and spore-producing organisms, including fungi and molds. It can be considered to be a potent chemical weapon against bacteria, viruses, and other pathogenic microorganisms that may invade the bee colony. Also, bees use propolis as an embalming substance, to mummify invaders such as other insects, that have been killed and are too heavy to remove from the colony. Thus, propolis is important for bee health but it also has activity against many human diseases. It is a powerful anti-oxidant and can modulate the activity of reactive oxygen species within the human body. The most studied aspect of propolis is its anti-bacterial activity, which is almost always present at a moderate to high level depending on the exact type of propolis. It is in general more active against Gram positive than Gram negative bacteria, but activity against Gram negative bacteria has been observed. Propolis has been found to be active against a range of viruses and also is almost always active against protozoa such as Tryanosoma brucei and Leishmania donovani. Propolis also shows activity against cardiovascular diseases and diabetes and has immunomodulatory effects. Anti-cancer activity has also been observed. In summary, propolis is remarkable for its range of biological activities and for the variety of its chemical composition. It may be of great importance both to bees and humans.
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8,430 |
Case Study – Romania
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Countering bioterrorism, as other health threats caused by infectious agents, requires good preparedness, and early warning and response, which can be achieved by an efficient epidemiological surveillance system. In 1990, Romania inherited a functional and quite efficient epidemiological surveillance system from the former communist regime, based on pyramidal and autocratic principles where the state control was absolute. In 2001, the assessment conducted by WHO/Europe showed many unsatisfactory elements of the remaining epidemiological surveillance system for communicable diseases, with a lack of procedures, poor microbiology laboratory capacities, and overlapping responsibilities. The lack of a coordinating body was evident, especially during bioterrorist threats following 9/11 attacks in New York. In 2003 and 2004, the PHARE Project offered an important opportunity for Romania to improve the Romanian System of Epidemiological Surveillance and Control of Communicable Diseases. At the end of this project many of the technical capacities had been improved, specialized trainings of epidemiologists and microbiologists were carried out, and a coordinating body of the epidemiological surveillance network was established [1]. Furthermore, a National Plan of Action was approved by the Minister of Health with the declared objective to improve the system in order to comply with EU standards. At present, the National Institute of Public Health hosts the National Center for Communicable Diseases Surveillance and Control which coordinates the epidemiological network and serves as the Romanian focal point for international institutions such as WHO and ECDC. Each year, comprehensive reports regarding surveillance in Romania of many communicable diseases are published, including diseases potentially related to bioterrorism. Until now, no evidence of a bioterrorism event has been registered in Romania.
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8,431 |
Time and Travel
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8,432 |
Nanomolecular Diagnostics
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8,433 |
Phylogenetics Algorithms and Applications
|
Phylogenetics is a powerful approach in finding evolution of current day species. By studying phylogenetic trees, scientists gain a better understanding of how species have evolved while explaining the similarities and differences among species. The phylogenetic study can help in analysing the evolution and the similarities among diseases and viruses, and further help in prescribing their vaccines against them. This paper explores computational solutions for building phylogeny of species along with highlighting benefits of alignment-free methods of phylogenetics. The paper has also discussed the application of phylogenetic study in disease diagnosis and evolution.
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8,434 |
SARS coronavirus main proteinase 3.4.22.69
|
EC number 3.4.22.69 Recommended name SARS coronavirus main proteinase Synonyms 3C-like protease <2,3> [9,16,38,49,51] 3CL protease <2> [14,48] 3cLpro <1,2,3> [7,11,13,16,19,28,38,49,51] C30.004 (Merops-ID) Mpro SARS 3C-like protease <2> [17] SARS 3C-like proteinase <2> [15,18,27] SARS 3CL protease <2> [31] SARS 3CLpro <2> [49] SARS CoV main proteinase <2> [1,2,4,5] SARS CoVMpro <2> [33] SARS Mpro <2> [25] SARS coronavirus 3C-like protease <2> [48] SARS coronavirus 3C-like proteinase <2> [50] SARS coronavirus 3CL protease <2> [20] SARS coronavirus main peptidase <2> [23] SARS coronavirus main protease <2> [25] SARS coronavirus main proteinase <2> [5,33] SARS main protease <2> [12,25] SARS-3CL protease <2> [48] SARS-3CLpro <2> [29,50] SARS-CoV 3C-like peptidaseSARS-CoV 3C-like peptidase<2> [24] SARS-CoV 3C-like protease<1> [19] SARS-CoV 3CL protease <2> [22,30,44,46] SARS-CoV 3CLpro <2> [32,36,38,44,45] SARS-CoV 3CLpro enzyme <2> [11] SARS-CoV Mpro <2> [21,40] SARS-CoV main protease <2> [21,26,43] SARS-coronavirus 3CL protease <2> [8] SARS-coronavirus main protease <2> [47] TGEV Mpro coronavirus 3C-like protease <1> [19] porcine transmissible gastroenteritis virus Mpro severe acute respiratory syndrome coronavirus 3C-like protease <2> [41,42] severe acute respiratory syndrome coronavirus main protease <2> [21] severe acute respiratory syndrome coronavirus main proteinase <2> [33] CAS registry number 218925-73-6 37353-41-6
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8,435 |
Inflammation
|
Inflammation was described as early as 3000 BC in an Egyptian papyrus [1] and is still a common problem despite continuous advancements in prevention and treatment methods. The delineation of the site and extent of inflammation are crucial to the clinical management of infection and for monitoring the response to therapy [2].
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8,436 |
Intensivmedizin bei neurologischen Erkrankungen
|
Eine 73-jährige Frau wird verwahrlost und wesensverändert im Treppenhaus ihres Wohnhauses vorgefunden. Die Notärztin stellt eine Temperatur von 39,5°C, eine deutliche Exsikkose und basale Rasselgeräusche beidseits fest. Die Patientin lehnt eine stationäre Krankenhausbehandlung vehement ab und muss daher mittels Psychisch-Kranken-Gesetz (PsychKG) eingewiesen werden. Bei Verdacht auf eine Pneumonie ruft die Pflegekraft in der Notaufnahme den diensthabenden Internisten hinzu.
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8,437 |
Synthetic Biology, Dual Use Research, and Possibilities for Control
|
The anthrax attack on the human population in the United States in 2001/2002 may be considered the naissance of modern bioterrorism. This attack, e.g. the planned killing by means of deadly microorganisms (Bacillus anthracis) caused enormous public concern, because, numerous other deadly agents, now known as “select agents”, occur in nature and are available for misuse. The anthrax attack coincided with the first report in 2002 of the de novo synthesis in the test tube of a pathogenic human virus, poliovirus, that was equally shocking because it indicated that dangerous infectious agents could be produced in laboratories outside of government control. These events were synchronous with the advent of a new discipline, Synthetic Biology, which was an emerging area of research that can broadly be described “as the design and construction of novel artificial biological pathways, organisms or devices, or the redesign of existing natural biological systems.” The synthesis of viruses, or more broadly expressed: each experiment in Synthetic Biology, fits the definition of “Dual Use Research” – the dual use dilemma in which the same technologies can be used for the good of humans and misused for bioterrorism. In view of these threats the US Government has formulated rules that can lower the chances of misuse of biological research. That includes all research with select agents or the modification of agents to acquire dangerous traits (“Gain of Function”). It also calls for the continuous education of all generations entering research: to be aware that results of research can be dangerous, if not immediately then possibly at later times.
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8,438 |
The Microbe: The Basics of Structure, Morphology, and Physiology as They Relate to Microbial Characterization and Attribution
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This chapter is meant to (1) review classical methods used to characterize and classify microbes and (2) introduce new molecular methods used in microbial characterization. The fundamental composition of microbes is discussed as well as their importance in classification of microbes into genus and species. Classical microbiological methods in general seek to define the common features of specific bacterial groups as a means of classification and identification of microbes. Thus, the focus was to describe the common features which discriminated closely related groups of organisms. In contrast, the newer molecular methods often seek to expand the classification of microbes not only as a means to organize microbial phylogeny but also to differentiate signatures between microbes identified within a species in greater detail. Molecular biology tools are used both as an adjunct to established methods and as replacement for classical methods for detection, discrimination, or identification of bacterial and viral species.
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8,439 |
Intensivmedizin bei neurologischen Erkrankungen
|
Eine 73-jährige Frau wird verwahrlost und wesensverändert im Treppenhaus ihres Wohnhauses vorgefunden. Die Notärztin stellt eine Temperatur von 39,5°C, eine deutliche Exsikkose und basale Rasselgeräusche beidseits fest. Die Patientin lehnt eine stationäre Krankenhausbehandlung vehement ab und muss daher mittels Psychisch-Kranken-Gesetz (PsychKG) eingewiesen werden. Bei Verdacht auf eine Pneumonie ruft die Pflegekraft in der Notaufnahme den diensthabenden Internisten hinzu.
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8,440 |
In-Vehicle Exposures at Transportation and the Health Concerns
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In-vehicle environment is a special indoor environment, which is mobile, either open or closed. This chapter reviewed in-vehicle air quality and passenger exposures for roadway commuters, commercial airplanes, and marine transportation. The sources of pollutants in-vehicle can be categorized as the same as other indoor environments, including outdoor air, human activity, emission from building material and interior furnisher, and biological metabolic process from animals and microbes. However, the exposure in vehicles varies from now and then, influenced by window open/closed, speed, air flow, ventilation on/off, air conditioner on/off, pollutants from ambient outdoor air, interior material, and number of passengers. There are few studies on health condition of passengers, except infectious disease during airway transportation. Some health studies of related occupations are reviewed.
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8,441 |
Pneumologie
| null |
8,442 |
Environmental survival and microbicide inactivation of coronaviruses
| null |
8,443 |
Carbohydrate Microarrays
|
Carbohydrates, like nucleic acids and proteins, are essential biological molecules. Owing to their intrinsic physicochemical properties, carbohydrates are capable of generating structural diversity in a multitude of ways and are prominently displayed on the surfaces of cell membranes or on the exposed regions of macromolecules. Recent studies highlight that carbohydrate moieties are critical for molecular recognition, cell-cell interactions, and cell signaling in many physiological and pathological processes, and for biocommunication between microbes and host species. Modern carbohydrate microarrays emerged in 2002 and brought in new high-throughput tools for “glyco code” exploration. In this section, some basic concepts of sugar chain diversity, glyco-epitope recognition, and the evolving area of glyco-epitomics and biomarker discovery are discussed. Two complementary technologies, carbohydrate antigen arrays and photogenerated glyco-chips, serve as models to illustrate how to apply carbohydrate microarrays to address biomedical questions.
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8,444 |
Allgemeine Chirurgie
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Die chirurgische Diagnostik, bestehend aus Anamnese, klinischer Untersuchung und der meist nachfolgenden technischen Diagnostik, unterscheidet sich in ihren Grundprinzipien grundsätzlich nicht von denen anderer klinischer Fachgebiete. Bei akuten Erkrankungen muss sie schnell und zielführend erfolgen, um die Indikationsstellung zu einer Operation oder dem interventionellen oder konservativem Behandlungsverfahren nicht zu verzögern.
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8,445 |
Nephrologie
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Zentrale Themen in der Nephrologie und auch in diesem Kapitel sind akute und chronische Niereninsuffizienz. Ebenfalls behandelt werden Krankheiten aus der Gruppe der Glomerulonephritiden (wie z. B. IgA-Nephropathie oder rasch progrediente Glomerulonephritis), der tubulointerstitiellen Nierenerkrankungen (z. B. infolge von Hanta-Virus-Infektionen oder die Analgetika-Nephropathie) und der Nierentumoren/-zysten. Darüber hinaus ist ein Abschnitt den Harnwegsinfektionen sowie den Nierensteinen gewidmet.
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8,446 |
Multiple Sequence Alignment
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The multiple sequence alignment (MA) plays an important role in sequence analysis. However, it has been proven to be an NP-hard problem. This means the computation complexity of MSA increases exponentially with the number of sequences. The presented algorithms are mostly heuristic and many of them are based on pairwise sequence alignment. Hence we begin with pairwise alignment of multiple sequences and discuss the topological space induced by pairwise alignment of multiple sequences, since different optimization criteria may lead to different results. We discuss several optimization indices here: the sum of pairs (SP); Shannon entropy; similarity rate and the rate of virtual symbols. Based on this discussion, we present a new multiple sequence alignment based on SPA called super multiple sequence alignment (SMA). We give a detailed description of the algorithm and compare it to some popular MA algorithms and find that it works well enough, especially with respect to speed. An example of SARS multiple sequence alignment is given at the end of this chapter.
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8,447 |
Emerging Viral Infections
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Emerging viral pathogens are a major cause of severe infections that constitute serious complications in patients with hematological disorders. During the last decade, a large number of viruses were discovered using optimized molecular techniques and systematic screening approaches. Most of the newly detected viruses affect the respiratory tract, causing common colds and also, especially in high-risk patients, life-threatening events. On the other hand, a substantial proportion of patients are reinfected by old viruses that were previously described only rarely or not at all in cancer patients. This chapter focuses on both emerging viruses and reemerging viral infections that affect patients with hematological malignancies.
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8,448 |
Update in Pediatric Emergency Medicine: Pediatric Resuscitation, Pediatric Sepsis, Interfacility Transport of the Pediatric Patient, Pain and sedation in the Emergency Department, Pediatric Trauma
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This chapter summarizes the state-of-the-art approach to several critical aspects of pediatric emergency care. While the field of pediatric emergency medicine is much broader, we have chosen some key topics which are essential for every physician providing care to children. The resuscitation section highlights the challenges and the particularities of pediatric airway management as well as the correct technique for effective cardiopulmonary resuscitation, defibrillation and vascular access. The sepsis section stresses that the key to a successful outcome is early recognition; it outlines the clinical spectrum of sepsis, the systemic inflammatory response and the pathophysiology of septic shock, with emphasis on early clinical signs, airway management, volume resuscitation, vasoactive support and antibiotic therapy. In the last decade, attention to pediatric pain management has resulted in increasing awareness of assessment tools and pharmacologic as well as non-pharmacologic strategies for pain control and anxiolysis. The pain section updates these important aspects of pediatric care and includes management of procedural sedation. Although the general principles of trauma care in children are similar to those of adults, the trauma section highlights the key differences, with respect to anatomy and physiology, and how these impact on early recognition of hemorrhagic shock, susceptibility to specific injuries, indications for imaging (no pan-CTs!) and the more prevalent non-surgical management. Healthcare providers must also know how to safely transport a child who requires additional resources or an escalation in level of care. The regionalization of pediatric intensive care units and trauma services has made it imperative for pediatricians to understand the general principles of transport medicine outlined in this chapter. The overview of pediatric inter-facility transport discusses choice of transport team and modality, emphasizes patient stabilization prior to transport and outlines required medications and supplies.
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8,449 |
Prevention Strategies and Promoting Psychological Resilience to Bioterrorism Through Communication
| null |
8,450 |
A Compact Imaging Ellipsometer for Label-free Biosensor
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A compact model of imaging ellipsometer is used for the data acquisition and analysis of label free protein microarray. Its principle, methodology, and experimental setup as well as sampling conditions and a demonstration result are presented here. Furthermore, results of protein adsorption and protein interaction in the microarray may be deduced. This shows that the compact model is effectively performed as a reader for the protein microarray sampling and provides a potential for applications of label free protein microarrays on site of care.
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8,451 |
Pathogenesis
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Pathogenesis describes the spread of a virus in the organism and the mutual relationship between the pathogen and its host during infection. These processes can be analysed in several ways by using different histological, virological and immunological methods. Viral infections can be with or without symptoms (also called apparent or inapparent infection courses). In both cases, the host organism responds with immunological defence responses, which usually lead to overcoming the primary disease symptoms and to the elimination of the virus. The immune response may also contribute in the context of immunopathogenesis to specific disease symptoms and either temporary or permanent damage to the host.
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8,452 |
A Historical Perspective on Paper Microfluidic Based Point-of-Care Diagnostics
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Paper-based microfluidic systems have emerged as one of the most favorable technologies used in many potential applications such as point-of-care diagnostics, flexible electronics, energy storage, etc. From the past several decades, paper-based technology has readily accepted in the academic research lab and industries as well. The paper-based devices have changed the life of humankind. The distinguishing characteristics of paper substrate like low cost, biodegradability, biocompatibility, and ease of fabrication helped their adaptability in biosensing applications. This chapter gives a concise overview of the historical perspective of paper-based devices, classification of paper types, and their recent applications.
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8,453 |
Applications of Microbial Biopolymers in Display Technology
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Microorganisms produce a variety of different polymers such as polyamides, polysaccharides, and polyesters. The polyesters, the polyhydroxyalkanoates (PHAs), are the most extensively studied polymers in regard to their use in display technology. The material properties of bacterial PHAs in combination with their biocompatibility and biodegradability make them attractive substrates for use in display technology applications. By translationally fusing bioactive molecules to a gene encoding a PHA-binding domain, the appropriate functionalization for a given application can be achieved such that the need for chemical immobilization is circumvented. By separately extracting and processing the biopolymer, using it to coat a surface, and then treating this surface with the fusion proteins, surface functionalization for immunodiagnostic microarray or tissue engineering applications can be accomplished. Conversely, by expressing the fusion protein directly in the PHA-producing organisms, one-step production of functionalized beads can be achieved. Such beads have been demonstrated in diverse applications, including fluorescence-activated cell sorting, enzyme-linked immunosorbent assays, microarrays, diagnostic skin test for tuberculosis, vaccines, protein purification, and affinity bioseparation.
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8,454 |
Lungenfunktionsdiagnostik
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Lungenfunktionsdiagnostik beinhaltet eine Vielzahl von Messmethoden, mit denen jeweils bestimmte Qualitten der Lungen in verschiedenen Altersgruppen überwiegend nichtinvasiv untersucht werden können.
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8,455 |
A Tour of the Basic Reproductive Number and the Next Generation of Researchers
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The Mathematical and Theoretical Biology Institute (MTBI) is a national award winning Research Experience for Undergraduates (REU) that has been running every summer since 1996. Since 1997, students have developed and proposed their own research questions and derived their research projects from them as the keystone of the program. Because MTBI’s mentors have no control over what students are interested in, we need to introduce a suite of flexible techniques that can be applied to a broad variety of interests. In this paper, we walk through examples of some of the most popular techniques at MTBI: epidemiological or contagion modeling and reproductive number analysis. We include an overview of the next generation matrix method of finding the basic reproductive number, sensitivity analysis as a technique for investigating the effect of parameters on the reproductive number, and recommendations for interpreting the results. Lastly, we provide some advice to mentors who are looking to advise student-led research projects. All examples are taken from actual student projects that are generally available through the MTBI website.
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8,456 |
Volume 6 Indexes
|
This index lists all 3367 normalized pharmacological activity terms appeared in the encyclopedia in alphabetical order and a number code sequence of the related compounds follows the bold term immediately.
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8,457 |
Medical Technology Management in Hospital Certification in Mexico
|
Mexican health policy is promoting the quality of health services by hospital certification meeting the NMX-CC standards family, which is the Mexican equivalent of the ISO 9000 standards family. These standards can help both product- and service-oriented organizations achieve standards of quality that are recognized and respected throughout the world in developing a quality management system (QMS).
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8,458 |
Blut und Blutprodukte
| null |
8,459 |
Bildgebende Verfahren: Röntgen, Ultraschall, CT, Nuklearmedizin
|
In der Intensivmedizin findet die radiologische Diagnostik überwiegend am Krankenbett statt (»bedside radiology«). Etwa 90 % der radiologischen Untersuchungen in der Intensiv- und Notfallmedizin stellen projektionsradiographische Röntgenaufnahmen des Thorax, des Abdomens und des Skelettsystems dar. In zunehmendem Maße werden neben den klassischen Aufnahmen auch die Schnittbildverfahren eingesetzt. Hier kommt der Ultraschalldiagnostik eine führende Rolle zu, gefolgt von der Computertomographie (CT).
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8,460 |
Sports-Related Injuries and Deaths
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Physical activity in children and adolescents should be strongly encouraged. While there is a very low risk of death associated with participation in athletics within this age group, the epidemic of childhood obesity and sedentary lifestyle must be combated to ensure the long-term health and quality of life of today’s youth. Sports-related deaths due to trauma are usually readily identified; others require careful examination, adjunctive testing, and/or the expertise of consultants. A thorough investigation of circumstances surrounding the death, review of the medical records, and autopsy is mandated in these cases.
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8,461 |
Hyperlipidemias and Obesity
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The organs require oxygen and other types of nutrients (amino acids, sugars, and lipids) to function, the heart consuming large amounts of fatty acids for oxidation and adenosine triphosphate (ATP) generation.
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8,462 |
Survival of Microorganisms on Inanimate Surfaces
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In healthcare settings microbial contaminated surfaces play an important role in indirect transmission of infection. Especially surfaces close to the patients’ environment may be touched at high frequencies, allowing transmission from animated sources to others via contaminated inanimate surfaces. Therefore, the knowledge on the survival of bacteria, fungi, viruses and protozoa on surfaces, and hence, in a broader sense, in the human environment, is important for implementing tactics for prevention of Healthcare-acquired Infections (HAI). This chapter will elaborate the role of surfaces in the transmission of pathogens. Particular emphasis is laid on the current knowledge of the survival time and conditions favouring survival of the pathogens. Finally, mechanisms of transmission from inanimate surfaces to patients are highlighted. Within the multi-barrier strategy of the prevention of HAI, environmental disinfection policies should be based on risk assessments for surfaces with different risks for cross contamination such as high- and low-touched surfaces with appropriate standards for adequate disinfection measures under consideration of the persistence and infectious dose of the pathogens. As a result, surface disinfection is indicated in the following situations: Frequently touched surfaces adjacent to patients. Surfaces with assumed or visible contamination. Terminal disinfection in rooms or areas where infected or colonized patients with easily transferable nosocomial pathogens are cared for, and in outbreak situations. Furthermore, the knowledge of the persistence of pathogens will also support ensuring the biosafety in microbiological and biomedical laboratories, food-handling settings, and for hygienic behaviour in the everyday life to prevent transmission of infectious diseases.
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8,463 |
The Nucleolus: Structure and Function
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The nucleolus is the largest nuclear organelle and is the primary site of ribosome subunit biogenesis in eukaryotic cells. It is assembled around arrays of ribosomal DNA genes, forming specific chromosomal features known as nucleolar organizing regions (NORs) which are the sites of ribosomal DNA transcription. While the nucleolus main activity involve different steps of ribosome biogenesis, the presence of proteins with no obvious relationship with ribosome subunit production suggests additional functions for the nucleolus, such as regulation of mitosis, cell cycle progression, stress response and biogenesis of multiple ribonucleoprotein complexes. The many novel factors and separate classes of proteins identified within the nucleolus support this view that the nucleolus may perform additional functions beyond its known role in ribosome subunit biogenesis. Here we review our knowledge of the nucleolar functions and will provide a detailed picture of how the nucleolus is involved in many cellular pathways.
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8,464 |
SARS coronavirus infection: pathology and pathogenesis of an emerging virus disease
| null |
8,465 |
Cardiology
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myocardial—myocardial infarction, angina, myocarditis
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8,466 |
Dried Plasma
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Dried plasma provides an alternative for early plasma transfusion in the resuscitation of hemorrhagic shock in environments where fresh frozen plasma is not immediately available. It is produced by freeze-drying or spray-drying liquid or thawed plasma. It is shelf-stable for prolonged periods, can be stored at room temperature, and is easy to transport, reconstitute, and administer. It was widely used in WWII but fell out of favor due to the risk of infectious disease transmission. The German and French experiences with lyophilized plasma are the most extensive and show a good track record of efficacy and safety. Recent studies show many beneficial effects of dried plasma in the treatment of shock in large animal models. Currently, no FDA-licensed product is available in the USA, but several are under development.
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8,467 |
Importance of Natural Proteins in Infectious Diseases
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Proteins are important biomolecules, extensively involved in almost all biological processes. A number of proteins are also implicated in infectious diseases. Bacterial proteins used in adhesion to host epithelium, bacterial toxins, and viral membrane glycoproteins are some of the proteins involved in infectious diseases. Even components of the host innate immune system like Toll-like receptors and Nod-like receptors and adaptive immune components like immunoglobulins aiding in defense against pathogens are important biological proteins. Chaperones like acid and heat shock proteins provide protection from high temperatures, metabolic poisons, and other stressful conditions. Several natural and artificial proteins are components of vaccines, a key strategy to control fatal diseases, lacking empirical treatment. It is necessary to investigate these proteins, to develop new biomedical tools and technologies, aiding in eradication of various diseases. Thus, further research should be carried out in this field, for saving and improving quality of human lives.
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8,468 |
Current Concepts of Severe Pneumococcal Community-acquired Pneumonia
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Community-acquired pneumonia (CAP) is a major health problem, even in developed countries, being the leading cause of death due to infectious diseases in the USA [1]. CAP has a wide clinical spectrum of severity: up to 80% of patients are successfully managed in primary care, but 1% of patients with CAP are classified as having severe disease, needing intensive care unit (ICU) admission, with 20–50% dying despite all available support and treatment options being utilized. Streptococcus pneumoniae is the most common cause of CAP, enclosing the subset group of patients having severe disease [2]. Moreover, bacteremia is not uncommon in pneumococcal CAP (20%) and has been associated with increased severity and mortality compared with non-bacteremic pneumonia [3].
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8,469 |
Argument from Analogy
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Similarities between objects, people and places pervade our thinking and influence our interaction with the environment. Many of these similarities serve no logical purpose but have a descriptive or explanatory function in our cognitive affairs. However, for the substantial number of analogies which are used in argument, their logical and other attributes have long been a source of fascination for investigators in a range of disciplines. It is argued in this chapter that cognitive agents use the argument from analogy as a facilitative heuristic to guide their judgements about public health problems when evidence or knowledge is not available in a particular context. To this extent, the argument is one type of adaptation of our rational procedures to the problem of uncertainty in the cognitive domain. Several examples of the use of this argument in a public health context are examined. The dialectical and epistemic features of this argument are addressed within a discussion of the use of analogical argument in systematic and heuristic reasoning. The results of a study of public health reasoning reveal that members of the public are adept at identifying the conditions under which the use of analogical argument is more or less rationally warranted.
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8,470 |
Vaccinia and Pox-Virus
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Vaccinia virus has been studied extensively since its discovery as a smallpox vaccine in 1798. Its use as a smallpox vaccine documented its safety profile. It was later found that its large size and ability to accept large fragments of DNA combined with its natural tumor affinity make it an attractive agent for cancer therapy. This chapter discusses the history of the vaccinia, the various strains available, the biology of the virus as well as the steps in creating recombinants. The various clinical and safety considerations will be addressed. We will also discuss the various methods used to treat cancer using the vaccinia virus and will review the recent clinical trials using vaccinia in the treatment of cancer.
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8,471 |
Economic aspects of vaccines and vaccination: a global perspective
| null |
8,472 |
Infectious Diseases
|
Commercial airline travel creates conditions conducive to the spread of infectious diseases: the proximity of passengers in a confined space and the origin of flights from anywhere on the globe. This chapter describes symptoms of infectious diseases that might emerge in an airline passenger and the steps that a responding medical professional can take to stabilize the person and minimize the exposure risk for other passengers and the crew. It also reviews guidelines issued by the Centers for Disease Control regarding infectious diseases that might be encountered during flights, procedures for working with pilots to alert ground crews about passengers’ medical needs, and requirements for reporting incidents to authorities after landing.
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8,473 |
The Basic Concept of Microbiology
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Aseptic technique is a method that involves target-specific practices and procedures under suitably controlled conditions to reduce the contamination from microbes. It is a compulsory laboratory skill to conduct research related in the field of microbiology. Mycologist/microbiologists must follow aseptic techniques for multiplicity procedures such as screening of isolates/strains, pure cultures, slant cultures, single spore cultures, microbes transferring cultures, inoculating media, and conducting several microbiological experiments. Proper aseptic technique has prevented the cultures contamination from inborn and outborn microbes in the environment. As example, airborne microbes (e.g., fungi) handpicked from the surveyor’s health, the lab benchtop, unsterilized glassware and equipment, dust, and other areas, thus interfering to get proper experiment results. Using the proper aseptic technique can significantly reduce/minimize the risk of contamination.
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8,474 |
Respiratory Viruses and Other Relevant Viral Infections in the Lung Transplant Recipient
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As advances occur in surgical technique, postoperative care, and immunosuppressive therapy, the rate of mortality in the early postoperative period following lung transplantation continues to decline. With the improvements in immediate and early posttransplant mortality, infections and their sequel as well as rejection and chronic allograft dysfunction are increasingly a major cause of posttransplant mortality. This chapter will focus on infections by respiratory viruses and other viral infections relevant to lung transplantation, including data regarding the link between viral infections and allograft dysfunction.
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8,475 |
Computer Network Vulnerabilities
| null |
8,476 |
Attainment – achieving compliance with ESARIS standards
|
The ESARIS Attainment Model (or: ESARIS Compliance Attainment Model) relates to activities ensuring that the ESARIS security standards are actually implemented and comprise methods for verifying this (Sect. 7.1). In the first place, the ESARIS security standards have to be developed by starting with requirements engineering as the basis (Sect. 7.2). The “Attainment” is organized into five ESARIS Attainment Levels which relate to the achievement of milestones in delivering ICT services according to the methods, procedures, and standards of ESARIS. The first three levels are related to more technical activities (IT engineering, implementation), the set-up for delivery (operations) and include methods for measuring the compliance (Sect. 7.3). The other two levels relate to the integration into portfolio and service catalogs. The portfolio development and the consideration of security in service catalogs (Sect. 7.4) are important for user organizations or even the next party in the internal supply chain of the ICT Service Provider.
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8,477 |
Noncoding RNA Expression During Viral Infection: The Long and the Short of It
|
New technologies have expanded our view of viral–host interactions with the growing identification of non-coding RNAs (ncRNAs) that act as key regulators of viral infection. In this chapter, we explore novel genomics-based approaches used to characterize ncRNAs involved in viral infection, focusing mainly on microRNAs and long noncoding RNAs. We present recent evidence implicating virally encoded and host-derived ncRNAs in viral replication and pathogenesis regulation, focusing on four different viral diseases (IAV, KHSV, HIV, and HBV). Finally, we discuss the current knowledge of ncRNAs modulation of innate and adaptive immune responses to viral infection. These findings highlight the complexity of host–pathogen networks determining the outcome of viral disease. Understanding the role of ncRNAs in these networks may offer novel antiviral therapy and diagnostic tools.
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8,478 |
Public Health Lessons: Practicing and Teaching Public Health
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The following four cases represent events that actually occurred at the local, statewide, national, and international levels. A general, succinct overview is provided of each case with references listed should the reader want to access additional resource materials. The concise format of these cases is intended to generate questions. Following the general overview of each case, I examine the lessons learned from the practitioner and educator perspective and I list the skills necessary to address the issues in the case. The reader will note that there are skills that are essential for the public health practitioner to master, whether one is in an internship, entry-level position, or the director of a public health organization and so these skills are consistently listed. I encourage the reader to regularly keep abreast of the news locally and abroad and to set aside time before a staff meeting or supervisory group meeting, or use the first few minutes of a class to discuss these issues. Ask your workforce or students, “Are we ready to handle such an event if it were to occur here?”; “What resources would we need to have accessible?”; “Have we partnered with the correct agencies in the community?”; “Do we have an established, trusted presence in the community?”; “Who else do we need on our team?”; “Do we need training in a specialty area, e.g., emergency preparedness?”; “What skills have we mastered and what skills do we need to obtain?” The discussion-based questions are endless but one runs the risk of not being prepared, either individually, or in their agency, should they not discuss how public health events are occurring around us daily. I encourage you to adapt these selected cases to use in your organization and/or classroom. Discussing these issues and reviewing the lessons learned will only help us to be better prepared public health practitioners and educators of public health students.
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8,479 |
Herbonanoceuticals: A Novel Beginning in Drug Discovery and Therapeutics
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The Indian pharmaceutical industry is the world’s second largest industry (by volume) that develops products and market drugs licensed for use as medications. Medicines manufactured in the modern era are associated with major controversies such as non–target specificity, resistance, repeated administration, immune rejection, and other adverse effects on the body. Thus, there is a great need to find drugs that do not raise the aforementioned issues. Nature is an excellent hub providing a diverse range of phytoconstituents that open the way to phototherapeutics, which need a scientific path to deliver the active elements in a supported way to increase patient compliance and reduce the need for repeated administration. To discover a novel phytochemical as a lead compound for a therapeutic purpose is a real challenge. In former times, drug discovery was a complex process, as it took several years to find a lead compound for use against a particular disease. Nowadays, however, virtual screening methods have been developed, which are target specific, time consuming, and cost effective. To avoid increased and repeated administration of a drug, nanosized drug delivery systems for herbal drugs have been developed to enhance the activity and overcome problems associated with synthetic medicines. This review summarizes three main fields: drug discovery, docking for drug design, and last—but not least—drug delivery systems. Nowadays, nanobased drug delivery systems are in demand for delivery of herbal medicines used for therapeutic purposes. Herbonanoceuticals—herbal drugs of a nanosize—have better remedial value and fewer detrimental effects than modern medicines. Therefore, herbonanoceuticals can be a boon in the field of therapeutics.
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8,480 |
MedCERTAIN/MedCIRCLE: Using Semantic Web Technologies for Quality Management of Health Information on the Web
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8,481 |
Histopathology
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During the last 30 years, advances in intensive and critical care units, organ transplantation, concomitant use of immunosuppressive drugs, and increasing prevalence of chronic diseases, malnutrition, and other debilitating conditions, as well as the human immunodeficiency virus pandemic, have increased the incidence of systemic mycotic diseases, the most serious form of fungal diseases are the ones that comprise the central nervous system, representing the most dangerous clinical situations. In those cases, starting an adequate therapy through a rapid and assertive diagnosis is absolutely necessary. Considering the fastidious microbiological nature of some fungi (longtime requirement, specific culture conditions, and biohazard issues), as well as the lack of alternative testing availability, a rapid diagnosis is always challenging. When a tissue or liquid specimen is available, its pathological analysis constitutes a rapid and cost-effective way to provide a presumptive or definitive diagnosis of an invasive fungal infection; however, microbiologists, pathologists, and clinicians need to be aware of the limitations of microscopical diagnosis. In this chapter, we review the usual histological presentation of the most frequent central nervous system fungal infections.
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8,482 |
A Farewell to the “Sick Man of East Asia”: The Irony, Deconstruction, and Reshaping of the Metaphor
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Susan Sontag revealed how a disease could be turned into a metaphor in social evolution, from merely a disease of the body to moral judgment or even political oppression. In her article “AIDS and its Metaphors” written in 1989, she offers a plan to do away with the metaphor: “With this illness, one that elicits so much guilt and shame, the effort to detach it from these meanings, these metaphors, seems particularly liberating, even consoling. But the metaphors cannot be distanced just by abstaining from them. They have to be exposed, criticized, belabored, used up” (Songtag 2003). In Sontag’s terms, “metaphor” mainly refers to the symbolic social oppression of the diseases. For example, cancer is a metaphor for the defect of the sick person in personality. While diseases were a biological phenomenon, the “metaphor” was a social one. What I would like to demonstrate here was none other than the related “political metaphor” started by the “anti-germ warfare.”
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8,483 |
Ear, Nose, and Throat
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This chapter reviews otolaryngology conditions most commonly seen by pediatricians. Included are issues involving the ears, nose, and nasopharynx; the sinuses, throat, mouth, and oropharynx; and the neck. The most common surgical otolaryngologic procedures will also be discussed. Many of these conditions can be effectively identified, diagnosed, and treated by primary care physicians. However, for certain conditions, prompt identification and timely referral to an otolaryngologist is required.
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8,484 |
Organoselenium in Nature
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Selenium, among the naturally occurring elements, is nowadays considered the most relevant for the redox homeostasis of living systems. In this chapter, its role in plants, bacteria, and humans is scholarly discussed. Some plants have the possibility to accumulate this element, thus becoming a natural source for animals and humans, in which selenium is embedded in selenoproteins, as the 21(st) amino acid, selenocysteine (l-Sec). The main classes of selenoenzymes (glutathione peroxidase, thioredoxin reductase, and iodothyronine deiodinases) are reported here and the molecular mechanism that characterizes their physiological action is discussed.
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8,485 |
Allergie, Mikrobiom und weitere epigenetische Faktoren
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Die chinesische Medizin hat schon vor 2000 Jahren einen Zusammenhang zwischen Lunge und Dickdarm erkannt. Nach den Prinzipien der 5 Wandlungsphasen impliziert jegliche Behandlung des Yin-Organs Lunge (bzw. des Respirationstraktes) eine Regulation und Mitbehandlung des gekoppelten Yang-Organs, des Dickdarms. Nicht nur diese beiden Organe sind dem Element Metall zugeordnet, sondern auch die Haut als zugehörige Körperschichte und die Nase als Öffner (◘ Abb. 4.1).
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8,486 |
Allgemeine Chirurgie
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Die sechs klassischen Leitsymptome des Patienten erfordern eine sequenzielle Diagnostik.
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8,487 |
Nanomicrobiology
| null |
8,488 |
Kardiologie
|
—. meist bakterielle (selten mykotische) Entzündung der Herzinnenhaut unter Beteiligung der Herzklappen; —. oft Vorbestehen einer prädisponierenden strukturellen Herzerkrankung, z. B. Klappenvitium oder kongenitaler Herzfehler; —. Befall der Mitralklappe und Aortenklappe am häufigsten, bei i.v. Drogenabusus Befall der Herzklappen des rechten Herzens durch Staphylokokken; —. Streptokokken (60–80% aller Fälle, davon >50% S. viridans), Staphylokokken (20–35%), Enterokokken, gramnegative Bakterien und andere seltene Erreger, z. B. Pilze (10%); —. —. Destruktionen und Vegetationen an gesunden Herzklappen (Endocarditis ulcerosa et polyposa) durch hochvirulente Erreger; —. Erregerspektrum: β-hämolysierende Streptokokken, Staphylococcus aureus, Pneumokokken, Gonokokken, gramnegative Bakterien; —. —. meist an vorgeschädigten Herzklappen, z. B. nach rheumatischer Endokarditis; —. Erregerspektrum: Streptococcus viridans, Enterokokken, gramnegative Bakterien der Darmflora, Staphylokokken, Pilze;
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8,489 |
Engineering Ceramic Fiber Nanostructures Through Polymer-Mediated Electrospinning
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Electrospinning is increasingly used as a simple and straightforward technique to fabricate one-dimensional fibers from both organic and inorganic materials. These one-dimensional fibers with controlled sizes possess some unique features such as large surface area to volume ratio, high porosity, and low density. Compared to other conventional materials, these features make them attractive for applications such as energy harvesting, energy storage, super-hydrophobic membranes, and sensors. This chapter provides an overview on the synthesis of inorganic fibers through polymer-mediated electrospinning. Some of the common techniques employed by many researchers, such as solgel combined with electrospinning, emulsion electrospinning, and electrospinning combined with solid–gas reaction, to fabricate metal oxide fibers are discussed. In addition, techniques to fabricate ceramic and metal oxide fibers having different morphologies and hierarchical structures are described. Recent applications of electrospun metal oxide fibers are finally highlighted with a focus on filtration, sensors, photocatalysis, and energy.
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8,490 |
Neurochirurgie
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Das Gebiet der Neurochirurgie umfasst die Erkennung, operative, perioperative und konservative Behandlung, Nachsorge und Rehabilitation von Erkrankungen, Verletzungen, Verletzungsfolgen und Fehlbildungen des zentralen Nervensystems, seiner Gefäße und seiner Hüllen, des peripheren und vegetativen Nervensystems (Bundesärztekammer 06/2010).
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8,491 |
Health System in China
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The health of China’s population improved dramatically during the first 30 years of the People’s Republic, established in 1949. By the mid-1970s, China was already undergoing the epidemiologic transition, years ahead of other nations of similar economic status, and by 1980, life expectancy (67 years) exceeded that of most similarly low-income nations by 7 years. Almost 30 years later, China’s 2009 health reforms were a response to deep inequity in access to affordable, quality healthcare resulting from three decades of marketization, including de facto privatization of the health sector, along with decentralized accountability and, to a large degree, financing of public health services. The reforms are built on earlier, equity-enhancing initiatives, particularly the reintroduction of social health insurance since 2003, and are planned to continue until 2020, with gradual achievement of overarching objectives on universal and equitable access to health services. The second phase of reform commenced in early 2012. China’s health reforms remain encouragingly specific but not prescriptive on strategy; set in the decentralized governance structure, they avoid the issue of reliance on local government support for the national equity objective, leaving the detailed design of health service financing, human resource distribution and accountability, essential drug lists and application of clinical care pathways, etc. to local health authorities answerable to local government, not the Ministry of Health. Community engagement in government processes, including in provision of healthcare, remains limited. This chapter uses the documentation and literature on health reform in China to provide a comprehensive overview of the current situation of the health sector and its reform in the People’s Republic.
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8,492 |
The “City Operator” and the Tianyi Square Redevelopment Project
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After describing today’s Tianyi Square, this chapter looks at the dilapidated conditions of this area before the redevelopment. Then it depicts the nation-wide fever of building Central Business Districts in Chinese cities since the late 1990s as the background. Afterward it analyzes the mechanism of the “city operator” (chengshi yunyingshang) in the Tianyi Square redevelopment project, which describes the role played by an entrepreneurial state and its subordinate urban development corporation in downtown redevelopment in Ningbo, as well as the origin of this mechanism back in the city of Dalian in the 1990s. It also analyzes the methods of compensating relocated residents, financing with land mortgage loans, historic conservation, promotion, and governance structure in the Tianyi Square project.
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8,493 |
Mikrobiologie und Antiinfektiva
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Bei einem 38-jährigen Patienten wurde eine Analfistel operiert. Am 3. postoperativen Tag kommt es zur akuten Verschlechterung des Gesundheitszustands mit hämodynamischer Instabilität und Fieber. Daraufhin wird der Patient in eine Klinik der Maximalversorgung verlegt. Beim Eintreffen im Schockraum ist der Patient somnolent und kaltschweißig. Der Blutdruck beträgt 70/40 mmHg, die Herzfrequenz 120/min und die Körpertemperatur 39,6°C. Das Hautkolorit ist blass-grau. Im Verlegungsbericht wird bei stark ödematös geschwollenem Skrotum der Verdacht auf eine Fournier-Gangrän nach Analfistel-OP gestellt. Der diensthabende Intensivmediziner muss nun parallel die hämodynamische Situation stabilisieren, mikrobiologisches Material gewinnen, eine kalkulierte antimikrobielle Therapie beginnen und weitere Maßnahmen zur Diagnosesicherung einleiten.
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8,494 |
Makroamputationsverletzungen im Bereich der oberen Extremität
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Alle Amputationsverletzungen im Bereich der oberen Extremität distal des Radiokarpalgelenks werden als Mikroamputationsverletzungen bezeichnet.
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8,495 |
Advances in Gastrointestinal Surgery
|
Carcinoma of the stomach is a global disease with the highest incidence in Asia, South America and Eastern Europe. The disease is least common in USA and Western Europe [1]. The disease is common among smokers. Other risk factors are H. pylori infection, atrophic gastritis, Menetrier’s disease and previous gastrectomy. The disease can be genetic as in familial adenomatous polyposis, hereditary non-polyposis colorectal cancer, Peutz-Jegher’s syndrome, etc. [2]. Screening for gastric carcinoma is done in high incidence areas such as Japan, Korea and China.
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8,496 |
Gastroenteritis and Intractable Diarrhea in Newborns
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Gastroenteritis (GE) still represents a major cause of morbidity and mortality in children worldwide. Although the implementation of effective measures resulted in a significant decrease of global mortality, much remains to be done. The burden of GE in the neonatal age is generally reduced in relation to some protective factors (breastfeeding, minimal exposure to water and contaminated food, passive maternal immunity). In newborns, the contribution of the various causative agents could differ from that of the other pediatric age groups, nevertheless Rotavirus and pathogenic strains of E. coli remain the main etiologies. The acquisition of the pathogen generally occurs through the contaminated birth canal or by the use of contaminated tools, objects, or hands of the caregivers. The clinical presentation may vary widely from an acute, self-limiting disease to life-threatening complicated infections. The assessment of the dehydration and its rapid correction represent the cornerstones of the management of any GE. Antibiotic therapy should be reserved to cases with systemic symptoms, severe dehydration, or in the presence of bloody diarrhea. While the occurrence of diarrhea in the neonatal age is mainly caused by acute gastrointestinal infections, differential diagnosis with several other diseases including forms of severe congenital disorders should be considered.
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8,497 |
Management of Peritoneal Malignancies
|
Peritoneal malignancies may result in a widespread disease process, peritoneal carcinomatosis (PC), which has significant morbidity and mortality for patients afflicted by this disease. Dissemination into the peritoneum and throughout the abdomen can be due to a primary peritoneal cancer or other primary malignancies that have metastasized, including (but not limited to) colorectal cancer, gastric cancer, pancreatic cancer, appendiceal cancer, ovarian cancer, and mesothelioma. Patients with gastrointestinal (GI) or gynecologic malignancies with peritoneal carcinomatosis may have dismal survival due to a high disease burden within the abdominal cavity. Some studies suggest the average survival for patients with peritoneal carcinomatosis of colorectal origin is 18–48 months, for high-grade appendiceal adenocarcinoma 12–36 months, and for low-grade appendiceal neoplasms >60 months. As the understanding of peritoneal malignancies and peritoneal carcinomatosis evolved, it may now be acceptable to treat this as locoregional disease.
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8,498 |
Lung Biopsy in Acute Respiratory Distress Syndrome
| null |
8,499 |
Disaster Resilient Future in Korea
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The Republic of Korea has not only monumentally progressed socially, economically, and politically since 1948, but has taken the arduous undertaking of reforming the way it reduces disaster risk, mitigates the impact, and prepares for and responds to disasters for a resilient future. The administrative and organizational reforms have not been without its setbacks or obstacles; however, they were not so insurmountable that they could not be overcome by one of Korea’s greatest assets: persisting endeavors to build back better and to enhance resilience. Starting with an independent national agency in 2004 to manage natural and human-caused disasters and preparedness, the government quickly realized, through focusing events, it was insufficient to handle the increasing complexity and intensifying of disasters striking the nation. Therefore, through political will and hindsight, it continuously coalesced pertinent disaster management responsibilities into newer and newer agencies until 2016, when it enacted a progressively more ubiquitous and self-propelling agency. However, although the agency is apt for current disasters, it will not be for future disaster, which needs the integration of resilience into Disaster Risk Management (DRM). Therefore, we suggest five tenets on how to make Korea’s resilient future as well as for other nations that are and will follow in Korea’s footsteps, especially for those nations in Asia and Africa. A future that is resilient against all types of disaster risks, especially being prepared well for “low probability and high impact” focusing events that are located in the long-tail of the Power-law Distribution.
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