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8,900 |
Infektiologie, Immunologie
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Die Infektiologie besch ä ftigt sich mit der Entstehung, Klinik, Diagnostik, Therapie und Pr ä vention von Infektionskrankheiten. Hierzu bedient sie sich der Methoden der Mikrobiologie, Inneren Medizin, Epidemiologie und Hygiene. Sie ist eng mit anderen medizinischen Fachgebieten wie Innere Medizin, Chirurgie, Dermatologie/Venerologie, P ä diatrie oder Pharmakologie verzahnt.
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8,901 |
Radiological and Nuclear Terrorism: The Oncologic Emergency Response
|
Public concern about the possibility of terrorism involving radiological materials has grown rapidly since the September 11, 2001 terrorist attacks on New York City, the Pentagon, and Pennsylvania. Such concern is driven by the widespread availability of radiological materials and the intentions of malfeasants and organizations around the world to do harm to others. In contrast to nuclear materials, radiological materials are ubiquitous and are found in most cities throughout the country at academic institutions, hospitals, and many businesses and industrial settings. In contrast, nuclear materials are difficult to access because of their rarity and the security of the settings in which they are found. A radiological or nuclear incident of any kind will require prompt assessment of the location and nature of the incident, activation of mass casualty response systems, followed by immediate consultation of hematology, health and medical physics, and nuclear medicine personnel. Radiation-induced injuries and illnesses are typically delayed. Successful assessment and management of individuals with acute radiation syndrome (ARS), including the hematopoietic subsyndrome (HS), is required to support management of injuries resulting from a high radiation dose, including injuries to the gastrointestinal and neurovascular systems. Administration of cytokines within 24 h of exposure shortens the period of granulocytopenia and is strongly recommended by subject matter experts in the management of the HS. Hematopoietic stem cell transplantation after failure of a 2–3 week trial of cytokines has been clearly documented and is weakly recommended in selected individuals with the HS. Administration of prophylactic and therapeutic broad-spectrum antimicrobials (including antibacterial, antiviral, and antifungal agents) is recommended and should be guided by recommendations of the Infectious Diseases Society of America for management of febrile neutropenia. This article provides an overview for clinicians who are called upon in a radiological and/or nuclear incident to manage individuals with ARS and other radiation-related illnesses.
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8,902 |
Biotechnology, In Vitro Production of Natural Bioactive Compounds, Herbal Preparation, and Disease Management (Treatment and Prevention)
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Biotechnology uses living systems to develop products and plant biotechnology generates useful products or services, e.g., different bioactive secondary metabolites including alkaloids, flavonoids and other phenolics, saponins, terpenoids, steroids, glycosides, tannins, volatile oils, etc., from plant cells, tissues or organs culture independent of geographical and climatic factors under aseptic conditions. These bioactive compounds are economically important as drugs (pharmaceuticals), flavors, perfumes (fragrances), pigments (dyes), agrochemicals as well as cosmetics, food additives, etc. Different strategies, e.g., genetic transformation of plants with Agrobacterium rhizogenes, hairy roots and others can be applied for the improvement of production of bioactive compounds of secondary metabolic origin. Recombinant DNA techniques can be used to manipulate metabolic pathways and produce protein pharmaceuticals such as antibodies, and protein hormones. Bioinformatics and genomics can find application in drug discovery from plant-based products and biotechnological procedures can enhance and advance the studies of medicinal plants. Molecular biotechnology uses laboratory techniques to study and modify nucleic acids and proteins for applications in areas such as human and animal health, agriculture, and the environment. Herbal extracts are now widely used in the management of chronic diseases like diabetes, hypertension, cancer, etc., as a part of CAM therapy. Plant-derived immune stimulators diverse small or large molecules (saponins, tomatine, inulin, polysaccharides), fungal β-glucans, complex molecules from marine sponge (α-galactosylceramide), shrimp chitin (chitosan), etc., have established adjuvant activity. Immunotherapy may be activation immunotherapy or suppression immunotherapy. Vaccines provide immune protection against diseases and plant-based edible vaccine production mainly involves the integration of transgene into the plant cells to produce the antigen protein for specific disease.
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8,903 |
Critical Care Management: Sepsis and Disseminated and Local Infections
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Local and systemic infections are a significant cause of morbidity and mortality among immunocompromised children, including but not limited to patients with hematologic and solid malignancies, congenital or acquired immunodeficiencies, or hematopoietic cell or solid organ transplantation patients. Progression to septic shock can be rapid and profound and thus requires specific diagnostic and treatment approaches. This chapter will discuss the diagnosis and the initial hemodynamic management strategies of septic shock in immunocompromised children, including strategies to improve oxygen delivery, reduce metabolic demand, and monitor hemodynamic response to resuscitation. This chapter also discusses strategies to reverse septic shock pathobiology, including the use of both empiric and targeted anti-infective strategies and pharmacologic and cell therapy-based immunomodulation. Specific consideration is also paid to the management of high-risk subpopulations and the care of septic shock patients with resolving injury.
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8,904 |
Cycloadditions for Studying Nucleic Acids
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Cycloaddition reactions for site-specific or global modification of nucleic acids have enabled the preparation of a plethora of previously inaccessible DNA and RNA constructs for structural and functional studies on naturally occurring nucleic acids, the assembly of nucleic acid nanostructures, therapeutic applications, and recently, the development of novel aptamers. In this chapter, recent progress in nucleic acid functionalization via a range of different cycloaddition (click) chemistries is presented. At first, cycloaddition/click chemistries already used for modifying nucleic acids are summarized, ranging from the wellestablished copper(I)-catalyzed alkyne–azide cycloaddition reaction to copper free methods, such as the strain-promoted azide–alkyne cycloaddition, tetrazole-based photoclick chemistry and the inverse electron demand Diels–Alder cycloaddition reaction between strained alkenes and tetrazine derivatives. The subsequent sections contain selected applications of nucleic acid functionalization via click chemistry; in particular, site-specific enzymatic labeling in vitro, either via DNA and RNA recognizing enzymes or by introducing unnatural base pairs modified for click reactions. Further sections report recent progress in metabolic labeling and fluorescent detection of DNA and RNA synthesis in vivo, click nucleic acid ligation, click chemistry in nanostructure assembly and click-SELEX as a novel method for the selection of aptamers.
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8,905 |
Gesundheitsberichterstattung
|
Die Gesundheitsberichterstattung (GBE) des Bundes stellt kontinuierlich aktuelle Daten und Informationen zum Gesundheitszustand und zur Gesundheitsversorgung der Bevölkerung in Deutschland bereit. Das Themenspektrum ist vielfältig und reicht von Krankheiten, Beschwerden und Risikofaktoren über die subjektive Gesundheit und gesundheitsbezogene Lebensqualität bis hin zur Inanspruchnahme von Präventions- und Versorgungsangeboten sowie den Strukturen und Kosten des Gesundheitswesens. Die Themen werden auf breiter Datengrundlage und unter Berücksichtigung ihrer gesellschaftlichen Relevanz sowie der sozialen, ökonomischen und politischen Rahmenbedingungen behandelt. Die Ergebnisse werden fortlaufend veröffentlicht, wobei unterschiedliche, auf den Informationsbedarf der jeweiligen Adressaten abgestimmte Publikationsformen genutzt werden.
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8,906 |
Glucocorticoids (as an Etiologic Factor)
|
Adrenocortical hormones were first prepared from the adrenal gland as a new compound by Kendall in 1935 [1]. Thirteen years later, Hench et al. [2] observed a miraculous effect of cortisone in a patient with severe rheumatoid arthritis, which opened new doors to innovative treatments for a variety of inflammatory diseases. Against this background, Kendall, Hench, and Reichstein were awarded the 1950 Nobel Prize for Physiology or Medicine. Since then, glucocorticoids have been used as a first-line therapy for immune-mediated conditions or as an adjunctive therapy in many inflammatory, infectious, or malignant diseases.
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8,907 |
Emergency Preparedness in Ambulatory Surgery Centers and Office-Based Anesthesia Practices
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Natural or manmade disasters, mass causality events, and other emergencies can disrupt healthcare delivery and change the demand for healthcare services. In order to protect patients, staff, and facilities it is essential that healthcare facilities be prepared for such emergency events. Ambulatory surgery centers (ASC) and Office Based Anesthesia (OBA) practices are unique healthcare settings that necessitate specific emergency planning since they typically do not have rapid response or code teams on site. In addition, they typically operate with fewer personnel and have staff members who often perform multiple functions. Previously there has been variability in the emergency preparedness amongst ASCs and OBA practices. The Centers for Medicare & Medicaid Services (CMS) has recently identified three requirements for maintaining healthcare services during an emergency. These are 1) safeguarding human resources, 2) maintaining business operations, and 3) protecting physical resources. In 2016 CMS issued new rules establishing national emergency preparedness requirements for Medicare and Medicaid participating providers in the United States. In addition there are requirements specifically for ASCs and OBAs. The first step in emergency preparedness is performing a risk assessment for a practice using an “all-hazards” approach. In this approach, the practice attempts to identify all hazards that could potentially affect the practice as well as evaluating the likelihood of such hazards. This risk assessment is then incorporated into an emergency plan for the facility. In addition to reviewing specific components of an emergency plan for ASCs and OBAs, the need to test the plan and create a subsequent corrective action plan is reviewed. It is important that healthcare providers at all ambulatory surgery centers and office based anesthesia practices are aware of regulations for emergency preparedness and work to ensure that patients, staff and physical resources are protected during natural disasters and other emergencies.
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8,908 |
Pneumonia After Thoracic Surgery
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The most frequent and severe complication after thoracic surgery is pneumonia. Hypoventilation due to pain and insufficient cough is the reason for postoperative pneumonia after thoracic surgery. There is a risk index developed from preoperative patients and operation-specific risk factors. The risk index may be useful for high-risk patients; therefore giving these patient groups more attention in the perioperative period and taking preventive measures may reduce the incidence of pneumonia. Postoperative period composed of pulmonary rehabilitation and analgesia includes breathing exercise, cough training, self-management education, and psychosocial support, and they have been shown to decrease complications. According to some new studies, paravertebral block has similar analgesic effects with thoracic epidural analgesia (TEA). Although paravertebral block has fewer adverse effects, TEA is still the gold standard for pain relief after thoracotomies. The incidence of pneumonia varies in the literature because there is no gold standard for the diagnosis of postoperative pneumonia. Many centers use only clinical criteria, whereas others use invasive diagnostic techniques. Empirical antibiotic treatment should be started based on patient factors, local infection, and susceptibility patterns.
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8,909 |
Intelligenzminderung
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Schwachsinn Der Gebrauch des Terminus »Schwachsinn« ist wegen seines globalen und wenig präzisen Charakters und durch seine historisch und umgangssprachlich bedingte sozial diskriminierende Tönung inzwischen in der wissenschaftlichen Literatur zu Recht weitgehend aufgegeben worden. In der Rechtsprechung speziell in der Forensik ist Schwachsinn als eine schuldausschließende bzw. schuldminderende juristische Kategorie ein nach wie vor gebräuchlicher Begriff.
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8,910 |
Processing of Mass Spectrometry Data in Clinical Applications
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Mass spectrometry-based proteomics has become the leading approach for analyzing complex biological samples at a large-scale level. Its importance for clinical applications is more and more increasing, thanks to the development of high-performing instruments which allow the discovery of disease-specific biomarkers and an automated and rapid protein profiling of the analyzed samples. In this scenario, the large-scale production of proteomic data has driven the development of specific bioinformatic tools to assist researchers during the discovery processes. Here, we discuss the main methods, algorithms, and procedures to identify and use biomarkers for clinical and research purposes. In particular, we have been focused on quantitative approaches, the identification of proteotypic peptides, and the classification of samples, using proteomic data. Finally, this chapter is concluded by reporting the integration of experimental data with network datasets, as valuable instrument for identifying alterations that underline the emergence of specific phenotypes. Based on our experience, we show some examples taking into consideration experimental data obtained by multidimensional protein identification technology (MudPIT) approach.
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8,911 |
Disaster Medicine
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Millions of people every day face disasters, for example, typhoons, terrorist attacks, earthquakes, famine, civil wars, explosions, and tornadoes. Disaster is defined as every event that causes serious disruption which exceeds the ability of the affected community or society to cope using its own resources. Disasters are usually categorized as natural or man-made and are described using a series of steps called the disaster cycle, defined in four phases: mitigation and prevention, preparedness and planning, response, and recovery. Disaster medicine is an emerging specialty that integrates the medical response to disaster with the systems of disaster management.
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8,912 |
Stable-Isotope-Aided NMR Spectroscopy
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Boundless progress in isotope-aided NMR methods still continues to provide the driving force for developing novel NMR strategies for structural biology research of proteins. In the first edition of this book, we described an overview of the isotope labeling methods available at that time. In this second edition, we will mainly focus on newer isotope-aided NMR methods, such as the methyl-specific labeling and stereo-array isotope labeling (SAIL) methods, which have rapidly developed during the past decade. The methyl-specific labeling is currently used as the most practical technique applicable to large protein complexes and membrane proteins. The standard methyl labeling protocols employ isotope-labeled α-keto acid precursors, which enable selective observations of the methyl groups of Ile, Leu, and Val residues. More recently, the stereo-specific isotope labeling methods of prochiral methyl groups have become available, using either regio-selectively isotope-labeled precursors or stereo-specifically (13)CH(3)-labeled amino acids. We also focus on the stereo-array isotope labeling (SAIL) method, which is a breakthrough isotope labeling technology using stereo- and regio-selectively [(2)H, (13)C, (15)N]-labeled amino acids with isotope labeling patterns optimized for NMR studies. Various applications of SAIL and related methods to structural studies, including protein dynamics such as aromatic ring-flipping motions, hydrogen-deuterium exchange rates, conformational analysis, and dynamics about disulfide bonds, will be discussed.
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8,913 |
Seltene Lungenerkrankungen
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Die interstitiellen Lungenerkrankungen (ILE) des Kindesalters sind eine heterogene Gruppe seltener, chronischer Lungenerkrankungen, die charakterisiert sind durch entzündliche und fibrotische Veränderungen im Bereich der Alveolen und der angrenzenden distalen Atemwege.
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8,914 |
Microbiology of Rhinosinusitis and Antimicrobial Resistance
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Acute rhinosinusitis (ARS) is the inflammation of the nasal mucous membrane and can be separated into acute viral and acute bacterial rhinosinusitis. It is frequently observed after viral rhinitis or common cold. Viral, post-viral, and acute bacterial ARS (ABRS) display significantly similar clinical presentation and inflammatory mechanism. Viral infection of the sinus cavity can cause numerous changes such as post-viral inflammation and epithelial damage, which enhance the susceptibility to bacterial infection. The most common virus families that cause ARS are coronavirus and rhinovirus. Approximately 50% of common colds are caused by the human rhinovirus. Other viral offenders include parainfluenza, influenza, respiratory syncytial virus (RSV), adenovirus, and enterovirus. The most widely recognized bacteria in ABRS are S. pneumonia, H. influenza, and M. catarrhalis and S. aureus, while other species and anaerobic bacteria may also contribute to the infection (Payne and Benninger, Clin Infect Dis 45(10):e121–7, 2007; Anonymous, Otolaryngol Head Neck Surg 130(1 SUPPL):1–45, 2004; Brook, Arch Otolaryngol Head Neck Surg 128(5):583–5, 2002). Interestingly, Payne and colleagues performed a meta-analytic study on reports about the microbiology of ABRS, which evaluated the most common bacterial occurrence within the sinus. S. aureus is commonly associated with the pathogenesis of sphenoid sinusitis. The 7-valent pneumococcal vaccine was presented in the United States in 2000 and aided in the reduction of the recovery rate for S. pneumoniae and the increase in the rate of H. influenza. Chronic rhinosinusitis (CRS) vary in comparison to ARS. Bacteria that have been recorded in many samples acquired by endoscopy or sinus puncture in CRS patients are Staphylococcus aureus (both MSSA and MRSA), Staphylococci (coagulase-negative) (SCN), H. influenza, M. catarrhalis, S. pneumonia, S. intermedius, P. aeruginosa, N. species, and other anaerobic bacteria. In this chapter, microbiology of rhinosinusitis and antimicrobial resistance are discussed.
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8,915 |
Ultraviolet Radiation for Disinfection
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Natural water, such as surface water and groundwater, exists as an open system. Natural and/or synthesized organic substances, oxygen, nutrients are thus able to enter various waters. Owing to the presence of these key elements, microbial growth eventually becomes possible. Different microorganisms can therefore exist and grow in the waters. Similarly, domestic and industrial wastewater and treated wastewater contain significantly high amounts of microorganisms.
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8,916 |
Toxicant-Induced Hepatic Injury
|
The sudden failure of a previously healthy and functioning liver is a dramatic and devastating event. Acute liver failure is the common final pathway of a multitude of conditions and insults, all of which result in massive hepatic necrosis or loss of normal hepatic function. The ensuing multiorgan system failure frequently has a fatal outcome, with mortality rates in most series ranging from approximately 55% to 95% [1]. Acute liver failure (ALF, previously often referred to as fulminant hepatic failure (FHF)) knows no age boundaries, with many cases occurring in those younger than 30 years. Short of excellent intensive care unit (ICU) support and liver transplantation in selected cases, few viable treatment options are available. Over the past few decades, however, survival has been improved by anticipation, recognition, and early treatment of associated complications, as well as the application of prognostic criteria for early identification of patients requiring liver transplantation (along with improvement in the techniques and science of transplantation itself). The etiology of ALF varies from country to country and the incidence change over time. Paracetamol (acetaminophen) has now replaced viral hepatitis as the leading cause of ALF [2]. In a study from London including 310 patients with ALF in the period 1994–2004, 42% of the cases were caused by paracetamol [3], whereas this was only the cause in 2% of 267 patients in Spain from 1992 to 2000 [4]. However, less than 10% of all liver transplants are performed in patients with ALF [5, 6].
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8,917 |
Transplantationsmedizin in der Intensivmedizin
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Die postoperative intensivmedizinische Behandlung von Patienten nach Herztransplantation basiert häufig auf Erfahrung und deren Weitergabe zwischen den Transplantationszentren (hohe Variabilität).
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8,918 |
Nucleic Acid Extraction and Enrichment
|
Nucleic acid extraction is the first step of any amplification experiment no matter what kind of amplification is used to detect a specific pathogen. Efficient nucleic acid extraction is essential to obtain good results using any molecular test. The optimal extraction method should fulfill the following conditions: speed, short working time, cost-effectiveness, high sensitivity and specificity, good reproducibility, and safety. The methods can be divided into solution or column based according to differences of their principles. The automated extraction instruments have many advantages, and these have proven to be very useful. Moreover, in recent years, fully automated instruments combining NA extraction and amplification have been commercially available. However, the method itself does not provide assurance, and the DNA recovery can be different among various kits or instruments that use the similar principles. Therefore, it is important to carefully evaluate the performance of any extraction method used in the clinical microbiology laboratory even though manufacturers may have reported good validation results with specific organisms.
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8,919 |
Hospital-Based HTA and Know4Go at MEDICI in London, Ontario, Canada
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The majority of healthcare in Canada is universally provided and publicly funded through the provincial government.
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8,920 |
Strategies and Challenges for the Development of Industrial Enzymes Using Fungal Cell Factories
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Industrial enzymes have been produced from microorganisms for more than a century. Today, a large share of enzyme products is manufactured using recombinant microorganisms. This chapter focuses on major industrial fungal species belonging to the ascomycetes like Aspergillus niger, A. oryzae, and Trichoderma reesei. Many of the commercially available recombinant enzymes are manufactured using fungi. Examples of fungal enzymes used in food products are described. The enzyme industry is to a large extent cost-driven, so the enzyme product needs to meet strict COGS (cost of goods sold) targets. Therefore, the cell factory must be very efficient to produce the enzyme in high titers and efficiently utilize raw materials. Secondly, it must be designed for a robust and generic fermentation process. When developing fungal hosts for enzyme production, several properties of the system need to be considered relating to efficiency of the cell factory, purity of the product, and safety of both the cell factory and the product. Purity is secured by engineering of the cell factory, and properties related to safety must also be engineered into the fungal host. The methods used for strain improvement are continuously being developed to increase yields and are described herein. More automation using precision tools for modification of the genome (i.e., CRISPR) and low-cost sequencing have vastly expanded the possibilities and enabled fast strain development. Using systems biology approaches, better understanding of cellular processes is now possible enabling advanced engineering of fungal cell factories. Surprisingly, a survey of innovation in the field revealed a decrease in the number of patent applications in recent years. Finally, the requirements for enzyme approval, especially in food and feed, have increased significantly worldwide in the last few years. A description of the regulatory landscape and its challenges in food and feed is included.
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8,921 |
Challenges in Economics
|
In the same way as the Hilbert Program was a response to the foundational crisis of mathematics [1], this article tries to formulate a research program for the socio-economic sciences. The aim of this contribution is to stimulate research in order to close serious knowledge gaps in mainstream economics that the recent financial and economic crisis has revealed. By identifying weak points of conventional approaches in economics, we identify the scientific problems which need to be addressed. We expect that solving these questions will bring scientists in a position to give better decision support and policy advice. We also indicate, what kinds of insights can be contributed by scientists from other research fields such as physics, biology, computer and social science. In order to make a quick progress and gain a systemic understanding of the whole interconnected socio-economic-environmental system, using the data, information and computer systems available today and in the near future, we suggest a multi-disciplinary collaboration as most promising research approach.
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8,922 |
Epidemiology
|
The common cold is the result of an upper respiratory tract infection causing an acute syndrome characterised by a combination of non-specific symptoms, including sore throat, cough, fever, rhinorrhoea, malaise, headache, and myalgia. Respiratory viruses, alone or in combination, are the most common cause. The course f illness can be complicated by bacterial agents, causing pharyngitis or sinusitis, but the are a rare cause of cold and flu-like illnesses (CFLIs). Our understanding of CFLI epidemiology has been enhanced by molecular detection methods, particularly polymerase chain reaction (PCR) testing. PCR has not only improved detection of previously known viruses, but within the last decade has resulted in the detection of many divergent novel respiratory virus species. Human rhinovirus (HRV) infections cause nearly all CFLIs and they can be responsible for asthma and chronic obstructive pulmonary disease exacerbations. HRVs are co-detected with other respiratory viruses in statistically significant patterns, with HRVs occurring in the lowest proportion of co-detections, compared to most other respiratory viruses. Some recently identified rhinoviruses may populate an entirely new putative HRV species; HRV C. Further work is required to confirm a causal role for these newly identified viruses in CFLIs. The burden of illness associated with CFLIs is poorly documented, but where data are available, the impact of CFLIs is considerable. Individual infections, although they do not commonly result in more severe respiratory tract illness, are associated with substantial direct and indirect resource use. The product of frequency and burden for CFLIs is likely to be greater in magnitude than for any other respiratory syndrome, but further work is required to document this. Our understanding of the viral causes of CLFIs, although incomplete, has improved in recent years. Documenting burden is also an important step in progress towards improved control and management of these illnesses.
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8,923 |
Neurologie
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Bewusstsein. Orientierung (zu Zeit, Ort, Situation und Person). Aufmerksamkeit und Gedächtnis (amnestische Funktion). Affektivität. Antrieb;
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8,924 |
Bacterial Sepsis and Shock
| null |
8,925 |
The Ecology of Pathogen Spillover and Disease Emergence at the Human-Wildlife-Environment Interface
|
Novel diseases are increasingly emerging into human populations through the complex—and often, unseen—stepwise process of spillover from a combination of wildlife, livestock, vectors, and the abiotic environment. Characterizing and modeling the spillover interface are a key part of how eco-epidemiologists respond to the growing global burden of emerging infectious diseases; but the diversity of pathogen life cycles and transmission modes poses a complex challenge for ecologists and clinicians alike. We review our current understanding of the spillover process and present a framework that relates spillover rates and human-to-human transmissibility to the basic reproduction number (R (0)). Using pathogens that exemplify important transmission pathways (anthrax, Ebola, influenza, and Zika), we illustrate key aspects of the spillover interface and discuss implications to public health and management of emerging infectious disease.
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8,926 |
Infektionen
|
Die Meldung und Erfassung von Infektionskrankheiten ist in Deutschland durch das Infektionsschutzgesetz (IfSG) geregelt. In §6 sind meldepflichtige Krankheiten nach gewissen Vorgaben geregelt.
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8,927 |
Establishment and Development of the Disease Surveillance System
|
Disease surveillance is the long-term, continuous, systematic collection of information about diseases and their relevant influencing factors, followed by analysis of the data in a timely manner to guide intervention measures and evaluate their effectiveness. This definition reflects the three basic characteristics of disease surveillance: (1) distributions and trends of diseases can be evaluated only through long-term, continuous, systematic collection of data; (2) original data can be translated to valuable information only through analysis and interpretation of the data; and (3) results can be fully utilized in the real world only after information is provided back to the relevant departments and personnel – hence the importance of timely feedback.
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8,928 |
Simulation and Modeling Applications in Global Health Security
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Global health security (GHS) is dependent upon having an adequate and prepared health security workforce. There are currently numerous challenges in establishing and maintaining a health security workforce. The frequency and magnitude of disasters have increased significantly over the past 30 years. Current and future GHS threats, both manmade and natural, require a prepared and flexible healthcare provider workforce ready to respond to current or emerging GHS threats. Developing and maintaining GHS -specific skills in the healthcare workforce is a tremendous logistical challenge. Innovative education technologies, including simulation and digital learning, can be leveraged to achieve preparedness for GHS threats. This chapter focuses on the application of modeling and simulation to support Global Health Security planning, preparedness and operations.
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8,929 |
Genus Avipoxvirus
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Poxviruses identified in skin lesions of domestic, pet or wild birds are assigned largely by default to the Avipoxvirus genus within the subfamily Chordopoxvirinae of the family Poxviridae. Avipoxviruses have been identified as the causative agent of disease in at least 232 species in 23 orders of birds. Vaccines based upon attenuated avipoxvirus strains provide good disease control in production poultry, although with the large and intensive production systems there are suggestions and real risks of emergence of strains against which current vaccines might be ineffective. Sequence analysis of the whole genome has revealed overall genome structure and function resemblance to the Chordopoxvirinae; however, avipoxvirus genomes exhibit large-scale genomic rearrangements with more extensive gene families and novel host range gene in comparison with the other Chordopoxvirinae. Phylogenetic analysis places the avipoxviruses externally to the Chorodopoxvirinae to such an extent that in the future it might be appropriate to consider the Avipoxviruses as a separate subfamily within the Poxviridae. A unique relationship exists between Fowlpox virus (FWPV) and reticuloendothelosis viruses. All FWPV strains carry a remnant long terminal repeat, while field strains carry a near full-length provirus integrated at the same location in the FWPV genome. With the development of techniques to construct poxviruses expressing foreign vaccine antigens, the avipoxviruses have gone from neglected obscurity to important vaccine vectors in the past 20 years. The seminal observation of their utility for delivery of vaccine antigens to non-avian species has driven much of the interest in this group of viruses. In the veterinary area, several recombinant avipoxviruses are commercially licensed vaccines. The most successful have been those expressing glycoprotein antigens of enveloped viruses, e.g. avian influenza, Newcastle diseases and West Nile viruses. Several recombinants have undergone extensive human clinical trials as experimental vaccines against HIV/AIDS and malaria or as treatment regimens in cancer patients. The safety profile of avipoxvirus recombinants for use as veterinary and human vaccines or therapeutics is now well established.
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8,930 |
Pneumonie
| null |
8,931 |
Etiopathogenesis and Pathophysiology of Malaria
|
Malaria is a parasitic disease caused by Plasmodium protozoan parasites and transmitted by Anopheles mosquitoes. The disease is diffused in tropical areas, where it is associated with high morbidity and mortality. P. falciparum is the most dangerous species, mainly affecting young children. The parasite cycle occurs both in humans (asexual stages) and in mosquitoes (sexual stages). In humans, Plasmodium grows and multiplies within red blood cells using hemoglobin as essential source of nutrients and energy. However, this process generates toxic heme that the parasite aggregates into an insoluble inert biocrystal called hemozoin. This molecule sequesters in various organs (liver, spleen, and brain), potentially contributing to the development of malaria immunopathogenesis. Uncomplicated falciparum malaria clinical frame ranges from asymptomatic infection to classic symptoms such as fever, chills, sweating, headache, and muscle aches. However, malaria can also evolve into severe life-threatening complications, including cerebral malaria, severe anemia, respiratory distress, and acute renal failure.
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8,932 |
Entzündliche Erkrankungen
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Meningitiden zeigen die Trias Kopfschmerz, Meningismus und Fieber mit positiven Dehnungszeichen. Bei Kindern sind gramnegative Enterokeime und Hämophilus, bei Erwachsenen Meningo- und Pneumokokken wichtigste Erreger der bakteriellen Meningitis. Entscheidend für die Diagnose ist die Liquordiagnostik mit Gramfärbung. Empirisch werden ein Cephalosporin der dritten Generation und Ampicillin eingesetzt.
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8,933 |
Virus-Gastroenteritis
|
Zu den Viren, die eine Gastroenteritis verursachen, zählt man Rota- und Adeno-Viren, ferner Calici-Viren (Genus Noro- und Sapo-Virus u.a.) sowie Astro- und Corona-Viren u.a. (➤ Kap.59). Die viral bedingte Gastroenteritis ist die Hauptursache der hohen Säuglings- und Kleinkindersterblichkeit in den Tropen. Man schätzt, dass dort pro Jahr etwa 1–2 Mio. Kinder an einer Virus-Gastroenteritis sterben.
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8,934 |
Pathology of Sepsis
| null |
8,935 |
The TIE Receptor Family
|
The endothelial TIE1 and TIE2 receptor tyrosine kinases form a distinct subfamily characterized by their unique extracellular domains. Together with the angiopoietin growth factors (ANGPT1, ANGPT2, ANGPT4, also abbreviated as ANG), the TIE receptors form an endothelial specific signaling pathway with important functions in the regulation of lymphatic and cardiovascular development and vascular homeostasis. Angiopoietins exist in multimeric forms that activate the TIE receptors via unique mechanism. In endothelial cell–cell contacts, angiopoietins induce the formation of homomeric in trans TIE receptor complexes extending across the cell junctions, whereas matrix-bound angiopoietin-1 (ANG1) activates the TIE receptors in a cis configuration. In comparison to the vascular endothelial growth factor receptors, the TIE receptors undergo little ubiquitin-mediated degradation after activation, whereas TIE2 signaling is negatively regulated by the vascular endothelial protein tyrosine phosphatase, VE-PTP. ANG1 activation of TIE2 supports vascular stabilization, whereas angiopoietin-2 (ANG2), a context-dependent weak TIE2 agonist/antagonist, promotes pathological tumor angiogenesis, vascular permeability, and inflammation. Recently, ANG2 has been found to mediate some of its vascular destabilizing and angiogenic functions via integrin signalling. The circulating levels of ANG2 are increased in cancer, and in several human diseases associated with inflammation and vascular leak, for example, in sepsis. Blocking of ANG2 has emerged as a potential novel therapeutic strategy for these diseases. In addition, preclinical results demonstrate that genetic TIE1 deletion in mice inhibits the vascularization and growth of tumor isografts and protects from atherosclerosis, with little effect on normal vascular homeostasis in adult mice. The ability of the ANG-TIE pathway to control vessel stability and angiogenesis makes it an interesting vascular target for the treatment of the various diseases.
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8,936 |
Antigenicity, Immunogenicity, Allergenicity
|
The term “immune” pertains to the body keeping itself free from diseases, not to trigger any diseases. In this regard, it makes sense for us to divide antigenicity into immunogenicity and allergenicity. This distinction allows for the characterization of all types of modern antigens, i.e., to evaluate and modify a priori the allergenicity of an antigen before it is applied to humans. In this chapter, we also formulated the hypothesis that “Balanced Stimulation by Whole Antigens” is essential for immune development. This hypothesis revives the practicality of the “Hygiene Hypothesis” and can provide a fundamental solution to curb the increasing prevalence of allergic disease, namely, early exposure, at 0–1 year old or earlier, in utero, of representative allergens/protein antigens with immunogenicity retained or improved and allergenicity attenuated or eliminated.
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8,937 |
Protein Structure Prediction by Protein Threading
|
The seminal work of Bowie, Lüthy, and Eisenberg (Bowie et al., 1991) on “the inverse protein folding problem” laid the foundation of protein structure prediction by protein threading. By using simple measures for fitness of different amino acid types to local structural environments defined in terms of solvent accessibility and protein secondary structure, the authors derived a simple and yet profoundly novel approach to assessing if a protein sequence fits well with a given protein structural fold. Their follow-up work (Elofsson et al., 1996; Fischer and Eisenberg, 1996; Fischer et al., 1996a,b) and the work by Jones, Taylor, and Thornton (Jones et al., 1992) on protein fold recognition led to the development of a new brand of powerful tools for protein structure prediction, which we now term “protein threading.” These computational tools have played a key role in extending the utility of all the experimentally solved structures by X-ray crystallography and nuclear magnetic resonance (NMR), providing structural models and functional predictions for many of the proteins encoded in the hundreds of genomes that have been sequenced up to now.
|
8,938 |
From “Health for All” to “Health as Investment:” The Role of Economic Rationalities in the Transition from International to Global Health 1978–2013
|
This chapter examines the role of economic rationalities in the transition from international health to global health since the late 1970s. It focuses, in particular, on the recent rise to prominence of non-communicable diseases on the global health agenda. Once considered to be diseases of affluence, non-communicable diseases (NCDs) such as cancer, diabetes, cardiovascular disease have recently come to be seen as a threat to both the global population and the global economy. Strategies to combat the proliferation of NCDs have simultaneous been shown to be particularly cost-effective, making NCD interventions a solid global health investment. This chapter contrasts the current era of global health, in which health is imagined in as a form of human capital and a site of investment with a post-war era of international health during which health was advocated as a human right and public good. Drawing on empirical material including historical documents, published reports and the scientific literature, it argues that the transition from international to global health can be best understood as resulting from the rise of economic rationalities in the field of world health over the last 25 years.
|
8,939 |
SARS Accessory Proteins ORF3a and 9b and Their Functional Analysis
|
The SARS coronavirus (CoV) positive-stranded RNA viral genome encodes 14 open reading frames (ORFs), eight of which encode proteins termed as “accessory proteins.” These proteins help the virus infect the host and promote virulence. In this chapter we describe some of our latest investigations into the structure and function of two such accessory proteins: ORF3a and 9b. The ORF3a accessory protein is the largest accessory protein in SARS-CoV and is a unique membrane protein consisting of three transmembrane domains. It colocalizes on the cell membrane and host Golgi networks and may be involved in ion channel formation during infection. Similarly the ORF9b accessory protein is 98 amino acids, associates with the spike and nucleocapsid proteins and has unusual membrane binding properties. In this chapter we have suggested possible new roles for these two accessory proteins which may in the long run contain answers to many unanswered questions and also give us new ideas for drugs and vaccine design.
|
8,940 |
Erkrankungen der Atemwege und der Lunge
|
Der italienische Arzt Girolamo Cardano (1501–1576), der zu seiner Zeit als einer der größten Gelehrten und Ärzte in ganz Europa galt, wurde im Jahre 1552 von John Hamilton, dem Erzbischof von St. Andrews in Edinburgh, zur Konsultation eingeladen. Hamilton, der Bruder des Regenten von Schottland, litt seit mehreren Jahren an Husten, Dyspnoe und Expektoration, die nach Ansicht der königlichen Leibärzte von einem kalten und feuchten Hirn herrührten, in dem sich durch Destillation Phlegma anhäufte, das anschließend durch die Luftröhre in die Lunge absank. Cardano beobachtete seinen Patienten 40 Tage lang und kam zu dem Schluss, dass asthmatische Beschwerden durch eine Unverträglichkeit von Bettfedern mitverursacht werden. Heute ist bekannt, dass Allergien – wie in diesem Fall die Hausstaubmilbenallergie – oft an der Auslösung des kindlichen Asthma bronchiale beteiligt sind. In Mitteleuropa ist das Asthma mittlerweile die häufigste chronische Erkrankung im Kindes- und Jugendalter. Maßnahmen der Allergenkarenz sind auch heute noch von essenzieller Bedeutung.
|
8,941 |
The ‘delayed infection’ (aka ‘hygiene’) hypothesis for childhood leukaemia
|
The common variant of childhood acute lymphoblastic leukaemia (cALL) is the most frequent paediatric cancer subtype. Its incidence rate appears to have increased substantially in Western societies during the mid-20th century and continues to increase at ∼1%/year. Worldwide cALL appears to track with affluence of societies. The ‘delayed infection’ hypothesis, first formulated in 1988, parallels the hygiene hypothesis and has an evolutionary foundation in the concept of a mismatch between prior genetic selection and programming (of the immune system) and contemporary social circumstances. In essence, the hypothesis predicts that ALL is triggered by an abnormal immune response to one or more common microbial infections and that the abnormality arises for two reasons: (i) infectious exposures being delayed beyond the immunologically anticipated period of infancy; (ii) some degree of inherited genetic susceptibility via, for example, allelic variation in genes involved in the MHC and/or immune response network. The hypothesis also has a framework in the underlying cell and molecular biology of ALL and its natural history. Epidemiological studies of social contacts in infancy (as a proxy for common infections) and risk of ALL provide indirect but strong support for the hypothesis. The idea still requires mechanistic and genetic endorsement and the appropriate studies are in progress.
|
8,942 |
Engineering Spirulina for Enhanced Medicinal Application
|
Cyanobacteria are prokaryotes which can perform photosynthesis like higher plants. Their genomic organisation is very simple and thus is suitable for the study of detailed photosynthesis mechanism at a molecular level also for many other genomic manipulations relevant to benefit of living organisms. This unicellular alga, Spirulina has a thin thread like elongated structure and classified under Cyanobacteriaceae which is blue green in colour. Under microscope it looks like bunch of bright helical threads (Fig. 11.1).
|
8,943 |
Types of Recombinant Vaccines
|
The original scientific strategy behind vaccinology has historically been to “isolate, inactivate, and inject,” first invoked by Louis Pasteur.
|
8,944 |
Infectious Diseases
|
As infectious diseases are very commonly seen in the ICU, this chapter covers both typical and atypical infections found in this setting. If the patient has been transferred to the ICU after a prolonged stay in the hospital, the treatment should be focused on a nosocomial infection. This chapter emphasizes that the first thing to do is to identify the organisms causing the patients’ infection, keeping in mind frequently found organisms. Pneumonia, severe adult respiratory syndrome (SARS), sepsis, toxic shock syndrome, and infections in patients with AIDS are among the most common infectious diseases treated in the ICU. An appropriate initial empiric therapy and correct treatment once cultures and susceptibility become available are crucial for a successful treatment.
|
8,945 |
Health in Africa and the Role of International Organizations
|
For Africa, international health financial organizations, such as the United Nations (UN) through the World Health Organization, and bi-lateral assistance programs represent a curse and a blessing simultaneously. While they provide needed assistance and help meet the health needs of Africans, they make the continent dependent on hand-outs, unwittingly encouraging unscrupulous leaders not to generate or make national resources available to the people. Worse even, foreign assistance leaves a vacuum when it is depleted or, for various reasons, withdrawn. Foreign funds are also easily prone to misuse by leaders and unscrupulous high and middle level civil servants. Furthermore, as is the case with the IMF, assistance has always come with strings attached, forcing Africa to rely on international generosity to meet the health needs the West deems a priority for the continent. These conditions often imply at times that the donors know best what is good for Africans. While not denying the usefulness and the need for international assistance, the author argues that the use of financial assistance must be completely transparent to prevent misuse and abuse, not condescending, and always respectful of Africa’s sovereignty. In this context, world leaders must also note that the globalizing trend is often one-sided, unidirectional—from North to South—always exploitative in nature and accompanied by a cultural baggage that corrupts the youth, unwittingly promotes violence, sex, decadent practices, and unhealthy behaviors, such as the consumption of fast foods and tobacco, bad diets and alcohol abuse, thus contributing to non-communicable diseases, such as liver and stomach cancers, now dubbed by the UN as Africa’s second disease burden.
|
8,946 |
Fibrinogen α-Chain as a Serum Marker of Liver Disease
|
Liver fibrosis is the hepatic response to an insult characterized by an accumulation of extracellular matrix proteins. If the underlying cause is not treated or eliminated, the disease can progress and may lead to several clinical complications including hepatocellular carcinoma or even death. Thus, detection, staging, and follow-up of liver fibrosis are the main issues in the prognosis and treatment of patients with chronic liver disease. In recent years, new advances in mass spectrometry-based proteomics technology and protein fractionation techniques have improved protein identification as well as protein quantification in many different samples and diseases including liver fibrosis. In particular, the fibrinogen α chain and more specifically the serum levels of the 5.9 kDa fragment of fibrinogen α C-chain have shown to be altered in several hepatic etiologies. In fact, these results have been reproduced by different laboratories, and recently a marked downregulation of this protein fragment has also been described in the initial stages of liver fibrosis. In this chapter, we have described the potential role of fibrinogen α chain and particularly the 5.9 kDa fragment of fibrinogen α C-chain as a circulating marker of liver fibrosis.
|
8,947 |
Virological laboratory diagnosis of SARS
| null |
8,948 |
Biomolecular Structure and Modeling: Historical Perspective
|
physics, chemistry, and biology have been connected by a web of causal explanation organized by induction-based theories that telescope into one another. … Thus, quantum theory underlies atomic physics, which is the foundation of reagent chemistry and its specialized offshoot biochemistry, which interlock with molecular biology — essentially, the chemistry of organic macromolecules — and hence, through successively higher levels of organization, cellular, organismic, and evolutionary biology. … Such is the unifying and highly productive understanding of the world that has evolved in the natural sciences.
|
8,949 |
WhyZombie? Zombie Pop Culture to Improve Infection Prevention and Control Practices
|
Wikipedia currently lists 383 feature length ‘A-list’ zombie films, released between 1932 and 2014. These films indicate a number of causes of ‘zombification.’ A significant number of these films had an infectious cause of some kind (viral, bacterial, parasite, extra-terrestrial, zoonotic or other biological cause). The chapter explores this phenomenon and indicates that global health issues result in an increase in the release of infectious biohorror films in the years following outbreaks such as SARS and pandemic influenza, influencing pop culture. There are clear indications that contemporary infection prevention control (IPC) technologies are evident in these films, successful or not. Using contemporary cultural influences allows healthcare workers and the public to contextualise IPC theory and practice in an accessible and memorable way.
|
8,950 |
Mathematical Studies of Dynamics and Evolution of Infectious Diseases
| null |
8,951 |
Epidemiology, etiology, and risk factors of bacterial pneumonia
|
Hospital-acquired pneumonia (HAP) is the second most common nosocomial infection after urinary tract infections. The incidence of HAP ranges from 5 to 15 cases per 1000 hospital admissions, and is a frequent problem in general wards (incidence ranging from 1.6 to 3.67 cases per 1000 admissions).
|
8,952 |
Besondere Patientengruppen im Intensivtransport
|
Neben den im vorrangegangenen Kapitel besprochenen Krankheitsbildern gibt es im Rahmen der Durchführung eines Intensivtransportes Patienten, die nicht »krank« im eigentlichen Sinne sind, jedoch aufgrund spezieller Entwicklungs-, Krankheits- oder Therapieverläufe einer besonderen Aufmerksamkeit bedürfen. Hierzu zählen Früh - und Neugeborene ebenso wie Patienten, bei denen eine Infektion mit therapieresistenten Erregern besteht.
|
8,953 |
A Novel Disease Outbreak Prediction Model for Compact Spatial-Temporal Environments
|
One of the popular research areas in clinical decision supporting system (CDSS) is Spatial and temporal (ST) data mining. The basic concept of ST concerns about two combined dimensions of analyzing: time and space. For prediction of disease outbreak, we attempt to locate any potential uninfected by the predicted virus prevalence. A popular ST-clustering software called “SaTScan” works by predicting the next likely infested areas by considering the history records of infested zones and the radius of the zone. However, it is argued that using radius as a spatial measure suits large and perhaps evenly populated area. In urban city, the population density is relatively high and uneven. In this paper, we present a novel algorithm, by following the concept of SaTScan, but in consideration of spatial information in relation to local populations and full demographic information in proximity (e.g. that of a street or a cluster of buildings). This higher resolution of ST data mining has an advantage of precision and applicability in some very compact urban cities. For proving the concept a computer simulation model is presented that is based on empirical but anonymized and processed data.
|
8,954 |
Gastroenterologie
| null |
8,955 |
Pulmonary Hemorrhage, Transient Tachypnea, and Neonatal Pneumonia
|
The intent of this chapter is to address three other common pulmonary causes of respiratory distress in the high-risk infant. These other forms of parenchymal lung disease range in severity from mild, as seen in transient tachypnea, to severe as is often the case in pulmonary hemorrhage. It is worth noting that on occasion, one or more of these conditions may coexist in the same patient. The treatment for all conditions is largely supportive or involves the use of targeted antimicrobial therapy.
|
8,956 |
Impacts on Human Health Caused by Zoonoses
|
Zoonosis is an infectious disease and a potential bioterrorism agent. Bioterrorism aimed at a society, government, and/or its citizens is meant to cause destabilization, fear, anxiety, illness, and death in people, animals, or plants using biological agents. A bioterrorism attack is the intentional release of biological agents such as viruses, bacteria, fungi, rickettsial or chlamydial organisms, toxins, or other harmful agents. This chapter focuses on the induction, monitoring, and prevention of some zoonotic diseases that have potential as bioterrorism agents. The etiology, clinical manifestations, transmission routes, and treatment of these zoonotic agents are briefly discussed.
|
8,957 |
Disaster Risk Management
|
This chapter illustrates disaster and risk management. The disaster management includes hazard management and disaster issue management. Disaster risk management relies on the institution, policy, and scientific and technological progress for disaster reduction. Improving disaster risk management capacity is the key point to improving the utilization efficiency and effectiveness of disaster reduction resources, which is also an important guarantee for disaster risk reduction.
|
8,958 |
Nephrologie
|
—. primäre/idiopathische Glomerulonephritis: primäre Erkrankung der Glomeruli; —. sekundäre Glomerulonephritis: Systemerkrankung mit renaler Beteiligung; —. : —. Immunkomplexnephritis (z. B. akute postinfektiöse Glomerulonephritis); —. Anti-Basalmembran-Glomerulonephritis (z. B. rasch progrediente Glomerulonephritis); —. IgA-Nephropathie; —. : —. initial asymptomatisch/oligosymptomatisch: (Mikro-)Hämaturie, in der Regel ohne Proteinurie, normale Nierenfunktion, evtl. Hypertonie; —. akut: Mikrohämaturie, leichte Proteinurie, evtl. nephrotisches Syndrom, akutes oligoanurisches Nierenversagen; —. chronisch-progredient: Erythrozyturie, Proteinurie, meist Hypertonie, langsames Fortschreiten der Niereninsuffizienz; —. verantwortlich für 10% aller chronischen Niereninsuffizienzen;
|
8,959 |
Proportionality Review in EU Gambling Law
|
This chapter starts with a thorough introduction to gambling addiction according to the current state of research. It explains the nature and mechanisms of this mental disorder. These findings lay the ground to analyse the proportionality review: judicial views are contrasted with empirical findings. It is shown that the Court of Justice's – legally relevant(!) – assumptions on gambling addiction are (only) partly supported by empirical evidence. The chapter also establishes that different standards of review have applied to different aspects of gambling regulation, with the most lenient review being applied to national choices of licensing models and the strictest to penalties and procedural requirements in licensing tenders. In a next step, the Court’s review practice is compared to judgments in other areas that involved similar consumer protection concerns (alcohol addiction and youth drinking; internet threats). Again, a diverging standard of review is noted. The chapter inquires the causes for the Court’s peculiar approach to gambling issues. It analyses in particular the political context of the early case law and it identifies passages in the jurisprudence that illustrate a subjective-moral rather than objective-scientific perspective on gambling-related risks. Finally, the chapter addresses the consequences of the Court’s diverging approach. Dealing with gambling as a ‘peculiar issue’ and a topos of public morality led to a lack of a science-informed assessment of gambling-related risks. The chapter notes a ‘judicial vacuum’ in the review practice; the numerous cases referred to the Court of Justice are an expression of this problem as predicted by the late Advocate General Colomer.
|
8,960 |
Hämostyptika
|
Desmopressin (DDAVP) wurde 1966 als Abkömmling des antidiuretischen Hypophysenhormons Arginin-Vasopressin synthetisch hergestellt. Zu den antidiuretischen Indikationen zählen Diabetes insipidus und Enuresis nocturna, zudem wird es in Tests zur Bestimmung der Nierenkonzentrationsfähigkeit verwendet
|
8,961 |
Nanomicrobiology
|
Microbiology plays an important role in practice of medicine. Nanodiagnostics have refined the detection of infectious diseases and many new nanotechnology-based therapies, particularly of viral diseases, are in development.
|
8,962 |
Transcriptomics of the Fungal Pathogens, Focusing on Candida albicans
|
The past century brought the availability of vaccines and antibiotics, leading to a dramatic fall in mortalities caused by infectious diseases. This led to the assumption that infectious disease has been defeated by medicine. In 1969 the United States Surgeon General actually claimed that “we can close the book on infectious diseases”. However, today we know that this assumption was naïve, not taking into account that evolution is a constant motor in adapting the existing organisms to changing environmental conditions, including the adaptation of pathogens to changes in the host. Today nearly 25% of the annual deaths world-wide are directly related to pathogens (Morens et al. 2004). This can be attributed to the appearance of new diseases, like HIV, SARS or West Nile Virus, but also to an increase of resistance to antibiotics in pathogens thought to be defeated, like Mycobacterium tuberculosis or Staphylococcus and Enterococcus strains. In addition the progress in medical care results in a large proportion of immune-deficient patients and consequently in an increase in opportunistic infections. Especially fungi have gained an infamous reputation during recent decades as being highly detrimental to patients with haematologiconcologic diseases, neutropenia or after organ transplantation. A review of the current literature identified 1415 species as known to be pathogenic to humans, including 538 bacteria and 307 fungi (Cleaveland et al. 2001). The fungi are a large group of diverse eukaryotic organisms. Only about 74 000 to 120 000 of the estimated 1.5×10(6) existing species of fungi have been described. Of the approximately 300 fungal species that are known to cause human infections, the most commonly observed live threatening systemic infections are caused by opportunistic infections of Candida species or Aspergilli. Therefore the major scientific interest with regard to fungal pathomechanisms has focused on these organisms in the past decade. The early availability of the genome sequence of Candida albicans (the first assembly of the genome sequence was publicly available in 2000, at http://www-sequence.stanford.edu/group/candida),the availability of molecular tools and the use of Saccharomyces cerevisiae as a model for many characteristics of C. albicans relevant for pathogenesis (including morphogenesis and signalling pathways involved in stress response) resulted in a major body of work concerning this opportunistic fungal pathogen (Berman and Sudbery 2002; Braun et al. 2005; Jones et al. 2004). Until 2004 C. albicans was actually the only fungal pathogen on which genome-wide transcriptomics using arrays had been published. The sequences of other pathogenic fungi or the tools required for genome-wide transcriptomics had not been available to the public until then. However, a major body of molecular work has been performed on other opportunistic fungal pathogens, including C. glabrata, C. parapsylosis, C. tropicalis, Cryptococcus neoformans and Aspergillus species, where Aspergillus fumigatus is leading the clinically relevant species, as well as on the genera of primary fungal pathogens, including Blastomyces, Coccidioides, Histoplasma and Paracoccidioides. Due to the advancement of Candida albicans transcriptomics this chapter mainly focuses on this organism and only briefly touches the current work on other fungal pathogens.
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8,963 |
Immunization and Vaccination
|
Vaccines have been recognized as one of the most successful public health measures. In this chapter, we provide a historical overview of immunization measures and discuss the basics of immunization and vaccination in the context of a pandemic outbreak. We will also discuss vaccine hesitancy, the factors that lead to vaccine acceptance and refusal, the determinants of individual decision-making about vaccination, and strategies of how to approach it on an individual, community, and global level.
|
8,964 |
Global control of infectious diseases by vaccination programs
|
In both industrialized and developing countries, childhood immunization has become one of the most important and cost-effective public health interventions. National immunization programs have prevented millions of deaths since WHO initiated the ‘Expanded Program on Immunization’ in 1974. Smallpox was eradicated in 1979, poliomyelitis is on the verge of eradication, and two thirds of developing countries have eliminated neonatal tetanus. Global immunization coverage was at 78% in 2005. Through their impact on childhood morbidity and mortality, immunization programs are contributing to reaching the ‘Millennium Development Goal 4’ — a two-thirds reduction of under-five mortality by 2015. However, the failure to reach more than 20% of the world’s children with existing vaccines was responsible for at least 2.5 million of an estimated 10.5 million deaths of children under 5 years, mainly in developing countries. Of these deaths, 1.4 million could have been prevented by vaccines currently recommended by WHO. Rapid progress in our understanding of the pathogenesis of infectious diseases, immunology, and biotechnology has increased the number of candidate vaccine antigens available. Pressures are growing on public health decision makers to establish evidence-based ways to decide which new vaccines should be introduced on a large scale into national immunization programs. The gap in access to new vaccines between the developing and industrialized worlds is still wide, and wealthy countries are still the first to introduce and use new vaccines. Interest from countries and partner agencies in vaccination, as one of the most cost-effective public health interventions, continues to be strong, also due to rapid progress in biotechnology and vaccine development and the emergence of global infectious disease threats, including HIV/AIDS, SARS, and influenza. The establishment of the Global Alliance for Vaccines and Immunization has focused global activities to support vaccination programs through raising considerable funds, and to assist especially poorer countries in improving and expanding their vaccination programs. Global efforts concentrate on further reducing the gap in the access to all existing vaccines between industrialized and developing countries.
|
8,965 |
Sepsis
|
1. Hyperthermie (>38,5 °C) oder Hypothermie (<36,0 °C). 2. Tachykardie (Herzfrequenz >2SD über der altersentsprechenden Norm) oder Bradykardie (Herzfrequenz <10. Perzentile) im Alter <1 Jahr. 3. Tachypnoe (Atemfrequenz >2SD über der altersentsprechenden Norm). 4. Leukozytose oder Leukozytopenie oder Linksverschiebung (>10 % unreife Neutrophile), 5. Nachweis oder Verdacht auf eine Infektion;
|
8,966 |
Staphylococcal Infections
| null |
8,967 |
Geschichte, Theorie und Ethik der Medizin
|
Von Medizin kann erst dann die Rede sein, wenn zur heilkundlichen Praxis eine Theorie hinzukommt, die sich an der jeweils aktuellen Naturwissenschaft ausrichtet.
|
8,968 |
Modeling the Case of Early Detection of Ebola Virus Disease
|
The most recent Ebola outbreak in West Africa highlighted critical weaknesses in the medical infrastructure of the affected countries, including effective diagnostics tools, sufficient isolation wards, and enough medical personnel. Here, we develop and analyze a mathematical model to assess the impact of early diagnosis of pre-symptomatic individuals on the transmission dynamics of Ebola virus disease in West Africa. Our findings highlight the importance of implementing integrated control measures of early diagnosis and isolation. The mathematical analysis shows a threshold where early diagnosis of pre-symptomatic individuals, combined with a sufficient level of effective isolation, can lead to an epidemic control of Ebola virus disease.
|
8,969 |
Corona-Viren
|
Im Genus Corona-Virus finden sich 5 humanpathogene Viren, welche Erkrankungen der oberen Luftwege, Gastroenteritis sowie schwere Pneumonien hervorrufen können. Der Name leitet sich von dem wie eine Krone (“Corona„) aussehenden Besatz der äußeren Hülle des Virus mit knöpfchentragenden Spikes (= Glykoproteine) her. Bei Vögeln und Säugetieren kennt man Corona-Viren als Erreger von schwerer Bronchitis und Gastroenteritis.
|
8,970 |
Herpes Simplex Virus Pneumonia in Patients with Hematologic Malignancies
|
Herpes simplex virus (HSV) pneumonia is rare and is usually seen in immunocompromised patients. Patients with hematologic malignancies and hematopoietic stem cell transplant (HSCT) are at risk. Most of the cases of HSV pneumonia are caused by HSV-1; however, cases caused by HSV-2 have also been reported. Mucocutaneous disease often precedes the development of pneumonia, with nonspecific symptoms that include fever, cough, and dyspnea. Worsening oxygenation and failure to wean off mechanical ventilation despite broad-spectrum antimicrobial coverage is also a common presentation. Diagnosis requires a high degree of suspicion and is based on isolation of the virus from respiratory secretions and demonstration of cytopathic effects on histopathology. Acyclovir is the most widely used drug for treatment and prophylaxis. With increasing evidence of resistance to acyclovir and its analogs, newer agents such as foscarnet and cidofovir are being recommended as treatment options. Prophylaxis in patients with seropositive HSV undergoing chemotherapy or in the immediate post-HSCT period has been shown to reduce HSV disease rates and mortality rates. This chapter will focus on incidence and transmission, pathogenesis, risk factors, clinical features, diagnosis, and management of HSV pneumonia in patients with hematologic malignancies and HSCT, as well as outcome and prognosis.
|
8,971 |
Building Applied Mathematics Knowledge Base in East Africa
|
There is vast demand in Africa for technological development including modernization of higher education. Reforms in industrial processes through engineering skills are pivotal for the environmental concern and goals of sustainable development. Lappeenranta University of Technology has actively contributed to the spread of Industrial Mathematics in East African region over the past decade through development projects financed by the Finnish Ministry of Foreign Affairs. In this article, we summarize these projects and present their achievements. The story of European Consortium for Mathematics in Industry (ECMI) and the accumulated experience over 25 years have been the encouragement and inspiration for our initiatives. They were focused on Applied Mathematics curriculum development in Partner countries, and on organization of ECMI-style practical workshops like modeling weeks. There is obvious demand to broaden the cooperation between Africa and the European applied mathematics community.
|
8,972 |
Respiratory Syncytial Virus
|
Name of Virus: Respiratory Syncytial Virus
|
8,973 |
Applications of Loop-Mediated Isothermal Amplificaton Methods (LAMP) for Identification and Diagnosis of Mycotic Diseases: Paracoccidioidomycosis and Ochroconis gallopava infection
|
Loop-mediated isothermal amplification (LAMP) methods are now useful for the detection of a specific gene in infectious diseases, genetic diseases, and/or genetic disorders in the large number of medical fields, and it was recently introduced to fungal investigation. It is characterized by the use of four different primers specifically designed to recognize six distinct regions of the target gene, and the reaction process proceeds at a constant temperature using strand displacement reaction. Quickness and simplicity is the advantage of the method. Amplification and detection of gene can be completed in a single step, by incubating the mixture of samples, primers, DNA polymerase with strand displacement activity and substrates at a constant temperature. The method was applied to two fungal infections; paracoccidioidomycosis (PCM), a deep mycosis caused by Paracoccidioides brasiliensis and Ochroconis gallopava infection. For PCM a combination of F3, B3, FIP, and BIP primers designed from the partial sequence of P. brasiliensis gp43 gene was used. The PCR products amplified by the primer set; F3 and B3 showed species specificity for P. brasiliensis and the detection limit of the PCR was 100 fg of fungal genomic DNA. The specific DNA banding pattern of P. brasiliensis was detected in the clinical and nine-banded armadillo derived isolates, paraffin-embedded tissue sample or sputum from PCM patient. LAMP method was used also for the identification of O. gallopava by using species-specific primer sets based on the D1/D2 domain of the LSU rDNA sequence. The method successfully detected the gene from both fungal DNA derived from brains and spleens of experimentally-infected mice with O. gallopava and environmental isolates. In conclusion, LAMP method for PCM and O. gallopava seemed to be useful for identification, diagnosis or retrospective study with advantage in the quickness and simplicity procedure, but require strictly-controlled environments.
|
8,974 |
PCR in Integrated Microfluidic Systems
|
Miniaturized integrated DNA analysis systems offer the potential to provide unprecedented advances in cost and speed relative to current benchtop-scale instrumentation by allowing rapid bioanalysis assays to be performed in a portable self contained device format that can be inexpensively mass-produced. The polymerase chain reaction (PCR) has been a natural focus of many of these miniaturization efforts, owing to its capability to efficiently replicate target regions of interest from small quantities template DNA. Scale-down of PCR has proven to be particularly challenging, however, due to an unfavorable combination of relatively severe temperature extremes (resulting in the need to repeatedly heat minute aqueous sample volumes to temperatures in the vicinity of 95°C with minimal evaporation) and high surface area to volume conditions imposed by nanoliter reactor geometries (often leading to inhibition of the reaction by nonspecific adsorption of reagents at the reactor walls). Despite these daunting challenges, considerable progress has been made in the development of microfluidic devices capable of performing increasingly sophisticated PCR-based bioassays. This chapter reviews the progress that has been made to date and assesses the outlook for future advances.
|
8,975 |
Diseases of the Pulmonary Vascular System
| null |
8,976 |
Urgent Epidemic Control Mechanism for Aviation Networks
|
In the current century, the highly developed transportation system can not only boost the economy, but also greatly accelerate the spreading of epidemics. While some epidemic diseases may infect quite a number of people ahead of our awareness, the health care resources such as vaccines and the medical staff are usually locally or even globally insufficient. In this research, with the network of major aviation routes as an example, we present a method to determine the optimal locations to allocate the medical service in order to minimize the impact of the infectious disease with limited resources. Specifically, we demonstrate that when the medical resources are insufficient, we should concentrate our efforts on the travelers with the objective of effectively controlling the spreading rate of the epidemic diseases.
|
8,977 |
Pulmonary Surfactant: Biology and Therapy
| null |
8,978 |
Biosurveillance and Dentistry
|
Events of public health concern continue to present a challenge for the general population. A key element to address appropriate health responses is the establishment of modern public health surveillance mechanisms. In this chapter we explore possible scenarios/use cases where dentists can use electronic dental record technology to increase the accuracy, coverage, and timeliness of existing public health surveillance efforts. We identify organizational, technical, and regulatory elements that influence the adoption of such approaches and possible benefits when integrated to the public health system at large.
|
8,979 |
The Economy and the Construction Industry
|
Generally, there are three levels to define construction within the literature (Dang and Low in Infrastructure Investments in Developing Economies. Springer, 2015). At one extreme, construction is referred to as an economic activity that involves the entire construction process from producing raw and manufactured building materials and components, and providing professional services such as design and project management, to executing the physical work on site.
|
8,980 |
Hämatologie
|
—. Anämie = Hämoglobinkonzentration (Hb) ↓ unterhalb des alters-/geschlechtsspezifischen Normwertes; —. Hb korreliert mit dem Hämatokrit (Hkt), aber nicht direkt mit der Erythrozytenzahl; —. jede Anämie bedarf der Ursachenabklärung ➲ Memo keine Therapie ohne Diagnose!); —. Einteilung der Anämien nach mittlerem korpuskulärem Volumen (MCV) und mittlerem korpuskulärem Hb-Gehalt (MCH) (▸ Tabelle) [Image: see text] —. —. Kopfschmerzen, Konzentrationsschwäche; —. Ohrgeräusche; —. verminderte Leistungsfähigkeit, leichte Ermüdbarkeit; —. Belastungsdyspnoe; —. Schwindel- und Schwächegefühl Tachykardie, evtl. systolisches Herzgeräusch (Strömungsgeräusch infolge von Turbulenzen bei verminderter Viskosität; DD Endokarditis lenta mit Infektanämie); —. Blässe der Haut und Schleimhäute; —. Einteilung der Anämien nach ihrer Åtiologie (▸ Tabelle); —. mit 80% häufigste Anämieform; 80% aller Fälle sind Frauen; —. Eisenverluste durch chronische Blutungen (80% der Fälle): meist genitale Blutungen bei der Frau (z. B. Uterus myomatosus) oder Blutungen aus dem Verdauungstrakt; —. mangelnde Eisenzufuhr: v. a. bei Säuglingen, Kleinkindern und Vegetariern; —. ungenügende Eisenresorption: Anazidität nach Magenresektion, Malassimilationssyndrom, CED; —. gesteigerter Eisenbedarf: Gravidität, Stillperiode, Wachstum;
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8,981 |
Triterpene einschließlich Steroide
|
Die Triterpene gehören zur Naturstoffgruppe der Isoprenoide (vgl. Kap. 23). Sie stellen eine außerordentlich umfangreiche Klasse von Terpenen dar. Sie werden in diesem Kapitel zusammen mit den sich davon ableitenden Steroiden zusammengefasst. Die Muttersubstanz aller Triterpene ist der azyklische C(30)-Kohlenwasserstoff Squalen. Seine Zyklisierung wird durch Epoxidierung einer endständigen Doppelbindung eingeleitet. Da die Squalen-2,3-Epoxidstufe vor der Zyklisierung obligat durchlaufen werden muss, enthalten nahezu alle Triterpene und Steroide in Position C-3 eine Sauerstofffunktion. Vom Squalen ausgehend lassen sich zwei Hauptwege erkennen: Der eine führt zu den tetra- und pentazyklischen Triterpenen, der andere über Cycloartenol zu den Cucurbitacinen und via das wichtigste Stoffwechselintermediärprodukt, das Cholesterol, zu den Phytosterolen, Cardenoliden und Bufadienoliden sowie zu den Steroidsapogeninen.
|
8,982 |
Southeast Asia: Beyond Crises and Traps
|
There is persistent concern that Southeast Asian economies may eventually fall into the ‘middle-income trap’ due to the slow upgrading of their technological capabilities. However, the five Southeast Asian countries (Malaysia, Thailand, Indonesia, Philippines, and Vietnam) covered by this volume have performed much better economically than many non-Asian middle-income countries although not as well as the four East Asian ‘tiger economies’ and China. Those Southeast Asian economies have derived an important part of their vitality by pursuing economic growth and competitiveness along lesser known or recommended pathways such as niche-oriented activities, natural resource processing, and cheap labour-based production, or a combination of these. In the final analysis the technological upgrading of industries and services, including resource-based and niche-oriented ones, will remain the most plausible way to continue catching up with the advanced economies and to stay competitive vis-à-vis emerging rivals. However, just as past development trajectories had been shaped by domestic socio-political configurations and the international/regional environment, so future prospects for these countries depend on how well they adapt to the fluid conditions of global competition and the uncertain state of global markets. They would also have to overcome a sort of ‘socio-political trap’ of oligarchic aggrandizement and populist pressures that result in fragmented interests without a national consensus for upgrading industries and services.
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8,983 |
Risks and Epidemiology of Infections After Hematopoietic Stem Cell Transplantation
|
Infections following HCT are frequently related to risk factors caused by the procedure itself. Neutropenia and mucositis predispose to bacterial infections. Prolonged neutropenia increases the likelihood of invasive fungal infection. GVHD and its treatment create the most important easily identifiable risk period for a variety of infectious complications, particularly mold infections. Profound, prolonged T cell immunodeficiency, present after T cell-depleted or cord blood transplants, is the main risk factor for viral problems like disseminated adenovirus disease or EBV-related posttransplant lymphoproliferative disorder.
|
8,984 |
Life-threatening Respiratory Failure from H1N1 Influenza: Lessons from the Southern Cone Outbreak
|
A sharp increase in the hospitalization rate for pneumonia, particularly among adults between 20 and 40 years old, and an unusual series of deaths, coincident with an increase in laboratory-confirmed influenza cases, were reported in the spring of 2009 in Mexico. This outbreak appeared after the end of influenza season, and was associated with mortality in a younger age-group than the pattern observed in temperate areas in the northern hemisphere [1]. The concurrent finding of a novel, swine-origin influenza A virus (so called pandemic influenza [H1N1] 2009) from infected children in the United States [2] completed the picture.
|
8,985 |
Ventilator-Associated Pneumonia
|
The area of the alveolar epithelium of the lung is approximately 70 m(2). This area is constantly in contact with the ambient air and is therefore vulnerable to contamination with airborne microbes and particles of respirable size. Due to the configuration of the respiratory tract, airborne particles having diameters in the range of 0.5-2.0 μ can reach and deposit in the terminal part of the tracheobronchial tree - most bacteria are of this size. In reality, very few bacteria cause infections by spreading via the airborne route (e.g., mycobacteria, viruses, and legionella). Most bacteria cause pneumonia by first colonizing the upper respiratory tract and later descending into the tracheobronchial tree.
|
8,986 |
Intensivbehandlung nach Transplantation solider Organe
| null |
8,987 |
Macrophage Inflammatory Protein-1 Alpha (MIP-1 alpha)/CCL3: As a Biomarker
|
Macrophage inflammatory protein-1 alpha (MIP-1α/CCL3) is a chemotactic chemokine secreted by macrophages. It performs various biological functions, such as recruiting inflammatory cells, wound healing, inhibition of stem cells, and maintaining effector immune response. It activates bone resorption cells and directly induces bone destruction. Cells that secrete MIP-1α/CCL3 are increased at sites of inflammation and bone resorption. MIP-1α/CCL3 plays an important role in the pathogenesis of various inflammatory diseases and conditions that exhibit bone resorption, such as periodontitis, multiple myeloma, Sjögren syndrome, and rheumatoid arthritis. Biological fluids from patients with these diseases exhibit elevated levels of MIP-1α/CCL3. This finding indicates that MIP-1[Formula: see text] /CCL3 protein may have diagnostic potential for the detection of several inflammatory diseases and conditions. This chapter discusses the biological functions of MIP-1α/CCL3; describes several diseases associated with MIP-1α/CCL3, particularly periodontitis; and delineates the potential application of MIP-1α/CCL3 as a biomarker.
|
8,988 |
Identification of Essential Genes as a Strategy to Select a Sars Candidate Vaccine Using a SARS-CoV Infectious cDNA
| null |
8,989 |
Roadmap of Agricultural Production and Food Safety Science and Technology Development
|
As Food is related to human survival and health, the country’s reputation and image, and the economic benefit and position in the international trade, it has become one of the hottest issues in the world now. As the continuous growth of world population, the constant changes of human life style and the continued deterioration of natural environment, higher requests for food safety are put forward by human society. Therefore, we should not only ensure the safety of quantity, but also to ensure the safety of quality in the food safety field by 2050. New concepts and technological means should be adopted to ensure the constant production and supply of the “green” and safe agricultural production to meet the people’s great need for food safety, nutrition and health.
|
8,990 |
Infektiologie
| null |
8,991 |
Pulmonary Effects of Antineoplastic Therapy
|
Pulmonary toxicity is common after cancer therapy and can result from all therapeutic modalities. The consequential decrease in lung function ranges in severity from subclinical to life-threatening or even fatal and can manifest in the acute setting or many years after completion of therapy. Radiation effects are due to direct insult to the pulmonary parenchyma and, for younger children, impaired thoracic musculoskeletal development. Radiation pneumonitis can occur in the acute/subacute setting, as well as fibrosis with comprised gas exchange as a late effect of direct lung irradiation; thoracic wall malformation can cause restriction of function as a chronic sequela. The pulmonary effects of cytotoxic drugs usually present as acute effects, but there is the potential for significant late morbidity and mortality. Of course, surgical interventions can also cause both acute and/or late pulmonary effects as well, depending on the specific procedure. Although treatment approaches for the management of pediatric cancers are continually adapted to provide optimal therapy while minimizing toxicities, to a varying degree all therapies have the potential for both acute and late pulmonary toxicity. Of note, the cumulative incidence of pulmonary complications rises with increasing time since diagnosis, which suggests that adult survivors of childhood cancer require lifelong monitoring and management of potential new-onset pulmonary morbidity as they age. Knowledge of cytotoxic therapies and an understanding of lung physiology and how it may be altered by therapy facilitate appropriate clinical care and monitoring of long-term survivors.
|
8,992 |
Ergebnisdarstellung: Fallrekonstruktionen und Typisierungen
|
In diesem Kapitel werden die empirischen Befunde der Arbeit vorgestellt. Die nachfolgend präsentierten Interpretationsergebnisse stellen das Resultat einer abstrahierenden Typisierung dar, zu deren Zustandekommen folgendermaßen vorgegangen wurde: Zunächst wurde jeder Fall aus jeder Samplegruppe einzeln betrachtet und anhand des im letzten Kapitels vorgestellten Vorgehens analysiert; infolgedessen zeigte sich, dass sich dabei fallübergreifende Gemeinsamkeiten herausstellten. Indem nach Abschluss der Fallrekonstruktion festgestellt werden konnte, dass sich die Fälle einer Subgruppe unter eine gemeinsame übergreifende Orientierung fassen ließen, wurde eine samplegruppenbezogene Abstrahierung vorgenommen. Dass im Folgenden zwölf generalisierte Orientierungsrahmen präsentiert werden, ist sowohl auf die Sample- als auch auf die dreigeteilte Themenstruktur zurückzuführen.
|
8,993 |
Valuable Secondary Metabolites from Fungi
|
Fungi are amazing producers of natural products, including secondary metabolites. These compounds are crucial to the health and well-being of people throughout the world. They also provide agriculture and livestock with many essential products. Production of secondary metabolites is improved by mutagenesis and recombinant DNA technologies allowing commercial production of these valuable compounds. This chapter centers on these fungal beneficial products, the discovery of which goes back 85 years to the time that penicillin was discovered by Alexander Fleming.
|
8,994 |
Stem Cells and Organ Transplantation: Resetting Our Biological Clocks
|
The human body has only a limited ability to repair itself. Illness, injury, and aging can overwhelm its built-in capability to replace dysfunctional, damaged, or destroyed tissues. We can at best only partly regenerate our organs and cannot grow back a whole limb.
|
8,995 |
Anaesthetic and Perioperative Management for Liver Transplantation
|
This chapter concerns about perioperative anaesthesiologic management of liver transplantation. Liver cirrhosis and its complications often involve different organs whose derangements could severely worsen postoperative outcome; hence, their preoperative diagnosis and treatment are fundamental; the first part of this chapter describes the most frequent complications of cirrhosis and their implications in preoperative care. Liver transplantation is a challenging task for the anaesthesiologist because of the risk of bleeding, cardiovascular derangements, coagulation impairment and metabolic disturbances; the second part of this chapter describes the main anaesthetic and monitoring techniques used for liver transplantations and the most important intraoperative problems which need to be faced by the anaesthesiologist in each phase of the intervention. Early postoperative management of liver transplant recipients is crucial because of their comorbidities and the potential surgical and medical complications of the intervention; the third part of this chapter describes the ICU management after liver transplantation and the main medical complications for every organ system that needs a critical care approach.
|
8,996 |
Hygiene, Mikrobiologie, Virologie
|
Die Mikrobiologie und Infektionsepidemiologie umfasst die Laboratoriumsdiagnostik mikrobiell bedingter Erkrankungen und die Aufklärung ihrer epidemiologischen Zusammenhänge und Ursachen. Weiterhin gehört in dieses Gebiet die Unterstützung der in der Vorsorge, in der Krankenbehandlung und im Öffentlichen Gesundheitsdienst tätigen Ärzte bei der Diagnose von Infektionskrankheiten, ihrer Prophylaxe und Bekämpfung sowie bei der mikrobiologischen Bewertung antimikrobieller Substanzen.
|
8,997 |
Lebererkrankungen
|
Die Leber als größtes inneres Organ des menschlichen Körpers ist ein zentrales Organ in Kohlehydrat- und Fettstoffwechsel, in der Herstellung zahlreicher Eiweiße, Enzyme und Gerinnungsfaktoren und in der Entgiftung und Ausscheidung verschiedenster Substanzen. Dieses Kapitel gibt einen Überblick über angeborene und erworbene Lebererkrankungen, deren Epidemiologie, Pathophysiologie, klinische Symptome, Komplikationen und Verlauf, typische Befunde zur Diagnosestellung und Differentialdiagnosen sowie therapeutische Möglichkeiten und Prognose. Das breite Spektrum der Lebererkrankungen umfasst angeborene Defekte des Eisen- und Kupferstoffwechsels, virale und bakterielle Infektionen, Parasitenbefall, vaskuläre und autoimmune Erkrankungen, Schädigung durch Alkohol oder Verfettung, sowie benigne und maligne primäre und sekundäre Lebertumore.
|
8,998 |
Infektionen des ZNS
|
Durch Bakterien hervorgerufene Meningitis mit der klassischen Trias Kopfschmerzen, Fieber und Meningismus
|
8,999 |
Pathogenität — Infektionsverlauf
|
Die Pathogenität von Viren ist die Voraussetzung für die Entstehung von Krankheiten. Sie kommt durch vielfältige Eigenschaften des Wirts und des Virus zustande. Im Brennpunkt stehen der virusbedingte primäre Zellschaden und die Entzündung mit sekundären immunpathologischen Zellschädigungen.
|
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