title: Cysteine/Glutathione Deficiency: A Significant and Treatable Corollary of Disease

text: Glutathione (GSH) deficiency may play a pivotal role in a variety of apparently unrelated clinical conditions and diseases. Orally administered N-acetylcysteine (NAC), which replenishes the cysteine required for GSH synthesis, has been tested in a large number of randomized placebo-controlled trials involving these diseases and conditions. This chapter focused on developing a base of evidence suggesting that NAC administration improves disease by increasing cysteine and/or GSH in a variety of diseases, thereby implying a significant role for GSH deficiency in the clinical basis of many diseases. To develop this base of evidence, we systematically selected studies which considered the hypothesis that the therapeutic efficacy for NAC is an indication that cysteine and/or GSH deficiency is a pathophysiological part of the diseases studied. In this manner we focus this chapter on explaining the biological mechanisms of NAC therapy in a wide variety of disorders and demonstrate its ubiquitous role in improving disease that involves disrupted GSH and/or cysteine metabolism. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/978-981-10-5311-5_20) contains supplementary material, which is available to authorized users.


Mapping and Modeling Disease Risk Among Mobile Populations


title: Die Gesellschaft Deutscher Neurologen und Psychiater im Zweiten Weltkrieg

text: Mit Beginn des Zweiten Weltkriegs kam es – als Folge der Einberufung wichtiger Protagonisten – zu einer deutlichen Beeinträchtigung der Organisationsstrukturen der Gesellschaft Deutscher Neurologen und Psychiater. Im Verlauf des Krieges lösten sich die formalen Strukturen weiter auf, während das informelle Netzwerk, das die Fachgesellschaft zusammenhielt, weitgehend intakt blieb und es an der Schnittstelle von Wissenschaft und Politik zu neuen Konstellationen und Kooperationen kam.


title: Bronchiolitis

text: Bronchiolitis produces significant morbidity and mortality worldwide every year. Approximately 3–10 % of all infants hospitalized with bronchiolitis develop acute respiratory failure and require admission to a pediatric intensive care unit. The vast majority of cases are caused by Respiratory Syncytial Virus (RSV), though other viruses (human metapneumovirus, parainfluenza, influenza, adenovirus, rhinovirus, coronavirus and bocavirus) may also cause bronchiolitis. Bronchiolitis is not merely a single organ disease (i.e. lung), but impacts on extrapulmonary organ systems. Basic supportive management remains the cornerstone. There is a paucity of established therapeutic options, with supplementary oxygen, continuous positive airway pressure (CPAP), humidified high-flow nasal oxygen, mechanical ventilation being the mainstay of respiratory support.


title: RNA Pseudoknot Folding through Inference and Identification Using TAG(RNA)

text: Studying the structure of RNA sequences is an important problem that helps in understanding the functional properties of RNA. After being ignored for a long time due to the high computational complexity it requires, pseudoknot is one type of RNA structures that has been given a lot of attention lately. Pseudoknot structures have functional importance since they appear, for example, in viral genome RNAs and ribozyme active sites. In this paper, we present a folding framework, TAG(RNA)Inf, for RNA structures that support pseudoknots. Our approach is based on learning TAG(RNA) grammars from training data with structural information. The inferred grammars are used to indentify sequences with structures analogous to those in the training set and generate a folding for these sequences. We present experimental results and comparisons with other known pseudoknot folding approaches.


title: Taxonomy, Physiology, and Ecology of Aquatic Microorganisms

text: The principles behind the taxonomy of the microorganisms, especially the molecular approach (using the sequence of the 16S RNA in the small subunit of the ribosome) in the identification of bacteria, are discussed. The detailed taxonomy of bacteria, fungi, algae, protozoa, and viruses (including bacteriophages) is discussed, and emphasis is laid on those microorganisms which are aquatic. The chapter includes information on some of the smaller macroorganisms found in water such as nematodes and rotifers. The activities of aquatic microorganisms in photosynthesis, and the global cycling of nitrogen and sulfur is discussed.


title: Health Research Behind Bars: A Brief Guide to Research in Jails and Prisons

text: While most people make staying out of jail and prison a priority, a growing number of researchers are eager to get into correctional facilities in order to study the criminal justice system, the causes and consequences of incarceration, and the role of corrections in our society. For health researchers and their collaborators, the audience for this chapter, correctional facilities offer several unique advantages: a population at high risk of many health problems including infectious and chronic diseases, substance abuse, and mental health problems; social and physical environments that can enhance or impede well-being; a setting that is a focal point for the class, racial/ethnic, and gender differences that divide the United States; a site where health and mental health services and prevention programs are offered and can be evaluated; a controlled environment for administration of treatments such as directly observed therapy for tuberculosis; and a stopping point in the cycle of incarceration and reentry that so profoundly affects community well-being.


title: Acronyms and Abbreviations

text: “The patient went from the ER to the OR and then to the ICU.” It is an irrefutable fact that doctor’s speech is full of abbreviations. Health-care professionals in general and cardiologists in particular use many abbreviations. This high prevalence has led us to consider medical abbreviations as a challenging pandemic.


title: Sickle Cell Disease

text: Sickle cell disease is characterized by vaso-occlusive and hemolysis events that may occur in a variable range of clinical presentations. Patients with this disease, particularly with acute chest syndrome, suffer acute episodes of chest pain caused by vaso-occlusive crisis, that tend to repeat, especially under the influence of lower respiratory infections, dehydration, and any cause of hypoxemia. Children and adolescents with sickle cell disease must be periodically evaluated through oximetry, lung function tests, sleep study, and echocardiograms to detect obstructive and restrictive diseases that frequently worsens the lung condition. Asthma and sleep disorders contribute to morbidity and must be controlled.


Anti-viral approaches against influenza viruses


title: Management of the Rheumatoid Arthritis Patient with Interstitial Lung Disease

text: The treatment of rheumatoid arthritis (RA) has undergone considerable changes over the last 15–20 years. With an expansion in the armamentarium of therapies available for RA comes a wider choice in selecting the best treatment in terms of comparative safety in the presence of comorbidities. Clinicians frequently encounter patients with RA-associated interstitial lung disease with uncontrolled joint disease and have to make decisions about the safest treatments in this context with the eventual goal of joint remission. In this chapter, available evidence is reviewed on the comparative pulmonary safety of non-biologic disease-modifying antirheumatic drugs (nbDMARDs), biologic DMARDs, biosimilars and targeted synthetic DMARDs in RA-ILD. In addition, the potential role for additional immunosuppression in RA-ILD is reviewed as well as overarching recommendations proposed for patient assessment to guide treatment decisions and management.


docid: axbgacot

title: Molecular farming for antigen (vaccine) production in plants

text: Genomic and proteomic approaches to the study of fundamental cell mechanisms are rapidly contributing to broaden our knowledge on metabolic pathways for the optimal exploitation of the cell as a factory. In the last few years this knowledge has led to important advances in the large scale production of diagnostic and therapeutic proteins in heterologous hosts (bacteria, yeasts, mammalian and insect cells or transgenic animals and plants), allowing the comparison of the most efficient methods in terms of costs, product quality and safety.


title: Cytopenias in Transplant Patients

text: Anemia, leukopenia, thrombocytopenia, as well as pancytopenias can be seen following solid organ transplant. Varying patterns of cytopenia can be seen based on the drugs used in the posttransplant period, infections encountered by the individual, as well as the individual’s immune response and bone marrow function. The chapter discusses the main causes of anemia, leukopenia/neutropenia, and thrombocytopenia. The differential diagnosis for anemia after solid organ transplant includes hemolysis, drug toxicities, iron deficiency, infection, posttransplant lymphoproliferative disorder, graft-vs.-host disease, and hemophagocytic syndrome. Etiologies for leukopenia and neutropenia include drug toxicities and infection, and etiologies for thrombocytopenia include drug toxicities, infections, autoimmune events such as immune thrombocytopenic purpura, and underlying causes such as persistent portal hypertension and splenomegaly.


title: Astrovirus Infections in Animal Mammalian Species

text: The first reports of astroviruses in animals date back to the end of the 1970s, when infections in mammals such as lambs and calves suffering from diarrhea were reported for the first time. Since then, several mammalian species have been shown to be susceptible to astroviruses which appear to be genetically diverse and to have acquired host-specificity. To date, astroviruses have been detected in 16 different orders or species of mammals in addition to humans, and signs of infection range from unapparent infection or very mild disease to diarrhea, lethargy, and anorexia, mainly observed in young individuals. This chapter describes those astroviruses detected in nonhuman mammalian species worldwide, as well as their molecular and phenotypic characteristics and their role in diseases. The capacity of these viruses to cross-species barriers and their subsequent adaptation to novel hosts is also highlighted.


title: Diabetes Mellitus: New Challenges and Innovative Therapies

text: Diabetes is a common chronic disease affecting an estimated 285 million adults worldwide. The rising incidence of diabetes, metabolic syndrome, and subsequent vascular diseases is a major public health problem in industrialized countries. This chapter summarizes current pharmacological approaches to treat diabetes mellitus and focuses on novel therapies for diabetes mellitus that are under development. There is great potential for developing a new generation of therapeutics that offer better control of diabetes, its co-morbidities and its complications. Preclinical results are discussed for new approaches including AMPK activation, the FGF21 target, cell therapy approaches, adiponectin mimetics and novel insulin formulations. Gene-based therapies are among the most promising emerging alternatives to conventional treatments. Therapies based on gene silencing using vector systems to deliver interference RNA to cells (i.e. against VEGF in diabetic retinopathy) are also a promising therapeutic option for the treatment of several diabetic complications. In conclusion, treatment of diabetes faces now a new era that is characterized by a variety of innovative therapeutic approaches that will improve quality of life in the near future.


title: Metalloproteases and Proteolytic Processing

text: Proteolytic enzymes constitute around 2% of the human genome and are involved in all stages of cell and organism development from fertilization through to cell death. In the human genome the major classes of peptidases are represented by cysteine-, serine- and metalloenzymes, which possess a wide spectrum of substrate specificity and physiological functions. The identification of many novel peptidases from genome sequencing programmes has suggested potential new therapeutic targets. In addition, several well characterised peptidases were recently shown to possess new and unexpected biological roles in neuroinflammation, cancer and angiogenesis, cardiovascular diseases and neurodegeneration. This chapter will briefly characterize the main classes of metallopeptidases and their roles in health and disease. Particular attention will be paid to the angiotensin-converting enzyme (ACE), neprilysin (NEP) and adamalysin (ADAM) families of proteases and their pathophysiological roles with a particular emphasis on cancer and neurodegeneration. The roles and mechanisms of protein shedding which primarily involve the ADAMs family of metallopeptidases will be explained using amyloid protein precursor (APP) processing cascades as a well characterized example. The therapeutic significance of modulating (activating or inhibiting) metallopeptidase activity will be a particular focus of this chapter.


title: Axons and Neurons in Corona Virus-Induced Demyelination

text: Infection of mice with the coronavirus mouse hepatitis virus induces primary demyelination in susceptible strains of rodents. Although demyelination is the primary pathological process detected in the central nervous system of infected mice, axonal dysfunction and damage also occur concomitantly with demyelination. This process is T cell mediated, with either CD4 or CDS T cells sufficient for MHV-induced axonal damage. A striking feature is that axonal damage occurs early in the disease process, at nearly the same time as demyelination is first observed. Axonal damage in MHV-infected mice has many similarities with the parallel process in humans with multiple sclerosis.


title: Xenotransplantation

text: The above statement was made by Guido Persijn, former Medical Director of the Eurotransplant Foundation, an international organisation that coordinates organ donation and transplantation. Xenotransplantation is the transplantation of organs, tissues or cells from one species of animal to another. This chapter will look at transplantations between animal and humans. Xenotransplantation is one possible solution for the organ donor shortage in the area of transplant medicine(77). However, there is still a ban on this type of procedure because of the lack of clarity about the sort of risks entailed. The natural rejection responses to cross–species components still create insurmountable problems. The transfer of viral DNA with, as yet, unpredictable consequences is also another matter that requires due attention. The various facets of this topic will be discussed in this chapter, as will the question of whether or not xenotransplantation is ethically responsible. We’ll begin with the history of xenotransplantation, which has its origins in a dark past.


title: Respiratoire aandoeningen

text: De incidentie van community-acquired pneumonie (cap, pneumonie begonnen thuis of binnen 48 uur na ziekenhuisopname) bedraagt 0,5-i,5%. Zij is hoger bij jonge kinderen en ouderen en stijgt tijdens een influenza-epidemie. Slechts 10-20% van de patiënten moet worden opgenomen vanwege de ernst van de pneumonie of een belangrijke bijkomende aandoening. De mortaliteit van deze patiënten bedraagt 5-15%; pneumonie is dus de frequentste infectieuze doodsoorzaak.


title: The Global Threats from Naturally Occurring Infectious Diseases

text: Biological risk relates to a broad spectrum of possible scenarios, that can be classified in three categories: natural occurring, unintended and deliberate. The prevention and management of such events require dedicated measures at national and international level, in terms of biosafety and biosecurity: an optimized intervention can minimize the probability of occurrence, but also adverse short-term (i.e.: number of casualties, population reaction…) and long-term (i.e.: chronic illnesses, ecological changes, trades drop…) consequences. Natural scenarios include common, emerging/re-emerging and chronic infectious diseases: they are caused by biological agents, which can be normally present in the communities, as acute or chronic pathologies, or suddenly appear, causing new or uncommon syndromes. In particular, a lot of environmental and human factors can influence emerging and re-emerging diseases: for example, urbanization and people mobility facilitate microorganisms spread, while climate changes are likely to induce a relocation of pathogens vectors. Unintended events are usually due to research and diagnostic activities: laboratories are the places where biological agents are handled and a lack in Biosafety measures or negligence can result in accidental release; the so called Laboratory Acquired Infections represent the main consequence, since they cause pathologies in the laboratory workers, but could be also transmitted in the population. Deliberate use of biological agents is strictly related to terroristic activities: microorganisms are very suitable for this purpose, since they are hidden and can easily spread. The present chapter summarizes the main characteristics of biological agents related events, taking in account their origin and the principal consequences on the community.


title: Health, Disease, and Illness as Conceptual Tools

text: There is no absolute consensus on the definitions of health, disease, and illness, even though these concepts are central not only in medicine but also in the health social sciences. A definition of each of the concepts is imperative because they constitute part of the analytical tools in medical sociology. This chapter presents definitions of these concepts, noting that each of them is multidimensional, complex, and sometimes elusive. The WHO’s definition of health is critically examined with respects to its components, criticisms, and alternative definitions of health. This chapter proceeds to discuss the features of a disease and the specific realities of illness by showing the difference between the two concepts. Disease and illness categories (acute, chronic, accidents/injuries, and mental disease/illness) are discussed. The chapter concludes with a strong emphasis on the cultural beliefs regarding illness causation among lay populations, especially in the African context. The natural, supernatural, mystical, and hereditary/genetic causations are discussed based on cultural realities but are sometimes divergent from biomedical models of disease causation.


title: 4 Infectieziekten

text: In het vorige hoofdstuk hebben we gezien dat de mens zich tegen velerlei soorten prikkels kan beschermen door middel van ontstekings- of immuunreacties. In dit hoofdstuk wordt besproken welke veranderingen in het lichaam plaatshebben indien de noxe bestaat uit micro-organismen.


title: Infektionsimmunologie8

text: Im Laufe der Entwicklung der Lebewesen traten die Organismen gegeneinander in Konkurrenz und entdeckten andere Spezies als eigene Lebensgrundlage oder Nahrung. Bei höheren Lebewesen sehen wir dies als selbstverständlich an und teilen Sie in Fleisch- und Pflanzenfresser ein. Bei niederen Lebewesen bezeichnen wir dies jedoch als pathogene Eigenschaft oder als parasitäre Lebensweise, wenn wir ihnen als Nahrungsgrundlage dienen. Zur Abwehr der Krankheitserreger entwickelten alle höheren Lebewesen ein Immunsystem, um das Fortbestehen der Spezies zu garantieren. Je weiter sich die Lebewesen entwickelt haben, desto höher hat sich auch das Immunsystem in einer Coevolution in Konkurrenz zu den Erregern entwickelt. Da das Immunsystem in der Evolution zur Infektionsabwehr entstanden ist, leiten sich seine übrigen physiologischen und pathophysiologischen Mechanismen von denen der Infektionsabwehr ab. Die Tumorabwehr entspricht der Abwehr von Viren und die Allergie der Abwehr von „nicht vorhandenen Parasiten“. Damit ist die Infektionsimmunologie der zentrale Punkt der Immunologie. Während wirbellose Tiere nur eine angeborene Immunität besitzen, hat sich bei den Wirbeltieren zusätzlich die spezifische (adaptive) Immunität entwickelt. Die Komplexität des Immunsystems steht dabei mit der Lebensdauer der Organismen und der Rate an Nachkommen im Einklang, d. h., je länger die Lebensdauer und je geringer die Anzahl der Nachkommen, desto komplexer muss das Immunsystem aufgebaut sein, um das Überleben der Art zu gewährleisten. Somit haben sich im Laufe der Evolution die in den vorherigen Kapiteln beschriebenen Abwehrsysteme entwickelt, die für die Abwehr von Infektionen koordiniert zusammenarbeiten müssen. Wichtig ist dabei, dass das Immunsystem den richtigen Reaktionsweg einschlägt, der den Erreger spezifisch bekämpfen kann, da sonst die Immunreaktion ins Leere läuft und der Erreger sich trotzdem weitervermehrt und den Körper schädigt.


title: Contrast-Enhanced MRI and Micro-CT Adopted for Evaluation of a Lipid-Lowering and Anticoagulant Herbal Epimedium-Derived Phytoestrogenic Extract for Prevention of Steroid-Associated Osteonecrosis

text: We developed an alternative steroid-associated osteonecrosis (ON) rabbit model using a combination of a single injection of low-dose lipopolysaccharide (LPS) and three subsequent injections of pulsed high-dose methylprednisolone (MPS).The usefulness of this experimental ON model was evaluated using both conventional and advanced bio-imaging techniques, including contrast-enhanced dynamic MRI and a high-resolution micro-CT. Details on establishment of methodology are described, which were adopted into an efficacy study on a herbal Epimedium-derived phytoestrogenic extract (HEPE) developed for prevention of steroid-associated ON using an established rabbit model. The underlying mechanisms of HEPE for prevention of steroid-associated ON were found to be associated with inhibition of both intravascular thrombosis and extravascular bone marrow lipid deposition, the two known mechanistic pathways in pathogenesis of ON. Our experimental results provide for potential clinical trials or applications of HEPE in the prevention of ON among hig-hrisk patients undergoing steroid treatment.


title: Ambient Temperature and Major Infectious Diseases in China

text: Infectious diseases are a group of diseases which have complex transmission ways and various influencing factors. Clarifying the correlation between ambient temperature and major infectious diseases in China is a crucial step toward the successful control of infectious diseases including vector-borne diseases, water-borne diseases, food-borne diseases, respiratory infectious diseases, etc. and the implementations of climate change adaption strategy and measures in China. However, no study has systematically reviewed the available evidences on the impact of ambient temperature on the incidence of major infectious diseases, and such information is essential for policymakers and stakeholders to take specific actions to control infectious diseases and protect the vulnerable population in the future. In order to fill this gap, we systematically review the current evidence for the effect of ambient temperature on major infectious diseases in China. The findings could provide explicit information for the scientific prevention and control of infectious diseases in China.


Nasal Cavity and Paranasal Sinuses


title: La terapia antimicrobica nella pratica clinica

text: In questa sezione vengono riportate le informazioni utili per un uso adeguato degli antimicrobici. Lo schema di presentazione ricalca il percorso clinico abituale: prima un approccio empirico, poi una terapia mirata nella quale è noto il patogeno e infine una classificazione che si concentra sul singolo principio attivo.


title: The Impact and Control of Emerging and Re-Emerging Viral Diseases in the Environment: An African Perspective

text: Emerging viral infections (EVI), and re-emergent variants of existing ones, are a growing threat to public health worldwide with outbreaks occurring sporadically especially in Africa associated with significant adverse ecological, socioeconomic and public health implications. These pathogens have devised evolved environmental adaptations, including the possession of genomic resistance mutations. Haemorrhagic fever viruses like Ebola, Marburg and Lassa fever viruses and respiratory pathogens like the avian and human influenza severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) viruses, most from zoonotic reservoirs, may significantly increase morbidity and mortality in the human population in the nearest future. Likewise, vector-borne zoonotic viral diseases including Rift Valley fever, yellow fever, dengue, chikungunya and West Nile, transmitted by arthropods from animal reservoirs, occur frequently in the tropics, exhibiting previously unseen patterns of infection and spread. These patterns are facilitated by many intrinsic factors like mutated sites in the viral genome, and external factors including urbanization, displacement, human migration and climate change. Emerging viruses can easily cross boundaries and pose severe threats to the human populations in new geographical areas. Here, we outline the features of common emergent viruses and factors facilitating their emergence, effects, control and sustained management in the environment.


title: Guangdong Province: Trade Liberalization and HIV

text: The Guangdong experience is interesting as a case study, given its role as an economic hub, having attracted both domestic migrant workers, as well as people from abroad ever since the economic reforms of the late 1970s. The first Special Economic Zones were set up in Guangdong, due to its proximity to Hong Kong, most famously in the city of Shenzhen. The region has a prospering manufacturing industry, where both labor-intensive manufacturing products, as well as high-end technology products, are produced and assembled. Trade liberalization and rapid economic growth have also created a booming commercial sex industry and a situation where many economically-marginalized workers are migrating to the region. Here, we document the development of Guangdong’s HIV epidemic, which has grown dramatically from 1997 to 2017, and we describe epidemic response efforts in Guangdong over the same period.


title: Geschichtlicher Überblick

text: Für die Krankheiten, die wir heute als Viruserkrankungen kennen, sah man ursprünglich „Gifte“ als Ursache an. Mit den damals üblichen Methoden ließen sich keine (krankheitserzeugenden) pathogenen Organismen wie Bakterien oder Protozoen in den „giftigen Materialien“ nachweisen. Erst gegen Ende des 19. Jahrhunderts legten Tierversuche, die von Louis Pasteur durchgeführt wurden und bei denen sich auch nach mehreren Passagen keine Ausverdünnung der giftigen Eigenschaften einstellte, nahe, dass das krankheitsauslösende Agens in der Lage war, sich im Organismus zu vermehren. Man sprach deshalb von einem in lebenden Organismen, später auch von einem in Zellen vermehrungsfähigen „Virus“ (lateinisch für „Gift“ oder „Schleim“). Im Jahre 1892 konnte Dimitri I. Iwanowski in St. Petersburg zeigen, dass die Mosaikkrankheit der Tabakpflanzen durch ein „ultrafiltrierbares“ und damit deutlich unter Bakteriengröße liegendes Agens verursacht wird: das Tabakmosaikvirus.


Erkrankungen der Trachea und der Bronchien


title: Lung

text: In the present chapter, we review and summarize current advances on the role of angiotensin-(1-7) [Ang-(1-7)] in the pathophysiology of main lung diseases: pulmonary hypertension (PH), acute respiratory distress syndrome (ARDS), asthma, and pulmonary fibrosis. Understanding the involvement of renin angiotensin system (RAS) in pulmonary inflammation may open new therapeutic possibilities for the treatment of respiratory diseases. Studies to date showed that Ang-(1-7) presents anti-inflammatory, antifibrotic activities and reduces pulmonary remodeling. These actions support the development of new pharmacological therapies based on the increase in Ang-(1-7) in the lungs to improve the treatment of inflammatory diseases.


title: Issues in Community-Acquired Pneumonia

text: Pneumonia is one of the most commonly diagnosed infectious diseases and is the third most frequent cause of death worldwide. Accurate statistics of community-acquired pneumonia incidence globally or in countries of various regions are lacking. Although the clinical diagnosis of pneumonia is not difficult, the etiology diagnosis to guide targeted specific antimicrobial therapy still poses a challenge even with novel molecular methods. This has led to different approaches and guidelines for the empiric treatment of community-acquired pneumonia, often with broad-spectrum antimicrobial agents which may play a role in fostering the worldwide development of antibiotic resistant bacteria. Severe community-acquired pneumonia, seen mainly at the extremes of age and in persons with chronic underlying diseases, is associated with high mortality of 20–40%. Pneumonia severity tools, such as CURB-65, have been developed over the past decade to assist emergency department physicians to recognize, admit, and implement rapid antimicrobial therapy in severely ill patients. The evidence for the beneficial effects of these tools will be reviewed in this chapter. Issues in the management of severe community-acquired pneumonia that are discussed include: combination with newer macrolides [irrespective of microbial etiology], value of adjunctive therapy such as corticosteroids and statins.


title: Rhinoviruses

text: Picornaviruses, which include the human rhinoviruses (HRVs) and enteroviruses (EVs), are the most frequent cause of acute human illness worldwide. HRVs are the most prevalent cause of acute respiratory tract illnesses (ARIs) which usually commence in the upper respiratory tract (URT). ARIs are the leading cause of morbidity in children under 5 years and occur in all seasons. ARIs linked to HRV infections are associated with excessive and perhaps inappropriate antibiotic prescribing and with significant direct and indirect healthcare expenditure. ARI incidence is highest in the first 2 years of life, with up to thirteen episodes per year including up to six positive for an HRV, and it is not uncommon to average one infection per child-month.


title: The Baboon in Xenotransplant Research

text: If cross-species transplantation is ever to become a reasonable therapeutic modality for human beings, it will be because the potential for success has been demonstrated in a nonhuman primate model. The imperative has always been to select a primate research subject from a species that is plentiful, is not endangered, readily procreates in a managed environment, and mimics the human response (immunologic homology) to both organ transplantation and potential transfer of infectious disease. Several Papio subspecies of baboons, including Papio hamadryas anubis (olive baboon), meet these important criteria. These animals remain ubiquitous throughout sub-Saharan Africa and have adapted well to the managed environments of major primate centers worldwide. A list of United States-based primate centers housing breeding colonies of baboons can be found in Table 19.1. The Surgical Research Laboratory at Loma Linda University, for instance, has maintained a salutary relationship with the Southwest National Primate Research Center in San Antonio, Texas, for the procurement of juvenile baboon research subjects.


title: Medicinal Plant Active Compounds Produced by UV-B Exposure

text: Ultraviolet (UV) radiation is a part of the sunlight reaching Earth surface. The UV spectrum of solar radiation is by convention divided into three parts: UV-A: 310–400 nm, UV-B: 280–310 nm and UV-C: less than 280 nm. UV-B is the most energetic component reaching Earth surface because the stratospheric ozone layer effectively absorbs completely wavelengths below 290 nm. UV-B is an increasing threat due to increasing UV-B levels on Earth surface as a consequence of depletion of stratospheric O(3). In general, the effects of atmospheric UV-B radiation are negative for biological life. Enhanced levels of UV-B radiation can indeed negatively change plant physiological processes, growth and productivity. However, while studying UV-B effects on medicinal plants, some interesting phenomena have been discovered. For example, basil plants respond positively to UV-B radiation by increasing oil yield (Chang et al. J Horticult For 1:27–31, 2009). In other studies medicinal plants show beneficial aspects in term of increase in volatile oil yield and secondary metabolite production (Kumari et al. Ecotoxicol Environ Safety 72:2013–2019, 2009c, 2010). Medicinal herbs have great market value in India and worldwide. The medicinal value of plants depends upon phenolics, antioxidants and volatile yield. Therefore further UV-B experiments increasing the levels of these compounds are needed. Here we review the effect of UV-B exposure on metabolites, volatiles, and antioxidants potential in medicinal plants. This chapter reports: (1) aspects of the global market for medicinal and aromatic plants in India in order to assist the medicinal plant industry to make informed decisions. (2) The biodiversity loss due to wild harvesting of plants, and as an alternative the cultivation strategy of medicinal plants. (3) Main medicinal plant species having rich antioxidant potential. (4) Main secondary metabolites of plant origin such as phenylpropanoids, terpenes, alkaloids, and volatile oil, and other important metabolites containing high antioxidant level used in human diet and health. (5) UV-B factors that enhance the quality of medicinal plant by increasing the content of secondary bioactive products. (6) Secondary metabolic pathways involving regulation of key enzymes, chalcone synthase, and phenylalanine ammonia lyase. Understanding of UV-B responses on secondary plant metabolites expand new opportunities for plant enriched in medicinal active compounds.


title: Venous Thrombus

text: Venous thromboembolism (VTE) includes pulmonary thromboembolism (PE) and deep venous thrombosis (DVT). Both belonging to thrombus, acute arterial thrombus is white thrombus, while acute venous thrombus is red thrombus. What does the pathological difference mean? Venous thrombosis can autolyze, while arterial thrombosis cannot. For VTE patients, oral anticoagulants are usually recommended for 3, 6, or 12 months and occasionally lifelong, but the course cannot be determined. Furthermore, even with standard anticoagulation therapy and INR, some patients still develop chronic thromboembolic pulmonary hypertension (CTEPH). Thus, the physicians are extremely puzzled about anticoagulant usage. Proposed risk factors for VTE include advanced age, infection, malignancy, autoimmune disease, surgery, trauma, pregnancy, long trip syndrome, family history, AMI, heart failure, and so on. Relevant risk factors are increasing over time. Risk factors are derived from the summary of evidence-based medicine. Although these factors are found to be associated with venous thrombosis, the intrinsic factors have not been well elucidated.


title: Optimal Control of Multi-strain Epidemic Processes in Complex Networks

text: The emergence of new diseases, such as HIV/AIDS, SARS, and Ebola, represent serious problems for the public health and medical science research to address. Despite the rapid development of vaccines and drugs, one challenge in disease control is the fact that one pathogen sometimes generates many strains with different spreading features. Hence it is of critical importance to investigate multi-strain epidemic dynamics and its associated epidemic control strategies. In this paper, we investigate two controlled multi-strain epidemic models for heterogeneous populations over a large complex network and obtain the structure of optimal control policies for both models. Numerical examples are used to corroborate the analytical results.


title: Challenges in modelling complexity of fungal entomopathogens in semi-natural populations of insects

text: The use of fungal entomopathogens as microbial control agents has driven studies into their ecology in crop ecosystems. Yet, there is still a lack of understanding of the ecology of these insect pathogens in semi-natural habitats and communities. We review the literature on prevalence of fungal entomopathogens in insect populations and highlight the difficulties in making such measurements. We then describe the theoretical host-pathogen models available to examine the role that fungal entomopathogens could play in regulating insect populations in semi-natural habitats, much of the inspiration for which has been drawn from managed systems, particularly forests. We further emphasise the need to consider the complexity, and particularly the heterogeneity, of semi-natural habitats within the context of theoretical models and as a framework for empirical studies. We acknowledge that fundamental gaps in understanding fungal entomopathogens from an ecological perspective coupled with a lack of empirical data to test theoretical predictions is impeding progress. There is an increasing need, especially under current rapid environmental change, to improve our understanding of the role of fungi in insect population dynamics beyond the context of forestry and agriculture.


title: Damage Control Resuscitation

text: Damage control resuscitation is a resuscitation modality that integrates permissive hypotension, hemostatic resuscitation, and damage control surgery, initially addressing all three components of the “lethal triad”: coagulopathy, acidosis, and hypothermia. Trauma patients predicted to require massive transfusion, administration of fresh frozen plasma, packed red blood cells, and platelets in a 1:1:1 ratio (of individual units) are associated with improved survival and less need for innumerous transfusions. In addition, the evidence so far indicates that the incorporation of these principles into a MTP will also contribute to less transfused units by minimizing variability of transfusion practices. Importantly, fewer units transfused will contribute to fewer complications associated with transfusions. These conclusions will need to be verified, especially with regard to the effect of MTPs incorporating higher ratios of FFP:PRBC:platelets effect on varying mechanism of injury, the timing of transfusions, and the number of units actually transfused. Also recombinant factor VIIa, cryoprecipitate, and tranexamic acid can be considered adjunctive treatments for coagulopathy. Lastly, damage control surgery is a surgical strategy aimed at restoring normal physiology rather than anatomical integrity; however, this component of damage control resuscitation should not be applied in isolation.


title: Health Issues in Returned Travellers

text: Travellers are more than ever choosing to visit adventurous destinations, sometimes in remote places. In addition, the ease of international travel makes it possible for travellers with underlying medical conditions, such as immunosuppression, the elderly, pregnant women and children to travel to destinations that may place them at risk of a range of exotic infections. It is therefore important for the travel medicine practitioner to have a firm understanding of the spectrum of infections that travellers may acquire according to their travel destination. This chapter provides an overview of the spectrum of infections travellers may encounter and provides an approach to the diagnosis and management of ill returned travellers.


title: 1.2 The Health System

text: There are several factors (or determinants 1. Biology: the age and sex of the person; the genetic makeup including heritable diseases. At the current time, biological factors are the hardest to change, although many are hopeful that genetic engineering may change this at some point. For this reason, most public-sector investment in public health aims to affect the behavioral, social, environmental and medical access determinants. . 2. Behaviors: alcohol, tobacco, substance abuse; risk-prone lifestyles, such as working as a miner or prostitute. . 3. Social: discrimination, income disparities, socioeconomic status, education, occupation, class, social support. Poorer people often lack time and opportunity to exercise. Food for a healthier diet tends to be more expensive and takes longer to prepare. A strong and consistent finding of epidemiological research is that there are health differences among socioeconomic groups. Lower mortality, morbidity, and disability rates among socioeconomically advantaged people have been observed for hundreds of years. . 4. Environment (or total ecology): where a person lives, sanitary and crowding conditions, air and water quality, lead exposure, and the design of neighborhoods. Some of the most dramatic improvements in population health during the twentieth century include: improved water, food, and milk sanitation, reduced physical crowding, improved nutrition, and central heating with cleaner fuels. Most Americans live in urban areas, which are often associated with harmful health behaviors, such as exercise, diet, sexual behavior, alcohol and substance abuse. Cities also have higher levels of air pollution, which may cause cardiovascular and respiratory disease. Crowded buildings may increase the risk of lead exposure as well as asthma. Those that live in rural areas have other risks, such as exposure to pesticides. . 5. Medical care: access to quality health care; having insurance. For example, the availability of Medicaid (health insurance for the poor) was expanded greatly with the passage of the Affordable Care Act. This resulted in greater access to medical care for a previously underserved population. Similarly, the nationwide shift to high-deductible insurance plans has actually reduced accessibility to affordable healthcare for many. ;


title: Vaccines: Biotechnology Market, Coverage, and Regulatory Challenges for Achieving Sustainable Development Goals

text: This chapter provides an overview, from bioeconomic and global sustainability perspectives, of the main constraints to the current global vaccine innovation system for achieving Sustainable Development Goals – SDGs. Biotechnology market trends, gaps in vaccine coverage against emerging and neglected diseases, and patent protection and regulation are discussed. A structured long-term “public-return-driven” innovation model to overcome vaccine market failure is proposed.


title: Towards Automated TEM for Virus Diagnostics: Segmentation of Grid Squares and Detection of Regions of Interest

text: When searching for viruses in an electron microscope the sample grid constitutes an enormous search area. Here, we present methods for automating the image acquisition process for an automatic virus diagnostic application. The methods constitute a multi resolution approach where we first identify the grid squares and rate individual grid squares based on content in a grid overview image and then detect regions of interest in higher resolution images of good grid squares. Our methods are designed to mimic the actions of a virus TEM expert manually navigating the microscope and they are also compared to the expert’s performance. Integrating the proposed methods with the microscope would reduce the search area by more than 99.99 % and it would also remove the need for an expert to perform the virus search by the microscope.


title: Understanding and Exploring HIV/AIDS and Discrimination

text: This chapter outlines the main theories of discrimination and stigma and the methodology of the research. Both qualitative and quantitative techniques were used in collecting and analyzing the data. Research on refugees is a complex undertaking, and there is no tested method for studying both refugees and HIV/AIDS. This results in the enhanced challenge of conducting research in precarious conditions where refugees reside, owing to displacement of refugees caused by myriad of factors that we have to take into consideration. In this way, it addresses the vacuum in scholarship and prepares the ground for designing research based on geographical and political settings, and proposes new alternatives for addressing them. This will be an important contribution to the methodological underpinning in refugee research. Ethical issues pose a significant challenge as this research involves human subjects and deals with delicate and sensitive issues. This chapter also explains the process for handling confidential research material, developing intersectional analyses and answering specific questions related to multi-strategy research design that are crucial in researching refugees.


Krim-Kongo-Virus


title: Leberversagen

text: Das Leberversagen ist eine schwere Leberfunktionseinschränkung mit Auftreten einer hepatischen Enzepha-lopathie infolge einer akuten oder chronischen Lebererkrankung. Ob es reversibel oder irreversibel ist, hängt von der Grunderkrankung, dem Lebensalter, einer Vorschädigung der Leber und dem Auftreten von Komplikationen ab.


title: Disinfection Room: Cleaning Room

text: The disinfection room is central to all operations and is a multifunctional room. Here, all contaminants and organic materials are taken care of and removed. Contaminated textiles are sorted and ordinary waste from infectious waste. Used syringes and other stabbing/cutting waste, glass, etc. are collected as hazardous waste. Used wheelchairs and other major patient aids are usually washed here. The bedpan, urine bottles, etc. are disinfected in the decontaminator. The room has a large load of dirt and microbial agents where the personnel may perform many space-demanding tasks. A large and efficient area with good separation between clean and unclean work tasks, good ventilation and negative pressure ventilation and good methods for cleaning and disinfection are necessary. The following chapter is focused on areal and outfit of the disinfection room to avoid transmittance of infections between patients, personal and environment.


title: Interstitial Lung Diseases

text: The term interstitial lung disease (ILD) comprises a diverse group of diseases that lead to inflammation and fibrosis of the alveoli, distal airways, and septal interstitium of the lungs. The ILDs consist of disorders of known cause (e.g., collagen vascular diseases, drug-related diseases) as well as disorders of unknown etiology. The latter include idiopathic interstitial pneumonias (IIPs), sarcoidosis and a group of miscellaneous, rare, but nonetheless interesting, diseases. In patients with ILD, MDCT enriches the diagnostic armamentarium by allowing volumetric high resolution scanning, i.e., continuous data acquisition with thin collimation and a high spatial frequency reconstruction algorithm. CT is a key method in the identification and management of patients with ILD. It not only improves the detection and characterization of parenchymal abnormalities, but also increases the accuracy of diagnosis. The spectrum of morphologic characteristics that are indicative of interstitial lung disease is relatively limited and includes a reticular pattern (with or without traction bronchiectasis), thickening of interlobular septa, honeycombing, nodules, and ground-glass opacities. In the correct clinical context, some patterns or combination of patterns, together with the anatomic distribution of the abnormality, i.e., from the lung apex to the base, or peripheral subpleural versus central bronchovascular, can lead the interpreter to a specific diagnosis. However, due to an overlap of the CT morphology between the various entities, complementary lung biopsy is recommended in virtually all cases of ILDs.


title: Understanding the Impact of Face Mask Usage Through Epidemic Simulation of Large Social Networks

text: Evidence from the 2003 SARS epidemic and 2009 H1N1 pandemic shows that face masks can be an effective non-pharmaceutical intervention in minimizing the spread of airborne viruses. Recent studies have shown that using face masks is correlated to an individual’s age and gender, where females and older adults are more likely to wear a mask than males or youths. There are only a few studies quantifying the impact of using face masks to slow the spread of an epidemic at the population level, and even fewer studies that model their impact in a population where the use of face masks depends upon the age and gender of the population. We use a state-of-the-art agent-based simulation to model the use of face masks and quantify their impact on three levels of an influenza epidemic and compare different mitigation scenarios. These scenarios involve changing the demographics of mask usage, the adoption of mask usage in relation to a perceived threat level, and the combination of masks with other non-pharmaceutical interventions such as hand washing and social distancing. Our results shows that face masks alone have limited impact on the spread of influenza. However, when face masks are combined with other interventions such as hand sanitizer, they can be more effective. We also observe that monitoring social internet systems can be a useful technique to measure compliance. We conclude that educating the public on the effectiveness of masks to increase compliance can reduce morbidity and mortality.


title: The Mighty World of Microbes: An Overview

text: The world of microbes on our planet is vast and diverse. This includes the normal bacterial flora present on the skin and mucous membranes of humans. The human microbiome project (HMP) was launched by NIH in 2007 as a part of a road map for medical research. The HMP serves as a template for researchers who are studying more than 1,000 microbial genomes with a focus on their role in health and disease. The study samples have been derived from five human body regions that are known to be inhabited by microbial flora. These include the gastrointestinal tract, female urogenital tract, mouth, nose, and skin. The techniques being used include finger printing, sequencing, dynamic range, and comparison of multiple samples. It is now well accepted that there are more microbial cells than human cells in the human body. Just the gastrointestinal tract harbors more than tenfold microbial cells than the number of human cells in the entire body. The understanding of the relationship between microbes and humans is at best rudimentary at this point in time. Similarly, the relationship between humans and microbes in the environment and environmental surfaces is poorly understood except for a few pathogenic microbes.


title: Financial Services Industry

text: Critical infrastructure and services in financial industry are important for our society and the financial industry starts to understand the topic beyond the normal and well maintained Business Continuity Management and Disaster Recovery Plans (BCM & DRP). Today, the international backbone financial infrastructures operate pretty well, but in the infrastructure towards clients, two issues are utmost critical for the banks: Drive By Download and Phishing; both are related to steeling identity and money via e-banking. This is one of the results achieved by the EU project Parsifal (Protection and Trust in Financial Infrastructure (Parsifal-Team, 2010), for compositing a research agenda for the cyber security of the financial industry.


title: Infections in Transplantation: Introduction and Overview

text: Over the last 70 years, a steady growth in population of patients with severe and mostly iatrogenically induced immune suppression while undergoing myeloablative antineoplastic therapy and blood- and marrow-derived stem cell or solid organ transplantation has resulted in a near-explosive growth of opportunistic infections. Furthermore, the advent and now common use of biologic immunosuppressive drugs are given to an increasing number of patients prior to transplantation or for treatment of complications arising during the posttransplant period such as graft-versus-host disease, lymphoproliferative disorders, opportunistic malignancies, cancer recurrences, and rejection of solid organ allograft. These and other recent therapeutic advances in transplantation procedures continue to be fraught with prolonged and often unpredictable period of drug-induced immune dysregulation. The emergence and spread of difficult-to-treat opportunistic bacterial, viral, fungal, and parasitic diseases in transplant population have evolved under the influence of environmental-, host-, disease-, and treatment-specific variance. A diligent diagnostic adjudication is of utmost importance in a population with known proclivity for atypical disease presentation. Inaccurate diagnosis may result in inappropriate and ineffective empiric therapy that may worsen patients’ morbidity and heighten the risk for further complications and death. Advancement in understanding the immunopathogenesis of infectious diseases, hosts’ immunologic vulnerability for infections, emerging molecular diagnostic paradigms, deciphering potential therapeutic impact of immune modulation by existing and new antimicrobial drugs, and active research and development in mitigation strategies to promote immune recovery and immune preservation are encouraging developments in optimizing care for patients in need for lifesaving transplantation procedures.


title: How Governmental Regulation Can Help or Hinder the Integration of Bt Crops within IPM Programs

text: Regulatory risk assessments are an important part of the introduction of insect-resistant genetically modified (GM) crops (e.g., Bacillus thuringiensis [Bt] crops) into the environment to ensure the safe use of such products. In doing so, the regulatory assessment process can be clearly beneficial to integrated pest management (IPM) programs. In general, the regulatory framework for insect-resistant GM crops includes an assessment of the following: effects of the insecticidal trait on non-target organisms, other potential adverse environmental impacts, evolution of resistance to target pests, and environmental and agronomic benefits of the insecticidal trait. Each country’s regulatory system is dependent on the overall environmental risk management goals, relevant and available risk information, scientific capacity, and the available financial resources. A number of regulatory activities can help to ensure that new products such as Bt crops fit well within IPM programs: (1) evaluation of the environmental safety of new products, and their ability to enhance IPM; (2) encouragement of the adoption of new technologies with improved environmental safety profiles; (3) adoption of an expedited regulatory review system; and (4) encouragement and appropriate oversight of sustainable use of such products. Governmental regulation of insect-resistant GM crops can also hinder IPM programs by creating significant barriers to the adoption of such technologies. Such barriers include: (1) absence of functioning regulatory systems in many developing countries; (2) meeting the obligations and understanding the various interpretations of international treaties, e.g., Cartagena Protocol on Biosafety; (3) lack of public sector research to generate data supporting the safety of these crops; and (4) regulatory costs involved in the development and commercialization of novel products for small market sectors. Ways in which regulatory data requirements can be globally harmonized need to be considered to decrease the regulatory barriers for insect-resistant GM crops and comparable technologies. International organizations can play a key role in rationalizing regulatory systems; however, public sector research will also be needed to make sure that the risk assessment process is scientifically sound and transparent.


title: Aircraft Environmental Control Systems

text: The external environment at 41000 ft (12500 m), a typical cruise altitude for modern civil aircraft, is hostile to human life. Aircraft environmental control systems are designed to ensure the survival of the aircraft occupants as well as providing them with a comfortable atmosphere. Major design drivers for the environmental control system are thermal comfort, pressurisation and cabin air quality. However, these parameters cannot be considered independently. They interact between themselves and with other parameters, which may or may not be controllable by the system designer. These interactions occur in a highly complex manner. Research has led to a good understanding of the basic functions to allow safe and comfortable aircraft environmental conditions. Future research efforts will be increasingly focussed on identifying and elaborating the interdependency of factors in order to further enhance the aircraft cabin environment.


docid: ouwwkxox

title: Ventilator-Associated Pneumonia and Other Complications

text: Ventilator-associated pneumonia occurs in patients who have been intubated for two to three days with significant exposure to hospital-acquired organisms. Treatment should be initiated rapidly and cover P. aeruginosa, Escheriochia coli, Klebsiella pneumonia, and Acinetobacter species as well as methicillin-resistant S. aureus. Within 72 h or with the availability of culture results, antibiotics should be narrowed. Active research is on-going to identify patients at risk for ventilator-associated complications and to minimize the likelihood of infection in these patients.


title: Diagnosis of Viral Infections

text: Accurate diagnosis of viral infections enhances the ability of the clinician to make decisions on appropriate treatment of patients, evaluate disease progression and prevent misuse of antibiotics. Knowledge of the pathogen involved also allow implementation of infection control and monitoring of success of antiviral treatments that may affect the prognosis of patients. Epidemiological data collected through accurate diagnostics play an important role in public health through identification and control of outbreaks, implementation of appropriate diagnostic tests, vaccination programs and treatment but also to recognize common and emerging pathogens in a community. It is key that the clinician have an understanding of appropriate specimens to send to the laboratory and the value of specific nucleic acid and serological testing for different viral pathogens. Molecular techniques have revolutionized viral diagnoses over the past decade and enhanced both the sensitivity and specificity of tests and the speed by which a diagnosis can be made and new tests be developed. The continued use of serology for viruses with a short viremia, or for chronic infections should however complement these tests. This chapter aims to provide an overview of the available tests, the principles of testing and appropriate tests to select for different viruses and syndromes. Also provided is a glimpse of new developments in diagnostics that may further enhance the capacity to make a conclusive diagnosis in the near future.


title: The CD95/CD95L Signaling Pathway: A Role in Carcinogenesis

text: Apoptosis is a fundamental process contributing to tissue homeostasis, immune response, and development. CD95, also called Fas, is a member of the tumor necrosis factor receptor (TNF-R) superfamily. Its ligand, CD95L, was initially detected at the plasma membrane of activated T lymphocytes and natural killer (NK) cells where it contributes to the elimination of transformed and infected cells. Given its implication in immune homeostasis and immune surveillance combined with the fact that various lineages of malignant cells exhibit loss-of-function mutations, CD95 was initially classified as a tumor suppressor gene. Nonetheless, in different pathophysiological contexts, this receptor is able to transmit non-apoptotic signals and promote inflammation and carcinogenesis. Although the different non-apoptotic signaling pathways (NF-κB, MAPK, and PI3K) triggered by CD95 are known, the initial molecular events leading to these signals, the mechanisms by which the receptor switches from an apoptotic function to an inflammatory role, and, more importantly, the biological functions of these signals remain elusive.


title: Wie katz und Maus

text: Die Patientin M.S. ist eine 20-jährige Frau, bei der vor etwa 2 Jahren eine akute lymphoblastische Leukämie festgestellt wurde. Die Erstmanifestation war ein lymphozytäres Chlorom an der rechten Seite des Kopfes. Nach der operativen Entfernung des Chloromes erhielt Frau S. eine kurative Radio- und Chemotherapie. Rund 18 Monate später kam es zu einem Rezidiv, das nach Konditionierung mit Cyclophosphamid, Anti-Thymozyten-Globulin und Ganzkörperbestrahlung mit einer allogenen Stammzelltransplantation behandelt wurde. Die Patientin war seit einem halben Jahr in einer kompletten Remission. Vor einigen Tagen bekam sie plötzlich Fieber bis zu 40°C. Bis zur Aufnahme im Krankenhaus entwickelte sie Dyspnoe, Tachypnoe und etwas unproduktiven Husten.


title: Krätzmilben (Sarcoptes scabiei und ähnliche)

text: Acarus scabiei, Sarcoptes scabiei scabiei, itch mite


title: Appropriate Antibiotic Use for Treatment of Nonspecific Upper Respiratory Infections, Rhinosinusitis, and Acute Bronchitis in Adults

text: Acute sinusitis, bronchitis, pharyngitis, and nonspecific upper respiratory tract infections (URIs) account for the majority of antibiotics prescribed by primary care physicians in the United States. The emergence of antibiotic-resistant bacteria in the community setting is now an issue for individual patients as well as society at large, and it is the responsibility of all clinicians to limit antibiotic treatment to those patients who are most likely to benefit from it. The vast majority of acute respiratory infections are caused by viruses. Antibiotic treatment of patients with these infections selects for resistant nasopharyngeal bacteria, acutely increasing the spread of resistant pathogens through secretions and predisposing the treated patient to more serious bacterial infections in the future. The guidelines summarized in this chapter were designed by a panel of physicians representing family medicine, internal medicine, emergency medicine, and infectious diseases to provide a practical approach to the appropriate diagnosis and treatment of previously healthy adults with nonspecific URI, acute sinusitis, or acute bronchitis in the ambulatory care setting. Recommendations for the diagnosis and treatment of pharyngitis are provided in a separate chapter.


title: 7 Leverfalen

text: De lever vervult tal van essentiële functies in het menselijk lichaam, waaronder ontgifting van het bloed en aanmaak van diverse eiwitten en hormonen. Tevens speelt de lever een rol in het afweersysteem. Leverfalen kan omschreven worden als een situatie van onvoldoende werking van de lever bij deze processen. Dit beeld ontstaat wanneer door het verlies van functionele cellen het totale effectieve levervolume beneden een kritische grens komt. In dit hoofdstuk wordt ingegaan op diverse vormen van leverfalen en twee specifieke bij leverfalen voorkomende problemen, namelijk hepatische encefalopathie en verhoogde bloedingsneiging.


title: Using Emergency Department Data For Biosurveillance: The North Carolina Experience

text: Biosurveillance is an emerging field that provides early detection of disease outbreaks by collecting and interpreting data on a variety of public health threats. The public health system and medical care community in the United States have wrestled with developing new and more accurate methods for earlier detection of threats to the health of the public. The benefits and challenges of using Emergency Department data for surveillance are described in this chapter through examples from one biosurveillance system, the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT). ED data are a proven tool for biosurveillance, and the ED data in NC DETECT have proved to be effective for a variety of public health uses, including surveillance, monitoring and investigation. A distinctive feature of ED data for surveillance is their timeliness. With electronic health information systems, these data are available in near real-time, making them particularly useful for surveillance and situational awareness in rapidly developing public health outbreaks or disasters. Challenges to using ED data for biosurveillance include the reliance on free text data (often in chief complaints). Problems with textual data are addressed in a variety of ways, including preprocessing data to clean the text entries and address negation. The use of ED data for public health surveillance can significantly increase the speed of detecting, monitoring and investigating public health events. Biosurveillance systems that are incorporated into hospital and public health practitioner daily work flows are more effective and easily used during a public health emergency. The flexibility of a system such as NC DETECT helps it meet this level of functionality.


title: Viral Gene Compression: Complexity and Verification

text: The smallest known biological organisms are, by far, the viruses. One of the unique adaptations that many viruses have aquired is the compression of the genes in their genomes. In this paper we study a formalized model of gene compression in viruses. Specifically, we define a set of constraints that describe viral gene compression strategies and investigate the properties of these constraints from the point of view of genomes as languages. We pay special attention to the finite case (representing real viral genomes) and describe a metric for measuring the level of compression in a real viral genome. An efficient algorithm for establishing this metric is given along with applications to real genomes including automated classification of viruses and prediction of horizontal gene transfer between host and virus.


title: Immunomodulators: interleukins, interferons, and IV immunoglobulin

text: The outstanding progress in immunology and the development of new technologies have resulted in the introduction of new immunotherapies, the so-called “immunomodulators”, for autoimmune diseases, inflammatory disorders, allograft rejection, and cancer. These immunomodulators comprise recombinant cytokines and specific blocking or depleting antibodies. Many of these therapies achieve their effect by stimulating the release of cytokines. The term cytokines includes interleukins (IL-), chemokines, growth factors, interferons (IFN), colony stimulating factors (CSF), and tumor necrosis factors (TNF). These molecules are involved in inflammation, cell proliferation and apoptosis, tissue injury and repair. These new therapeutic tools can be associated with side effects among which nephrotoxicity. The most common immunomodulators associated with nephrotoxicity are described in Table 1. The nephrotoxic side effects of immunomodulators can be roughly divided into (ischemic) tubular necrosis, thrombotic microangiopathy, serum sickness, and autoimmune disorders.


title: Designing Medical Facilities to Care for Patients with Highly Hazardous Communicable Diseases

text: Certain highly hazardous communicable diseases (HHCD), including viral hemorrhagic fevers, the Middle East respiratory syndrome coronavirus (MERS-CoV), and severe acute respiratory syndrome virus (SARS), have caused nosocomial outbreaks in unprepared facilities. Consequently, biocontainment units have been constructed to protect caregivers, patients, and family members, in addition to providing optimal care of the infected patient. Biocontainment units have adopted many of the design features originally found in biocontainment laboratories and can serve as national referral facilities for the most severe and highly hazardous infections. Although a patient with a HHCD can show up at any healthcare facility unannounced, not every hospital can or should attempt to establish a biocontainment unit. Nevertheless, there are design features or management principles found in biocontainment units that can be adopted in most facilities. Awareness of the potential risk, in addition to adopting structural and policy control measures, can do a lot to prepare a facility for the next unexpected infectious disease outbreak.


title: High Frequency Oscillatory Ventilation

text: Forty years have elapsed since investigators first appreciated that tidal volumes measuring less than the physiologic dead space can produce reliable ventilation when delivered at high frequencies. Of all high frequency ventilation techniques, high frequency oscillatory ventilation (HFOV) is the most well studied and is the most commonly utilized in clinical practice today. In HFOV, small volume oscillatory vibrations are superimposed on continuous distending pressure in a manner that allows efficient CO(2) elimination during continuous alveolar recruitment. By preserving end-expiratory lung volume, minimizing cyclic stretch, and avoiding alveolar overdistension at end-inspiration, HFOV is uniquely capable of providing the ultimate “open lung” strategy of ventilation. Over the past decade, a growing evidence base implicating phasic alveolar stretch in the pathogenesis of acute and chronic lung injury in patients with respiratory failure has driven the iterative refinement of HFOV management protocols for infants, children, and adults. The next step toward applying HFOV in a manner that takes into account the heterogeneity of parenchymal involvement in diseases such as the acute respiratory distress syndrome will require the development of non-invasive bedside technologies capable of identifying regional changes in lung volume and lung mechanics. Electrical impedance tomography (EIT) is a promising technique that could play a supporting role in the conduct of future clinical trials seeking to identify HFOV strategies that are maximally lung protective.


title: Kardiologie

text: Dieses Kapitel gibt einen Überblick über Ätiologie, Häufigkeit und Einteilung angeborener Herzfehler. Die einzelnen Herzfehler werden nach Definition, Einteilung, Klinik, Diagnostik, Therapie und Prognose beschrieben. Gleiches folgt für die erworbenen Herzerkrankungen. Abschließend werden die im Kindesalter typischen Herzrhythmusstörungen betrachtet.


title: What We Think About When We Think About Triffids: The Monstrous Vegetal in Post-war British Science Fiction

text: In the face of continuing post-war reconstruction and the rising tide of urbanization, British science fiction writers such as John Wyndham (a pseudonym for John Beynon Harris) and John Christopher (Sam Youd) portrayed post-apocalyptic scenarios in which the vegetal directly determines the fate of human civilization. By destabilizing the relationship between plant and human, Wyndham and Christopher open up a space to reconsider the vegetal as a distinct life form itself, beyond its instrumental use-value, or as an anthropomorphized reflection of human thought. Although plant life is traditionally defined by its inability to move or to speak, both writers suggest that communication bound to the visual or oral is highly limited (for instance, human sight is confined to a limited spectrum). In Wyndham’s The Day of the Triffids (1951) plants become mobile and seemingly sentient, in the process becoming an invasive presence that exposes and challenges the limits of anthropocentric thought. By contrast, in Christopher’s The Death of Grass (1956), the absence of the vegetal renders manifest the subaltern status of plant life, while suggesting that plants are able to communicate through their materiality and posture. Both texts signal that what is conventionally understood as Other is actually a blank repository that ventriloquizes humans’ unconscious desire. Following the population’s sudden loss of sight in The Day of the Triffids, the characters begin to project their own thoughts and emotions onto the triffids, which highlights the indeterminate limits of anthropomorphic representation. The Death of Grass demonstrates that such anthropocentrism constitutes an act of metaphysical violence that, at the same time, under-imagines plant life and installs specialist terminology and botanical classification as a substitute. Presenting the relationship between plant life and human life as a contested space, these texts manifest the problem of anthropocentric certainties and the absolute alterity of plant-thought.


title: Infections in Patients with Acute Leukemia

text: Patients with acute leukemia are at increased risk of developing infections both as a result of the leukemia and its treatment. Neutropenia is the primary risk factor associated with the development of infection, with the severity and frequency of infection increasing as the absolute neutrophil count drops below 500 cells/mm(3), as initially described by Bodey and colleagues. Other risk factors may be present including impaired cellular or humoral immunity, breakdown of normal barriers such as the skin and mucosal surfaces, and vascular access catheters and other foreign medical devices. Multiple risk factors are often present in the same patient. Additionally, the frequent use of antimicrobial agents for various indications (prophylaxis, empiric therapy, pre-emptive administration, specific or targeted therapy, and occasionally maintenance or suppressive therapy) has an impact on the nature and spectrum of infections, with the emergence/selection of multidrug-resistant (MDR) organisms being of particular concern. Bacterial infections tend to occur early on in a neutropenic episode, with fungal infections being uncommon at this stage. If neutropenia persists, the risk for fungal infections increases. There are periodic changes in the epidemiology/spectrum of infection in patients with leukemia. It is important to conduct periodic epidemiologic and susceptibility/resistance surveys, especially at institutions dealing with large numbers of such patients, in order to detect these shifts and changes in susceptibility/resistance patterns, since empiric therapy is largely based on this information. Such surveys are conducted every 3–5 years at our institution.


title: Physical, Social and Cultural, and Global Influences

text: In Chap. 5, we examined the technological environment of the health care policy-making system. Specifically, we examined the classification, evolution, and diffusion of medical technology; the effects of medical technology on medical training and the practice of medicine; effects on medical costs, quality of care, and quality of life; effects on access to care; the ethical concerns raised by medical technology; and the practice of technology assessment. We concluded the chapter by observing that the growth of technology, as well as other human endeavors, affects other important aspects of our lives, most notably, the air we breathe, the food we eat, the generation of radioactive by-products and toxic chemicals, the manufacture of illicit drugs, and the generation of natural and man-made hazards. In other words, in addition to their effects on the health care system, technology and other human activities affect many other aspects of our lives that are associated with health.


docid: fphwlxiq

title: Avian Infectious Bronchitis Virus

text: Avian infectious bronchitis (IB) is caused by avian infectious bronchitis virus (IBV) belonging to Coronaviridae family. The disease is prevalent in all countries with almost 100% incidence rate. Chicken and commercially reared pheasant are the natural host for IBV. Virus causes respiratory diseases, poor weight gain, feed efficiency in broiler, damage to oviduct, and abnormal egg production in mature hens resulting in economic losses. IBV also replicates in tracheal and renal epithelial cells leading to prominent tracheal and kidney lesions. Virus undergoes spontaneous mutation leading to continual emergence of new variants. The effectiveness of immunization program is diminished because of poor cross-protection among the serotypes. Identification of circulating serotypes is important in controlling IBV infection. Toll-like receptor 3 (TLR3) and TLR21 are involved in early recognition of virus resulting in induction of inflammatory cytokines. Both humoral and cellular immune responses are important in the control of infection. Humoral immunity plays an important role in recovery and clearance of viral infection. IBV-specific cytotoxic T lymphocytes induce lysis of IBV-infected cells. Effective diagnostic tools are required at field level to identify different IBV variants. Embryonated chicken eggs are effective model for virus isolation. Identification by other specific methods like virus neutralization (VN), hemagglutination inhibition (HI), enzyme linked immunosorbent assay (ELISA), immunohistochemistry, or nucleic acid analysis or by electron microscopy is also indispensable. VN test in tracheal organ culture is the best method for antigenic typing for surveillance purposes. Continuous epidemiological surveillance, strict biosecurity measures, and vaccine effective against various serotypes are necessary for controlling IB in chickens.


title: Biotechnology Applications of Grapevine Viruses

text: Plant virus genomes are engineered as vectors for functional genomics and production of foreign proteins. The application of plant virus vectors is of potential interest to the worldwide, multibillion dollar, grape and wine industries. These applications include grapevine functional genomics, pathogen control, and production of beneficial proteins such as vaccines and enzymes. However, grapevine virus biology exerts certain limitations on the utility of the virus-derived gene expression and RNA interference vectors. As is typical for viruses infecting woody plants, several grapevine viruses exhibit prolonged infection cycles and relatively low overall accumulation levels, mainly because of their phloem-specific pattern of systemic infection. Here we consider the biotechnology potential of grapevine virus vectors with a special emphasis on members of the families Closteroviridae and Betaflexiviridae.


title: Acute Pancreatitis

text: Early diagnosis and treatment are crucial in the management of acute pancreatitis to prevent complications and to reduce morbidity and mortality.


title: Advanced Pathology Techniques for Detecting Emerging Infectious Disease Pathogens

text: The control and prevention of infectious diseases remain a fundamental part of public health programs throughout the world. The modern medicine and public health have been challenged by a series of emerging and reemerging infections in the past three decades. These diseases have occurred following a false sense of victory over infectious diseases on a global scale due to effective vaccinations and antibiotic agents against certain microorganisms. Because of the unique circumstances of the modern world, these new infectious diseases are emerging at much faster rates than before, and old ones are returning with formidable strength. These infections have posed severe threats to global public health and have raised serious questions regarding the capability of modern medicine to face their challenges. Therefore, it is crucial to understand the dynamics and impact of these emerging and reemerging infectious diseases. Diagnostic pathology continues to be an essential counterpart of clinical microbiology in dealing with emerging and reemerging infections. Diagnosis with advanced pathology techniques not only helps identify or confirm the novel pathogens causing emerging infections but is also essential for epidemiologic surveillance and studying pathogenesis of these emerging infections.


title: Beeldvormende diagnostiek

text: Radiologie en nucleaire geneeskunde zijn geïntegreerd in de opleiding radiologie. Expertise binnen de radiologie is naar orgaansysteem georganiseerd, maar in dit hoofdstuk wordt de radiologie per beeldvormende techniek besproken, dat wil zeggen conventionele radiologie, computertomografie (CT), echografie, magnetische resonantie imaging (MRI) en de nucleaire geneeskunde. De binnen de interne geneeskunde meest voorkomende indicaties voor de verschillende onderzoeken worden besproken inclusief de risico’s en gevaren van beeldvormende diagnostiek. ELEKTRONISCH AANVULLEND MATERIAAL: De online versie van dit hoofdstuk (doi:10.1007/978-90-368-1841-4_2) bevat aanvullend materiaal, dat beschikbaar is voor geautoriseerde gebruikers.


title: The Needs of Children in Natural or Manmade Disasters

text: Disasters have been described as “events of sufficient scale, asset depletion, or numbers of victims to overwhelm medical resources” [1] or as “a serious disruption of the functioning of a community or a society causing widespread human, material, economic or environmental losses that exceed the ability of the affected community or society to cope using its own resources” [2]. Importantly, that definition goes on to state: “A disaster is a function of the risk process. It results from the combination of hazards, conditions of vulnerability and insufficient capacity or measures to reduce the potential negative consequences of risk.”


title: Alcohol-Mediated Zinc Deficiency Within the Alveolar Space: A Potential Fundamental Mechanism Underlying Oxidative Stress and Cellular Dysfunction in the Alcoholic Lung

text: Zinc is one of the most abundant trace elements in the human body, and its presence is essential for numerous biological processes including enzymatic activity, immune function, protein synthesis, and wound healing. Given these important roles, zinc has a sophisticated transport system to regulate its homeostasis. Determination of zinc status, however, is difficult to determine as serum levels are closely maintained and are not an accurate reflection of total body zinc or metabolism at the organ level. Fortunately, the discovery of zinc-specific fluorescent dyes has allowed for a much better assessment of zinc status in the respiratory system and has revealed that alcoholism perturbs this highly developed zinc metabolism such that its distribution to the lung and alveolar space is significantly decreased. As a result, this pulmonary zinc deficiency impairs function in the alveolar macrophage, which is the primary host immune cell within the lower airway. Experimental models have demonstrated that correction of this zinc deficiency restores immune function to the alveolar macrophage as best reflected by improved bacterial clearance in response to infection. While the precise mechanisms underlying alcohol-induced zinc deficiency are still under investigation, there is experimental evidence of several important connections with granulocyte–macrophage colony-stimulating factor and oxidative stress, suggesting that alteration of zinc homeostasis may be a fundamental mechanism underlying the cellular pathology seen in the alcohol lung phenotype. This chapter reviews zinc homeostasis and offers insight into our understanding of zinc deficiency in the setting of alcoholism and the potential of zinc as a therapeutic modality in the vulnerable alcoholic host.


title: Fever in Common Infectious Diseases

text: #x203A; Infection of the respiratory tract is the most common reason for seeking medical advice and hospital admission in children. A viral upper respiratory tract infection (URTI) is the most common infection of the respiratory tract. › In developing countries, acute respiratory infection remains a leading cause of childhood mortality, causing an estimated 1.5–2 million deaths annually in children younger than 5 years of age. › In developed countries, viruses are responsible for most upper and lower respiratory tract infections, including pharyngitis and pneumonia. › Although the degree of fever cannot differentiate between viral and bacterial diseases, high fever is associated with a greater incidence of serious bacterial diseases such as pneumonia or meningitis. › Worldwide, diarrheal disease is the leading cause of childhood deaths under 5 years of age. › If the fever does not have an evident source, urinary tract infection (UTI) should be considered, particularly if the fever is greater than 39.0°C and persists for longer than 24–48 h. › Widespread vaccinations against bacteria causing meningitis, such as Hib, and vaccines against meningococci and pneumococci have dramatically reduced the incidence of meningitis. › A child with fever and nonblanching rash should be promptly evaluated to exclude meningococcal diseases. › Young children with malaria may present with irregular fever and not with typical paroxysms of fever, occurring particularly in early falciparum infection or as a consequence of previous chemoprophylaxis, which modifies the typical pattern of fever.


title: Die Zelle als gengesteuertes System

text: Die genetische Information der Pflanzenzelle ist in den DNA-Molekülen des Zellkerns (nucleäres Genom), der Plastiden (plastidäres Genom) und der Mitochondrien (mitochondriales Genom) niedergelegt. Die Genome der Plastiden und Mitochondrien leiten sich von Genomen prokaryotischer Organismen ab, die während der Evolution als Endosymbionten in die Eukaryotenzelle aufgenommen wurden, Endosymbiontentheorie.Diese Organellengenome, und die zugehörigen Mechanismen der Genexpression, zeichnen sich auch heute noch durch viele prokaryotische Merkmale aus.


title: Editoriale — Polmoniti acquisite in comunità e polmoniti nosocomiali

text: Per polmonite si intende un’infezione del parenchima polmonare.


title: Automated Solid Phase Oligosaccharide Synthesis

text: Of the three classes of biopolymers—nucleic acids, proteins and glycoconjugates, nucleic acids and proteins have seen the most breakthroughs in understanding their biological role, in part due to their ready availability. The automation of oligonucleotide and peptide synthesis has been fruitful in providing biologists and biochemists with pure, well-defined structures. This work reviews the recent developments in the automated synthesis of oligosaccharides, the third class of biopolymers. Both glycosyl phosphates and glycosyl trichloroacetimidates have been used successfully in the automated assembly of oligosaccharides employing an octenediol-functionalized polystyrene resin. The product was cleaved either by methanolysis of an ester bond or by olefin cross metathesis. Several biologically important carbohydrates have been synthesized by automation, in a fraction of the time needed to synthesize them by traditional methods. For example, the tumor associated antigens Lewis Y, Le(y)-Le(x), were synthesized by automation. A Leishmania cap tetrasaccharide and a malaria toxin vaccine candidate were also assembled.


title: Deconstructing the Medical Chart

text: This chapter provides an overview of the medical chart, and its sections. The neuropsychologist will be provided with detailed information about how to decipher some of the many abbreviations, and we also provide the neuropsychologist, who may not be familiar with common lab values with descriptions of the neurologic examination common grading systems such as motor and sensory functions. In addition, this chapter provides a brief overview of neurologic terms commonly encountered in general medical and more detailed neurological examinations along with figures and illustrations of some of these terms.


title: Diagnostic Imaging in Sepsis of Pulmonary Origin

text: Lung infections (community- or hospital-acquired) represent the most common cause for sepsis. Diagnostic imaging plays a crucial role in the initial evaluation of patients with criteria for sepsis and suspected pulmonary infection. In patients with clinical signs and symptoms of respiratory infection, the chest X-ray allows confirming the diagnosis of pneumonia. On the other hand, the chest X-ray can be useful to assess response to treatment (in some patients), define a pattern suggesting specific germs (particularly TB), identify complications (empyema and ARDS), and propose a differential diagnosis.


Plague as a Biological Weapon


title: Construction and Building Applications

text: The construction industry is a particularly attractive industry for nanotechnology applications. Since it employs a diversity of building materials, nanomaterials can be employed to enhance the materials’ performances, durability, longevity and sustainability. The construction and building practice is detrimental to the environment in various aspects such as electricity consumption, landfill accumulation, unhealthy aesthetics and neighborhoods. This chapter shows how nanotechnology-based building materials are playing an important role in green architectural design and construction, which has become a growing trend in many countries. Nanomaterials could be integrated with cement, concrete, or windows to conserve energy, minimize electricity bills and sanitize the surrounding atmosphere. Nevertheless, the industry is still facing many hurdles towards the wide application of nanomaterials in a cost effective manner.


title: Infections in Burns

text: Infections remain a leading cause of death in burn patients. This is as a result of loss of the environmental barrier function of the skin predisposing these patients to microbial colonization leading to invasion. Therefore, reconstitution of the environmental barrier by debriding the devitalized tissue and wound closure with application of allograft versus autograft is of optimal importance.


title: Understanding Objectivity in Research Reported in the Journal Science & Education (Springer)

text: Based on a website search with the keyword “objectivity,” 131 articles in the 23 year period (1992–2014) referred to some form of objectivity and were classified according to the following criteria: Level I, traditional understanding of objectivity as found in science textbooks and positivist philosophers of science; Level II, a simple mention of objectivity as an academic/literary objective; Level III, problematic nature of objectivity is recognized, however, no mention is made of its changing/evolving nature; Level IV, an approximation to the evolving/changing nature of objectivity based on social and cultural aspects; Level V, a detailed historical reconstruction of the evolving nature of objectivity that recognized the role of the scientific community and its implications for science education. Results obtained showed the following distribution of the 131 articles evaluated: Level I = 5, Level II = 56, Level III = 58, Level IV = 10, and Level V = 2. Only 9% (12 out of 131) of the articles were considered to have an understanding of objectivity that approximated to its historical evolution. Four articles referred to the work of Daston and Galison on objectivity and only one mentioned “trained judgment.” One article based on the work of Longino (explanatory plurality) reconciled the objectivity of science with its social and cultural construction (Level IV).


Engels-Nederlands


docid: zrzlnptt

title: Pneumonie unter allogener Stammzelltransplantation

text: Die allogene Transplantation beinhaltet im Gegensatz zur autologen Transplantation die Übertragung von Knochenmark oder Blutstammzellen eines anderen Spenders. Im Falle einer Pneumonie reflektiert die Phase der Immunsuppression das zu erwartende Erregerspektrum. Im Unterschied zur autologen Stammzelltransplantation umfasst das Risiko für bestimmte Erreger je nach Phase nicht nur das der Neutropenie, sondern auch der zellulären und humoralen Immunsuppression durch die immunsuppressive Medikation bzw. die akute und chronische GvHD. Zudem besteht das Risiko für nichtinfektiöse pulmonale Komplikationen. Das Zytomegalievirus ist einer der wichtigsten Erreger von schweren Infektionen bzw. Pneumonien. Nach Etablierung der präventiven Therapien sind CMV-Pneumonien bis Tag 100 eher selten geworden; ein Problem bleiben weiterhin die späten CMV-Pneumonien durch ihre hohe Letalität. Die Indikation zur Bronchoskopie sollte den allgemeinen Prinzipien der Diagnostik von pulmonalen Komplikationen unter Immunsuppression folgen.


title: Semantic Tracking in Peer-to-Peer Topic Maps Management

text: This paper presents a collaborative semantic tracking framework based on topic maps which aims to integrate and organize the data/information resources that spread throughout the Internet in the manner that makes them useful for tracking events such as natural disaster, and disease dispersion. We present the architecture we defined in order to support highly relevant semantic management and to provide adaptive services such as statistical information extraction technique for document summarization. In addition, this paper also carries out a case study on disease dispersion domain using the proposed framework.


title: Agrochemical Poisoning

text: A general increase in the use of chemicals in agriculture has brought about a concomitant increase in the incidence of agrochemical poisoning. Organophosphates are the most common agrochemical poisons followed closely by herbicides. Many agricultural poisons, such as parathion and paraquat are now mixed with a coloring agent such as indigocarmine to prevent their use criminally. In addition, paraquat is fortified with a “stenching” agent. Organo-chlorines have an entirely different mechanism of action. Whereas organophosphates have an anticholinesterase activity, organochlorines act on nerve cells interfering with the transmission of impulses through them. A kerosene-like smell also emanates from death due to organochlorines. The diagnosis lies in the chemical identification of organochlorines in the stomach contents or viscera. Organochlorines also resist putrefaction and can be detected long after death. Paraquat has been involved in suicidal, accidental, and homicidal poisonings. It is mildly corrosive and ulceration around lips and mouth is common in this poisoning. However, the hallmark of paraquat poisoning, especially when the victim has survived a few days, are the profound changes in lungs. Other agrochemicals such as algicides, aphicides, herbicide safeneres, fertilizers, and so on, are less commonly encountered. Governments in most countries have passed legislations to prevent accidental poisonings with these agents. The US government passed the Federal Insecticide, Fungicide and Rodenticide Act (FIFRA) in 1962 and the Indian government passed The Insecticides Act in 1968. Among other things, these acts require manufacturers to use signal words on the labels of insecticides, so the public is warned of their toxicity and accompanying danger.


title: Antiviral Properties of Phytochemicals

text: In recent years, significant progress has been achieved for the development of novel anti-viral drugs. These newly developed drugs belong to three groups of compounds, nucleoside analogues, thymidine kinase-dependent nucleotide analogues and specific viral enzyme inhibitors. It has been found that the natural products, like plant-derived compounds (phytochemicals) as well as traditional medicines, like traditional Chinese medicines (TCM), Ayurvedic medicines and so on, are the important sources for potential and novel anti-viral drugs. In this chapter, the history of natural products as antiviral drugs, the approaches to discover potential lead compounds, and the anti-viral properties of phytochemicals with different action mechanisms are discussed. The key conclusion is that natural products are most important sources for novel anti-viral drugs.


title: Application in Medicine Systems

text: Modern pharmacological studies on Danshen have shown that the pharmacologic actions of Danshen mainly include dilating vessels, promoting blood flow, improving microcirculation, changing blood viscosity, increasing myocardial blood and oxygen supplies, reducing myocardial consumption of oxygen, etc. The drug is used to treat diseases of the cardio-cerebrovascular system. In addition, Danshen also has antitumor, antibacterial, and anti-inflammatory functions. Therefore, Danshen has wide clinical application. In recent years, there has been an increase in the number of reports on the clinical application of Danshen extract and Danshen compound preparations. Danshen is seldom used alone; rather, it is usually combined with other drugs to form compound preparations. Various Danshen preparations have been developed, such as Compound Danshen Tablets, Compound Danshen Dropping Pill ( Dantonic™), Compound Danshen Granules, Compound Danshen Capsule, Compound Danshen Oral Liquid, Compound Danshen Aerosol, and Compound Danshen Injection (CDI), etc. The successful development of these preparations has improved product quality, enhanced efficacy, and opened up broader prospects for Danshen’s clinical application.


title: Structure of an ECMO Network for Respiratory Support

text: In adult patients with respiratory failure refractory to conventional treatment, ECMO represents a potentially lifesaving option, and the CESAR trial indeed indicated that significantly more patients with severe ARDS survived without severe disability if they were transferred to a single ECMO center compared with patients who were managed conventionally at remote hospitals. During the 2009 influenza A (H1N1) pandemic, the Italian Ministry of Health instituted a national network of selected ICU centers, the Extracorporeal Membrane Oxygenation Network (ECMOnet). The Italian network was set up to centralize all potentially severe patients in a limited number of tertiary hospitals to provide advanced treatment options including ECMO and identify predictors of mortality in order to define the best timing of ECMO institution. The institution of the Italian ECMO network allowed a high survival rate of patients with severe ARDS due to H1N1 infection treated by ECMO, providing effective and safe centralization and creating an important organization platform to face future possible epidemics with high demand for critical care services and specialized respiratory support.


title: Pädiatrische Intensivmedizin

text: Dieses Kapitel soll einen verständlichen Überblick geben über Besonderheiten der intensivmedizinischen Betreuung des Kindes, insbesondere des Kleinkindes, im Vergleich zur Intensivmedizin beim Erwachsenen. Es werden deshalb nicht alle Aspekte der pädiatrischen Intensivmedizin im Sinne eines eigenständigen Lehrbuchs beleuchtet. In einem ersten Teil (·Kap. 84.2-84.4) werden allgemeine Themen und Aspekte inklusive die kardiopulmonale Reanimation behandelt, in einem zweiten Teil (·Kap. 84.5) werden spezifische pädiatrische Krankheitsbilder und ihre Therapie diskutiert.


title: Immunisierung

text: Wie funktionieren Impfungen? Wir unterscheiden aktive und passive Vakzinierungen. Bei der aktiven Vakzinierung wird Antigen appliziert, das im Organismus eine adaptive Immunantwort auslöst. Dies benötigt Zeit, doch hält die Wirkung lange an, da ein antigenspezifisches Immungedächtnis aufgebaut wird. Bei der passiven Vakzinierung werden immunologische Effektormoleküle oder Immunzellen appliziert, die ihre Wirkung sofort entfalten.