title: 5 Koorts bij volwassenen

text: Koorts wordt bij niet-immuungecompromitteerde volwassenen in de eerste lijn zonder recent verblijf in het buitenland meestal veroorzaakt door een luchtweginfectie. Bij ouderen vormen urineweginfecties een relatief frequente oorzaak van koorts. Bij ontbreken van richtinggevende voorgeschiedenis, klachten of verschijnselen volstaat men in eerste instantie met lichamelijk onderzoek van KNO-gebied en longen. Bij negatieve bevindingen volgt urineonderzoek. Wanneer geen afwijkingen gevonden worden, gaat men uit van een onschuldige virale oorzaak. Bij een ernstig zieke indruk of verminderd bewustzijn is het lichamelijk onderzoek allereerst gericht op eventuele stoornissen in de vitale functies, omdat deze onmiddellijke therapeutische implicaties hebben. Als de koorts een week aanhoudt of eerder bij verandering van het beeld, dient een uitgebreide anamnese en algemeen lichamelijk onderzoek plaats te vinden om diagnostische aanknopingspunten op te sporen. Ook kan de arts dan aanvullend onderzoek laten verrichten: in eerste instantie bloed-, urine- en fecesonderzoek en een X-thorax, eventueel gevolgd door X-sinussen en een mantouxreactie. Medicatie wordt zoveel mogelijk gestaakt om een allergie aan te tonen of uit te sluiten. Na enkele dagen herhaalt men anamnese en lichamelijk onderzoek. Twee weken onbegrepen koorts is reden voor verdere (poli)klinische evaluatie. Concrete aanwijzingen op grond van steeds herhaalde anamnese en lichamelijk onderzoek zijn richtinggevend voor de inzet van complex aanvullend onderzoek. Dit bestaat onder meer uit bloedkweken, uitgebreider bloedonderzoek, leverbiopsie, beenmergpunctie en CT-scan buik en thorax. Bij patiënten ouder dan 55 jaar met koorts en een verhoogde bezinking is een biopsie van de arteria temporalis zinvol.


title: Identity Health

text: Identity health has especially specific meanings for social relationships in contemporary digital age. First, computerized digital communication makes many citizens in severe maladaptation. The WHO often warns mental addictions of internet usages and online gaming among the youth. The advent of social media and online networking has endangered them in ambiguous situations which are not stabilizing in those basic grounds for human relationships. Further, because social networking sites and social gaming frequently enforce each member to interconnect with the others, many of participating members often hold harder mental debts to respond and maintain their interconnections. In this situation, in other words, it can say that all of users simultaneously might share common conditions under mental illness.


title: The Role of T Cells in Corona-Virus-Induced Demyelination

text: Mice infected with neurotropic strains of coronavirus develop acute encephalomyelitis and eliminate infectious virus. However, control of acute infection is incomplete resulting in persistence of viral RNA in the central nervous system (CNS) associated with ongoing primary demyelination. A high prevalence of virus specific CD8 and CD4 T cells within the CNS correlates with ex vivo cytolytic activity and IFN-γ secretion, which are both required for virus reduction during the acute infection. Although most infected cell types are susceptible to perforin mediated clearance, IFN-γ is required for controlling infection of oligodendrocytes. Furthermore, by enhancing class I expression and inducing class II expression within resident CNS cells IFN-γ optimizes T cell receptor dependent functions. In addition to its direct anti viral activity, these multifactorial effects make IFN-γ more essential than perforin for viral control. CD4 T cells enhance CD8 T cell expansion, survival and effectiveness. Although both CD8 and CD4 T cells are retained within the CNS during persistence, they cannot control viral recrudescence in the absence of humoral immunity. Demyelination can be mediated by either CD8 or CD4 T cells; however, although a variety of effector molecules have been excluded, a dominant common denominator remains elusive. Thus concerted efforts to control infection coincide with a variety of potential mechanisms causing chronic demyelinating disease.


title: Apoptosis in Critical Illness: A Primer for the Intensivist

text: The complexities of the cell cycle have occupied a prominent place in the history of cellular biology. Recognition of the process of mitosis dates back over a century, when Fol, Butschli, and Strasburger identified a network of intracellular points and lines, then called the karyokinetic figure, and today known as the mitotic apparatus. This discovery, dating to 1873, laid the foundation for the discovery of chromosomes and, later, the fundamental biologic processes of mitosis and meiosis [1]. But, while cellular growth and proliferation were understood to be essential to the emergence of multicellular organisms, the corollary — that controlled cell death must be part of this calculus of cellular homeostasis — was not appreciated until quite recently. Although cell death was first described in 1859 by Virchow, it took more than a century to appreciate the importance of programmed cell death as a physiological process that eliminated unwanted cells [2]. The term ‘apoptosis’ was coined in 1972 by Kerr, Wyllie, and Currie to describe a distinct type of cell death characterized by the degradation of cellular constituents into membrane-bound apoptotic bodies [3]. Since then, recognition of the importance of apoptosis in health and disease, and an understanding of its cellular mechanisms, has increased exponentially.


title: The Genetics of Sepsis: The Promise, the Progress and the Pitfalls

text: Physicians are used to taking a family history of cardiovascular disease because of the known significant hereditary risk; yet the familial risk of dying from infection is even greater than that for atherosclerotic disease (Sorensen et al. 1988). There is certainly no doubt that genetic differences impact on the risk of developing or dying from infection. Obvious but rare examples include selective immunoglobulin deficiencies, complement deficiencies, and neutrophil function abnormalities. Genetic factors may also be protective, such as with sickle cell trait and malaria or mutations conferring resistance to human immunodeficiency virus infection. Much more subtle differences in immune responses are now being described, usually as the result of one or more single nucleotide polymorphisms (SNP) in a gene. Rather than causing the failure of production of a protein or the production of a nonfunctional protein, SNPs are usually associated with changes in the rate of transcription, producing a much less severe phenotype than the classical examples of genetic defects mentioned above. It is now being appreciated that for many complex diseases, such as sepsis, the ultimate phenotype is the result of the interaction of genetic differences across many loci, not the dominant effect of a few key mutations. As seen in Fig. 3.1, since the mid 1990s, an increasing body of literature has focused on the role that gene polymorphisms in key inflammatory genes play in sepsis. Indeed, with advances in knowledge of the human genome, greater understanding of the inflammatory response, and the development of high throughput genotyping technologies, so many genetic associations have been described that discussion of each one is well beyond the scope of this chapter. I will however summarize those findings that have been reported by multiple groups, as well as give an overview of the major groups of genes that have been implicated in genetic predisposition to sepsis and its adverse outcomes.


title: Lung Transplantation for Idiopathic Pulmonary Fibrosis

text: Despite advances in the development of novel pharmaceutical agents to treat idiopathic pulmonary fibrosis (IPF), there are no medical therapies known to resolve fibrosis or improve lung function in IPF. Therefore, lung transplantation remains the only life-saving therapy available to treat patients with IPF. However, a shortage of suitable donor organs limits the number of affected individuals who can undergo this procedure, and this shortage highlights the need to allocate donor lungs to those who are in the greatest need of a life-saving therapy yet ensure that those who undergo transplantation will have a reasonable expectation of long-term survival. Still, outcomes remain relatively poor for many patients after lung transplantation, although a sizable minority of patients can enjoy long-term survival after lung transplantation.


title: Severe Sepsis and Septic Shock

text: This chapter reviews the remarkable recent advances in the understanding of the molecular basis that underlies the pathophysiology of sepsis. This knowledge has improved diagnostic techniques and introduced new therapeutic agents into the standard management of patients with severe sepsis/septic shock. The current treatment regimens for sepsis are discussed, and the evidence to support each major treatment strategy is outlined in detail. Research priorities to further the optimal management of septic shock in the future are highlighted.


title: Mechanisms of Acute Liver Failure

text: Acute liver failure is characterized by the sudden onset of liver failure in a patient without evidence of chronic liver disease. This definition is important, as it differentiates patients with acute liver failure from patients who suffer from liver failure owing to end-stage chronic liver disease.


title: Vitamin D: Photobiological and Ecological Aspects

text: Vitamin D was discovered as a result of its ability to cure rickets, but recently a wide range of other functions for it in the human body has been suggested. Vitamin D is not a vitamin in the strict sense as it can be synthesised in the human body following exposure of the skin to ultraviolet radiation. Provitamin D (7-dehydrocholesterol) is converted to previtamin D which is further modified by a series of reactions to the active form, 1,25-dihydroxyvitamin D. This Chapter summarises the discovery of vitamin D and reviews the chemistry and photochemistry of its precursors, transformations and metabolites. The production of vitamin D in various human populations is described, and how to assess vitamin D status. The skeletal and non-skeletal effects of vitamin D are discussed, particularly its role in immunomodulation with consequences for protection against a variety of human diseases. The Chapter concludes with evolutionary aspects, the occurrence and role of vitamin D in the plant kingdom, biogeographical considerations, and the nonphotochemical production of vitamin D in certain plants.


title: Preventing Airborne Disease Transmission: Implications for Patients During Mechanical Ventilation

text: The organisms causing respiratory infections such as influenza are spread in droplets or aerosols or by direct or indirect contact with contaminated surfaces. Certain medical procedures have been termed aerosol generating because they are associated with high or augmented inspiratory and expiratory flows, which can increase microbial dissemination. Invasive ventilation maneuvers and noninvasive ventilation (NIV) fall into that category. We discuss the risk of transmitting these procedures and the strategies for mechanical ventilation in future airborne epidemics with special consideration given to the issue of protecting health care workers (HCWs).


title: Infections Diseases in the Context of Terrorist Threat

text: From the great number of pathogenic and conventionally pathogenic for human beings microorganisms, only some of them can be used for terroristic purposes, since they should meet a lot of the relevant properties. Today priority is given to those biological agents, which have undergone successful tests, and are characterized by high index of morbidity, pathogenicity, low lethal doses, high contagiousness with short incubation period, and which result in high social and economic costs.


title: Otitis Media and Sinusitis

text: Otitis media (OM) and sinusitis are common and costly maladies that are often preceded by the development of a viral upper respiratory infection (vURI). Although antibiotics have been shown to be somewhat effective in the treatment of these disorders, increasing concern over the emergence of pathogen resistence to these agents underscores the need for the development of other treatment options, including agents to treat and/or prevent vURIs. Earlier research implicated roles for cytopathology, cellular infiltration, and inflammatory mediators such as bradykinin, in the pathogenesis of vURIs and its complications, including OM and sinusitis, but these factors are now recognized as late events with specific and limited contributions to disease expression. Current therapies are relatively ineffective and aimed at reducing symptoms rather than moderating underlying mechanisms. Nasal elevations of proinflammatory cytokines and leukotrienes track symptom expression during vURIs, and it is hypothesized that these chemicals orchestrate a common response to infection with many different viruses causing vURIs. Moreover, recent evidence demonstrates that specific cytokine gene polymorphisms may modulate the severity of illness and incidence of complications during episodes of vURI. Additionally, other evidence supports a role for neurogenic inflammation in the development of complications. Future studies should dissect the role of proinflammatory cytokines, leukotrienes, and neuropeptides in the expression of symptoms, signs, pathophysiologies, and complications of vURIs.


title: Virological Synapse for Cell-Cell Spread of Viruses

text: Cell-to-cell spread of retroviruses via virological synapse (VS) contributes to overall progression of disease. VS are specialized pathogen-induced cellular structures that facilitate cell-to-cell transfer of HIV-1 and HTLV-1. VS provide a mechanistic explanation for cell-associated retroviral replication. While VS share some common features with neurological or immunological synapses, they also exhibit important differences. The role of VS might not be limited to human retroviruses and the emerging role of a plant synapse suggests that VS might well be conserved structures for cell-cell spreading of both animal and plant viruses. Dissection of the VS is just at its beginning, but already offers ample information and fascinating insights into mechanisms of viral replication and cell-to-cell communication.


title: Chemical, Biological, Radiological and Nuclear (CBRN) Casualty Management Principles

text: Chemical, biological, radiological or nuclear (CBRN) weapons have been used since antiquity. Examples of their recent use include war fighting, ethnic conflict, terrorism and assassination. In addition, CBRN incidents have also included accidental releases during peace time operations, and many of the principles for CBRN incident response can be applied to other hazardous material (HAZMAT) incidents. The impact of such weapons may have a range of implications for medical personnel both military and civilian.


title: Acute Disseminated Encephalomyelitis

text: Acute disseminated encephalomyelitis (ADEM) is an autoimmune demyelinating disease of central nervous system (CNS). ADEM is most commonly seen in children, although adults can also be affected. The disease typically starts with an abrupt onset within day to weeks after a viral infection or immunization. Presenting features include an acute encephalopathy with multifocal neurologic signs and fever. ADEM generally has a monophasic course, although recurrent ADEM has also been described and is defined as multiphasic ADEM. MRI shows widespread lesions located in both brain and spinal cord. An involvement of basal ganglia and thalami has also been described. Analysis of cerebrospinal fluid (CSF) may reveal mild lymphocytic pleocytosis and increased proteins, whereas oligoclonal bands are usually negative. In the absence of specific biologic markers, ADEM remains a diagnosis of exclusion and it is still based on clinical manifestations, imaging, and laboratory features. Therapy is based on steroid administration and the prognosis is usually favorable.


title: The Efficacy of Vaccines to Prevent Infectious Diseases in the Elderly

text: Infectious diseases still represent a major challenge to human progress and survival. Especially elderly persons are more frequently and severely affected by infectious diseases and they display distinct features with respect to clinical presentation and treatment. Although vaccinations are considered a vital medical procedure for preventing morbidity and mortality caused by infectious diseases, the protective effect of vaccinations is abrogated in elderly persons. This is due to a decline in the functions of the immune system referred to as immunosenescence. The first part of this chapter will therefore summarize the status quo of the efficacy of vaccines in preventing morbidity and mortality caused by typical infectious diseases in the elderly, such as influenza, pneumonia and tuberculosis. The second part will then elucidate the underlying age-related mechanisms which may contribute to the decreased efficacy of vaccines. Based on the complex mechanisms involved in immunosenescence, strategies will be outlined which may be succesfful in enhancing protective immune responses following vaccination in elderly persons.


The Role of the Renin-Angiotensin System in Hepatic Fibrosis


Risk Communication and the Community Response to a Bioterrorist Attack: the Role of an Internet-Based early warning system A.K.A “The Informal Sector”


title: Modification of Bone Marrow Stem Cells for Homing and Survival During Cerebral Ischemia

text: Over the last decade, major advances have been made in stem cell-based therapy for ischemic stroke, which is one of the leading causes of death and disability worldwide. Various stem cells from bone marrow, such as mesenchymal stem cells (MSCs), hematopoietic stem cells (HSCs), and endothelial progenitor cells (EPCs), have shown therapeutic potential for stroke. Concomitant with these exciting findings are some fundamental bottlenecks that must be overcome in order to accelerate their clinical translation, including the low survival and engraftment caused by the harsh microenvironment after transplantation. In this chapter, strategies such as gene modification, hypoxia/growth factor preconditioning, and biomaterial-based methods to improve cell survival and homing are summarized, and the potential strategies for their future application are also discussed.


title: Toxic Shock Syndromes

text: Staphylococcal toxic shock syndrome (TSS) was first described in seven children aged 8–17 years by Todd et al. in 1978 [1]. It shortly thereafter became well known as an illness of menstruating women who used tampons [2, 3]. The syndrome is characterized by rapid onset of fever, hypotension, and multisystem failure with desquamating rash occurring in convalescence [4]. The majority of early cases reported were menstrually associated (MTSS) but this has been changing with an increasing proportion of cases non-menstrually associated (NMTSS) [5].


docid: tvukwfcq

title: Gefährderkonzepte im Bereich des Terrorismus

text: Die Terrorismusbekämpfung ist der Bereich, anhand dem sich die in dieser Studie erforschte Strategie zur Prävention von schwerer Gewalt am besten schildern lässt. Die gezielte Sicherheit gegen die Drohung von Terroranschlägen hat zu einer kontinuierlichen Einführung von gesetzlichen Vorschriften und der Entwicklung von Praktiken der Sicherheitsbehörden geführt.


docid: oqsmfmju

title: Vegetables

text: The conscious promotion of health by an appropriate, balanced diet has become an important social request. Vegetable thereby possesses a special importance due to its high vitamin, mineral and dietary fibre content. Major progress has been made over the past few years in the transformation of vegetables. The expression of several genes has been inhibited by sense gene suppression, and new traits caused by new gene constructs are stably inherited. This chapter reviews advances in various traits such as disease resistance, abiotic stress tolerance, quality improvement, pharmaceutical and industrial application. Results are presented from most important vegetable families, like Solanaceae, Brassicaceae, Fabaceae, Cucurbitaceae, Asteraceae, Apiaceae, Chenopodiaceae and Liliaceae. Although many research trends in this report are positive, only a few transgenic vegetables have been released from confined into precommercial testing or into use.


The SARS Coronavirus receptor ACE 2 A potential target for antiviral therapy


title: Adenovirus-Based Vectors for the Development of Prophylactic and Therapeutic Vaccines

text: Emerging and reemerging infectious diseases as well as cancer pose great global health impacts on the society. Vaccines have emerged as effective treatments to prevent or reduce the burdens of already developed diseases. This is achieved by means of activating various components of the immune system to generate systemic inflammatory reactions targeting infectious agents or diseased cells for control/elimination. DNA virus-based genetic vaccines gained significant attention in the past decades owing to the development of DNA manipulation technologies, which allowed engineering of recombinant viral vectors encoding sequences for foreign antigens or their immunogenic epitopes as well as various immunomodulatory molecules. Despite tremendous progress in the past 50 years, many hurdles still remain for achieving the full clinical potential of viral-vectored vaccines. This chapter will present the evolution of vaccines from “live” or “attenuated” first-generation agents to recombinant DNA and viral-vectored vaccines. Particular emphasis will be given to human adenovirus (Ad) for the development of prophylactic and therapeutic vaccines. Ad biological properties related to vaccine development will be highlighted along with their advantages and potential hurdles to be overcome. In particular, we will discuss (1) genetic modifications in the Ad capsid protein to reduce the intrinsic viral immunogenicity, (2) antigen capsid incorporation for effective presentation of foreign antigens to the immune system, (3) modification of the hexon and fiber capsid proteins for Ad liver de-targeting and selective retargeting to cancer cells, (4) Ad-based vaccines carrying “arming” transgenes with immunostimulatory functions as immune adjuvants, and (5) oncolytic Ad vectors as a new therapeutic approach against cancer. Finally, the combination of adenoviral vectors with other non-adenoviral vector systems, the prime/boost strategy of immunization, clinical trials involving Ad-based vaccines, and the perspectives for the field development will be discussed.


title: Strategic Actionable Net-Centric Biological Defense System

text: Technologies required for strategic actionable net-centric biological defense systems consist of : 1) multiplexed multi-array sensors for threat agents and for signatures of the host response to infection; 2) novel vaccines and restricted access antivirals/bacterials to reduce emergence of drug resistant strains pre- and post-event; 3) telemedicine capabilities to deliver post-event care to 20,000 victims of a biological strike; and 4) communication systems with intelligent software for resource allocation and redundant pathways that survive catastrophic attack. The integrated system must detect all threat agents with minimal false positive/negative events, a seamless integrated broad-band communications capability that enables conversion of data to actionable information, and novel pre- and post-event treatments. The development of multiplexed multi-array sensors, appropriate vaccines and antibiotics, and integrated communication capabilities are critical to sustaining normal health, commerce, and international activities.


title: Streptococcal Infections

text: The streptococci are a large heterogeneous group of gram-positive spherically shaped bacteria widely distributed in nature. They include some of the most important agents of human disease as well as members of the normal human flora. Some streptococci have been associated mainly with disease in animals, while others have been domesticated and used for the culture of buttermilk, yogurt, and certain cheeses. Those known to cause human disease comprise two broad categories: First are the pyogenic streptococci, including the familiar β-hemolytic streptococci and the pneumococcus. These organisms are not generally part of the normal flora but cause acute, often severe, infections in normal hosts. Second are the more diverse enteric and oral streptococci, which are nearly always part of the normal flora and which are more frequently associated with opportunistic infections.


title: Reverse Genetics of Mononegavirales: The Rabies Virus Paradigm

text: The neurotropic rabies virus (RABV) is a prototype member of the Mononegavirales order of viruses and is the most significant human pathogen of the Rhabdoviridae family. A reverse genetics system for RABV was established almost 20 years ago, providing a paradigm for other Mononegavirales members as well. The availability of engineered recombinant viruses opened a new era to study common aspects of Mononegavirales biology and specific aspects of the unique lifestyle and pathogenesis of individual members. Above all, the knowledge gained has allowed engineering of beneficial biomedical tools such as viral vectors, vaccines, and tracers. In this chapter, the development of the classical rabies virus reverse genetics approach is described, and some of the most exciting biomedical applications for recombinant RABV and other Mononegavirales are briefly addressed.


title: Extracorporeal Circulation Membrane Oxygenation Therapy for Acute Respiratory Diseases

text: Extracorporeal circulation membrane oxygenation provides pulmonary and/or cardiac support over a limited period of time for severe reversible cardio pulmonary diseases. It is an invasive technique with large risks associated but an improved survival rate of around 80%. It has strict selection criteria for neonatal and pediatric patients. The main complications are hemorrhage, stroke, convulsions, cardiac failure, kidney failure, arterial hypertension, and hemolysis. Extracorporeal circulation membrane oxygenation must be implemented only in high-complexity neonatal and pediatric centers with trained personnel.


docid: geeshxcm

title: Infections of the Liver

text: The portal vein carries blood from the gastrointestinal tract to the liver and in so doing carries microbes as well. The liver may therefore be involved in infections with a myriad number of microbial organisms. While some of these infections most commonly occur in the immunocompromised host, others affect the immune competence. Hepatic infections may be primary in nature or secondary, as part of systemic or contagious disease. The purpose of this chapter is to provide a brief overview of the various infections of the liver in the pediatric patient.


Lungenerkrankungen


Economic Migrants and Health Vulnerability


title: GIS in Health and Human Services

text: The chapter begins with a general overview of how GIS has evolved in the health and human services over the last several decades providing readers with important definitions and descriptions (Sects. 29.1, 29.2). Sections 29.3, 29.4 uncovers how GIS became an important tool for epidemiologists in the work of tracking infectious diseases and perfecting the study of population health. Readers will also learn that GIS adoption by hospital marketers and planners in the United States accelerated rapidly after the 1970, when US Census data became relatively freely available in digital form. The importance of the legendary work of the Dartmouth Health Care Atlas Project and its founder Jack Wennberg. In areas where high GIS adoption rates occurred, such as in public health, we feature key applications such as immunization management, disease tracking, outbreak analysis, disease surveillance, syndromic surveillance, emergency preparedness and response, community health assessment, environmental health, chronic disease prevention, and animal and veterinary health. The final Sect. 29.5 describes how GIS education has expanded across the academic fields of public health, healthcare administration, and social services. It is pointed out that the material presented in this chapter is not intended to be an exhaustive examination of the history of GIS, but rather, a brief introduction and overview which will generate further interest and self-discovery.


title: Acute Chest Diseases: Infection and Trauma

text: Acute chest diseases include clinical situations with infectious and traumatic etiology. Pulmonary infection is the most common indication for performing chest radiography. Radiological imaging often confirms the diagnosis and allows the evaluation of the location and extent of infection. Chest radiography is the primary imaging procedure and the starting point for the evaluation of all children with acute chest disease. Accurate interpretation of pediatric chest films also requires a basic understanding of the physiologic and anatomic differences among adults, neonates, and infants and their most important differences will be referred. Characterization of pulmonary infiltrates is important, because patterns of abnormality suggest specific organisms and aetiologies. Although providing evidence suggestive of the causative agent, the chest radiograph cannot confirm viral infection, confirm or exclude bacterial etiology. In fact, in infancy, pneumonia usually produces a combination of alterations of the airspace and interstitium. However, some aspects may be useful in distinguishing between viral and bacterial pneumonia. Close attention to CT technique is crucial for imaging evaluation of pneumonia in pediatric patients, namely those with persistent symptoms and/or progressive symptoms despite medical or surgical therapy, or in immunocompromised patients. CT with low radiation dose technique should be carefully performed in these cases. CT examination with IV contrast is very useful for the evaluation of complications of chest infection. Thoracic trauma in children is rare, only 4–6 % of children are hospitalized following severe trauma. Only a small number of children with trauma have thoracic injury (14 %), but the injuries tend to be of serious nature. About 25–50 % of thoracic trauma cases occur in combination with other trauma locations. Pulmonary contusion and lacerations, tracheobronchial injuries, pneumothorax, and esophageal rupture are referred as the main consequences of trauma. The decision for the appropriate use of imaging techniques must consider the specific case under review. Chest radiography should be the initial screening method. The decision to use CT is determined by the nature of the trauma, the clinical circumstances, and the prediction of future revaluation, always taking into account the radiation dose applied to the child.


title: Risiko-Akteur-Netzwerke

text: Einen Monat nach dem globalen Ausbruch einer bisher unbekannten, jedoch hochgradig ansteckenden und lebensbedrohlichen atypischen „Lungenkrankheit“ – die Rede ist von SARS, einer Krankheit, die zum ersten Mal im Februar 2003 in einer südchinesischen Provinz beobachtet wurde – beschreibt David L. Heymann, Leiter der Abteilung Emerging and other Communicable Diseasesder World Health Organization(WHO), das spezifische Risiko- und Gefahrenpotential des Severe Acute Respiratory Syndrom: „SARS is emerging in ways that suggest great potential for rapid international spread under the favorable conditions created by a highly mobile, closely interconnected world. Anecdotal data indicate an incubation period of 2 to 10 days (average 2 to 7 days), allowing the infectious agent to be transported, unsuspected und undetected, in a symptomless air traveler from one city in the world to any other city having an international airport. Person-to-person transmission through close contact with respiratory secretions has been demonstrated. The initial symptoms are nonspecific and common. The concentration of cases in previously healthy staff and the proportion of patients requiring intensive care are particularly alarming. The „21 century“ disease could have other consequences as well. Should SARS continue to spread, the global economic consequences – already estimated at around US $ 30 billion – could be great in a closely interconnected and interdependent world.“ (WHO 2003: 5)


title: The Zincins: Collagen Fiber Processing and Degradation

text: This chapter discusses the zinc-containing metalloendoproteinases. These enzymes remodel the stroma during development and around tissues that have been injured or stressed. Section 1 describes the three major classes of metalloproteases, their metal ion cofactors, their functions in biology, and the metzincin catalytic mechanism in procollagen and stromal protein processing. Section 2 describes the astacin and adamalysin metzincin subclasses and how they process procollagen to tropocollagen. Section 3 describes the matrilysin metzincin subclass and their roles in collagen and stromal tissue degradation and in enamel synthesis.


title: Noninvasive Respiratory Support in Pediatrics

text: The conventional management of acute respiratory failure (ARF) consists of endotracheal intubation; this carries potential risks, including ventilator-associated pneumonia and laryngeal-tracheal damage [1,2]. Noninvasive respiratory support (NRS) is an alternative form of respiratory treatment which incorporates various techniques aimed at improving alveolar ventilation, oxygenation, and unloading of the respiratory muscles without the need for an invasive tracheal device. Because of its safety and effectiveness, the use of NRS has been adopted throughout the world. During the last 25 years, NRS techniques have increasingly been used in the treatment of both chronic respiratory failure and ARF in adult patients in several pathological conditions. NRS applied to adults in the acute setting has been found to improve outcome, reduce the rate of intubation, and decrease the rate of complications [3].


docid: fwjjgvzy

title: Coronaviruses and Neuroantigens: myelin proteins, myelin genes

text: Multiple sclerosis (MS) is an autoimmune disease in which autoreactive T cells specific to central nervous system (CNS) myelin antigens are activated. Although disease etiology remains unknown, coronaviruses are suspected to be involved in MS pathology. Molecular mimicry, the recognition of two antigens by a single immune cell, could be the mechanism explaining the link between a viral infection and MS through activation of myelin-reactive T cells by a virus infection in a genetically predisposed individual. Evidence supporting this hypothesis in humans has been accumulated in our laboratory. Human coronavirus (HCoV) — myelin cross-reactive T-cell lines (TCL) were predominantly found in MS patients compared to patients with other neurological or inflammatory diseases, or healthy controls. Moreover, virus-myelin T cell cross-reactivity was confirmed at the clonal level. Molecular mimicry between infectious pathogens such as the ubiquitous human respiratory coronaviruses could, in genetically susceptible individuals, play a role leading to the development of MS. Together with other possible mechanisms such as bystander effects, epitope spreading or even superantigenic activities, this pathogen-associated immune induction could play a role in maintaining and broadening the autoimmune response associated with MS pathology.


title: Ziektebeelden van importziekten

text: In dit hoofdstuk worden de ziektebeelden op het gebied van de importziekten op een beknopte, heldere wijze behandeld. Het zijn allemaal infectieziekten die in eigen land (= inheems) niet voorkomen, maar tijdens een verblijf in het buitenland (= uitheems) zijn opgelopen. De volgorde van de paragrafen is alfabetisch.


docid: pqwcoure

title: A Social Network Model Based on Topology Vision

text: There are many researchers proposed social network models in recent years, and most of them focus on clustering coefficient property of a small-world network and power law degree distribution of a scale-free property. In social network topology, we observed the network is consisted of many nodes with small connectivity and a few high-degree nodes. In the small connectivity part, there are many nodes which have only one degree. Most of past social network models can not generate this part. In this paper, we proposed a social network model based on topology vision and with tunable high hub connectivity. At the same time, we suggested a new characteristic of social network, condensed clustering coefficient, to replace the original clustering coefficient. Finally, this study also includes the analysis of real social network data.


docid: hjdzbdai

title: Assessment of Age-Related Decline of Immunological Function and Possible Methods for Immunological Restoration in Elderly

text: The immune system plays an important role in protection against infection and cancer, and in the maintenance of the internal environment of the body. However, such important immune functions are known to decline with age in many mammals, including humans. It is a matter of clinical importance that the incidence of various age-associated diseases such as infections, cancer, and vascular disorders increases with a decrease in immunological vigor. The extent of immunologic decline is variable and exhibits wide interindividual variations. Thus, it is important to assess the extent of immunologic decline in both patients suffering from various diseases and in healthy people in order to maintain healthy conditions. To this end, we have developed a scoring system that analyzes immune parameters according to a database of known age-associated immune changes obtained from a healthy population. Using this scoring system, we can combine several different immunological parameters and express the immune status of individuals as a simple numeral. Several methods of immunological restoration were introduced and the magnitude of restoration was evaluated by the quantitative assessment of immunological level.


title: Inflammation During Virus Infection: Swings and Roundabouts

text: Inflammation constitutes a concerted series of cellular and molecular responses that follow disturbance of systemic homeostasis, by either toxins or infectious organisms. Leukocytes modulate inflammation through production of secretory mediators, like cytokines and chemokines, which work in an autocrine and/or paracrine manner. These mediators can either promote or attenuate the inflammatory response and depending on differential temporal and spatial expression play a crucial role in the outcome of infection. Even though the objective is clearance of the pathogen with minimum damage to host, the pathogenesis of multiple human pathogenic viruses has been suggested to emanate from a dysregulation of the inflammatory response, sometimes with fatal consequences. This review discusses the nature and the outcome of inflammatory response, which is triggered in the human host subsequent to infection by single-sense plus-strand RNA viruses. In view of such harmful effects of a dysregulated inflammatory response, an exogenous regulation of these reactions by either interference or supplementation of critical regulators has been suggested. Currently multiple such factors are being tested for their beneficial and adverse effects. A successful use of such an approach in diseases of viral etiology can potentially protect the affected individual without directly affecting the virus life cycle. Further, such approaches whenever applicable would be useful in mitigating death and/or debility that is caused by the infection of those viruses which have proven particularly difficult to control by either prophylactic vaccines and/or therapeutic strategies using specific antiviral drugs.


title: Imaging of Pulmonary Infections

text: Pneumonia is one of the most frequent causes of morbidity and mortality throughout the world. It is the most prevalent community-acquired infection and the second most common nosocomial infectious disorder. Infections may occur in healthy people or individuals with concomitant intrapulmonary or extrathoracic diseases. Pneumonia may develop into a life-threatening condition, especially in immunocompromised patients, in children, and in the elderly.


title: Infectious Disease Modeling

text: Infectious disease models are mathematical descriptions of the spread of infection. The majority of infectious disease models consider the spread of infection from one host to another and are sometimes grouped together as “mathematical epidemiology.” A growing body of work considers the spread of infection within an individual, often with a particular focus on interactions between the infectious agent and the host’s immune responses. Such models are sometimes grouped together as “within-host models.” Most recently, new models have been developed that consider host–pathogen interactions at two levels simultaneously: both within-host dynamics and between-host transmissions. Infectious disease models vary widely in their complexity, in their attempts to refer to data from real-life infections and in their focus on problems of an applied or more fundamental nature. This entry will focus on simpler models tightly tied to data and aimed at addressing well-defined practical problems.


title: Allergie, Pathomechanismen, Krankheitsbilder

text: Etwa ein Fünftel der Bevölkerung industrialisierter Länder leidet an mindestens einer Erkrankung aus dem allergischen Formenkreis. Hierzu gehören neben Manifestationen der Haut und des Gastrointestinaltrakts insbesondere die allergischen Erkrankungen der oberen und unteren Atemwege. Aufgrund der hohen und weiter steigenden Prävalenz von Allergien und den sich hieraus ableitenden volkswirtschaftlichen Belastungen ist die Allergologie in den letzten Jahren mehr und mehr in den Mittelpunkt des allgemeinen Interesses gerückt. Zudem haben neue wissenschaftliche Erkenntnisse zu einer Erweiterung des pathogenetischen Verständnisses insbesondere allergischer Atemwegserkrankungen geführt, die zunehmend auch die therapeutischen Möglichkeiten erweitern.


title: Specific Adoptive T-Cell Therapy for Viral and Fungal Infections

text: Despite advances in anti-infective agents, viral and fungal infections after hematopoietic stem cell transplantation (HSCT) continue to cause life-threatening complications that limit the success of HSCT. Early adoptive T-cell immunotherapy studies showed that administration of allogeneic virus-specific cytotoxic T lymphocytes (vCTL) can prevent and control viral infections and reconstitute antiviral immunity to cytomegalovirus (CMV) and Epstein-Barr virus (EBV). Advances in immunobiology, in vitro culture technology, and current good manufacturing practice (cGMP) have provided opportunities for advancing adoptive cell therapy for viral infections: (1) T cells have been expanded targeting multiple pathogens; (2) vCTL production no longer requires viral infection or viral vector transduction of antigen-presenting cells (APCs); (3) the source of lymphocytes is no longer restricted to donors who are immune to the pathogens; (4) naive T cells have been redirected with chimeric antigen receptor T cells (CARTs) or armed with bispecific antibody-armed T cells (BATs) to mediate vCTL activity; (5) these technologies could be combined to targeted multiple viral or fungal pathogens; and (6) pathogen-specific T-cell products manufactured from third parties and banked for “off-the-shelf” use post-HSCT may soon become a reality.


title: Devil Facial Tumour Disease (DFTD): Using Genetics and Genomics to Investigate Infectious Disease in an Endangered Marsupial

text: The Tasmanian devil (Sarcophilus harrisii), so named for its blood-curdling, nocturnal shrieks and snarls, is the largest of the carnivorous marsupials. Although once widely persecuted, concerted efforts are now being made to save the devil from extinction following the emergence of a fatal transmissible malignancy known as devil facial tumour disease (DFTD). DFTD is unusual in that the infectious agent is the cancer cell itself. This chapter discusses the aetiology and pathogenesis of DFTD as well as the profound impact the spread of DFTD has had on the devil’s conservation status. Strategies for managing DFTD and conserving the devil will be explored and the contribution of new sequencing technology to the field of conservation genetics and genomics will be examined with regard to the Tasmanian devil and DFTD.


title: The Respiratory Tract

text: Cytological investigation of the pulmonary tract is one of the most useful diagnostic tests available to the clinician. A wide range of samples can be provided to the laboratory from a variety of sampling techniques. In many cases, the cytologist can provide a clear diagnosis of malignancy, infection, or other specific disease. Even if a diagnosis cannot be offered, the sample frequently aids the clinician with future management by providing reassurance that tumor is unlikely to be present (in the appropriate clinical and radiological setting). This chapter outlines the various samples that the cytopathologist may be faced with and provides a description of the microscopic features that aid diagnosis.


title: Dysbiosis, Probiotics, and Prebiotics: In Diseases and Health

text: The microbiome like any other components of the body undergoes numerous challenges during the life-span of a human being. These complications may involve injuries, aggression by pathogens, pollution, hormonal variations, genetic pre-disposition, unbalanced nutrition and onset of diseases. Although the microbial reconfiguration provoked by these stressors are not immediately evident as in the case of an afflicted visible organ where the abnormality is readily observable, the biological perturbations induced manifest themselves in form of various illnesses. The disruption of a working microbiome is referred to as dysbiosis and is a condition whereby the fine balance between the microbial communities and the host is distressed. Diseases such as cancer, irritable bowel syndrome, rheumatoid arthritis, acne, gastric ulcers, obesity and hypertension can ensue. The pathogeneses of some pulmonary disorders, digestive complications and neurological abnormalities can be traced to the imbalance in the constituents of the microbiome. However, rebiosis, the re-establishment of the native microbiota is proving to be an excellent remedy against this condition. Probiotics, prebiotics, and synbiotics are potent therapeutic tools designed to rectify this situation. Probiotics such as Lactobacillus spp are more or less like stem cells utilized to replenish and rejuvenate the microbiome while prebiotics like fructose oligosaccharides (FOS) are microbiome fertilizers akin to mineral supplements or energy nutrients aimed at promoting the proliferation of select microbes in the invisible organ. Synbiotics is a combination of both probiotics and prebiotics in a proper dosage aimed at remedying dysbiosis. The molecular understanding of dysbiosis and rebiosis will offer a very effective non-invasive means in preventing and curing diseases with probiotics and prebiotics. This will have a dramatic impact on our well-being.


title: Procedure diagnostiche invasive nelle malattie infiltrative diffuse del polmone

text: Le malattie polmonari che, già all’esordio clinico e/o nel loro decorso, coinvolgono più di un lobo e caratterizzate dall’accumulo od infiltrazione nel lobulo polmonare secondario di sostanze o cellule non normalmente presenti in tale sede o presenti, comunque, in quantità anomala, possono essere definite con il termine di pneumopatie infiltrative diffuse (PID) [1].


title: 6 Infectieziekten

text: Infectieziekten (synoniem: infecties) zijn ziekten veroorzaakt door levende micro-organismen. Niet alle ziekmakende micro-organismen kunnen van de ene op de andere mens worden overgedragen; in dat geval zijn de patiënten niet besmettelijk.


title: Collagen Fabrication for the Cell-based Implants in Regenerative Medicine

text: Though transplantation of cells, tissue or organ has been regarded as an ideal approach, scarcity of donor is a practical barrier in clinics. Current progresses in cell engineering has opened a new era, providing tools for host-regeneration by implanting manipulated cells in forms of cell therapy, which includes delivery of single cells or multicellular structural support of hybridized cells, as a representative individualized treatment method. This chapter mainly concerns on the cellbased implant made of cells and collagen, the main structural protein in extracellular matrix in mammalian tissue, as it has been regarded as a promising method for manufacturing a biologically mimicked artificial tissues.


docid: pketymav

title: Kindergeneeskunde

text: Ieder kind maakt tijdens zijn of haar groei en ontwikkeling ziekten door. Veelal betreft het onschuldige aandoeningen, vaak van infectieuze aard. Meestal zijn deze aandoeningen ‘self-limiting’ en horen ze bij een normale ontwikkeling. De toediening van medicijnen heeft zin als onderdeel van een gerichte behandeling. Het voorschrijven van geneesmiddelen aan kinderen is helaas (nog steeds) zelden onderbouwd door goed wetenschappelijk onderzoek naar de effectiviteit en veiligheid ervan bij kinderen. Veelal zijn het soort en de dosering van geneesmiddelen afgeleid van bekende toepassingen en doseringen bij volwassenen. Een dosering wordt daarbij veelal omgerekend op grond van het lichaamsgewicht. Hoewel dit bij jonge kinderen over het algemeen een goed uitgangspunt is voor het berekenen van de juiste dosering, moet er bij oudere kinderen (globaal boven de acht jaar) rekening worden gehouden met de maximale dosering voor volwassenen, omdat men deze onbedoeld kan overschrijden bij het berekenen van de dosering per kg lichaamsgewicht bij deze (oudere) leeftijdsgroep. Voor pasgeborenen en zuigelingen bestaan vaak aparte doseringsvoorschriften. Het therapeutisch effect en bijwerkingen van veel medicamenten zijn bij zuigelingen vaak anders dan bij kinderen en volwassenen.


title: Working Group II: The Threat from Armed Conflict and Terrorism

text: Both terrorism and armed conflict can be threats to water security, either directly or indirectly. Both forms of violence have used disruption or poisoning of water supplies as a weapon, and both may cause collateral damage to water supplies. The distinction between war and terrorism can be arguable. Special Operations forces may use some tactics similar to terrorists, with similar repercussions for water systems, but the main practical distinction is between formal military actions and more informal, smaller scale guerrilla-style activities that may be directed more at civilian personnel and designed to engender fear and panic as much as specific damage.


title: CD4 T-Cell Immunity in the Lung

text: T helper cells are a distinct lineage of T-cells that can differentiate into the well-characterized subsets, Th1 and Th2 and a newer subset called Th17 cells. Data to date suggest that these cells play specific roles in host defense in the lung and thus, these subsets can also be targeted for vaccine-induced immunity. Here we summarize recent progress in our understanding of these specific T-cell subsets, their effector cytokines, and how these cells regulate host defense against pulmonary infection.


Proteasome inhibitors as complementary or alternative antiviral therapeutics


title: Engineering Plants for the Future: Farming with Value-Added Harvest

text: Plants and their rich variety of natural compounds are used to maintain and to improve health since the earliest stages of civilization. Despite great advances in synthetic organic chemistry, one fourth of present-day drugs have still a botanical origin, and we are currently living a revival of interest in new pharmaceuticals from plant sources. Modern biotechnology has defined the potential of plants to be systems able to manufacture not only molecules naturally occurring in plants but also newly engineered compounds, from small to complex protein molecules, which may originate even from non-plant sources. Among these compounds, pharmaceuticals such as vaccines, antibodies and other therapeutic or prophylactic entities can be listed. For this technology, the term plant molecular farming has been coined with reference to agricultural applications due to the use of crops as biofactories for the production of high-added value molecules. In this perspective, edible plants have also been thought as a tool to deliver by the oral route recombinant compounds of medical significance for new therapeutic strategies. Despite many hurdles in establishing regulatory paths for this “novel” biotechnology, plants as bioreactors deserve more attention when considering their intrinsic advantages, such as the quality and safety of the recombinant molecules that can be produced and their potential for large-scale and low-cost production, despite worrying issues (e.g. amplification and diffusion of transgenes) that are mainly addressed by regulations, if not already tackled by the plant-made products already commercialized. The huge benefits generated by these valuable products, synthesized through one of the safest, cheapest and most efficient method, speak for themselves. Milestone for plant-based recombinant protein production for human health use was the approval in 2012 by the US Food and Drug Administration of plant-made taliglucerase alfa, a therapeutic enzyme for the treatment of Gaucher’s disease, synthesized in carrot suspension cultures by Protalix BioTherapeutics. In this review, we will go through the various approaches and results for plant-based production of proteins and recent progress in the development of plant-made pharmaceuticals (PMPs) for the prevention and treatment of human diseases. An analysis on acceptance of these products by public opinion is also tempted.


title: Structural Alignment of Pseudoknotted RNA

text: In this paper, we address the problem of discovering novel non-coding RNA (ncRNA) using primary sequence, and secondary structure conservation, focusing on ncRNA families with pseudo-knotted structures. Our main technical result is an efficient algorithm for computing an optimum structural alignment of an RNA sequence against a genomic substring. This algorithm finds two applications. First, by scanning a genome, we can identify novel (homologous) pseudoknotted ncRNA, and second, we can infer the secondary structure of the target aligned sequence. We test an implementation of our algorithm (Pal), and show that it has near-perfect behavior for predicting the structure of many known pseudoknots. Additionally, it can detect the true homologs with high sensitivity and specificity in controlled tests. We also use Pal to search entire viral genome and mouse genome for novel homologs of some viral, and eukaryotic pseudoknots respectively. In each case, we have found strong support for novel homologs.


title: Insect RNAi: Integrating a New Tool in the Crop Protection Toolkit

text: Protecting crops against insect pests is a major focus area in crop protection. Over the past two decades, biotechnological interventions, especially Bt proteins, have been successfully implemented across the world and have had major impacts on reducing chemical pesticide applications. As insects continue to adapt to insecticides, both chemical and protein-based, new methods, molecules, and modes of action are necessary to provide sustainable solutions. RNA interference (RNAi) has emerged as a significant tool to knock down or alter gene expression profiles in a species-specific manner. In the past decade, there has been intense research on RNAi applications in crop protection. This chapter looks at the current state of knowledge in the field and outlines the methodology, delivery methods, and precautions required in designing targets. Assessing the targeting of specific gene expression is also an important part of a successful RNAi strategy. The current literature on the use of RNAi in major orders of insect pests is reviewed, along with a perspective on the regulatory aspects of the approach. Risk assessment of RNAi would focus on molecular characterization, food/feed risk assessment, and environmental risk assessment. As more RNAi-based products come through regulatory systems, either via direct application or plant expression based, the impact of this approach on crop protection will become clearer.


title: Introducing Ebola (EVD): An Unnecessary Surprise

text: Chapter 4 tackles the Ebola (Ebola Virus Disease, EVD) pandemic of 2014/2015. It notes that coming in the wake of the ongoing HIV pandemic, the rights of those infected with Ebola to be identified and treated were largely uncontested. The questions of who would be treated, by whom, with what, remained however extremely contentious. The international response to the pandemic also saw, for the first time, not only non-state actors involved in mediating and mitigating a health crisis, but also military intervention. This chapter lays out both the uses and the dilemmas of military response. It explores the impact of these interventions in this Ebola pandemic, with a view towards possible future military deployments against health threats, and offers an initial analysis of the consequences thereof on the relationship between individual and state rights and responsibilities.


title: Interstitial Lung Diseases

text: The term interstitial lung diseases (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 ILD 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), 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 the linear and reticular pattern, the nodular pattern, the increased attenuation pattern (such as ground-glass opacities and consolidation), and the low attenuation pattern (such as emphysema and cystic lung diseases). 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, the final diagnosis of many ILD requires close cooperation between clinicians and radiologists and complementary lung biopsy is recommended in many cases.


title: The Scientific Challenge

text: In the last chapter, I described how a number of argument forms that had traditionally been characterized by philosophers as weak or fallacious modes of reasoning could be shown to facilitate scientific inquiry into BSE when little was known about this new brain disease in cattle. The point was made that these argument forms have relevance to the epidemiologists and public health scientists whose task it was to identify and respond to this emerging infectious disease. However, this point requires some explanatory work if it is to have more than a very general application to the work of these public health professionals. For these professionals might ask with some justification why they should treat seriously argument forms that have been deemed to be logically inadequate by generations of philosophers. They might also wonder if philosophical discussion of reasoning has anything but the most abstract lessons for scientists who are charged with containing infectious diseases. In this chapter, I undertake this explanatory work by arguing that philosophical contributions on reasoning and argument are not only relevant to epidemiology, but that they also represent the very best prospect for investigators of addressing some of the criticisms of epidemiology that have been raised in recent years. These criticisms have been expressed most clearly by Christakos et al. (2005), although other theorists have also added their voices to the exchange.


title: Protein-Based Bioproducts

text: Plant proteins can be used for the production of a variety of bioproducts, including films and coatings, adhesives, fibres and pharmaceuticals. Proteins derived from plant production systems have many advantages: they are safe, low-cost and rapidly deployable, allow for simple product storage and result in proteins that are properly folded, assembled and post-translationally modified. While plant-derived protein-based products are natural, renewable, biodegradable and environmentally friendly, they tend to be lower in strength and elasticity than their corresponding synthetic products. Current research in this area is focused on overcoming challenges in plant production platforms related to yield, purification, regulatory approval and customer acceptance.


title: The History and Formation of East Asian Sports Leagues

text: This chapter considers the creation and growth of professional sport leagues throughout East Asia. In this, the different leagues and sport are examined, and noted for their hybrid use of both North American and European methods of business and regulation of sport leagues. Notably, prominent Japanese, Chinese, South Korean, and Taiwanese sport organizations are covered in their emergence as the top sport businesses within the region. The creation of these leagues varies from the old (Japanese baseball) to the new (Chinese football). As the dynamics of political and economic power has shifted in East Asia in the last several decades, so has the popularity and importance of many of the sport leagues in the region. At the same time, as these leagues have grown, many of the top stars have begun to leave for more popular and competitive leagues in North America and Europe. This chapter concludes in considering the future potential of sport leagues in Asia, and whether the teams and leagues will be able to continue to survive in their current formats.


title: Errors, Uncertainty, and Ethical Issues

text: Various medical giants have admonished us to “do no harm,” and yet as we swim in waters of uncertainty, errors do happen. Physician author Lewis Thomas praises restraint in health care, and Arthur Bloomfield reminds us that in our quest to help some, there are no patients we cannot harm.


title: Biomarkers of Infectious Diseases

text: Infection is defined as a pathologic process caused by the invasion of normally sterile tissue or fluid or body cavity by pathogenic or potentially pathogenic microorganisms. Sepsis is defined as the presence of organ dysfunction occurring as the result of a dysregulated host response to an infection.


title: Artikel von A bis Z

text: Nach frühem Tod der Eltern Erziehung in Genf; 1843–1848 Studium in Genf und Berlin, dort Bekanntwerden mit der deutschen Philosophie; Reisen in Frankreich und Italien; 1849 Professur für Ästhetik in Genf; 1854 Professur für Philosophie; Wegbereiter des späten deutschen Idealismus in der frankophonen Welt; wenige Veröffentlichungen (Gedichte und Essays) zu Lebzeiten; Verfasser eines postum veröffentlichten Tagebuchs, das für den Ich-Kult des späteren 19. Jh.s von großer Bedeutung war.


title: Animal Models of Multiple Sclerosis

text: To determine whether an immunological or pharmaceutical product has potential for therapy in treating multiple sclerosis (MS), detailed animal models are required. To date many animal models for human MS have been described in mice, rats, rabbits, guinea pigs, marmosets, and rhesus monkeys. The most comprehensive studies have involved murine experimental allergic (or autoimmune) encephalomyelitis (EAE), Semliki Forest virus (SFV), mouse hepatitis virus (MHV), and Theiler’s murine encephalomyelitis virus (TMEV). Here, we describe in detail multispecies animal models of human MS, namely EAE, SFV, MHV, and TMEV, in addition to chemically induced demyelination. The validity and applicability of each of these models are critically evaluated.


title: Adenosine Receptors in the Lungs

text: The ubiquitous adenine nucleoside adenosine (Ado), which plays an important role in cellular energetics, is released from cells under physiologic and pathophysiologic conditions. Another source of extracellular Ado is rapid degradation of extracellular adenosine 5′-triphosphate (ATP) by ectoenzymes. Extracellular Ado acts as an autocrine and paracrine agent by the activation of G protein-coupled cell surface receptors (GPCRs), designated as A(1), A(2A), A(2B), and A(3). Almost four decades ago, published data have indicated that Ado could play a role in immune-mediated histamine release from pulmonary mast cells. Since then, numerous studies have indicated that Ado’s signal transductions are involved in various pulmonary pathologies including asthma and COPD. This chapter is a succinct review of recent studies in this field.


title: Rethinking Sepsis: New Insights from Gene Expression Profiling Studies

text: Critically ill patients encompass an enormously heterogeneous population and, as such, therapeutic interventions, including drug therapy, can produce multiple outcomes in different patient subgroups. For example, researchers not only look for an ‘average effect’ of a drug on a typical patient, but also seek to understand individual variability. The presence of variability impacts significantly on the success of clinical trials and failure to identify this variability can result in the clinical trial being under-powdered to detect a treatment effect. For clinicians, failure to recognize variability can result in unintended toxicity or excessive harm in certain patients. Hence, understanding variability is critically important in both research and clinical practice.


title: Promoting an Inclusive Approach to Benefit Sharing: Expanding the Scope of the CBD?

text: The Convention on Biological Diversity (CBD) is a major international agreement to ensure the conservation of biological diversity, the sustainable use of various components of biological diversity, and fair and equitable access and benefit sharing of advances arising from the use of related genetic resources. The CBD excludes human genetic resources. In light of the rapid advances in biotechnology, genetic resources are increasingly being utilised by different types of users and in different industries. This usage is not confined to plants, animals or micro-organisms but includes human genetic resources and sometimes a mix of such resources. In the absence of any international agreement, various national governments are framing their own rules and guidelines. This patchwork of regulation may eventually impede global research efforts. This chapter argues that the CBD is qualified to be the central agency at the global level for the advance of broader benefit sharing frameworks. By implication, the scope of the CBD should be expanded to include human genetic resources.


title: Lung

text: The lungs are particularly sensitive to RT, and are often the primary dose-limiting structure during thoracic therapy. The alveolar/capillary units and pneumocytes within the alveoli appear to be particularly sensitive to RT. Hypoxia may be important in the underlying physiology of RT-associated lung injury. The cytokine transforming growth factor-beta (TGF-β), plays an important role in the development of RT-induced fibrosis. The histopathological changes observed in the lung after RT are broadly characterized as diffuse alveolar damage. The interaction between pre-treatment PFTs and the risk of symptomatic lung injury is complex. Similarly, the link between changes in PFTs and the development of symptoms is uncertain. The incidence of symptomatic lung injury increases with increase in most dosimetric parameters. The mean lung dose (MLD) and V20 have been the most-often considered parameters. MLD might be a preferable metric since it considers the entire 3D dose distribution. Radiation to the lower lobes appears to be more often associated with clinical symptoms than is radiation to the upper lobes. This might be related to incidental cardiac irradiation. In pre-clinical models, there appears to be a complex interaction between lung and heart irradiation. TGF-β has been suggested in several studies to predict for RT-induced lung injury, but the data are still somewhat inconsistent. Oral prednisone (Salinas and Winterbauer 1995), typically 40–60 mg daily for 1–2 weeks with a slow taper, is usually effective in treating pneumonitis. There are no widely accepted treatments for fibrosis. A number of chemotherapeutic agents have been suggested to be associated with a range of pulmonary toxicities.


title: Cibotium barometz

text: Cibotium barometz plant habit


title: Fetal and Neonatal Illnesses Caused or Influenced by Maternal Transplacental IgG and/or Therapeutic Antibodies Applied During Pregnancy

text: The human fetus is protected by the mother’s antibodies. At the end of the pregnancy, the concentration of maternal antibodies is higher in the cord blood, than in the maternal circulation. Simultaneously, the immune system of the fetus begins to work and from the second trimester, fetal IgM is produced by the fetal immune system specific to microorganisms and antigens passing the maternal-fetal barrier. The same time the fetal immune system has to cope and develop tolerance and T(REG) cells to the maternal microchimeric cells, latent virus-carrier maternal cells and microorganisms transported through the maternal-fetal barrier. The maternal phenotypic inheritance may hide risks for the newborn, too. Antibody mediated enhancement results in dengue shock syndrome in the first 8 month of age of the baby. A series of pathologic maternal antibodies may elicit neonatal illnesses upon birth usually recovering during the first months of the life of the offspring. Certain antibodies, however, may impair the fetal or neonatal tissues or organs resulting prolonged recovery or initiating prolonged pathological processes of the children. The importance of maternal anti-idiotypic antibodies are believed to prime the fetal immune system with epitopes of etiologic agents infected the mother during her whole life before pregnancy and delivery. The chemotherapeutical and biological substances used for the therapy of the mother will be transcytosed into the fetal body during the last two trimesters of pregnancy. The long series of the therapeutic monoclonal antibodies and conjugates has not been tested systematically yet. The available data are summarised in this chapter. The innate immunity plays an important role in fetal defence. The concentration of interferon is relative high in the placenta. This is probably one reason, why the therapeutic interferon treatment of the mother does not impair the fetal development.


title: The Dynamic World View in Action

text: The dynamical system is a mathematical concept motivated first by Newtonian mechanics. The state of the system is generally denoted by a point in an appropriately defined geometrical space. A dynamical system operates in time. Typically, we take the time set T to be the real line R (a continuous-time system) or the set of integers Z (a discrete-time system). We then formalize an autonomous system as a ordered pair (Q, g), where Q is the state space, and g : T × Q → Q is a function that assigns to each initial state x(0) ∈ Q the state x = g(t, x(0)), in which the system will be after a time interval t if it started in state x(0). A fundamental property of g, then, is the validity of the identity g(t + s, x(0)) ≡ g(s, g(t, x(0))) (4.1) for all states x, and times t, s. Loosely speaking g is a fixed rule which governs the motion of the system.


title: Microbiology

text: In order to render an accurate diagnosis, and correctly identify clinically important microorganisms, a good understanding and knowledge of microbiology is essential. This chapter provides a broad overview of microbiology that is relevant to the practicing cytologist. Virology addresses the cytopathic effects caused by viruses and discusses many key infections. Bacteriology covers important bacterial causes of infection including those due to mycobacteria and filamentous bacteria. Mycology deals with common fungi as well as deep mycoses, particularly those caused by invasive and dimorphic fungal organisms. Parasitology highlights the protozoa, apicomplexans, and helminths likely to be seen in cytology samples. Algae are also briefly mentioned.


title: The Crowded Cytosol

text: While, given the expansion of the world population, it cannot be guaranteed that it will always be so, currently one accepts as a temporary discomfort short periods of crowding, as in a crowded elevator or subway train. However, if, like most intracellular macromolecules, one were both blind and deaf, the need to communicate by touch might make crowding an option of choice. It seems likely that the first cells to evolve soon discovered the advantage of intracellular crowding, which persists to this day [2]. Indeed, the physiological environment of enzymes is very different from the environment we can normally create in the test-tube.


title: Infecties van de luchtwegen en cystische fibrose

text: Sereuze of mucopurulente neusuitvloed, passagebelemmering, minimale algemene verschijnselen; meestal geen koorts.


title: Human Mobility, Networks and Disease Dynamics on a Global Scale

text: Disease dynamics is a complex phenomenon and in order to address these questions expertises from many disciplines need to be integrated. One method that has become particularly important during the past few years is the development of computational models and computer simulations that help addressing these questions. In the focus of this chapter are emergent infectious diseases that bear the potential of spreading across the globe, exemplifying how connectivity in a globalized world has changed the way human-mediated processes evolve in the 21st century. The examples of most successful predictions of disease dynamics given in the chapter illustrate that just feeding better and faster computers with more and more data may not necessarily help understanding the relevant phenomena. It might rather be much more useful to change the conventional way of looking at the patterns and to assume a correspondingly modified viewpoint—as most impressively shown with the examples given in this chapter.


title: Immune response in human pathology: infections caused by bacteria, viruses, fungi, and parasites

text: Despite the introduction of effective health measurements, vaccination and antimicrobial therapy infectious diseases continue to threaten human life. The reasons are numerous and diverse: antibiotic resistance, hospital-invading pathogens, new emerging infectious diseases, bioterrorism, biological warfare. This chapter is an introduction to several aspects of infectious diseases viewed from the host as well as from the pathogen (bacterium, virus and parasite). Furthermore the basic principles of INNATE and ADAPTIVE IMMUNE RESPONSES, especially in debilitated patients, are described. Detailed information is given on the pathogenesis of septic shock, AIDS and vaccination strategies.


title: Bronchitis, Bronchiolitis und Lungenemphysem

text: Die Bronchitis wird in die akute und die chronische Erkrankungsform eingeteilt. Bei der chronischen Form müssen zusätzlich das Vorhandensein einer zusätzlichen Atemwegsobstruktion und Sekundärveränderungen, insbesondere das Lungenemphysem, berücksichtigt werden.


title: Mediator-Based Architecture for Integrated Access to Biological Databases

text: The amount of biological information accessible via the internet is growing at a tremendous rate. The biologists often encounter problems in accessing huge amount of widely spread data due to disparate formats, remotely dispersed and varying implementation on different platforms and data models. Besides that, the custom browsing and querying mechanism implemented in different data sources requires the users to uniquely query each individual database. Instead of having different custom interfaces to these public bioinformatics databases, an intuitive common integrated data access method is proposed to provide uniform transparent access to disparate biological databases. The proposed mediator-based architecture consists of three conceptual layers namely Query Formulation, Query Transformation and Query Execution.


title: Neurotische, Belastungs- und somatoforme Störungen (F40–F48)

text: Epidemiologischen Studien zufolge beträgt die durchschnittliche Lebenszeitprävalenz der Zwangsstörung bei Erwachsenen der Allgemeinbevölkerung ca. 2,5 %. Die Punktprävalenz liegt bei etwa 1,5 %. Bei der Zwangsstörung finden sich keine Geschlechterunterschiede in den Häufigkeitsraten.


title: Unmet Medical Needs and the Role of Pharmaceutical Companies

text: Rising health care costs have been prioritized in the budget planning of all Western countries. Rising R&D costs of up to $800 million per marketed new pharmaceutical have dramatically reduced the approval of new chemical entities (NCEs). Globalization of diseases like AIDS and SARS has had a definite impact on the economic situation not only in the Western world, but also in developing countries, especially for AIDS in Africa and SARS in Asia. The World Health Organization (WHO) is calling for free anti-tuberculosis (TB) drugs to be made available to people living with human immunodeficiency virus (HIV). The spread between unmet medical need in large indications (e.g. Alzheimer's disease) and in niche indications (e.g. Huntington disease) and the economic burden to create a blockbuster ($1 billion sales within one year after launch) has created a marketing-driven clinical development of new chemical entities. A paradigm shift has occurred by which developing a new innovative drug by documenting shortterm efficacy, quality and safety rather than long-term efficacy and emphasizing pharma-covilliglance including considerations of health economy within the medical environment a shift that has fundamentally changed and challenged the pharmaceutical industry.


title: The Golgi apparatus and main discoveries in the field of intracellular transport

text: In this chapter, we summarize important findings in the field of intracellular transport, which have considerably contributed to the understanding of the function and organization of the Golgi apparatus (GA). It is not possible to mention all authors in this huge field. We apologize for gaps and incompleteness, and are thankful for suggestions and corrections.


title: Respiratory Failure in a Patient with Idiopathic Pulmonary Fibrosis

text: Idiopathic pulmonary fibrosis, in its advanced stages, commonly causes chronic respiratory failure. Additionally, patients with fibrotic lung disease can develop acute respiratory failure due to a myriad of causes, though one of the most common and most deadly is an acute exacerbation of idiopathic pulmonary fibrosis. In this chapter we review the differential diagnosis for patients with idiopathic pulmonary fibrosis who present with acute respiratory failure. Furthermore, we review the available evidence pertinent to the intensivist when these patients are cared for in the intensive care unit. Lastly, we explore treatment controversies (Extracorporeal Life Support, corticosteroids, non-invasive ventilation strategies) that are employed by some centers, but with limited evidence.


title: Respiratory Diseases of Pregnancy

text: Respiratory complaints in the gravid patient are often difficult to identify as a disease state, expected physiologic changes of pregnancy or both. Understanding the underlying pulmonary physiologic changes that come with pregnancy as well as those conditions which are unique to the pregnant patient will help arrive at the correct diagnosis and management. Recognizing that the gravid patient has other physiologic changes that contribute to decreased respiratory reserve, increased risk of aspiration, infection, and difficult airway can help in managing these patients acutely.


Aminopeptidases


title: Respiratory Emergencies in Children

text: Focused clinical observation is the key in the initial recognition of respiratory distress in an acutely ill child.


title: Pädiatrische Transfusionsmedizin

text: Die Indikation zur Transfusion von Blutprodukten wird in den letzten Jahren zurückhaltender gestellt. Dazu trägt die Sorge vor möglichen übertragbaren Infektionen ebenso bei wie eine verbesserte Kenntnis der Gewebeoxygenierung. Prinzipiell sollten nur die fehlenden Blutkomponenten verabreicht werden, die der Patient benötigt, und alle unnötigen und möglicherweise gefährlichen Bestandteile vermieden werden („Hämotherapie nach Maß“). In der Intensivmedizin erlaubt z.B. die Messung der zerebralen Sauerstoffausschöpfung eine auf die individuelle Oxygenierung des Patienten abgestimmte Entscheidung zur Erythrozytensubstitution; vorgegebene starre Transfusionsgrenzen verlieren dadurch an Bedeutung.


title: Relative Lempel-Ziv Compression of Genomes for Large-Scale Storage and Retrieval

text: Self-indexes – data structures that simultaneously provide fast search of and access to compressed text – are promising for genomic data but in their usual form are not able to exploit the high level of replication present in a collection of related genomes. Our ‘RLZ’ approach is to store a self-index for a base sequence and then compress every other sequence as an LZ77 encoding relative to the base. For a collection of r sequences totaling N bases, with a total of s point mutations from a base sequence of length n, this representation requires just [Formula: see text] bits. At the cost of negligible extra space, access to ℓ consecutive symbols requires [Formula: see text] time. Our experiments show that, for example, RLZ can represent individual human genomes in around 0.1 bits per base while supporting rapid access and using relatively little memory.


title: Ventilator-Associated Pneumonia

text: A 50-year-old diabetic male patient was admitted to the hospital with ischemic stroke (GCS = E1V1M3). He was put on invasive positive-pressure ventilation support. On the fourth day of ICU stay, he developed fever (38.6 °C), a rise in total leukocyte count (156,000, N 93%), and heterogeneous, ill-defined shadows in the right lower zone in the chest X-ray. Chest auscultation revealed bronchial breathing in the right infra-axillary area, and the nurse reported an increase in amount and purulence of secretions requiring frequent suctioning. The patient needed 5 mcg/min noradrenaline to maintain systolic blood pressure of more than 100 mmHg.


title: Koorts en koortssyndromen

text: Ongeveer 25–40 % van de kinderen zoeken acute kindergeneeskundige hulp in verband met koorts. In dit hoofdstuk behandelen de auteurs: (1) alarmsymptomen en beleid van een ernstige of specifieke infectie (bijv. pneumonie en urineweginfectie); (2) febris e causa ignota (koorts e.c.i.), die zich kenmerkt door aanhoudende of recidiverende koorts; (3) kinderen met een tropische infectieziekte (waaronder malaria en dengue); dit is zeldzaam, maar er zijn veel mogelijke oorzaken van koorts na tropenbezoek. Een systematische benadering is van belang om de aandoeningen te identificeren die bedreigend, behandelbaar en/of besmettelijk zijn.


title: 5 Zorgvuldig en verantwoord werken

text: Verzorgenden in verpleeg- en verzorgingshuizen willen meer scholing over handelingen die de vrijheid van zorgvragers beperken. Ook is er te weinig toezicht op bewoners en zorgvragers. Verzorgenden beperken wekelijks de vrijheid van zorgvragers, maar zijn zich daar niet altijd van bewust. Dat blijkt uit onderzoek onder het Panel Verpleegkundigen & Verzorgenden (TvV, april 2007).


title: 16 Longziekten

text: Longziekten komen zeer frequent voor. De meeste longaandoeningen ontstaan in de luchtwegen; voorbeelden hiervan zijn astma en COPD (chronic obstructive pulmonary disease).


title: Litigations for Unexpected Adverse Events

text: A 53-year-old Iranian female who immigrated to Canada about 3.5 years before was referred to an internist for a positive Mantoux skin test (11 mm in diameter). The subject was previously well with no symptoms indicative or suggestive of active tuberculosis. A routine tuberculosis skin test was performed because the patient had applied to be a volunteer at a local hospital. She had no significant past illness or known allergies, and she was never diagnosed with nor had known contact with anyone with active tuberculosis. The subject never ingested alcohol and was not known to have hepatitis or be a carrier of any hepatitis virus. Baseline investigations performed by the internist included routine complete blood count, routine biochemical tests (liver enzymes, creatinine, and glucose), serum ferritin, and thyroid-stimulating hormone – all of which were normal. A chest radiograph was reported to be normal.


title: Investigation of Animal Reservoir(s) of SARS-CoV

text: Severe acute respiratory syndrome (SARS) is a novel infectious disease in the new millennium. It has been ascertained that a new coronavirus, SARS-CoV, is the etiological agent of SARS. While the extraordinarily rapid isolation and full genome sequencing of SARS-CoV constituted a remarkable scientific achievement, identification of the actual animal reservoir(s) of SARS-CoV is more difficult. Initial evidences indicated that the masked palm civet (Paguma larvata) was the primary suspect of the animal origin of SARS (Guan et al., 2003; Song et al., 2005). Recent studies suggested that horseshoe bat is one of the real reservoirs (Lau et al., 2005; Li et al., 2005) and masked palm civet may have only served as an intermediate amplification host for SARS-CoV and fulfilled efficient interspecies transmission (Lau et al., 2005). This chapter will summarize the studies on the animal reservoir(s) of SARS-CoV.


title: Rhinosinusitis and Tonsillopharyngitis

text: Sinusitis is characterized by mucosal inflammation of the sinuses which is almost always accompanied by inflammation of the nasal passages. Since nasal mucosa is contiguous with paranasal sinus mucosa, the term sinusitis is often used interchangeably with [1]; the latter term will be used in this chapter. Rhinosinusitis can be acute (less than 4 weeks’ duration), subacute (4–12 weeks), or chronic (greater than 12 weeks) [2].


title: A Graph Cellular Automata Model to Study the Spreading of an Infectious Disease

text: A mathematical model based on cellular automata on graphs to simulate a general epidemic spreading is presented in this paper. Specifically, it is a SIR-type model where the population is divided into susceptible, infected and recovered individuals.


title: Die Vielfalt des Fachjournalismus

text: Als zusammenfassendes Verständnis von Fachjournalismus lässt sich bis an diese Stelle aus der theoretischen Analyse heraus formulieren: Fachjournalismus ist Journalismus. In diesem Sinne ist Fachjournalismus ein Sub- und Leistungssystem des publizistischen Systems Journalismus. Er hat sich in viele Richtungen aus-differenziert aufgrund der Komplexität seiner Beobachtungsobjekte. Ebenso wenig wie es den einen Journalismus gibt, existiert nur ein Fachjournalismus. Der Singular bezeichnet das System, die Pluralform muss angewendet werden bei der Beschreibung der empirischen Vielfalt.


Mykobakteriose (pulmonale)


docid: irysyflt

title: Current Issues in Ventilator-Associated Pneumonia

text: Infections in critically ill patients account for a major proportion of the mortality, morbidity, and cost associated with their care. Infection rate in critically ill patients are about 40% and may be 50–60% in those remaining in the intensive care unit (ICU) for more then 5 days.(1,2) Pneumonia acquired in the ICU (after 48 h intuba tion) ranges from 10% to 65%,(3,4) and respiratory infections account for 30–60% of all infections acquired in the ICU(.5,6) Mortality rates of ventilator-associated pneumonia (VAP) have been very high (30–70%) and may account for 15% of all deaths in the ICU. (7–9) When controlled for severity of underlying disease and other factors the attributable mortality of VAP range from 0% to 50% absolute increase, and prolonged length of ICU stay (range 5–13 days).(10) In a recent review of the clinical and economic consequences of VAP from analysis of studies published after 1990, the findings were: 10–20% of ICU-ventilated patients will develop VAP, and are twice as likely to die compared to patients without VAP, with 6 extra days in the ICU and an additional US$10019 hospital cost per case.(11) Empiric broad-spectrum antimicrobials in the ICU for presumed pneumonia has contributed substantially to the worldwide increase in antibiotic-resistant bacteria in hospitals. This has compounded the problem of increasing morbidity, mortality, and cost because of the challenge posed by these difficult-to-treat microorganisms, particularly the use of expensive drugs and need for isolation.


Small Scale Academic Web Archiving: DACHS


title: Viral Infections of the Lung

text: The lungs are among the most vulnerable to microbial assault of all organs in the body. From a contemporary vantage, lower respiratory tract infections are the greatest cause of infection-related mortality in the United States, and rank seventh among all causes of deaths in the United States.2,3 From a global and historic perspective, the scope and scale of lower respiratory tract infection is greater than any other infectious syndrome, and viral pneumonias have proven to be some of the most lethal and dramatic of human diseases. The 1918–1919 influenza pandemic, perhaps the most devastating infectious disease pandemic in recorded history, resulted in an estimated 40 million deaths worldwide, including 700,000 deaths in the U.S.4 The global outbreak of severe acute respiratory syndrome (SARS) during 2003, although considerably smaller in scale, resulted in 8098 cases and 774 deaths5 and is a dramatic contemporary example of the ability of viral pneumonias to rapidly disseminate and cause severe disease in human populations.


title: The Physiology of Brain Death and Organ Donor Management

text: Brain death is associated with complex physiologic changes that may impact the management of the potential organ donor. Medical management is critical to actualizing the individual or family’s intent to donate and maximizing the benefit of that intent. This interval of care in the PICU begins with brain death and consent to donation and culminates with surgical organ procurement. During this phase, risks for hemodynamic instability and compromise of end organ function are high. The brain dead organ donor is in a distinct and challenging pathophysiologic condition that culminates in multifactorial shock. The potential benefits of aggressive medical management of the organ donor may include increased number of donors providing transplantable organs and increased number of organs transplanted per donor. This may improve graft function, graft survival, and patient survival in those transplanted. In this chapter, pathophysiologic changes occurring after brain death are reviewed. General and organ specific donor management strategies and logistic considerations are discussed. There is a significant opportunity for enhancing donor multi-organ function and improving organ utilization with appropriate PICU management.


title: Aandoeningen van de luchtwegen

text: Luchtwegaandoeningen vormen een van de meest frequente oorzaken van morbiditeit bij kinderen. Alleen al luchtweginfecties maken meer dan de helft uit van alle ziekteperioden bij kinderen en zijn verantwoordelijk voor ongeveer eenderde van alle schoolverzuim.


title: Chromatin and Aging

text: Recent studies from a number of model organisms have indicated chromatin structure and its remodeling as a major contributory agent for aging. Few recent experiments also demonstrate that modulation in the chromatin modifying agents also affect the life span of an organism and even in some cases the change is inherited epigenetically to subsequent generations. Hence, in the present report we discuss the chromatin organization and its changes during aging.


Schnupfenviren


title: The Past and Present Threat of Avian Influenza in Thailand

text: Avian influenza H5N1 infection was first identified in Thailand in January 2004. Since then, there have been three major outbreaks in the cold season of 2003–2004 and in the rainy and cold seasons of 2004–2005 and 2005–2006. More than 62 million birds died or were culled. The burden shifted from large industrial farming in the first outbreak to small farms, backyard chickens, and free-grazing ducks. Up to November 2005, there were 20 confirmed cases of human H5N1 infection. Thirteen of these died. Most of the confirmed cases were solitary ones except for three persons in a single family, and epidemiological evidence indicated that person-to-person transmission may have been involved in this cluster. However, sequence analysis of the virus in the cluster did not suggest any changes that might enhance the viral ability to get transmitted among humans. H5N1 viruses in Thailand and Vietnam belong to a single lineage genetically and are antigenically distinguishable from the viruses of the same genotype Z from southern China and Indonesia. Despite the seemingly subsiding epidemic in Thailand, the problem is far from resolved. H5N1 viruses are still sporadically isolated from domestic poultry as well as from wildlife. More important, isolates were also found in asymptomatic animals. Natural selection may have adapted the virus to a less aggressive form. This would make the virus more elusive and difficult to control. A threat of a pandemic strain emerging from the H5N1 virus is still imminent. A national strategic plan for avian influenza control and influenza pandemic preparedness has been implemented. The plan aims at effective control of avian influenza spread in animals as well as in humans for a three-year period and at efficient pandemic preparedness within one year. Nevertheless, more regional and international collaboration is needed. With proper collective preparedness, there is a hope that the threatening influenza pandemic can be prevented by confining and eliminating a potential pandemic strain at its origin. In December 2003, poultry farms in the eastern, central, and northern regions of Thailand experienced large-scale die-offs. The outbreak started from the eastern region of the country. The disease caused rapid death, with a very high attack rate. At that time, H5N1 outbreaks had been reported in South Korea, Vietnam, and Japan (OIE, 2005). A few humans with pneumonia were suspected to originate from contact with sick or dead poultry. Final diagnosis in these patients was not done as clinical samples were not available at the time when proper diagnostic testing became available. On 23 January 2004, the first case of human H5N1 infection in Thailand was reported. It was a boy from Kanchanaburi, a province about 100 km west of Bangkok. He was admitted to Siriraj Hospital in Bangkok and was diagnosed to have severe progressive pneumonia. The patient was initially treated with broad spectrum antibiotics, and respiratory samples were tested for influenza virus. The laboratory result showed that the patient harbored influenza virus, and sequencing of the viral RNA indicated that the virus belonged to the H5 subtype (Chokephaibulkit et al., 2005; Puthavathana et al., 2005). When this result was reported to the Ministry of Public Health, the government announced that there was a highly pathogenic avian influenza (AI) outbreak in Thailand. The Department of Livestock Development (DLD) confirmed the presence of H5N1 viruses in poultry on the same day. Subsequent analysis of the virus from patients and animals confirmed that it was H5N1 AI virus of genotype Z and was closely related to the virus from Vietnam (Viseshakul et al., 2004; Puthavathana et al., 2005).


title: P-Type Lectins: Cation-Dependent Mannose-6-Phosphate Receptor

text: In eukaryotic cells, post-translational modification of secreted proteins and intracellular protein transport between organelles are ubiquitous features. One of the most studied systems is the N-linked glycosylation pathway in the synthesis of secreted glycoproteins (Schrag et al. 2003). The N-linked glycoproteins are subjected to diverse modifications and are transported through ER and Golgi apparatus to their final destinations in- and outside the cell. Incorporation of cargo glycoproteins into transport vesicles is mediated by transmembrane cargo receptors, which have been identified as intracellular lectins. For example, mannose 6-phosphate receptors (Ghosh et al. 2003) function as a cargo receptor for lysosomal proteins in the trans-Golgi network, whereas ERGIC-53 (Zhang et al. 2003) and its yeast orthologs Emp46/47p (Sato and Nakano 2002) are transport lectins for glycoproteins that are transported out of ER.


Pharyngitis


title: Nierentransplantation

text: Die Nierentransplantation ist die effektivste Behandlungsmethode der chronischen terminalen Niereninsuffizienz. Seit den 1960er Jahren entwickelte sie sich zu einer Standardtherapie. Wichtige Voraussetzungen waren die Entdeckung des HLA-Systems, die Entwicklung der Immunsuppressiva sowie die technische Perfektionierung des Organerhaltes außerhalb eines lebenden Körpers. Die 5-Jahres-Überlebensrate für Allotransplantate beträgt etwa 65%, diejenige von Lebendspenden 79%.


title: International Flight Considerations

text: Combined with the rising number of passengers, and increased capacity of larger airplanes with more long-distance domestic and international flights, with long-haul aircrafts—such as the Airbus A380 and Boeing 777 LR now capable of extending flight times to 18–20 h—it is likely that the incidence of in-flight medical emergencies will continue to increase in the coming years. International air travel in particular combines long-haul, extended flight times with unique exposures and an even more austere, secluded environment for passengers with acute and/or chronic illnesses, and suggests unique medical challenges for recognition, stabilization, treatment, diagnosis, and disposition.


Disabled defences