bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterizing the trophic position and shift in Atlantic salmon (Salmo salar) from freshwater to marine life-cycle phases using stable isotopes
Authors: Dixon Heather J. , Power Michael , Dempson J. Brian , Sheehan Timothy F. , Chaput Gérald
Published: July 2012

Dixon, H. J., Power, M., Dempson, J. B., Sheehan, T. F., and Chaput, G. 2012. Characterizing the trophic position shift in Atlantic salmon (Salmo salar) from freshwater to marine life-cycle phases using stable isotopes. – ICES Journal of Marine Science, 69: 1646–1655. Marine survival and recruitment of Atlantic salmon (Salmo salar) are commonly thought to be influenced by linkages between marine temperature and growth. Salmon are opportunistic feeders that are likely to be affected by the quality and quantity of prey available. During the marine phase, salmon often target larger zooplankton and fish, with a preference for fish over crustaceans. European salmon recruitment appears to be linked to forage abundance, which affects post-smolt growth critically during the first summer at sea, but similar linkages have not been shown for North American populations. Here, trophic differences within and among populations and life stages of Atlantic salmon during the freshwater and marine life-history phases are investigated. Stable isotope methods were used to characterize trophic dynamics by sampling smolts and returning adult survivors from rivers spanning a broad geographic range in Canada (southern Labrador to the Bay of Fundy), as well as non-maturing salmon sampled at West Greenland. Analyses indicate that salmon undergo a marked change in feeding as they migrate from freshwater and show the expected high reliance on pelagic foodwebs in the marine environment. Documented changes in ocean climate, pH, and the possibility of regime shifts are likely to have significant impacts on pelagic feeding fish, including Atlantic salmon. Due to the similar marine feeding ecology suggested here for adults from different age groups, these changes could have a widespread effect on multiple life-history stages of Atlantic salmon.
Biochemistry in medicine—reference intervals: the use of biochemical analysis for diagnosis and management
Authors: Holloway P. , Stoddart Heather
Published: July 2012

Biochemistry, biochemical testing, and specialist biochemical practitioners have an important role in clinical practice in both diagnosis and management, as emphasized by the fact that some discussion of biochemical testing appears in almost every chapter of this book. Included in this chapter are (1) a listing of the reference intervals (formerly termed reference ranges) for the most widely used biochemical tests, with conversion factors included (where appropriate) to convert intervals from SI to conventional units, and their grouping into organ system profiles in common usage; (2) description of the pitfalls and limitations of interpretation of reference intervals; and (3) some commonly used protocols for dynamic function tests....
Clinical approach
Authors: Ellis Christopher J.
Published: July 2012

Infection is most often suspected when patients present with pyrexia and is certainly the most common cause of this presentation, whether in hospitalized patients or those in the community. The other principal causes of fever are primary inflammatory conditions and malignancy, but infections are likely to be most rapidly progressive and acutely life-threatening and hence must be the physician’s first concern....
Arenaviruses
Authors: ter Meulen J.
Published: July 2012

Arenaviruses are zoonotic RNA viruses that are distributed worldwide and are adapted to various rodent genera. Some are highly pathogenic and cause haemorrhagic fevers that are endemic in restricted regions of a few countries. Humans are thought to become infected mainly through inhalation of aerosolized rodent urine or dust particles to which infectious urine has dried, or by ingestion of contaminated foodstuff: prevention therefore depends on rodent control and avoidance of contact with rodents, their excreta, and nesting materials....
Hepatitis viruses (excluding hepatitis C virus)
Authors: Naoumov N.V.
Published: July 2012

The group of hepatitis viruses includes five unrelated human viruses (A to E), which differ in their genome organization, biology, and epidemiology, while being united by their hepatotropism. About 10 to 15% of cases of viral hepatitis are considered as non-A to E hepatitis, whose aetiology is still unknown, but the search for which has led to the identification of several new viruses (e.g. HGV or GB virus-C, TT, and SEN viruses) of uncertain pathogenic significance....
Haemophilus ducreyi and chancroid
Authors: O’Farrell Nigel
Published: July 2012

Haemophilus ducreyi is a Gram-negative, facultative anaerobic bacillus that is the cause of chancroid, which is endemic in sub-Saharan Africa and the Caribbean, although the overall global incidence of the condition has decreased dramatically since the mid 1990s.

Clinical features—After an incubation period of 4 to 10 days, presentation is with a tender genital papule that develops into a pustule and then an ulcer with a ragged undermined edge and a yellow base that bleeds readily. The usual sites of infection in men are the prepuce and coronal sulcus, and in women the labia minora and fourchette. Inguinal lymphadenopathy is found in about half the male cases. Chancroid is an important risk factor for the transmission of HIV infection. HIV infection may result in atypical manifestations if chancroid....
Pasteurella
Authors: Morgan Marina S.
Published: July 2012

Pasteurella multocida is an important human Gram-negative pathogen residing primarily in the oropharynx of mammals and transmitted through bites and scratches. Presentation is typically within 12 h of the injury with rapidly spreading cellulitis or sepsis, leading to serious morbidity and mortality (up to 40%) if untreated. Diagnosis is clinical: fresh bite wound cultures are unhelpful, but the organism may be cultured in cases with established infection. Treatment requires thorough wound debridement, with delayed closure if possible, along with antimicrobials to provide empirical cover against pasteurellae and other expected pathogens, e.g. amoxicillin-clavulanate plus ciprofloxacin, or imipenem plus ...
Amoebic infections
Authors: Knight Richard
Published: July 2012

Two very different groups of amoebic species infect humans. (1) Obligate anaerobic gut parasites—including the major pathogen Entamoeba histolytica, Dientamoeba fragilis (which causes relatively mild colonic involvement with diarrhoea), and eight non-pathogenic species including Entamoeba dispar. (2) Aerobic free-living, water and soil amoebae—these can become facultative tissue parasites in humans after cysts or trophozoites are inhaled, ingested, or enter damaged skin or mucosae....
Trichomoniasis
Authors: Hillier Sharon
Published: July 2012

Trichomonas vaginalis is a sexually transmitted protozoan pathogen that may cause more than one-half of all curable sexually transmitted genital infections worldwide. Women with trichomoniasis are often asymptomatic, but they may develop vaginal malodour, discharge, erythema, or itching, and their male or female sexual partners may also be infected, although urethritis in men is less likely to cause symptoms. Women with trichomoniasis have an increased risk of HIV acquisition, HIV shedding, pelvic inflammatory disease, and preterm birth. For diagnosis, rapid antigen detection, culture, and polymerase chain reaction (PCR) methods have advantages over conventional microscopy, but are more expensive. Oral metronidazole is usually an effective treatment, with both sexual partners needing to be treated to prevent reinfection....
Guinea worm disease (dracunculiasis)
Authors: Knight Richard
Published: July 2012

Guinea-worm disease (dracunculiasis)—now limited to sub-Saharan Africa—is caused by the nematode Dracunculus medinensis, whose life cycle involves water-borne copepod crustaceans and humans, who acquire the infection when they drink water containing infective larvae. Clinical presentation is usually with a skin blister, most often on the leg, sometimes preceded by allergic prodromal symptoms. Bacterial infection is a common complication. Most patients in endemic areas recognize their condition, but irrigation of ulcers can reveal larvae. Treatment is by physical removal of the worm; anthelmintics have no role in management. Provision of safe water for drinking is the key to prevention....
Schistosomiasis
Authors: Dunne D.W. , Vennervald B.J.
Published: July 2012

Schistosomiasis is caused by trematode worms Schistosoma spp., whose life cycle requires a definitive vertebrate host and an intermediate freshwater snail host. Transmission to humans occurs through exposure to fresh water containing infectious larvae, which can penetrate intact skin before developing into blood-dwelling adult worms. The disease is patchily distributed in parts of South America, Africa, the Middle East, China, and South East Asia, with about 200 million people infected and 20 million suffering severe consequences of infection....
Sexual history and examination
Authors: Sherrard Jackie , Luzzi Graz A.
Published: July 2012

Sexually transmitted infections (STIs) are common, especially in young people, and it is important that doctors recognize both the need to obtain a sexual history and when to perform genital examination. STIs can present with generalized or extragenital symptoms whose significance may be missed. This chapter gives advice on how to take a sexual history and perform genital examination in both sexes. It also summarizes the common symptoms and syndromes associated with STIs and their causative pathogens, cross-referring to other chapters in the textbook....
Disorders of the posterior pituitary gland
Authors: Pal Aparna , Karavitaki Niki , Wass John A. H.
Published: July 2012

The posterior pituitary produces arginine vasopressin, which has a key role in fluid homeostasis, and oxytocin, which stimulates uterine contraction during birth and ejection of milk during lactation.

Cranial diabetes insipidus is the passage of large volumes (>3 litres/24 h) of dilute urine (osmolality<300 mOsm/kg) due to vasopressin deficiency, and most commonly occurs as a consequence of trauma or tumour affecting the posterior pituitary. Diagnosed by a water deprivation test revealing urine osmolality less than 300 mOsml/kg with concurrent plasma osmolality more than 290 mOsml/kg after dehydration, with urine osmolality rising to more than 750 mOsml/kg after desmopressin. MRI of the neurohypophysis is required to delineate the cause. Mild polyuria can be managed simply by ensuring adequate fluid intake; treatment with the long-acting vasopressin analogue, desmopressin (desamino, D-8 arginine vasopressin; DDAVP), is used for more severe cases....
Blood disorders specific to pregnancy
Authors: Perry David J. , Lowndes Katharine
Published: July 2012

Plasma volume increases by more during pregnancy than does red cell mass, leading to haemodilution and a fall in the haematocrit from about 40% to 33%, with the nadir usually reached at 24 to 32 weeks gestation. Anaemia during pregnancy is defined as a haemoglobin concentration of <10.5 g/dl during the second and third trimesters....
Congenital disorders of the liver, biliary tract, and pancreas
Authors: Summerfield J.A.
Published: July 2012

Congenital disorders of the liver, biliary tract, and pancreas are rare or very rare.

Biliary atresias present with cholestatic jaundice starting after the first 2 weeks of life and may eventually cause biliary cirrhosis and liver failure. Prognosis depends on the type of atresia: (1) intrahepatic—both nonsyndromic (with cirrhosis usually developing in late childhood, and fatal without liver transplantation) and syndromic (e.g. Alagille’s syndrome, due to mutation in the ...
Urinary tract obstruction
Authors: Yaqoob Muhammad M. , Junaid Islam
Published: July 2012

Obstructive nephropathy can manifest as either a sudden or an insidious decline in renal function, which can be can halted or even reversed by relief of obstruction. Obstruction can be due to anatomical or functional abnormalities of the urethra, bladder, ureter, or renal pelvis, which may be congenital or acquired, and it can also occur as a consequence of diseases extrinsic to the urinary tract. Although dilatation of the outflow system proximal to the site of obstruction is a characteristic finding, widening of the ureter and/or pelvicalyceal system does not necessarily indicate the presence of obstruction, and flow may be obstructed without such dilatation....
Taking a psychiatric history from a medical patient
Authors: Feldman Eleanor
Published: July 2012

It is important to screen for mental health problems: they are common in general medical patients and failure to recognize and deal with them will often interfere with the management of the physical health of the patient.

Depression can kill, and if by screening you identify depression, you should ask about hopelessness and suicidal ideation (how to do this sensitively is discussed in ...
Neuropsychiatric disorders
Authors: Pitkanen Mervi L.S. , Stevens Tom , Kopelman Michael D.
Published: July 2012

Neuropsychiatry is concerned with disorders of affect, cognition, and behaviour that arise from overt disorder in cerebral function, or from indirect effects of extracerebral disease.

The clinician needs to have a practical approach to the assessment, investigation, and management of patients manifesting cognitive and behavioural change, and to be aware of the specific cerebral and extracerebral disorders that commonly involve or are accompanied by cognitive or behavioural change....
Anxiety and depression
Authors: Chwastiak Lydia , Katon Wayne J.
Published: July 2012

Depression is common, with point prevalence in Western industrialized nations about 3% for men and 7% for women, and lifetime risk is about 10% for men and 20% for women. Depression is the leading cause of years lived with disability. Physicians fail to make an accurate diagnosis in at least half of those with depressive or anxiety disorders....
Children's views of death
Authors: Bluebond-Langner Myra , DeCicco Amy , Schwallie Megan Nordquest
Published: July 2012

Death is a topic which adults find difficult to discuss with children. Talking about it seems a painful, confusing intrusion into a child’s world. This assumes that death is foreign to a child’s usual thoughts, that it is distressing for a child to even consider, and that it is difficult for them to grasp. Ideally, thoughts and talk about death should wait for a time of more maturity, both emotional and cognitive. However, as we all know, discussions of death are usually forced upon us by the death of a pet, a relative, or a close friend, or even the impending death of the child him- or herself. This leads us to ask whether adult reservations about discussing death with children are well founded. What should we say? What can they understand? In this chapter we shall consider what needs to be taken into account when assessing children’s understanding of death, and suggest guidelines for talking to well and ill children about dying. We begin with an overview of the literature on well and terminally ill children’s views of death, followed by a brief presentation of the thoughts of well siblings and how they communicate with their ill siblings.
Bereavement
Authors: Portnoy Sara , Stubbs Di
Published: July 2012

No family in western society expects to bury a child. Adults expect to die before children, certainly before their own children or grandchildren. Yet every year 12 500 parents in the UK face the enormous grief of having a precious child die, and it is estimated that around 5000 children and young people experience the death of a sibling. This chapter will describe the impact of a child’s death on families, adults, and children, and will also consider theoretical concepts of grief and grieving, and describe some interventions that may help bereaved families. Although it can seem unimaginable at first, most children and their families will be able to cope with the death of a close family member, especially if the family can talk about what is happening and about their memories of the person who has died, if they can express their feelings and thoughts, and if they have the opportunity to meet others who have been bereaved.
Skin symptoms
Authors: Liang YiFan , Denyer Jacqueline
Published: July 2012

Caring for children with life-limiting skin disorders poses a challenge for all involved in their management. It is essential that all professionals involved are familiar with the disease process and the particular symptoms that may develop, in order to provide multidimensional care in accordance with the wishes of the child and their family. Most professionals who are working in paediatric palliative care encounter such primary life-limiting skin diseases relatively infrequently. Much more often they are faced with the need to manage symptoms in the skin that arise from other, more general systemic life-limiting conditions. The range of these is very wide. This chapter has provided an overview of the pathophysiology and management of some of the more common symptoms that may be manifested in the skin.
Palliative care for children with HIV/AIDS
Authors: Meiring Michelle , Albertyn Rene
Published: July 2012

Seven years into the rollout of ARV treatment in the South African public healthcare sector, my response to my colleague’s statement that ‘now that we have antiretrovirals, we don’t need palliative care’ is that we certainly do, and that antiretrovirals have helped us to provide this care. Given the scale of the epidemic, especially in sub-Saharan Africa, this secret that is ‘palliative care’ cannot be limited to the knowledge and skills set of the very few paediatric palliative care practitioners who exist in these regions. It is a ‘secret’ that needs to be incorporated into the practice of every healthcare professional, and especially the HIV clinician and their team. We need each other — the HIV team needs to keep abreast of developments in the treatment of this evolving disease, and the palliative care practitioner needs to keep abreast of developments in palliative medicine and pain control. Not only has HAART improved the lives of many children, but it has also improved clinicians’ understanding of palliative care. It is not all about death and dying — it is, in the paraphrased words of Dame Cicely Saunders, about ‘helping children and their families to live until they die.’ This chapter covers the role of paliative care in children infected and affected by HIV, the control of pain and other symptoms in paediatric HIV, psychosocial support, and terminal care of children with AIDS.
Infraclavicular Blockade
Authors: Wilson Jack L. , Jacob Adam K. , Smith Hugh M.
Published: July 2012

Infraclavicular blockade is best suited for patients undergoing surgery of the elbow, forearm, wrist, or hand. The following aspects of the procedure are reviewed: clinical applications, relevant anatomy, patient position, technique (including neural localization techniques, needle insertion site, and needle redirection cues), and side effects and complications. Use of ultrasound guidance and continuous nerve catheters is also reviewed.
Ankle Blockade
Authors: Jacob Adam K. , Hebl James R.
Published: July 2012

Ankle blockade is a safe, efficacious, and well-tolerated anesthetic for foot and ankle surgery The following aspects of the procedure are reviewed: clinical applications, relevant anatomy, patient position, technique (including neural localization techniques, needle insertion site, and needle redirection cues), and side effects and complications.
Doctor Dolittle Visits a Sitting Case
Authors: Munis James R.
Published: July 2012

Any acceptable model must explain why the cerebral circulation must be robust enough to contend with different head positions yet continues to work in weightless environments (ie, during space flight) and it must explain the clinical phenomenon of air embolism, which is what happens when air gets sucked into perforated veins or sinuses when the surgical site is above the heart. 2 models of the cerebral circulation: the first is a common-sense model that most of us would draw without having thought about it much; the second is a model that makes a lot more physical sense and answers the questions above in a way that the first model cannot. The main difference between these models is that the correct one takes into account the principle of the siphon, whereas the incorrect one does not. A siphon is any arrangement of fluid-filled tubing that excludes air and is open on both ends to allow flow. It happens that the cerebral circulation functions like a siphon.
What Goes Around Comes Around—Venous Return
Authors: Munis James R.
Published: July 2012

By its nature, circulatory physiology is also susceptible to circular reasoning because every part of an interconnected system is affected by, and affects, every other part. If we're not careful, we end up saying things like ‘venous return equals cardiac output’ when, in the steady state, that is true by definition and nothing new is gained. If we grant that right atrial pressure (PRA) is the ‘downstream’ pressure for venous return, then it follows that PRA should be inversely related to venous return (and therefore, to cardiac output). If we simply apply Ohm's law to the cardiovascular system, we forget that the mean arterial pressure not only contributes to venous return but also is sustained by venous return. If venous return fails for any other reason (unrelated to arterial pressure), so too will mean arterial pressure eventually fail.
A Breath of Fresh Air—Ventilation
Authors: Munis James R.
Published: July 2012

The sine qua non of ventilation is arterial carbon dioxide. If you want to know about ventilation, just check the PaCO2. If it is low or normal, ventilation is fine, regardless of any other parameter, including respiratory rate, tidal volume, or dead space ratio. However, if PaCO2 is high, then alveolar ventilation (VA) is impaired (relative to the carbon dioxide load being presented to the lungs). In a conventional breathing circuit, dead space ends at the Y-shaped junction of the inspiratory and expiratory arms of the circuit and the endotracheal tube. On the machine side of that junction, the inspiratory and expiratory limbs see only fresh inspired or expired gas, respectively, but not both. You should know 2 other things about ventilation. One is the Bohr equation, which estimates the ratio of dead space to tidal volume. The anatomic dead space is estimated as the expired volume that coincides with half maximal nitrogen content. The second thing is the effect of gravity on the distribution of ventilation within the lung.
Bird Brains and Bird Breath
Authors: Munis James R.
Published: July 2012

To begin with, the bird lung is invested with a series of hollow air channels, not dead-end alveoli. These air channels are connected to a network of thoracic air sacs. When the air sacs contract and relax in coordination, they force inspired air through the air channels in an almost continuous, unidirectional flow. The air channels contact the pulmonary vessels in an architectural array that looks suspiciously like a countercurrent exchange device. Countercurrent exchange also is engineered into blood infusion devices to rapidly warm intravenous fluid or blood for patients with extensive hemorrhage. Countercurrent exchange takes advantage of the concept that 2 media will exchange properties between themselves more efficiently if they are very close to each other and flowing in opposite directions. There is also crosscurrent exchange. In a crosscurrent arrangement, one material divides into multiple parallel branches, and each of these branches crosses over the other material at multiple points. Although crosscurrent exchange looks similar, it is not quite as efficient as countercurrent exchange. There was controversy about whether the bird lung used crosscurrent or countercurrent gas exchange.
Pharmacokinetics and Pharmacodynamics of Antimicrobials
Authors: Estes Lynn L.
Published: July 2012

Pharmacokinetics is the disposition of drugs in the body (how the body acts on the drug); it incorporates terms such as absorption,
bioavailability, distribution, protein binding,
metabolism, and elimination. Pharmacodynamics is the interaction between the drug concentration at the site of action over time (drug exposure) and the pharmacologic effect, which, in the case of antimicrobials, is eradication of microorganisms. Pharmacokinetics and pharmacodynamics are interrelated. Both need to be taken into account to optimize antimicrobial therapy.
Antimicrobials
Authors: Estes Lynn L. , Wilson John W.
Published: July 2012

Antimicrobials include the following agents: antibacterials (eg, penicillins, cephalosporins), antifungals (eg, acyclovir, amandtadine), antivirals (eg, azoles, polyenes), and antimycobacterials (eg, isoniazid, rifabutin). Specific agents, mechanisms of action, spectrums of activity, toxicities, and major routes of elimination are discussed for all antimicrobial classes.
Mycobacterial and Fungal Diagnostics
Authors: Binnicker Matthew J. , Roberts Glenn D. , Wengenack Nancy L.
Published: July 2012

This chapter reviews diagnostic methods and tests for identifying mycobacterial and fungal organisms. Diagnostic methods include direct examination, staining, culture, molecular identification, DNA sequencing, chromatography, polymerase chain reaction, and immunodiagnostics. Organisms reviewed include Mycobacterium tuberculosis, M kansasii, M marinum, M leprae, M avium, and other mycobacteria; Aspergillus spp; Histoplasma spp; Coccidioides spp; Blastomyces spp; Candida spp; Fusarium spp; Trichophyton spp; and other fungi.
Candida Species
Authors: Kusne Shimon , McCullough Ann E.
Published: July 2012

Candida are oval yeast that are 4 to 6 μ‎m in diameter. They reproduce by budding, usually producing pseudohyphae (budding yeast without full detachment of daughter cell). Identification is usually based on morphology and sugar assimilation. Of the species that are human pathogens the most common (over 60% of cases) is Candida albicans. Others include Candida dubliniensis, Candida glabrata, Candida parapsilosis, Candida tropicalis, Candida kefyr (formerly Candida
pseudotropicalis), Candida krusei, Candida
lusitaniae, and Candida guilliermondii. Disease manifestations and treatment are reviewed.
Pneumonia
Authors: Sampathkumar Priya
Published: July 2012

There are 2 basic types of pneumonia: community-acquired pneumonia and nosocomial pneumonia. Community-acquired pneumonia is an acute infection of the pulmonary parenchyma acquired while the patient was in the community rather than in a hospital. Older or immunosuppressed patients with CAP may present with nonrespiratory symptoms: confusion, failure to thrive, worsening of an underlying chronic illness, or falls. Nosocomial pneumonia: pneumonia that develops more than 48 hours after admission to a health care facility and which was not incubating at the time of admission. Prevention, diagnosis, and treatment are also reviewed.
Skin and Soft Tissue Infections
Authors: Tleyjeh Imad M , Baddour Larry M
Published: July 2012

Common skin and soft tissue infections covered in this chapter include impetigo, folliculitis, furuncles, carbuncles, cellulitis, and necrotizing fasciitis. Impetigo is a superficial pustular skin infection. Multiple lesions occur on exposed skin of the face and extremities. Staphylococcus aureus causes most cases. Folliculitis is a superficial skin infection of hair follicles. A furuncle is a purulent, painful nodular skin infection involving the hair follicle that is usually a complication of folliculitis. A carbuncle is a cluster of abscesses in subcutaneous tissue that drain through hair follicles. The prevailing pathogen for both furuncles and carbuncles is S aureus. Skin abscesses involve the dermis and deeper skin tissues. Often a pustule is present on the skin. For most cases the pathogen is S aureus. Cellulitis involves skin and subcutaneous tissues. Clinical manifestations of cellulitis include swelling, erythema, tenderness, and warmth. Necrotizing forms of cellulitis are necrotizing fasciitis types I and II. Clinical features include fulminant destruction of tissue and systemic toxicity.
Sexually Transmitted Diseases
Authors: Edson Randall S.
Published: July 2012

Sexually transmitted diseases (STDs) are a significant public health problem. The Centers for Disease Control and Prevention estimates that approximately 19 million new cases of STDs occur annually. Approximately half of all STDs occur in persons aged 15 to 24 years. Figures are clearly an underestimate of the true burden of STDs. Many cases are not diagnosed. Infections due to herpes simplex virus (HSV) and human papillomavirus are not reportable. Diagnosis and treatment of genital ulcer disease, syphilis, herpes simplex, canchroid, urethritits, gonorrhea, HPV, chlamydia, and other less-common sexually transmitted diseases are reviewed.
Human Immunodeficiency Virus Infection
Authors: Temesgen Zelalem
Published: July 2012

Human immunodeficiency virus (HIV) is a lentivirus, a member of the Retroviridae family (retroviruses). There are 2 genetically distinct types of HIV: HIV-1 and HIV-2

HIV-1 is further classified into subtypes, also known as clades. HIV-1 is the predominant HIV type globally. Donated blood has been screened for HIV-1 since 1985 in the United States. The following factors have been identified with transmission of HIV: sexual contact, perinatal infection, parenteral inoculation (eg, intravenous drug injection, occupational exposure), receipt of blood products, and receipt of donated organs or semen. The most common mode of transmission is sexual intercourse. Traumatic intercourse and ulcerative genital infections increase the risk of HIV transmission. The proper use of condoms greatly reduces the risk of HIV transmission. The diagnosis and treatment of HIV and AIDS are also reviewed.
Infections in Patients With Hematologic Malignancies
Authors: Wilson John W , Elliott Michelle A
Published: July 2012

The clinical approach to patients with hematologic malignancies and infection requires definition of several patient factors (immunologic competence [or defect], residential environment, and the syndrome), infection factors (its type, location, progress, and pathogen), and treatment factors (medical or surgical or both). Management of patients with hematologic malignancies and infection requires knowledge of general infectious diseases and factors pertaining to the hematologic malignancy, pathophysiology of the hematologic malignancy, types of antineoplastic chemotherapy used in treatment, and immunologic effects of both the malignancy and the associated chemotherapy, and complications and toxicities of both the malignancy and the associated chemotherapy. Diagnosis and treatment of specific infections are reviewed.
Travel Medicine
Authors: Virk Abinash
Published: July 2012

Travel between developing countries and developed countries is increasing every year. Approximately 880 million passengers arrived at international airports in 2009. The increase in travel to Africa has outpaced the increase for all other regions by almost twice, with the rate of growth reaching 8.1% in 2006. Asian and Pacific Rim countries continue to hold substantial travel interest. Travel to the Middle East has kept pace with travel growth despite the political instability there. More people are traveling to destinations that present higher risks of infectious diseases. Knowledge of prevention measures for preventable diseases becomes increasingly important. Management of posttravel illness becomes increasingly important. Subjects covered include preparation for travel, deep vein thrombosis prevention, motion sickness, jet lag, altitude sickness, vaccination and immunization, and traveler's diarrhea.
First Report of Southern Blight of Iresine herbstii Caused by Sclerotium rolfsii in Taiwan
Authors: Fu C. H. , Huang Y. P. , Lin F. Y.
Published: July 2012

Widely cultivated commercially, Iresine herbstii Hook is a potted herbaceous plant popular for its foliage, which varies from a dark red to brownish maroon. In the summer of 2010, a sudden wilt of I. herbstii plants was observed at a recreational farm in Taipei City in northern Taiwan. The initial symptoms were water-soaked lesions that became soft and then rotted. Necrotic areas on the stems were covered with fans of white mycelium as well as abundant spherical, brown sclerotia. A fungus was isolated from both infected tissue and sclerotia and maintained on potato dextrose agar (PDA) plates incubated at 25°C without light. Colonies were white and cottony, often forming mycelial fans. Pure cultures were prepared by transferring single hyphal tips to PDA. Sclerotia formed after 7 days. Sclerotia were initially white becoming dark brown with age and were 0.8 to 1 mm in diameter at maturity. These are typical features of Sclerotium rolfsii. Koch's postulates were performed by inoculating five healthy, potted I. herbstii plants with 10 fresh sclerotia placed on the soil surface around the base of each plant. In a second test, five healthy potted plants were inoculated with a single 10-mm-diameter mycelial agar plug placed at the stem base of each plant. Five noninoculated plants served as controls. All plants were incubated in a growth chamber at 25 to 35°C. Basal stem rot and wilt developed within 4 days on plants inoculated with sclerotia or mycelial plugs. All plants were dead by 7 days after inoculation whereas the controls remained healthy. The fungus was reisolated from the symptomatic tissue and produced sclerotia and mycelium consistent with S. rolfsii. To confirm identity of the causal fungus, the complete internal transcribed spacer (ITS) rDNA region of the causal fungus was amplified using the primers ITS4 and ITS5 (3) and sequenced. The resulting sequence of 687 bp was uploaded in NCBI (Accession No. JN543691.1). The sequence was 98% similar to sequences of Athelia rolfsii (anamoprh S. rolfsii). This disease has been observed on many species of plants (1, 2). To our knowledge, this is the first report of I. herbstii caused by S. rolfsii in Taiwan or any other part of the world.

References: (1) T. T. Chang. Bull. Taiwan For. Res. Inst. 9:191, 1994. (2) Y. N. Wang et al. J. Exp. For. Nat. Taiwan Univ. 20:45, 2006. (3) T. J. White et al. PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, 1990.
Microsporidian genome analysis reveals evolutionary strategies for obligate intracellular growth
Authors: Cuomo Christina A. , Desjardins Christopher A. , Bakowski Malina A. , Goldberg Jonathan , Ma Amy T. , Becnel James J. , Didier Elizabeth S. , Fan Lin , Heiman David I. , Levin Joshua Z. , Young Sarah , Zeng Qiandong , Troemel Emily R.
Published: July 2012

Microsporidia comprise a large phylum of obligate intracellular eukaryotes that are fungal-related parasites responsible for widespread disease, and here we address questions about microsporidia biology and evolution. We sequenced three microsporidian genomes from two species, Nematocida parisii and Nematocida sp1, which are natural pathogens of Caenorhabditis nematodes and provide model systems for studying microsporidian pathogenesis. We performed deep sequencing of transcripts from a time course of N. parisii infection. Examination of pathogen gene expression revealed compact transcripts and a dramatic takeover of host cells by Nematocida. We also performed phylogenomic analyses of Nematocida and other microsporidian genomes to refine microsporidian phylogeny and identify evolutionary events of gene loss, acquisition, and modification. In particular, we found that all microsporidia lost the tumor-suppressor gene retinoblastoma, which we speculate could accelerate the parasite cell cycle and increase the mutation rate. We also found that microsporidia acquired transporters that could import nucleosides to fuel rapid growth. In addition, microsporidian hexokinases gained secretion signal sequences, and in a functional assay these were sufficient to export proteins out of the cell; thus hexokinase may be targeted into the host cell to reprogram it toward biosynthesis. Similar molecular changes appear during formation of cancer cells and may be evolutionary strategies adopted independently by microsporidia to proliferate rapidly within host cells. Finally, analysis of genome polymorphisms revealed evidence for a sexual cycle that may provide genetic diversity to alleviate problems caused by clonal growth. Together these events may explain the emergence and success of these diverse intracellular parasites.
Partial migration in fishes: definitions, methodologies and taxonomic distribution
Authors: Chapman B. B. , Skov C. , Hulthén K. , Brodersen J. , Nilsson P. A. , Hansson L.‐A. , Brönmark C.
Published: July 2012

Partial migration, where populations are composed of both migratory and resident individuals, is extremely widespread across the animal kingdom. Researchers studying fish movements have long recognized that many fishes are partial migrants, however, no detailed taxonomic review has ever been published. In addition, previous work and synthesis has been hampered by a varied lexicon associated with this phenomenon in fishes. In this review, definitions and important concepts in partial migration research are discussed, and a classification system of the different forms of partial migration in fishes introduced. Next, a detailed taxonomic overview of partial migration in this group is considered. Finally, methodological approaches that ichthyologists can use to study this fascinating phenomenon are reviewed. Partial migration is more widespread amongst fishes than previously thought, and given the array of techniques available to fish biologists to study migratory variation the future of the field looks promising.
Identification of olfactory receptor genes in Atlantic salmon Salmo salar
Authors: Johnstone K. A. , Lubieniecki K. P. , Koop B. F. , Davidson W. S.
Published: July 2012

It has been hypothesized that salmonids use olfactory cues to return to their natal rivers and streams. The key components of the molecular pathways involved in imprinting and homing, however, are still unknown. Aquatic chemical cues are received through the nares and into the nasal cavity that contains a single olfactory organ, the olfactory rosette. The olfactory rosette contains sensory neurons, each of which is thought to express only one olfactory receptor. If odorants are involved in salmonid homing migration then olfactory receptors should play a critical role in the dissipation of information from the environment to the fish. Therefore, to understand the molecular basis for imprinting and homing in Atlantic salmon Salmo salar it is important to identify and characterize the repertoire of olfactory receptors in this species. The first public assembly of the S. salar genome was searched for genes encoding three of the superfamilies of fish olfactory receptors: V2R‐like (olfc), V1R‐like (ora) and main olfactory receptor (mor). A further six ora genes were added to ora1 and ora2, which had been described previously. In addition, 48 putative mors were identified, 24 of which appear to be functional based on their gene structures and predicted amino‐acid sequences. Phylogenetic analyses were then used to compare these S. salar olfactory receptor genes with those of zebrafish Danio rerio, two pufferfish species Takifugu rubripes and Tetraodon nigroviridis, medaka Oryzias latipes and three‐spined stickleback Gasterosteus aculeatus.
Quantitative methods for analysing cumulative effects on fish migration success: a review
Authors: Johnson J. E. , Patterson D. A. , Martins E. G. , Cooke S. J. , Hinch S. G.
Published: July 2012

It is often recognized, but seldom addressed, that a quantitative assessment of the cumulative effects, both additive and non‐additive, of multiple stressors on fish survival would provide a more realistic representation of the factors that influence fish migration. This review presents a compilation of analytical methods applied to a well‐studied fish migration, a more general review of quantitative multivariable methods, and a synthesis on how to apply new analytical techniques in fish migration studies. A compilation of adult migration papers from Fraser River sockeye salmon Oncorhynchus nerka revealed a limited number of multivariable methods being applied and the sub‐optimal reliance on univariable methods for multivariable problems. The literature review of fisheries science, general biology and medicine identified a large number of alternative methods for dealing with cumulative effects, with a limited number of techniques being used in fish migration studies. An evaluation of the different methods revealed that certain classes of multivariable analyses will probably prove useful in future assessments of cumulative effects on fish migration. This overview and evaluation of quantitative methods gathered from the disparate fields should serve as a primer for anyone seeking to quantify cumulative effects on fish migration survival.
Abrupt decrease in serum testosterone levels after an oral glucose load in men: implications for screening for hypogonadism
Authors: Caronia Lisa M. , Dwyer Andrew A. , Hayden Douglas , Amati Francesca , Pitteloud Nelly , Hayes Frances J.
Published: July 2012

Objective

This study examines the physiological impact of a glucose load on serum testosterone (T) levels in men with varying glucose tolerance (GT).

Design

Cross‐sectional study.

Patients and Methods

74 men (19–74 years, mean 51·4 ± 1·4 years) underwent a standard 75‐g oral glucose tolerance test with blood sampling at 0, 30, 60, 90 and 120 min. Fasting serum glucose, insulin, total T (and calculated free T), LH, SHBG, leptin and cortisol were measured.

Results

57% of the men had normal GT, 30% had impaired GT and 13% had newly diagnosed type 2 diabetes. Glucose ingestion was associated with a 25% decrease in mean T levels (delta = −4·2 ± 0·3 nm, P < 0·0001). T levels remained suppressed at 120 min compared with baseline (13·7 ± 0·6 vs 16·5 ± 0·7 nm, P < 0·0001) and did not differ across GT or BMI. Of the 66 men with normal T levels at baseline, 10 (15%) had levels that decreased to the hypogonadal range (<9·7 nm) at one or more time points. SHBG, LH and cortisol levels were unchanged. Leptin levels decreased from baseline at all time points (P < 0·0001).

Conclusions

Glucose ingestion induces a significant reduction in total and free T levels in men, which is similar across the spectrum of glucose tolerance. This decrease in T appears to be because of a direct testicular defect, but the absence of compensatory changes in LH suggests an additional central component. Men found to have low nonfasting T levels should be re‐evaluated in the fasting state.
The effect of weight loss magnitude on pro‐/anti‐inflammatory adipokines and carotid intima–media thickness in obese adolescents engaged in interdisciplinary weight loss therapy
Authors: Masquio Deborah C. L. , de Piano Aline , Sanches Priscila L. , Corgosinho Flávia C. , Campos Raquel M. S. , Carnier June , da Silva Patrícia L. , Caranti Danielle A. , Tock Lian , Oyama Lila M. , Oller do Nascimento Claudia M. , de Mello Marco T. , Tufik Sergio , Dâmaso Ana R.
Published: July 2012

Background

Obesity is a chronic disease defined by an excess amount of adipose tissue and presents a low‐grade inflammatory state, increasing cardiovascular risk.

Objective

To assess the effect of weight loss magnitude on the inflammatory profile and carotid intima–media thickness (cIMT) in obese adolescents engaged in interdisciplinary therapy.

Design and patients

Seventy‐seven postpubertal obese adolescents with a BMI greater than the 95th percentile (37·18 ± 5·14), of both genders and between the ages of 14 and 19 years (16·74 ± 1·59) were subjected to a 1‐year period of interdisciplinary intervention (nutrition, psychology, physical exercise and clinical support).

Measurements

Blood samples were collected to analyse glucose, lipid and adipokine concentrations. Body composition, anthropometric profiles and cIMT were measured. The results are presented according to quartiles of weight loss: 1st (≤5·80 kg) = low; 2nd (5·80–10·90 kg) = low to moderate; 3rd (10·90–15·90 kg) = moderate; and 4th (>15·90 kg) = massive.

Results

Leptin, the leptin/adiponectin ratio and plasminogen activator inhibitor 1 (PAI‐1) were decreased significantly in the low‐to‐moderate weight loss. The cIMT was reduced in the moderate weight loss. Moreover, adiponectin was increased only in the massive weight loss. Additionally, weight loss was an independent predictor of changes in leptin level, the adiponectin/leptin ratio (A/L ratio) and PAI‐1 when the data were adjusted for age and gender. BMI changes were predictors of changes in leptin and PAI‐1 levels. A/L ratio was associated with lean body mass (%), independent of gender and age. In addition, changes in A/L ratio were independent predictors of cIMT alterations.

Conclusions

Interdisciplinary therapy may reduce cardiovascular risk factors among adolescents depending on their degree of weight loss (moderate to massive) and when correlated with their inflammatory profile, metabolic state and cIMT.
The positive impact of cytological specimens for EGFR mutation testing in non‐small cell lung cancer: a single South East Asian laboratory’s analysis of 670 cases
Authors: Pang B. , Matthias D. , Ong C. W. , Dhewar A. N. , Gupta S. , Lim G. L. , Nga M. E. , Seet J. E. , Qasim A. , Chin T. M. , Soo R. , Soong R. , Salto‐Tellez M.
Published: July 2012

B. Pang, D. Matthias, C.W. Ong, A.N. Dhewar, S. Gupta, G.L. Lim, M.‐E. Nga, J.E. Seet, A. Qasim, T.‐M. Chin, R. Soo, R. Soong and M. Salto‐Tellez

The positive impact of cytological specimens for EGFR mutation testing in non‐small cell lung cancer: a single South East Asian laboratory’s analysis of 670 cases

Objectives:  To compare the rejection rates of non‐small cell lung cancer (NSCLC) samples obtained by differing sampling methods for testing by Sanger sequencing for epidermal growth factor receptor (EGFR) mutations. To assess the association between unsatisfactory outcomes and the quantity of DNA extracted from cytological versus histological samples.

Methods:  Six hundred and seventy NSCLC samples referred to our centre from 2008 to 2010 were reviewed as a consequence of sample rejection, presence of EGFR mutations, cytological versus histological sampling methods, DNA quantity and the unsatisfactory genotyping rate.

Results:  Eighty samples were rejected for testing in similar proportions of histological and cytological samples (11.9% versus 10.9%) usually (n = 75) because the amount of cellular material was judged insufficient in small biopsies or cytology samples. The remaining 590 samples on which EGFR testing was attempted yielded 51 (8.6%) unsatisfactory test outcomes caused by failure of the polymerase chain reaction (PCR) (n = 47 cases), uninterpretable Sanger chromatograms (n = 3 cases) and insufficient DNA extracted for PCR (n = 1 case). The difference in rates of unsatisfactory outcomes between cytological samples (seven of 147 samples or 4.7%) versus tissue samples (44 of 443 samples or 9.9%) was clinically relevant but not statistically significant (Mann–Whitney test; P < 0.081). There was no association between the concentration of DNA extracted and the likelihood of an unsatisfactory analysis; which was similar in all types of sections (large and small) while 0% of 37 cytology slides were unsatisfactory.

Conclusions:  Utilizing cytology samples for EGFR testing avoids unnecessary patient re‐biopsing and yields a clinically superior satisfactory rate to the overall satisfactory rate of tissue biopsies of NSCLC. The quality rather than quantity of DNA extracted may be a more important determinant of a satisfactory result.