bluuebunny/crossref_metadata_2025 huggingface dataset:
Infection in transplant patients
Authors: Razonable Raymund R.
Published: January 2022

This chapter focuses on infection in transplant patients. Infections are common complications of organ, tissue, and stem cell transplantation. Whether it is due to a bacterium, virus, fungus, or parasite, the clinical disease caused by any of these pathogens is often severe, leading to increased morbidity and potential mortality. Several factors inherent to the transplant recipient or related to the donor, the environment, and circumstances surrounding the transplant procedure (such as surgical techniques and immunosuppressive drugs) increase the risk of infectious complications. Depending on risk profiles of transplant recipients, some infections are predictable and preventable while others remain unexpected. Generally, the overall risk of infection after transplantation is determined by epidemiologic exposures of the donor and recipient and the overall net state of immunosuppression.
Diabetes and infection
Authors: Shaw Sylvia J. , Iqbal Raza
Published: January 2022

This chapter looks at infection in diabetic patients. Diabetes is a metabolic and vascular disease; both microvascular and macrovascular complications are related to blood glucose control and disease duration and are more commonly seen in the elderly. Diabetic patients have increased risk for infections and are accountable for 50% of hospital admission or outpatient visits. Respiratory and foot infections are overrepresented and have increased risk of infection-related mortality. Mild infections without systemic symptoms can be treated with oral antibiotics. Because patients with diabetes mellitus have a high incidence of chronic kidney disease, adjustment of the antibiotic dose based on renal function is imperative. Indeed, drug interaction and toxicity should always be considered prior to therapy since these patients are frequently on multiple medications.
Infectious complications in the injection and non-injection drug user
Authors: Contoreggi Carlo
Published: January 2022

This chapter introduces drug abuse as a widespread public health problem with several medical complications that are infectious due to the transmission of blood-borne, environmental, and respiratory infectious agents. An ongoing opioid epidemic has changed the face of addiction in the United States and Canada and resulted in many publications about medical complications associated with substance abuse. Non-injection and injecting drug users (DUs/IDUs) are less likely to access care and maintain adherence for optimal benefit due to social and access factors related to criminalization and economic status. Endocarditis has emerged as the most serious infectious complication in the injection user. The chapter highlights complications due to intravenous drug use that include pneumonia, aspiration pneumonitis, lung abscess, and septic pulmonary emboli.
Infections in the alcoholic
Authors: Preheim Laurel C. , Velagapudi Manasa
Published: January 2022

This chapter focuses on alcohol use disorders (AUDs). Approximately 18 million adults in the United States meet the criteria for AUD. The authors point out that patients with AUD have an increased susceptibility to bacterial infections such as pneumonia, tuberculosis, peritonitis, and bacteremia, and individuals with AUD are more likely to develop viral hepatitis and HIV disease. The chapter explains how alcohol consumption can alter microbial communities of the gastrointestinal tract and the respiratory tree, including the oropharynx, mainstem bronchus, and lower bronchoalveolar spaces. The authors suggests that the immunotoxic effects of ethanol are caused by direct cytotoxicity and by a shift in the balance of cytokines produced from the pro-inflammatory to more immunoinhibitory products.
Pregnancy and the puerperium
Authors: Istùriz Raùl E. , Murillo Jorge
Published: January 2022

This chapter investigates infectious diseases that occur during pregnancy and the puerperium that pose special risks to the mother, fetus, and infant. It looks at the recommendation for pregnant women to culture urine at the first prenatal visit. It also reviews antimicrobial therapy that are usually effective in eradicating asymptomatic bacteriuria and mentions penicillins, cephalosporins, aztreonam, ertapenem, imipenem, and meropenem that are considered safe for pregnant women. The chapter looks at suppressive therapy until delivery that is suggested for women who have persistent bacteriuria after two or more courses of therapy. It highlights acute cystitis, in which pyuria is found in most patients and requires the performance of urine culture.
Asplenia-associated Infections
Authors: Lutwick Larry I.
Published: January 2022

This chapter discusses the human spleen as an organ that, at one point, was deemed as nonessential as the appendix and has been associated in history as the source of melancholy thoughts. The chapter reviews overwhelming postsplenectomy infection (OPSI) or postsplenectomy sepsis (PSS) as one of a group of infectious disease processes for which diagnosis and therapeutic intervention are required immediately to minimize disease impact. It also analyzes how the individual risk of OPSI depends on the cause of splenectomy as well as the time post procedure. The chapter looks at asplenic conditions that have a lower risk of OPSI, and points out that 5% to 6% of total OPSI cases occur in individuals with poorly functioning spleens.
HIV infection
Authors: Glatt Aaron E. , Sciberras Andréa , Weiss Steven M.
Published: January 2022

This chapter focuses on infection with human immunodeficiency virus (HIV), which can be devastating news to newly diagnosed patients. It considers how HIV is now considered a chronic disease process, and that those infected and treated can expect a relatively normal life and life expectancy. It also mentions that more than 36 million people worldwide, and more than 1 million in the United States are living with HIV infection. The chapter reviews how the Centers for Disease Control and Prevention (CDC) and US Preventive Services Task Force (USPSTF) made a Grade A recommendation to screen all patients aged 8 to 65 years for HIV in 2006. It describes the primary care physicians who are tasked to take care of a growing population of newly identified, relatively asymptomatic HIV patients and adhere to the latest recommendations for early treatment and prevention of transmission.
HIV
Authors: Brotherton Amy L. , Garland Joseph M.
Published: January 2022

This chapter recounts the syndrome now known as acquired immune deficiency syndrome (AIDS), which was first described in 1981 through a case series of five young gay men in Los Angeles who were diagnosed with Pneumocystis carinii pneumonia. It provides a brief overview of HIV replication along with a more detailed review of the currently approved antiretroviral therapy (ART) medications and classes. It also highlights the use of ART in the setting of a variety of host and viral characteristics. The chapter discusses the immune reconstitution inflammatory syndrome (IRIS) and analyzes the HIV viral replication cycle, which led to the identification of unique drug targets specific to the HIV virus. It looks at current ART medications that inhibit entry of virus into host cells and reverse transcription of viral DNA from an RNA template.
Prophylaxis of opportunistic infections in HIV disease
Authors: Manning Brandi , Bettiker Robert L. , Jacobson Jeffrey M.
Published: January 2022

This chapter explores the AIDS epidemic, which presents severe manifestations of various opportunistic infections (OIs) in hosts whose immune systems were compromised. It describes how individuals with AIDS succumbed to pneumocystic pneumonia, toxoplasmosis, disseminated mycobacterium, and several other OIs and malignancies. It explains how HIV-positive persons can be largely unaffected by OI when they remain well-adherent to antiretroviral therapy (ART). The chapter mentions barriers to care and medication adherence that allow HIV to progress, leaving patients susceptible to OI. It focuses on prophylaxis for OI in HIV-positive patients as an important topic and cornerstone of providing care for this patient population.
Transfusion-related infection
Authors: Jarvis William R. , Roth Virginia R.
Published: January 2022

This chapter focuses on bacterial complications of blood transfusion that can be diagnosed and treated. The transfusion of blood and blood components is associated with a very low but ever-present risk of infection, and it is estimated that the possibility exists that 1 in every 2,000 units of blood carries an infectious agent and that about 4 in 10,000 recipients develop a chronic disease or die as a result of receiving contaminated blood. The chapter analyzes the wide variety of viral, bacterial, and parasitic agents that have been associated with blood transfusion. It highlights concerns about the potential for transmission of Creutzfeldt–Jakob disease (CJD) and its new variant (vCJD) through blood products.
Postoperative wound infection
Authors: Dellinger E. Patchen
Published: January 2022

This chapter concentrates on postoperative wound infection or surgical site infection (SSI) as the archetypal surgical infection because it follows a surgical procedure and requires surgical intervention for resolution. It analyzes the density of bacterial contamination of the incision as the most obvious factor influencing the risk of infection. It also mentions the wound classification system that divides all surgical wounds into four categories: clean, clean-contaminated, contaminated, and dirty. The chapter emphasizes how infection risk ranges historically, before modern understanding and practice of perioperative antibiotic prophylaxis. It looks at studies done to demonstrate that all surgical incisions, even in clean operations, have some bacteria in the wound at the end of the procedure.
Trauma-related infection
Authors: Malangoni Mark A.
Published: January 2022

This chapter talks about infection as a serious complication of trauma among patients who have a greater severity of injury or suboptimal host defenses. It explains how injury patients who die later often succumb to infectious complications or their consequences, although exsanguination and central nervous system injury are the most common causes of mortality in the first 48 hours following injury. It also analyzes trauma-related infection that represents either infection at an original site of injury or infection that occurs as a direct result of injury. The chapter discusses infected laceration or osteomyelitis at the site of an open fracture. It describes empyema after a penetrating wound to the chest and an intra-abdominal abscess that follows repair of a gunshot wound to the colon.
Infection in the burn-injured patient
Authors: Yurt Roger W. , Magaña Rafael Gerardo
Published: January 2022

This chapter discusses the diagnosis of infection in the patient with major burn injury that is especially problematic because the signs of infection are the same as those of the response to injury. It explains tissue injury that occurs with a major burn and the associated inflammatory response to it, which causes one of the greatest perturbations of homeostasis that occurs in any disease state. It also examines the greatest challenge in developing a differential diagnosis in the burn-injured patient, which is to distinguish between the injury state and infection. The chapter explains how the manifestation of infection may be blunted by diminished immune response that further complicates evaluation of the patient while also contributing to an increased susceptibility to infection. It looks at the challenges posed in the clinical and laboratory evaluation of the burn-injured patient that is summarized in the outline of injury-related changes.
Surgical prophylaxis
Authors: Trinh Sonya , Pankey George A.
Published: January 2022

This chapter discusses surgical site infections (SSIs) as those related to operative procedures involving the incision site or surrounding tissues and organs. It emphasizes how SSIs increase direct and indirect healthcare costs related to prolonged hospital stays, emergency room visits, readmissions for treatment, and repeat surgical procedures. It talks about the estimated 95 million operative procedures that are performed annually in ambulatory settings and hospitals in the United States. The chapter analyzes SSIs of the incision that surrounds tissues or organs and that occur within 90 days of an operative procedure. It highlights the National Healthcare Safety Network's classification system for SSIs, which includes superficial incisional, deep incisional, and organ or space SSI.
Systemic infection from animals
Authors: Weber David J. , Juliano Jonathan J. , Rutala William A.
Published: January 2022

This chapter focuses on zoonoses that are defined as diseases and infections that are transmitted between vertebrate animals and humans. It analyzes how zoonotic diseases can be transmitted to humans through bites and scratches, direct contact, aerosols, arthropod vectors, or contamination of food or water. It also outlines reasons for the increased impact of zoonotics in current times as contact with domestic animals continues to be frequent, even in urban centers. The chapter concentrates on pets as a major reservoir and source of zoonoses, citing that 62 percent of US households, or approximately 72.9 million total households owned a pet from 2011 to 2012. It looks at recent factors that had substantial impact on the emergence of zoonotics, such as human encroachment on wildlife habitat, wildlife trade and translocation, the ownership of exotic pets, petting zoos, and ecotourism.
Travelers’ diarrhea
Authors: Vigil Karen J. , DuPont Herbert L.
Published: January 2022

This chapter provides details on diarrhea as the most frequent health problem encountered by persons going from industrialized to developing countries. It discusses travelers' diarrhea (TD), which is defined as the passage of three or more unformed stools within 24 hours that is associated with nausea, vomiting, abdominal pain or cramps, fever, fecal urgency, tenesmus, or the passage of bloody or mucoid stools. It also looks at cases of TD that can be categorized by severity as being mild or severe. The chapter explains the possible etiologies of persistent diarrhea that include intestinal infection by protozoal parasites, such as giardiasis or cryptosporidiosis. It analyzes postinfectious irritable bowel syndrome, which is recognized as a complication of bacterial enteric infection that has been shown to occur in as many as 10 percent of people after an episode of TD.
Actinomycosis
Authors: Russo Thomas A. , Trivedi Grishma R.
Published: January 2022

This chapter focuses on actinomycosis, an indolent, slowly progressive infectious syndrome caused by anaerobic or microaerophilic bacteria. Actinomyces israelii, A. naeslundii, A. odontolyticus, A. viscosus, A. meyeri, and A. gerencseriae are common causes of infection. Infections caused by A. neuii is being increasingly recognized. The chapter looks at advances in microbiologic taxonomy through genotypic methods that led to the identification of many new Actinomyces species from both human and animal specimens. It emphasizes how most actinomycotic infections are polymicrobial in nature, where “companion organisms” are commonly co-isolated with the agents of actinomycosis in various combinations depending on the site of the infection.
Anaerobic infections
Authors: Brook Itzhak
Published: January 2022

This chapter highlights infections caused by anaerobic bacteria that occur frequently and can be serious and life-threatening. anaerobes are endogenous in nature; they colonize the skin and are the main component of mucous membranes flora. The author investigates why anaerobes are difficult to isolate and are often unrecognized, and he points out why delaying appropriate therapy may lead to clinical failures. The chapter discusses the isolation of anaerobes, which requires proper methods of collection, transportation, and cultivation of specimens. It describes the treatment for anaerobes that is complicated by the slow in vitro growth, the infection's polymicrobial nature, and the organisms' mounting antimicrobial resistance.
Anthrax
Authors: Zangeneh Tirdad T. , Traeger Marc , Klotz Stephen A.
Published: January 2022

This chapter describes anthrax as a disease caused by the gram-positive, aerobic bacterium Bacillus anthracis, which was recognized in antiquity. Anthrax figures prominently in the history of modern medicine because it was the first bacterial illness for which successful vaccines were prepared by William Smith Greenfield in London and Louis Pasteur in Paris. Anthrax is a zoonosis of herbivores encountered worldwide, and human cases continue to be seen in southern Europe, Eurasia, south Asia, and sub-Saharan Africa. Grazing wild ruminants and cattle are very susceptible to anthrax, and human disease in animal husbandmen and herders is closely tied to exposure to infected beasts. The chapter analyzes reports of some areas of rural Kenya in which a substantial percentage of herdsmen are serologically positive for B. anthracis.
Brucellosis
Authors: Carrillo Carlo , Gotuzzo Eduardo
Published: January 2022

This chapter focuses on brucellosis as a zoonotic disease found in Latin America, Mediterranean countries, and Arabian countries. It points out how the number of cases of brucellosis dropped from 6,147 in 1947 to 104 in 1991 with modern bovine brucellosis eradication, mainly by pasteurization of milk or dairy products. It also looks at cases of brucellosis in the United States that are related to occupational exposure to Brucella abortus. The chapter discusses Brucella melitensis as the pathogen responsible for severe clinical patterns and chronic forms due to the ingestion of unpasteurized dairy products in Texas and Florida. It explains brucellosis as one of the most protean diseases, which can be divided it into three forms: Acute brucellosis, Subacute brucellosis, and Chronic brucellosis.
Neisseria gonorrhoeae
Authors: Mathers Amy J. , Rein Michael F.
Published: January 2022

This chapter analyzes Neisseria gonorrhoeae, which reportedly caused 583,405 infections in the United States in 2018, an increase of 63% since 2014. Gonococci attach primarily to columnar or cuboidal epithelial cells via pili and outer membrane proteins; the gonococcus penetrates between and through the cells to submucosal areas, where it elicits a neutrophilic host response. This chapter investigates the clinical spectrum of primary infection with N. gonorrhoeae, which mirrors that of Chlamydia trachomatis. The authors also discuss acute urethritis, which manifests as some combination of urethral discharge and dysuria and is known as the most common presentation of gonococcal disease in men.
Meningococcus and miscellaneous neisseriae
Authors: Lau Chuen-Yen , Tramont Edmund C.
Published: January 2022

This chapter focuses on meningococcal infection, which was first recognized over two centuries ago as epidemic cerebrospinal fever. It explains how meningococcal infection occurs worldwide as endemic sporadic cases that have the potential to spread and expand into an epidemic. It also investigates the transmission of meningococcal infection that occurs from person to person by direct contact with colonized respiratory secretions or airborne droplets with subsequent colonization of the nasopharynx. The chapter mentions nasopharyngeal carriage that approximates 5 to 15 percent in non-epidemic periods but may approach 50 to 95 percent during epidemics. It explains how nasopharyngeal carriage rate is increased when there is crowding or close personal contact, such as in military barracks, dormitories, prisons, convocations, and indoor sporting events.
Listeria
Authors: Lorber Bennett
Published: January 2022

This chapter discusses Listeria monocytogenes, an infrequent cause of illness in the general population. By contrast, L. monocytogenes is an important cause of life-threatening bacteremia and meningoencephalitis in certain groups, including neonates, pregnant women, elderly persons, and those with impaired cell-mediated immunity, whether due to underlying disease or immunosuppressive therapy. More recently, following several lethal foodborne epidemics, there has been increased interest in food safety as it pertains to L. monocytogenes, a small, facultatively anaerobic, nonsporulating, catalase-positive, oxidase-negative, gram-positive rod. The chapter discusses the testing, evaluation, and treatment of patients infected by L. monocytogenes, as well as prevention measures.
Pseudomonas, stenotrophomonas, and burkholderia
Authors: Daniels Titus L.
Published: January 2022

This chapter discusses Pasteurella multocida, a nonmotile, gram-negative, facultative coccobacillus that is best known for its association with soft-tissue infections after animal bites. It points out that P. multocida is an opportunistic pathogen capable of causing invasive and life-threatening infections. It also mentions Louis Pasteur, who first isolated P. multocida as the causative agent of fowl cholera in 1880. The chapter explains the human infection of P. multocida that is usually associated with animal exposure and direct traumatic inoculation by a bite or scratch as the most common route of transmission. It analyzes the infection of P. multocida after contact with animal respiratory secretions through licks, nuzzling, or grooming.
Salmonella
Authors: Ribner Bruce S.
Published: January 2022

This chapter describes the salmonellae as the gram-negative, non-spore-forming, facultatively anaerobic bacteria in the family Enterobacteriaceae. It mentions different serotypes of Salmonella that are widely distributed in nature and found in the gastrointestinal (GI) tracts of the hosts with which they are associated. It also looks at Salmonella typhi and Salmonella paratyphi that are found to colonize only the human GI tract. The chapter discusses other Salmonella serotypes, such as Salmonella typhimurium that have a wide range of hosts, and Salmonella dublin and Salmonella Arizona that are rarely found in the GI tracts of humans. It investigates the infections caused by the salmonellae that are grouped into three major syndromes: gastroenteritis, typhoid or enteric fever, and localized infection outside of the GI tract.
Streptococcus groups A, B, C, D, and G
Authors: Stevens Dennis L. , Mebane J. Anthony , Madaras-Kelly Karl
Published: January 2022

This chapter explores how Lancefield divided streptococci into groups based on carbohydrates present in the cell wall and designated the groups A through H and K through T. It discusses the classification of streptococci according to their characteristics on culture on sheep blood agar. It also mentions β‎-Hemolytic streptococci that produce zones of clear hemolysis around each colony and α‎-hemolytic streptococci that produce a green discoloration characteristic of incomplete hemolysis. The chapter includes Streptococcus pyogenes, which is the sole member of Lancefield group A, and Streptococcus agalactiae, which colonizes the vagina, gastrointestinal tract, and occasionally the upper respiratory tract of normal humans. It analyzes Groups C and G streptococci that may be isolated from the throats of both humans and dogs.
Nontuberculous mycobacteria
Authors: Aksamit Timothy , Griffith David E.
Published: January 2022

This chapter focuses on nontuberculous mycobacteria (NTM), organisms that are ubiquitous in the environment and are thus referred as “environmental mycobacteria” by some experts. Mycobacterium avium complex (MAC), which includes M. kansasii, M. fortuitum, and M. abscessus, is the most common NTM associated with human disease in the United States. It also Although NTM species rarely cause clinically relevant human disease, they are frequently isolated as specimen contaminants. The chapter describes infection that is thought to occur from environmental exposure to the NTM through three potential portals of entry: the respiratory tract, the gastrointestinal tract, and direct inoculation of the skin and soft tissues, although chronic pulmonary disease is the most common clinical manifestation of NTM infection in the immunocompetent host. The chapter discusses the testing, evaluation, and treatment of patients infected by NTM and MAC.
Lyme disease
Authors: Evans Janine
Published: January 2022

This chapter focuses on Lyme disease, a systemic illness caused by the spirochete Borrelia burgdorferi, considered the most common tick-borne disease in the United States. Since the original discovery of Lyme arthritis in the mid 1970s, the clinical spectrum of Lyme disease has been expanded to include a wide variety of organ systems, primarily the skin, joints, nervous system, and heart. The chapter emphasizes Lyme disease’s protean symptoms, the uncertainty of diagnosis due to lack of definitive testing methods, and the public fear of late sequelae of disease, all of which often lead to overdiagnosis and overtreatment. The chapter promotes a better understanding of the natural history, epidemiology, and pathogenesis of Lyme disease, which can help in the often confusing and difficult decisions related to diagnosis and treatment.
Chlamydia pneumoniae
Authors: Hammerschlag Margaret R.
Published: January 2022

This chapter examines discusses C. pneumoniae as a common human respiratory pathogen that has an uncertain mode of transmission and involves infected respiratory tract secretions. It also looks at reports on the spread of C. pneumoniae within families and enclosed populations, such as military recruits, prisons, and nursing homes. The chapter analyzes the proportion of community-acquired pneumonia in children and adults associated with C. pneumoniae infection, which has ranged from 0% to less than 44%, varying with geographic location, the age group examined, and the diagnostic methods used. It explores recent studies that use culture and/or polymerase chain reaction, which found similarities in the prevalence of C. pneumoniae infection in children beyond early infancy and adults.
Chlamydophila psittaci (psittacosis)
Authors: Marrie Thomas J.
Published: January 2022

Ritter provided the first description of a respiratory illness following exposure to a sick parrot in 1879. In 1892, Morange named the disease “psittacosis,” from the word “parrot” in Greek, after an outbreak of respiratory illness in that year. investigators in the United Kingdom, the United States, and Germany isolated the causative agent of the respiratory illness, which eventually was named Chlamydia psittaci in 1930. The Chlamydiae are a gram-negative obligate intracellular bacterial pathogens, and the phylum includes two genera: Chlamydia and Chlamydophila. This chapter investigates several species of Chlamydophila, such as C. pecorum, C. pneumoniae, C. psittaci; C. abortus, C. caviae, and C. felis. It analyzes how psittacosis manifests in birds as anorexia, apathy, ocular and nasal discharge, diarrhea, and conjunctivitis.
Aspergillus
Authors: Levitz Stuart M. , Ram Sanjay
Published: January 2022

This chapter covers Aspergillus, which is readily isolated from environmental samples of soil, water, and air worldwide. It discusses Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger, and Aspergillus terreus as the most common species that cause human disease. It also mentions how Aspergillosis follows exposure of a susceptible host to the ubiquitous conidia or spores, which germinates it to form hyphae, the invasive form of the fungus. The chapter examines Aspergillus hyphae that average 2 to 4 μ‎m in diameter and are septate, with dichotomous Y-shaped branching. It explores the spectrum of diseases caused by the aspergilli, which is wide and profoundly influenced by the underlying immune status of the host.
Dengue
Authors: Hung Nguyen Thanh
Published: January 2022

This chapter focuses on dengue, which is caused by closely related viruses, or serotypes that belong to the genus Flavivirus, family Flaviviridae. It explains how dengue is transmitted between people by the mosquitoes Aedes aegypti and Aedes albopictus, which are found throughout the world. It also mentions the dramatic increase in the global incidence of dengue virus infections in the last 50 years. The chapter discusses dengue virus infections that may cause symptomatic infections or asymptomatic seroconversion, which has a wide range of clinical presentations that includes severe and nonsevere manifestations. It looks at two major pathophysiological features that are associated with severe dengue infection: plasma leakage leading to hypovolemic shock and abnormal hemostasis leading to hemorrhage.
Varicella-zoster virus
Authors: Weinberg Jeffrey M.
Published: January 2022

This chapter focuses on the varicella-zoster virus (VZV), a member of the herpesviruses family and the etiologic agent of varicella and varicella-zoster. Varicella is the exanthem caused by primary infection with VZV, and shingles is the clinical syndrome of segmental, unilateral exanthem and neuralgic pain due to reactivation of latent VZV infection. Both primary and reactivated VZV infection can lead to severe generalized virus dissemination in an immunodeficient person. The chapter discusses the availability of antiviral agents for management of VZV infection, which has raised the importance of recognizing this infection in high-risk groups. It analyzes the association between aging and VZV vulnerability that is apparent in the epidemiology of the disease.
Schistosomes and other trematodes
Authors: Maguire James H.
Published: January 2022

This chapter investigates trematode flatworms that infect human beings. These include the schistosomes that live in venules of the gastrointestinal or genitourinary tract and other flukes that inhabit the bile ducts, intestines, or bronchi. It examines the geographic distribution of each species of trematode, which parallels the distribution of the specific freshwater snail that serves as its intermediate host. Schistosomes infect approximately 235 million persons worldwide, although infections caused by other flukes are more limited in distribution and number. Trematode infections may persist for years and are mostly subclinical. In patient presenting with nonspecific gastrointestinal complaints and a history of contact with possibly infested fresh water in an endemic area should prompt an evaluation for schistosomiasis, even in the absence of symptoms.
Tapeworms (cestodes)
Authors: Pawlowski Zbigniew S.
Published: January 2022

This chapter discusses cestodes that cause intestinal or tissue parasitoses. The intestinal tapeworms are meat- and fecal-borne parasites. Tissue infections with larval cestodes are acquired mainly through ingestion of tapeworm eggs found in human, dog, or fox feces. Taenia saginata, the beef tapeworm, may grow to 5 meters in length and live for up to 30 years in the small intestine of its human host. Humans may also be infected by ingestion of cysticercus, a bladder worm that is less than 1 cm in diameter and is present in raw or undercooked beef. The chapter details the testing, evaluation, and treatment of patients presenting with cestode infection and discusses methods of control and prevention.
Trypanosomes and leishmania
Authors: de Sousa Anastacio , Jeronimo Selma M. B. , Pearson Richard
Published: January 2022

American trypanosomiasis or Chagas disease, human African trypanosomiasis (HAT) or sleeping sickness, and leishmaniasis three diseases caused by related protozoa of the family Trypanosomatidae. The chapter examines the unique mitochondrial structure of these pathogens, the kinetoplast, which are transmitted in nature by insect vectors and exist in multiple morphologic forms in human hosts. Chagas disease, sleeping sickness, and leishmaniasis are important causes of morbidity and mortality in endemic areas of the world; Chagas disease in South and Central America, sleeping sickness in sub-Saharan Africa, and leishmaniasis in scattered areas on every continent except Antarctica.
Probiotics: an update
Authors: Gupta Varsha , Garg Ritu
Published: January 2022

Humans harbor vast numbers of microorganisms on the skin, in the mouth, and in the gastrointestinal tract. The gastrointestinal tract alone is home to more than 500 different bacterial species, some of which have important health functions in stimulating the immune system, protecting the host from invading bacteria and viruses, and aiding digestion. Nobel laureate Elie Metchnikoff proposed in the early 1900s that the long life of Bulgarian peasants resulted from their consumption of fermented milk products. The term “probiotic” was first used in 1965, and, in 2002, Marteau defined probiotics as microbial preparations or components of microbial cells that have a beneficial effect on health and well-being. This chapter examines the use of antibiotics, immunosuppressive therapy, irradiation, and other various means of treatment that may cause alterations in the normal human flora. It explores the idea of introducing beneficial bacterial species into the GI tract as an attractive option to reestablish microbial equilibrium and prevent disease.
Hypersensitivity to antibiotics
Authors: Alvarez-Arango Santiago , Adkinson N. Franklin
Published: January 2022

This chapter deals with adverse drug reactions (ADRs), which are separated into type A and type B reactions. Type A reactions are predictable from known pharmacologic properties and are largely dose related; these make up 85% to 90% of all ADRs. Type B reactions are unpredictable and are restricted to a vulnerable subpopulation; these include immunologic drug reactions, drug intolerance, and idiosyncratic reactions. The chapter looks at immune mechanisms that are thought to be involved in 6% to 10% of all ADRs. It analyzes allergenic drugs that can induce the entire spectrum of immunopathologic reactions, which are clinically indistinguishable from reactions elicited by foreign macromolecules. Testing and evaluation of patients with ADRs and methods for overcoming these limitations are discussed.
Confidence Versus Error
Authors: Silveira José , Rockman Patricia
Published: January 2022

In this chapter, the extent to which clinician confidence corresponds to objective uncertainty and clinician error is demonstrated. The lack of accuracy in mental health assessments is contrasted with the inflated confidence that clinicians have in their assessments. Two key issues are addressed. One is that clinician overconfidence is discordant with the level of objective uncertainty inherent to diagnostic and risk assessments. The second is that the degree of confidence clinicians have in their diagnostic impressions is a remarkably poor indicator of accuracy. The chapter illustrates that clinician confidence and accuracy are predictable and consistently misaligned regardless of discipline and experience levels.
Broadening Our View of Risk
Authors: Silveira José , Rockman Patricia
Published: January 2022

This chapter identifies critical areas of harm relevant to mental disorders. It introduces an expanded set of risks that should be incorporated within a routine and comprehensive approach to risk identification in mental health care. The set includes the most pressing risks associated with mental disorders and addiction. This finite set of risks is helpful when used as a list to check that specific risks are not overlooked throughout the duration that people are in care. The rationale and evidence supporting the inclusion of 13 areas of risk are provided. Special attention is given to an expanded view of risks related to child care, operating motor vehicles, victimization, work, and firearms.
Uncertainty as Teacher
Authors: Silveira José , Rockman Patricia
Published: January 2022

Aspects of education, training, and practice that are impacted by irreducible uncertainty and the field’s intentional and unintentional minimization of its influence on mental health care are addressed in this chapter. Teaching approaches that account for the limitations of knowledge, biases, automatic processing, and error in mental health care are necessary for reducing the unwarranted confidence in the field. The opportunity for clinicians to improve the alignment between their confidence and objective success, based on feedback, is explored. In addition, barriers to achieving clinical expertise such as inadequate feedback and constraints on accurate judgment in the mental health domain are elucidated.
Self-Transcendence
Authors: Cloninger C. Robert , Cloninger Kevin M.
Published: January 2022

Self-transcendence is the process by which a person becomes aware of their participation in something greater than their individual self. The conscious realization of participation in something beyond yourself, such as union with nature, humanity, or God, evokes positive emotions, particularly joy and awe, which are often combined with attitudes of humility and reverence. The cultivation of self-transcendence provides a coherent perspective on living that promotes physical, mental, and spiritual well-being. If we accept that virtue involves respect for the dignity of others and not just one’s individual self, then the cultivation of self-transcendence is essential to all aspects of virtue. In this chapter, we provide several lines of empirical evidence about human nature, ecological systems, well-being, and virtue that provide a solid foundation to guide clinical practice in promoting health. Prospective studies indicate that the cultivation of self-transcendence and well-being involves the dynamic interplay of three processes: the awakening of plasticity (i.e., being able and willing to change); virtue (i.e., having intuitive insight into what is good for a person’s self and others); and creative functioning (i.e., being innovative, purposeful and responsible so that our habits are congruent with our goals and values). The cultivation of self-transcendence by these three processes describes the essential features of the path to a life that is healthy, happy, and good. We describe evidence-based practices that are effective in motivating people to create opportunities for their own well-being and that of others by cultivating self-transcendence.
Early Imaging for Back Pain in Older Adults
Authors: Lee Christoph I.
Published: January 2022

This chapter provides a summary of a landmark study in radiology. What is the impact of early imaging for back pain among older adults? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study overview, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.
Endovascular Therapy for Acute Ischemic Stroke
Authors: Kalp Matthew D. , Hwang David Y.
Published: January 2022

This chapter provides a summary of a landmark study in neurology. Is intraarterial treatment effective for an acute ischemic stroke? Starting with this question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study overview, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.
Symptom Management—Overview
Authors: Hallenbeck James L.
Published: January 2022

This chapter presents an overview of symptom management in palliative care. It explains that when considering symptom management of known, chronic illnesses, what is usually more important is to understand what clues the disease process can provide to understand and treat the symptoms of the patient. In the palliative setting, the relationship between the disease and the symptom is reversed; it is the disease process that becomes a clue to the symptom or patient experience. An approach to understanding the taxonomy of symptoms is presented. Physical aspects of a symptom are divided into central and peripheral components. Affective, cognitive, and spiritual components of psychic aspects are also delineated.
The Stigma of Mental Illness
Authors: Dobson Keith , Stuart Heather
Published: January 2022

There is wide-spread recognition that people who struggle with mental illness often face negative reactions from others or systems with which they interact, and often internalize these reactions. This volume explores the many faces of the stigma of mental illness through a series of carefully chosen foci. The book begins with a series of chapters that explore models of stigma, and how stigma can present itself in different contexts such as health care, the workplace and postsecondary settings. The measurement of stigma is highlighted as an area of recent development, that is critical for evidence-based programming. A third part of the volume presents examples of innovative interventions that reduce the stigma of mental illness. Overall, the book provides a theoretically current, conceptually rich, and yet practical approach to the issues it covers, and includes a number of practical suggestions and tools for the reader from a series of global leaders.
The Opening Minds Stigma Scale for Health Providers
Authors: Knaak Stephanie , Patten Scott
Published: January 2022

This chapter details the consequences associated with mental health stigma among healthcare providers and the need for reliable and valid measurement of this stigma. The chapter details the development and initial validation of a novel scale to measure stigma within this domain: the Opening Minds Stigma Scale for Health Care Providers. Consistent with the emerging literature in this area, the scale has items designed to reflect negative attitudes, social distancing, and non-willingness to disclose mental health concerns. Data analyses reveal that the scale is practical to use in real-world evaluative studies and sensitive to change. The overall score provides a suitable index for assessing the efficacy and effectiveness of anti-stigma interventions among healthcare workers and is recommended for further use.
Stigma Reduction in the General Workplace
Authors: Luong Dorothy , Kirsh Bonnie
Published: January 2022

Stigma related to mental illness has unique manifestations in the workplace, and so stigma intervention in this context requires a critical understanding of the workplace and how the workplace itself may perpetuate stigma. This chapter details some of the critical issues in this context and presents a theoretical framework for workplace stigma. Models that employ features of this framework are discussed, with a focus on programs of the Mental Health Commission of Canada. These programs employ features such as a mental health continuum model, several key coping skills, and contact-based education. Evaluations of these programs are positive, and so their further use and evaluation are encouraged.
Media Programs
Authors: Whitley Rob
Published: January 2022

Research has indicated that negative media portrayals of people with mental illness can perpetuate stigma, suspicion, prejudice, social distance, and fear of people with mental illness. Three types of interventions can mitigate these portrayals, including education for journalism students, online education programs, and reporting guidelines for media outlets. In this chapter, these interventions are described and their results are reviewed. The chapter concludes with a discussion of the emerging practice of citizen journalism, which presents an opportunity for people with mental illness to produce locally grounded portrayals suitable for social media that may dispel common myths and erroneous stereotypes and further inform the public about life with a mental illness. A multidimensional approach appears to maximize success and is recommended for ongoing implementation and evaluation.
Future Directions of Stigma Reduction
Authors: Stuart Heather , Dobson Keith S.
Published: January 2022

Stigma reduction programing has come a long way since the beginning of the 21st century. There has been increased interest in measurement development, which in turn has led to a steady increase in studies examining risk and protective factors for various types of stigma. Though initially underrepresented, interest in structural stigma and the stigma associated with substance use disorders has increased, with the recognition that individuals with substance use problems and those with comorbid mental health and substance use disorders are among the most stigmatized and disadvantaged of any groups. There also has been steady growth in studies examining cultural aspects of stigma, including several international comparisons. There is a growing evidence base supporting best practices in stigma reduction. This chapter reviews some of the key lessons learned from the antistigma work undertaken as part of the Opening Minds antistigma initiative of the Mental Health Commission of Canada and makes suggestions for future directions.
The Antisocial Murderer
Authors: Black Donald W.
Published: January 2022

This chapter focuses on serial killer and study subject John Wayne Gacy, exploring what can happen when antisocial personality disorder (ASPD) reaches its worst potential. At the time of his arrest and conviction, Gacy was the most prolific serial killer in American history, and he remains one of the best-known members of a hideous fraternity—men who kill again and again, often for no apparent motive. Despite differences, their biographies often read like textbook studies of ASPD manifested in a most deadly way. Not all serial killers are antisocial and, certainly, few antisocial persons rise to the heights of violence reached by men like Gacy, Jeffrey Dahmer, Ted Bundy, Henry Lee Lucas, and David Berkowitz. However, ASPD symptoms—unruly childhoods, failures at school and work, legal skirmishes, instability, impulsiveness, and the like—are common themes in their lives.
Homelessness and mental illness in the UK: Some historical fragments
Authors: Timms Philip
Published: January 2022

Homelessness is often discussed as if it were a crisis—an interruption in the usual, civilized way of organizing society. However, the history of homeless people is a poorly documented but unbroken thread through the last 600 years of our history. Moreover, the literature suggests that severe mental illness has been a prominent feature of homeless populations from the age of monastic provision, through the ages of the bridewell and the asylum, and into the current era of community care. Although direct accounts are sparse, we can gain some sense of what happened to homeless people with mental illness through specific pieces of legislation, and the documented history of the institutions and services established to deal with the problem. A theme persisting through the centuries has been the tension between punishment and rehabilitation.
Continental European experience: Germany
Authors: Schreiter Stefanie , Gutwinski Stefan , Salize Hans-Joachim , Rössler Wulf
Published: January 2022

Homelessness has been in the focus of psychiatric research in Germany to a greater or lesser extent since the beginning of the nineteenth century. Recently, increasing numbers of homeless people in Germany due to the consolidation of poverty, the lack of affordable housing, and the processes of immigration have led again to an increased scientific and political interest. Prevalence rates of mental illnesses among homeless people in Germany are comparable to other Western countries, except for a higher prevalence of alcohol abuse. A broad range of social welfare and healthcare is currently not able to prevent the increase of people becoming homeless, mainly because of difficulties in apportioning responsibilities among welfare and healthcare institutions, complex administrative processes, language barriers, and barriers related to mental illness.