title: Genus Avipoxvirus

text: Poxviruses identified in skin lesions of domestic, pet or wild birds are assigned largely by default to the Avipoxvirus genus within the subfamily Chordopoxvirinae of the family Poxviridae. Avipoxviruses have been identified as the causative agent of disease in at least 232 species in 23 orders of birds. Vaccines based upon attenuated avipoxvirus strains provide good disease control in production poultry, although with the large and intensive production systems there are suggestions and real risks of emergence of strains against which current vaccines might be ineffective. Sequence analysis of the whole genome has revealed overall genome structure and function resemblance to the Chordopoxvirinae; however, avipoxvirus genomes exhibit large-scale genomic rearrangements with more extensive gene families and novel host range gene in comparison with the other Chordopoxvirinae. Phylogenetic analysis places the avipoxviruses externally to the Chorodopoxvirinae to such an extent that in the future it might be appropriate to consider the Avipoxviruses as a separate subfamily within the Poxviridae. A unique relationship exists between Fowlpox virus (FWPV) and reticuloendothelosis viruses. All FWPV strains carry a remnant long terminal repeat, while field strains carry a near full-length provirus integrated at the same location in the FWPV genome. With the development of techniques to construct poxviruses expressing foreign vaccine antigens, the avipoxviruses have gone from neglected obscurity to important vaccine vectors in the past 20 years. The seminal observation of their utility for delivery of vaccine antigens to non-avian species has driven much of the interest in this group of viruses. In the veterinary area, several recombinant avipoxviruses are commercially licensed vaccines. The most successful have been those expressing glycoprotein antigens of enveloped viruses, e.g. avian influenza, Newcastle diseases and West Nile viruses. Several recombinants have undergone extensive human clinical trials as experimental vaccines against HIV/AIDS and malaria or as treatment regimens in cancer patients. The safety profile of avipoxvirus recombinants for use as veterinary and human vaccines or therapeutics is now well established.


Pneumonie


title: Etiopathogenesis and Pathophysiology of Malaria

text: Malaria is a parasitic disease caused by Plasmodium protozoan parasites and transmitted by Anopheles mosquitoes. The disease is diffused in tropical areas, where it is associated with high morbidity and mortality. P. falciparum is the most dangerous species, mainly affecting young children. The parasite cycle occurs both in humans (asexual stages) and in mosquitoes (sexual stages). In humans, Plasmodium grows and multiplies within red blood cells using hemoglobin as essential source of nutrients and energy. However, this process generates toxic heme that the parasite aggregates into an insoluble inert biocrystal called hemozoin. This molecule sequesters in various organs (liver, spleen, and brain), potentially contributing to the development of malaria immunopathogenesis. Uncomplicated falciparum malaria clinical frame ranges from asymptomatic infection to classic symptoms such as fever, chills, sweating, headache, and muscle aches. However, malaria can also evolve into severe life-threatening complications, including cerebral malaria, severe anemia, respiratory distress, and acute renal failure.


title: Entzündliche Erkrankungen

text: Meningitiden zeigen die Trias Kopfschmerz, Meningismus und Fieber mit positiven Dehnungszeichen. Bei Kindern sind gramnegative Enterokeime und Hämophilus, bei Erwachsenen Meningo- und Pneumokokken wichtigste Erreger der bakteriellen Meningitis. Entscheidend für die Diagnose ist die Liquordiagnostik mit Gramfärbung. Empirisch werden ein Cephalosporin der dritten Generation und Ampicillin eingesetzt.


title: Virus-Gastroenteritis

text: Zu den Viren, die eine Gastroenteritis verursachen, zählt man Rota- und Adeno-Viren, ferner Calici-Viren (Genus Noro- und Sapo-Virus u.a.) sowie Astro- und Corona-Viren u.a. (➤ Kap.59). Die viral bedingte Gastroenteritis ist die Hauptursache der hohen Säuglings- und Kleinkindersterblichkeit in den Tropen. Man schätzt, dass dort pro Jahr etwa 1–2 Mio. Kinder an einer Virus-Gastroenteritis sterben.


Pathology of Sepsis


title: The TIE Receptor Family

text: The endothelial TIE1 and TIE2 receptor tyrosine kinases form a distinct subfamily characterized by their unique extracellular domains. Together with the angiopoietin growth factors (ANGPT1, ANGPT2, ANGPT4, also abbreviated as ANG), the TIE receptors form an endothelial specific signaling pathway with important functions in the regulation of lymphatic and cardiovascular development and vascular homeostasis. Angiopoietins exist in multimeric forms that activate the TIE receptors via unique mechanism. In endothelial cell–cell contacts, angiopoietins induce the formation of homomeric in trans TIE receptor complexes extending across the cell junctions, whereas matrix-bound angiopoietin-1 (ANG1) activates the TIE receptors in a cis configuration. In comparison to the vascular endothelial growth factor receptors, the TIE receptors undergo little ubiquitin-mediated degradation after activation, whereas TIE2 signaling is negatively regulated by the vascular endothelial protein tyrosine phosphatase, VE-PTP. ANG1 activation of TIE2 supports vascular stabilization, whereas angiopoietin-2 (ANG2), a context-dependent weak TIE2 agonist/antagonist, promotes pathological tumor angiogenesis, vascular permeability, and inflammation. Recently, ANG2 has been found to mediate some of its vascular destabilizing and angiogenic functions via integrin signalling. The circulating levels of ANG2 are increased in cancer, and in several human diseases associated with inflammation and vascular leak, for example, in sepsis. Blocking of ANG2 has emerged as a potential novel therapeutic strategy for these diseases. In addition, preclinical results demonstrate that genetic TIE1 deletion in mice inhibits the vascularization and growth of tumor isografts and protects from atherosclerosis, with little effect on normal vascular homeostasis in adult mice. The ability of the ANG-TIE pathway to control vessel stability and angiogenesis makes it an interesting vascular target for the treatment of the various diseases.


title: Antigenicity, Immunogenicity, Allergenicity

text: The term “immune” pertains to the body keeping itself free from diseases, not to trigger any diseases. In this regard, it makes sense for us to divide antigenicity into immunogenicity and allergenicity. This distinction allows for the characterization of all types of modern antigens, i.e., to evaluate and modify a priori the allergenicity of an antigen before it is applied to humans. In this chapter, we also formulated the hypothesis that “Balanced Stimulation by Whole Antigens” is essential for immune development. This hypothesis revives the practicality of the “Hygiene Hypothesis” and can provide a fundamental solution to curb the increasing prevalence of allergic disease, namely, early exposure, at 0–1 year old or earlier, in utero, of representative allergens/protein antigens with immunogenicity retained or improved and allergenicity attenuated or eliminated.


title: Protein Structure Prediction by Protein Threading

text: The seminal work of Bowie, Lüthy, and Eisenberg (Bowie et al., 1991) on “the inverse protein folding problem” laid the foundation of protein structure prediction by protein threading. By using simple measures for fitness of different amino acid types to local structural environments defined in terms of solvent accessibility and protein secondary structure, the authors derived a simple and yet profoundly novel approach to assessing if a protein sequence fits well with a given protein structural fold. Their follow-up work (Elofsson et al., 1996; Fischer and Eisenberg, 1996; Fischer et al., 1996a,b) and the work by Jones, Taylor, and Thornton (Jones et al., 1992) on protein fold recognition led to the development of a new brand of powerful tools for protein structure prediction, which we now term “protein threading.” These computational tools have played a key role in extending the utility of all the experimentally solved structures by X-ray crystallography and nuclear magnetic resonance (NMR), providing structural models and functional predictions for many of the proteins encoded in the hundreds of genomes that have been sequenced up to now.


title: From “Health for All” to “Health as Investment:” The Role of Economic Rationalities in the Transition from International to Global Health 1978–2013

text: This chapter examines the role of economic rationalities in the transition from international health to global health since the late 1970s. It focuses, in particular, on the recent rise to prominence of non-communicable diseases on the global health agenda. Once considered to be diseases of affluence, non-communicable diseases (NCDs) such as cancer, diabetes, cardiovascular disease have recently come to be seen as a threat to both the global population and the global economy. Strategies to combat the proliferation of NCDs have simultaneous been shown to be particularly cost-effective, making NCD interventions a solid global health investment. This chapter contrasts the current era of global health, in which health is imagined in as a form of human capital and a site of investment with a post-war era of international health during which health was advocated as a human right and public good. Drawing on empirical material including historical documents, published reports and the scientific literature, it argues that the transition from international to global health can be best understood as resulting from the rise of economic rationalities in the field of world health over the last 25 years.


title: SARS Accessory Proteins ORF3a and 9b and Their Functional Analysis

text: The SARS coronavirus (CoV) positive-stranded RNA viral genome encodes 14 open reading frames (ORFs), eight of which encode proteins termed as “accessory proteins.” These proteins help the virus infect the host and promote virulence. In this chapter we describe some of our latest investigations into the structure and function of two such accessory proteins: ORF3a and 9b. The ORF3a accessory protein is the largest accessory protein in SARS-CoV and is a unique membrane protein consisting of three transmembrane domains. It colocalizes on the cell membrane and host Golgi networks and may be involved in ion channel formation during infection. Similarly the ORF9b accessory protein is 98 amino acids, associates with the spike and nucleocapsid proteins and has unusual membrane binding properties. In this chapter we have suggested possible new roles for these two accessory proteins which may in the long run contain answers to many unanswered questions and also give us new ideas for drugs and vaccine design.


title: Erkrankungen der Atemwege und der Lunge

text: Der italienische Arzt Girolamo Cardano (1501–1576), der zu seiner Zeit als einer der größten Gelehrten und Ärzte in ganz Europa galt, wurde im Jahre 1552 von John Hamilton, dem Erzbischof von St. Andrews in Edinburgh, zur Konsultation eingeladen. Hamilton, der Bruder des Regenten von Schottland, litt seit mehreren Jahren an Husten, Dyspnoe und Expektoration, die nach Ansicht der königlichen Leibärzte von einem kalten und feuchten Hirn herrührten, in dem sich durch Destillation Phlegma anhäufte, das anschließend durch die Luftröhre in die Lunge absank. Cardano beobachtete seinen Patienten 40 Tage lang und kam zu dem Schluss, dass asthmatische Beschwerden durch eine Unverträglichkeit von Bettfedern mitverursacht werden. Heute ist bekannt, dass Allergien – wie in diesem Fall die Hausstaubmilbenallergie – oft an der Auslösung des kindlichen Asthma bronchiale beteiligt sind. In Mitteleuropa ist das Asthma mittlerweile die häufigste chronische Erkrankung im Kindes- und Jugendalter. Maßnahmen der Allergenkarenz sind auch heute noch von essenzieller Bedeutung.


title: The ‘delayed infection’ (aka ‘hygiene’) hypothesis for childhood leukaemia

text: The common variant of childhood acute lymphoblastic leukaemia (cALL) is the most frequent paediatric cancer subtype. Its incidence rate appears to have increased substantially in Western societies during the mid-20th century and continues to increase at ∼1%/year. Worldwide cALL appears to track with affluence of societies. The ‘delayed infection’ hypothesis, first formulated in 1988, parallels the hygiene hypothesis and has an evolutionary foundation in the concept of a mismatch between prior genetic selection and programming (of the immune system) and contemporary social circumstances. In essence, the hypothesis predicts that ALL is triggered by an abnormal immune response to one or more common microbial infections and that the abnormality arises for two reasons: (i) infectious exposures being delayed beyond the immunologically anticipated period of infancy; (ii) some degree of inherited genetic susceptibility via, for example, allelic variation in genes involved in the MHC and/or immune response network. The hypothesis also has a framework in the underlying cell and molecular biology of ALL and its natural history. Epidemiological studies of social contacts in infancy (as a proxy for common infections) and risk of ALL provide indirect but strong support for the hypothesis. The idea still requires mechanistic and genetic endorsement and the appropriate studies are in progress.


title: Engineering Spirulina for Enhanced Medicinal Application

text: Cyanobacteria are prokaryotes which can perform photosynthesis like higher plants. Their genomic organisation is very simple and thus is suitable for the study of detailed photosynthesis mechanism at a molecular level also for many other genomic manipulations relevant to benefit of living organisms. This unicellular alga, Spirulina has a thin thread like elongated structure and classified under Cyanobacteriaceae which is blue green in colour. Under microscope it looks like bunch of bright helical threads (Fig. 11.1).


title: Types of Recombinant Vaccines

text: The original scientific strategy behind vaccinology has historically been to “isolate, inactivate, and inject,” first invoked by Louis Pasteur.


title: Infectious Diseases

text: As infectious diseases are very commonly seen in the ICU, this chapter covers both typical and atypical infections found in this setting. If the patient has been transferred to the ICU after a prolonged stay in the hospital, the treatment should be focused on a nosocomial infection. This chapter emphasizes that the first thing to do is to identify the organisms causing the patients’ infection, keeping in mind frequently found organisms. Pneumonia, severe adult respiratory syndrome (SARS), sepsis, toxic shock syndrome, and infections in patients with AIDS are among the most common infectious diseases treated in the ICU. An appropriate initial empiric therapy and correct treatment once cultures and susceptibility become available are crucial for a successful treatment.


title: Health in Africa and the Role of International Organizations

text: For Africa, international health financial organizations, such as the United Nations (UN) through the World Health Organization, and bi-lateral assistance programs represent a curse and a blessing simultaneously. While they provide needed assistance and help meet the health needs of Africans, they make the continent dependent on hand-outs, unwittingly encouraging unscrupulous leaders not to generate or make national resources available to the people. Worse even, foreign assistance leaves a vacuum when it is depleted or, for various reasons, withdrawn. Foreign funds are also easily prone to misuse by leaders and unscrupulous high and middle level civil servants. Furthermore, as is the case with the IMF, assistance has always come with strings attached, forcing Africa to rely on international generosity to meet the health needs the West deems a priority for the continent. These conditions often imply at times that the donors know best what is good for Africans. While not denying the usefulness and the need for international assistance, the author argues that the use of financial assistance must be completely transparent to prevent misuse and abuse, not condescending, and always respectful of Africa’s sovereignty. In this context, world leaders must also note that the globalizing trend is often one-sided, unidirectional—from North to South—always exploitative in nature and accompanied by a cultural baggage that corrupts the youth, unwittingly promotes violence, sex, decadent practices, and unhealthy behaviors, such as the consumption of fast foods and tobacco, bad diets and alcohol abuse, thus contributing to non-communicable diseases, such as liver and stomach cancers, now dubbed by the UN as Africa’s second disease burden.


title: Fibrinogen α-Chain as a Serum Marker of Liver Disease

text: Liver fibrosis is the hepatic response to an insult characterized by an accumulation of extracellular matrix proteins. If the underlying cause is not treated or eliminated, the disease can progress and may lead to several clinical complications including hepatocellular carcinoma or even death. Thus, detection, staging, and follow-up of liver fibrosis are the main issues in the prognosis and treatment of patients with chronic liver disease. In recent years, new advances in mass spectrometry-based proteomics technology and protein fractionation techniques have improved protein identification as well as protein quantification in many different samples and diseases including liver fibrosis. In particular, the fibrinogen α chain and more specifically the serum levels of the 5.9 kDa fragment of fibrinogen α C-chain have shown to be altered in several hepatic etiologies. In fact, these results have been reproduced by different laboratories, and recently a marked downregulation of this protein fragment has also been described in the initial stages of liver fibrosis. In this chapter, we have described the potential role of fibrinogen α chain and particularly the 5.9 kDa fragment of fibrinogen α C-chain as a circulating marker of liver fibrosis.


Virological laboratory diagnosis of SARS


title: Biomolecular Structure and Modeling: Historical Perspective

text: physics, chemistry, and biology have been connected by a web of causal explanation organized by induction-based theories that telescope into one another. … Thus, quantum theory underlies atomic physics, which is the foundation of reagent chemistry and its specialized offshoot biochemistry, which interlock with molecular biology — essentially, the chemistry of organic macromolecules — and hence, through successively higher levels of organization, cellular, organismic, and evolutionary biology. … Such is the unifying and highly productive understanding of the world that has evolved in the natural sciences.


title: WhyZombie? Zombie Pop Culture to Improve Infection Prevention and Control Practices

text: Wikipedia currently lists 383 feature length ‘A-list’ zombie films, released between 1932 and 2014. These films indicate a number of causes of ‘zombification.’ A significant number of these films had an infectious cause of some kind (viral, bacterial, parasite, extra-terrestrial, zoonotic or other biological cause). The chapter explores this phenomenon and indicates that global health issues result in an increase in the release of infectious biohorror films in the years following outbreaks such as SARS and pandemic influenza, influencing pop culture. There are clear indications that contemporary infection prevention control (IPC) technologies are evident in these films, successful or not. Using contemporary cultural influences allows healthcare workers and the public to contextualise IPC theory and practice in an accessible and memorable way.


Mathematical Studies of Dynamics and Evolution of Infectious Diseases


title: Epidemiology, etiology, and risk factors of bacterial pneumonia

text: Hospital-acquired pneumonia (HAP) is the second most common nosocomial infection after urinary tract infections. The incidence of HAP ranges from 5 to 15 cases per 1000 hospital admissions, and is a frequent problem in general wards (incidence ranging from 1.6 to 3.67 cases per 1000 admissions).


title: Besondere Patientengruppen im Intensivtransport

text: Neben den im vorrangegangenen Kapitel besprochenen Krankheitsbildern gibt es im Rahmen der Durchführung eines Intensivtransportes Patienten, die nicht »krank« im eigentlichen Sinne sind, jedoch aufgrund spezieller Entwicklungs-, Krankheits- oder Therapieverläufe einer besonderen Aufmerksamkeit bedürfen. Hierzu zählen Früh - und Neugeborene ebenso wie Patienten, bei denen eine Infektion mit therapieresistenten Erregern besteht.


title: A Novel Disease Outbreak Prediction Model for Compact Spatial-Temporal Environments

text: One of the popular research areas in clinical decision supporting system (CDSS) is Spatial and temporal (ST) data mining. The basic concept of ST concerns about two combined dimensions of analyzing: time and space. For prediction of disease outbreak, we attempt to locate any potential uninfected by the predicted virus prevalence. A popular ST-clustering software called “SaTScan” works by predicting the next likely infested areas by considering the history records of infested zones and the radius of the zone. However, it is argued that using radius as a spatial measure suits large and perhaps evenly populated area. In urban city, the population density is relatively high and uneven. In this paper, we present a novel algorithm, by following the concept of SaTScan, but in consideration of spatial information in relation to local populations and full demographic information in proximity (e.g. that of a street or a cluster of buildings). This higher resolution of ST data mining has an advantage of precision and applicability in some very compact urban cities. For proving the concept a computer simulation model is presented that is based on empirical but anonymized and processed data.


title: Pulmonary Hemorrhage, Transient Tachypnea, and Neonatal Pneumonia

text: The intent of this chapter is to address three other common pulmonary causes of respiratory distress in the high-risk infant. These other forms of parenchymal lung disease range in severity from mild, as seen in transient tachypnea, to severe as is often the case in pulmonary hemorrhage. It is worth noting that on occasion, one or more of these conditions may coexist in the same patient. The treatment for all conditions is largely supportive or involves the use of targeted antimicrobial therapy.


title: Impacts on Human Health Caused by Zoonoses

text: Zoonosis is an infectious disease and a potential bioterrorism agent. Bioterrorism aimed at a society, government, and/or its citizens is meant to cause destabilization, fear, anxiety, illness, and death in people, animals, or plants using biological agents. A bioterrorism attack is the intentional release of biological agents such as viruses, bacteria, fungi, rickettsial or chlamydial organisms, toxins, or other harmful agents. This chapter focuses on the induction, monitoring, and prevention of some zoonotic diseases that have potential as bioterrorism agents. The etiology, clinical manifestations, transmission routes, and treatment of these zoonotic agents are briefly discussed.


title: Disaster Risk Management

text: This chapter illustrates disaster and risk management. The disaster management includes hazard management and disaster issue management. Disaster risk management relies on the institution, policy, and scientific and technological progress for disaster reduction. Improving disaster risk management capacity is the key point to improving the utilization efficiency and effectiveness of disaster reduction resources, which is also an important guarantee for disaster risk reduction.


title: Nephrologie

text: —. primäre/idiopathische Glomerulonephritis: primäre Erkrankung der Glomeruli; —. sekundäre Glomerulonephritis: Systemerkrankung mit renaler Beteiligung; —. : —. Immunkomplexnephritis (z. B. akute postinfektiöse Glomerulonephritis); —. Anti-Basalmembran-Glomerulonephritis (z. B. rasch progrediente Glomerulonephritis); —. IgA-Nephropathie; —. : —. initial asymptomatisch/oligosymptomatisch: (Mikro-)Hämaturie, in der Regel ohne Proteinurie, normale Nierenfunktion, evtl. Hypertonie; —. akut: Mikrohämaturie, leichte Proteinurie, evtl. nephrotisches Syndrom, akutes oligoanurisches Nierenversagen; —. chronisch-progredient: Erythrozyturie, Proteinurie, meist Hypertonie, langsames Fortschreiten der Niereninsuffizienz; —. verantwortlich für 10% aller chronischen Niereninsuffizienzen;


title: Proportionality Review in EU Gambling Law

text: This chapter starts with a thorough introduction to gambling addiction according to the current state of research. It explains the nature and mechanisms of this mental disorder. These findings lay the ground to analyse the proportionality review: judicial views are contrasted with empirical findings. It is shown that the Court of Justice's – legally relevant(!) – assumptions on gambling addiction are (only) partly supported by empirical evidence. The chapter also establishes that different standards of review have applied to different aspects of gambling regulation, with the most lenient review being applied to national choices of licensing models and the strictest to penalties and procedural requirements in licensing tenders. In a next step, the Court’s review practice is compared to judgments in other areas that involved similar consumer protection concerns (alcohol addiction and youth drinking; internet threats). Again, a diverging standard of review is noted. The chapter inquires the causes for the Court’s peculiar approach to gambling issues. It analyses in particular the political context of the early case law and it identifies passages in the jurisprudence that illustrate a subjective-moral rather than objective-scientific perspective on gambling-related risks. Finally, the chapter addresses the consequences of the Court’s diverging approach. Dealing with gambling as a ‘peculiar issue’ and a topos of public morality led to a lack of a science-informed assessment of gambling-related risks. The chapter notes a ‘judicial vacuum’ in the review practice; the numerous cases referred to the Court of Justice are an expression of this problem as predicted by the late Advocate General Colomer.


title: Hämostyptika

text: Desmopressin (DDAVP) wurde 1966 als Abkömmling des antidiuretischen Hypophysenhormons Arginin-Vasopressin synthetisch hergestellt. Zu den antidiuretischen Indikationen zählen Diabetes insipidus und Enuresis nocturna, zudem wird es in Tests zur Bestimmung der Nierenkonzentrationsfähigkeit verwendet


title: Transcriptomics of the Fungal Pathogens, Focusing on Candida albicans

text: The past century brought the availability of vaccines and antibiotics, leading to a dramatic fall in mortalities caused by infectious diseases. This led to the assumption that infectious disease has been defeated by medicine. In 1969 the United States Surgeon General actually claimed that “we can close the book on infectious diseases”. However, today we know that this assumption was naïve, not taking into account that evolution is a constant motor in adapting the existing organisms to changing environmental conditions, including the adaptation of pathogens to changes in the host. Today nearly 25% of the annual deaths world-wide are directly related to pathogens (Morens et al. 2004). This can be attributed to the appearance of new diseases, like HIV, SARS or West Nile Virus, but also to an increase of resistance to antibiotics in pathogens thought to be defeated, like Mycobacterium tuberculosis or Staphylococcus and Enterococcus strains. In addition the progress in medical care results in a large proportion of immune-deficient patients and consequently in an increase in opportunistic infections. Especially fungi have gained an infamous reputation during recent decades as being highly detrimental to patients with haematologiconcologic diseases, neutropenia or after organ transplantation. A review of the current literature identified 1415 species as known to be pathogenic to humans, including 538 bacteria and 307 fungi (Cleaveland et al. 2001). The fungi are a large group of diverse eukaryotic organisms. Only about 74 000 to 120 000 of the estimated 1.5×10(6) existing species of fungi have been described. Of the approximately 300 fungal species that are known to cause human infections, the most commonly observed live threatening systemic infections are caused by opportunistic infections of Candida species or Aspergilli. Therefore the major scientific interest with regard to fungal pathomechanisms has focused on these organisms in the past decade. The early availability of the genome sequence of Candida albicans (the first assembly of the genome sequence was publicly available in 2000, at http://www-sequence.stanford.edu/group/candida),the availability of molecular tools and the use of Saccharomyces cerevisiae as a model for many characteristics of C. albicans relevant for pathogenesis (including morphogenesis and signalling pathways involved in stress response) resulted in a major body of work concerning this opportunistic fungal pathogen (Berman and Sudbery 2002; Braun et al. 2005; Jones et al. 2004). Until 2004 C. albicans was actually the only fungal pathogen on which genome-wide transcriptomics using arrays had been published. The sequences of other pathogenic fungi or the tools required for genome-wide transcriptomics had not been available to the public until then. However, a major body of molecular work has been performed on other opportunistic fungal pathogens, including C. glabrata, C. parapsylosis, C. tropicalis, Cryptococcus neoformans and Aspergillus species, where Aspergillus fumigatus is leading the clinically relevant species, as well as on the genera of primary fungal pathogens, including Blastomyces, Coccidioides, Histoplasma and Paracoccidioides. Due to the advancement of Candida albicans transcriptomics this chapter mainly focuses on this organism and only briefly touches the current work on other fungal pathogens.


title: Immunization and Vaccination

text: Vaccines have been recognized as one of the most successful public health measures. In this chapter, we provide a historical overview of immunization measures and discuss the basics of immunization and vaccination in the context of a pandemic outbreak. We will also discuss vaccine hesitancy, the factors that lead to vaccine acceptance and refusal, the determinants of individual decision-making about vaccination, and strategies of how to approach it on an individual, community, and global level.


title: Global control of infectious diseases by vaccination programs

text: In both industrialized and developing countries, childhood immunization has become one of the most important and cost-effective public health interventions. National immunization programs have prevented millions of deaths since WHO initiated the ‘Expanded Program on Immunization’ in 1974. Smallpox was eradicated in 1979, poliomyelitis is on the verge of eradication, and two thirds of developing countries have eliminated neonatal tetanus. Global immunization coverage was at 78% in 2005. Through their impact on childhood morbidity and mortality, immunization programs are contributing to reaching the ‘Millennium Development Goal 4’ — a two-thirds reduction of under-five mortality by 2015. However, the failure to reach more than 20% of the world’s children with existing vaccines was responsible for at least 2.5 million of an estimated 10.5 million deaths of children under 5 years, mainly in developing countries. Of these deaths, 1.4 million could have been prevented by vaccines currently recommended by WHO. Rapid progress in our understanding of the pathogenesis of infectious diseases, immunology, and biotechnology has increased the number of candidate vaccine antigens available. Pressures are growing on public health decision makers to establish evidence-based ways to decide which new vaccines should be introduced on a large scale into national immunization programs. The gap in access to new vaccines between the developing and industrialized worlds is still wide, and wealthy countries are still the first to introduce and use new vaccines. Interest from countries and partner agencies in vaccination, as one of the most cost-effective public health interventions, continues to be strong, also due to rapid progress in biotechnology and vaccine development and the emergence of global infectious disease threats, including HIV/AIDS, SARS, and influenza. The establishment of the Global Alliance for Vaccines and Immunization has focused global activities to support vaccination programs through raising considerable funds, and to assist especially poorer countries in improving and expanding their vaccination programs. Global efforts concentrate on further reducing the gap in the access to all existing vaccines between industrialized and developing countries.


title: Sepsis

text: 1. Hyperthermie (>38,5 °C) oder Hypothermie (<36,0 °C). 2. Tachykardie (Herzfrequenz >2SD über der altersentsprechenden Norm) oder Bradykardie (Herzfrequenz <10. Perzentile) im Alter <1 Jahr. 3. Tachypnoe (Atemfrequenz >2SD über der altersentsprechenden Norm). 4. Leukozytose oder Leukozytopenie oder Linksverschiebung (>10 % unreife Neutrophile), 5. Nachweis oder Verdacht auf eine Infektion;


Staphylococcal Infections


title: Geschichte, Theorie und Ethik der Medizin

text: Von Medizin kann erst dann die Rede sein, wenn zur heilkundlichen Praxis eine Theorie hinzukommt, die sich an der jeweils aktuellen Naturwissenschaft ausrichtet.


title: Modeling the Case of Early Detection of Ebola Virus Disease

text: The most recent Ebola outbreak in West Africa highlighted critical weaknesses in the medical infrastructure of the affected countries, including effective diagnostics tools, sufficient isolation wards, and enough medical personnel. Here, we develop and analyze a mathematical model to assess the impact of early diagnosis of pre-symptomatic individuals on the transmission dynamics of Ebola virus disease in West Africa. Our findings highlight the importance of implementing integrated control measures of early diagnosis and isolation. The mathematical analysis shows a threshold where early diagnosis of pre-symptomatic individuals, combined with a sufficient level of effective isolation, can lead to an epidemic control of Ebola virus disease.


title: Corona-Viren

text: Im Genus Corona-Virus finden sich 5 humanpathogene Viren, welche Erkrankungen der oberen Luftwege, Gastroenteritis sowie schwere Pneumonien hervorrufen können. Der Name leitet sich von dem wie eine Krone (“Corona„) aussehenden Besatz der äußeren Hülle des Virus mit knöpfchentragenden Spikes (= Glykoproteine) her. Bei Vögeln und Säugetieren kennt man Corona-Viren als Erreger von schwerer Bronchitis und Gastroenteritis.


title: Herpes Simplex Virus Pneumonia in Patients with Hematologic Malignancies

text: Herpes simplex virus (HSV) pneumonia is rare and is usually seen in immunocompromised patients. Patients with hematologic malignancies and hematopoietic stem cell transplant (HSCT) are at risk. Most of the cases of HSV pneumonia are caused by HSV-1; however, cases caused by HSV-2 have also been reported. Mucocutaneous disease often precedes the development of pneumonia, with nonspecific symptoms that include fever, cough, and dyspnea. Worsening oxygenation and failure to wean off mechanical ventilation despite broad-spectrum antimicrobial coverage is also a common presentation. Diagnosis requires a high degree of suspicion and is based on isolation of the virus from respiratory secretions and demonstration of cytopathic effects on histopathology. Acyclovir is the most widely used drug for treatment and prophylaxis. With increasing evidence of resistance to acyclovir and its analogs, newer agents such as foscarnet and cidofovir are being recommended as treatment options. Prophylaxis in patients with seropositive HSV undergoing chemotherapy or in the immediate post-HSCT period has been shown to reduce HSV disease rates and mortality rates. This chapter will focus on incidence and transmission, pathogenesis, risk factors, clinical features, diagnosis, and management of HSV pneumonia in patients with hematologic malignancies and HSCT, as well as outcome and prognosis.


title: Building Applied Mathematics Knowledge Base in East Africa

text: There is vast demand in Africa for technological development including modernization of higher education. Reforms in industrial processes through engineering skills are pivotal for the environmental concern and goals of sustainable development. Lappeenranta University of Technology has actively contributed to the spread of Industrial Mathematics in East African region over the past decade through development projects financed by the Finnish Ministry of Foreign Affairs. In this article, we summarize these projects and present their achievements. The story of European Consortium for Mathematics in Industry (ECMI) and the accumulated experience over 25 years have been the encouragement and inspiration for our initiatives. They were focused on Applied Mathematics curriculum development in Partner countries, and on organization of ECMI-style practical workshops like modeling weeks. There is obvious demand to broaden the cooperation between Africa and the European applied mathematics community.


title: Respiratory Syncytial Virus

text: Name of Virus: Respiratory Syncytial Virus


title: Applications of Loop-Mediated Isothermal Amplificaton Methods (LAMP) for Identification and Diagnosis of Mycotic Diseases: Paracoccidioidomycosis and Ochroconis gallopava infection

text: Loop-mediated isothermal amplification (LAMP) methods are now useful for the detection of a specific gene in infectious diseases, genetic diseases, and/or genetic disorders in the large number of medical fields, and it was recently introduced to fungal investigation. It is characterized by the use of four different primers specifically designed to recognize six distinct regions of the target gene, and the reaction process proceeds at a constant temperature using strand displacement reaction. Quickness and simplicity is the advantage of the method. Amplification and detection of gene can be completed in a single step, by incubating the mixture of samples, primers, DNA polymerase with strand displacement activity and substrates at a constant temperature. The method was applied to two fungal infections; paracoccidioidomycosis (PCM), a deep mycosis caused by Paracoccidioides brasiliensis and Ochroconis gallopava infection. For PCM a combination of F3, B3, FIP, and BIP primers designed from the partial sequence of P. brasiliensis gp43 gene was used. The PCR products amplified by the primer set; F3 and B3 showed species specificity for P. brasiliensis and the detection limit of the PCR was 100 fg of fungal genomic DNA. The specific DNA banding pattern of P. brasiliensis was detected in the clinical and nine-banded armadillo derived isolates, paraffin-embedded tissue sample or sputum from PCM patient. LAMP method was used also for the identification of O. gallopava by using species-specific primer sets based on the D1/D2 domain of the LSU rDNA sequence. The method successfully detected the gene from both fungal DNA derived from brains and spleens of experimentally-infected mice with O. gallopava and environmental isolates. In conclusion, LAMP method for PCM and O. gallopava seemed to be useful for identification, diagnosis or retrospective study with advantage in the quickness and simplicity procedure, but require strictly-controlled environments.


title: PCR in Integrated Microfluidic Systems

text: Miniaturized integrated DNA analysis systems offer the potential to provide unprecedented advances in cost and speed relative to current benchtop-scale instrumentation by allowing rapid bioanalysis assays to be performed in a portable self contained device format that can be inexpensively mass-produced. The polymerase chain reaction (PCR) has been a natural focus of many of these miniaturization efforts, owing to its capability to efficiently replicate target regions of interest from small quantities template DNA. Scale-down of PCR has proven to be particularly challenging, however, due to an unfavorable combination of relatively severe temperature extremes (resulting in the need to repeatedly heat minute aqueous sample volumes to temperatures in the vicinity of 95°C with minimal evaporation) and high surface area to volume conditions imposed by nanoliter reactor geometries (often leading to inhibition of the reaction by nonspecific adsorption of reagents at the reactor walls). Despite these daunting challenges, considerable progress has been made in the development of microfluidic devices capable of performing increasingly sophisticated PCR-based bioassays. This chapter reviews the progress that has been made to date and assesses the outlook for future advances.


Diseases of the Pulmonary Vascular System


title: Urgent Epidemic Control Mechanism for Aviation Networks

text: In the current century, the highly developed transportation system can not only boost the economy, but also greatly accelerate the spreading of epidemics. While some epidemic diseases may infect quite a number of people ahead of our awareness, the health care resources such as vaccines and the medical staff are usually locally or even globally insufficient. In this research, with the network of major aviation routes as an example, we present a method to determine the optimal locations to allocate the medical service in order to minimize the impact of the infectious disease with limited resources. Specifically, we demonstrate that when the medical resources are insufficient, we should concentrate our efforts on the travelers with the objective of effectively controlling the spreading rate of the epidemic diseases.


Pulmonary Surfactant: Biology and Therapy


title: Biosurveillance and Dentistry

text: Events of public health concern continue to present a challenge for the general population. A key element to address appropriate health responses is the establishment of modern public health surveillance mechanisms. In this chapter we explore possible scenarios/use cases where dentists can use electronic dental record technology to increase the accuracy, coverage, and timeliness of existing public health surveillance efforts. We identify organizational, technical, and regulatory elements that influence the adoption of such approaches and possible benefits when integrated to the public health system at large.


title: The Economy and the Construction Industry

text: Generally, there are three levels to define construction within the literature (Dang and Low in Infrastructure Investments in Developing Economies. Springer, 2015). At one extreme, construction is referred to as an economic activity that involves the entire construction process from producing raw and manufactured building materials and components, and providing professional services such as design and project management, to executing the physical work on site.


title: Hämatologie

text: —. Anämie = Hämoglobinkonzentration (Hb) ↓ unterhalb des alters-/geschlechtsspezifischen Normwertes; —. Hb korreliert mit dem Hämatokrit (Hkt), aber nicht direkt mit der Erythrozytenzahl; —. jede Anämie bedarf der Ursachenabklärung ➲ Memo keine Therapie ohne Diagnose!); —. Einteilung der Anämien nach mittlerem korpuskulärem Volumen (MCV) und mittlerem korpuskulärem Hb-Gehalt (MCH) (▸ Tabelle) [Image: see text] —. —. Kopfschmerzen, Konzentrationsschwäche; —. Ohrgeräusche; —. verminderte Leistungsfähigkeit, leichte Ermüdbarkeit; —. Belastungsdyspnoe; —. Schwindel- und Schwächegefühl Tachykardie, evtl. systolisches Herzgeräusch (Strömungsgeräusch infolge von Turbulenzen bei verminderter Viskosität; DD Endokarditis lenta mit Infektanämie); —. Blässe der Haut und Schleimhäute; —. Einteilung der Anämien nach ihrer Åtiologie (▸ Tabelle); —. mit 80% häufigste Anämieform; 80% aller Fälle sind Frauen; —. Eisenverluste durch chronische Blutungen (80% der Fälle): meist genitale Blutungen bei der Frau (z. B. Uterus myomatosus) oder Blutungen aus dem Verdauungstrakt; —. mangelnde Eisenzufuhr: v. a. bei Säuglingen, Kleinkindern und Vegetariern; —. ungenügende Eisenresorption: Anazidität nach Magenresektion, Malassimilationssyndrom, CED; —. gesteigerter Eisenbedarf: Gravidität, Stillperiode, Wachstum;


title: Triterpene einschließlich Steroide

text: Die Triterpene gehören zur Naturstoffgruppe der Isoprenoide (vgl. Kap. 23). Sie stellen eine außerordentlich umfangreiche Klasse von Terpenen dar. Sie werden in diesem Kapitel zusammen mit den sich davon ableitenden Steroiden zusammengefasst. Die Muttersubstanz aller Triterpene ist der azyklische C(30)-Kohlenwasserstoff Squalen. Seine Zyklisierung wird durch Epoxidierung einer endständigen Doppelbindung eingeleitet. Da die Squalen-2,3-Epoxidstufe vor der Zyklisierung obligat durchlaufen werden muss, enthalten nahezu alle Triterpene und Steroide in Position C-3 eine Sauerstofffunktion. Vom Squalen ausgehend lassen sich zwei Hauptwege erkennen: Der eine führt zu den tetra- und pentazyklischen Triterpenen, der andere über Cycloartenol zu den Cucurbitacinen und via das wichtigste Stoffwechselintermediärprodukt, das Cholesterol, zu den Phytosterolen, Cardenoliden und Bufadienoliden sowie zu den Steroidsapogeninen.


title: Southeast Asia: Beyond Crises and Traps

text: There is persistent concern that Southeast Asian economies may eventually fall into the ‘middle-income trap’ due to the slow upgrading of their technological capabilities. However, the five Southeast Asian countries (Malaysia, Thailand, Indonesia, Philippines, and Vietnam) covered by this volume have performed much better economically than many non-Asian middle-income countries although not as well as the four East Asian ‘tiger economies’ and China. Those Southeast Asian economies have derived an important part of their vitality by pursuing economic growth and competitiveness along lesser known or recommended pathways such as niche-oriented activities, natural resource processing, and cheap labour-based production, or a combination of these. In the final analysis the technological upgrading of industries and services, including resource-based and niche-oriented ones, will remain the most plausible way to continue catching up with the advanced economies and to stay competitive vis-à-vis emerging rivals. However, just as past development trajectories had been shaped by domestic socio-political configurations and the international/regional environment, so future prospects for these countries depend on how well they adapt to the fluid conditions of global competition and the uncertain state of global markets. They would also have to overcome a sort of ‘socio-political trap’ of oligarchic aggrandizement and populist pressures that result in fragmented interests without a national consensus for upgrading industries and services.


title: Risks and Epidemiology of Infections After Hematopoietic Stem Cell Transplantation

text: Infections following HCT are frequently related to risk factors caused by the procedure itself. Neutropenia and mucositis predispose to bacterial infections. Prolonged neutropenia increases the likelihood of invasive fungal infection. GVHD and its treatment create the most important easily identifiable risk period for a variety of infectious complications, particularly mold infections. Profound, prolonged T cell immunodeficiency, present after T cell-depleted or cord blood transplants, is the main risk factor for viral problems like disseminated adenovirus disease or EBV-related posttransplant lymphoproliferative disorder.


title: Life-threatening Respiratory Failure from H1N1 Influenza: Lessons from the Southern Cone Outbreak

text: A sharp increase in the hospitalization rate for pneumonia, particularly among adults between 20 and 40 years old, and an unusual series of deaths, coincident with an increase in laboratory-confirmed influenza cases, were reported in the spring of 2009 in Mexico. This outbreak appeared after the end of influenza season, and was associated with mortality in a younger age-group than the pattern observed in temperate areas in the northern hemisphere [1]. The concurrent finding of a novel, swine-origin influenza A virus (so called pandemic influenza [H1N1] 2009) from infected children in the United States [2] completed the picture.


title: Ventilator-Associated Pneumonia

text: The area of the alveolar epithelium of the lung is approximately 70 m(2). This area is constantly in contact with the ambient air and is therefore vulnerable to contamination with airborne microbes and particles of respirable size. Due to the configuration of the respiratory tract, airborne particles having diameters in the range of 0.5-2.0 μ can reach and deposit in the terminal part of the tracheobronchial tree - most bacteria are of this size. In reality, very few bacteria cause infections by spreading via the airborne route (e.g., mycobacteria, viruses, and legionella). Most bacteria cause pneumonia by first colonizing the upper respiratory tract and later descending into the tracheobronchial tree.


Intensivbehandlung nach Transplantation solider Organe


title: Macrophage Inflammatory Protein-1 Alpha (MIP-1 alpha)/CCL3: As a Biomarker

text: Macrophage inflammatory protein-1 alpha (MIP-1α/CCL3) is a chemotactic chemokine secreted by macrophages. It performs various biological functions, such as recruiting inflammatory cells, wound healing, inhibition of stem cells, and maintaining effector immune response. It activates bone resorption cells and directly induces bone destruction. Cells that secrete MIP-1α/CCL3 are increased at sites of inflammation and bone resorption. MIP-1α/CCL3 plays an important role in the pathogenesis of various inflammatory diseases and conditions that exhibit bone resorption, such as periodontitis, multiple myeloma, Sjögren syndrome, and rheumatoid arthritis. Biological fluids from patients with these diseases exhibit elevated levels of MIP-1α/CCL3. This finding indicates that MIP-1[Formula: see text] /CCL3 protein may have diagnostic potential for the detection of several inflammatory diseases and conditions. This chapter discusses the biological functions of MIP-1α/CCL3; describes several diseases associated with MIP-1α/CCL3, particularly periodontitis; and delineates the potential application of MIP-1α/CCL3 as a biomarker.


Identification of Essential Genes as a Strategy to Select a Sars Candidate Vaccine Using a SARS-CoV Infectious cDNA


title: Roadmap of Agricultural Production and Food Safety Science and Technology Development

text: As Food is related to human survival and health, the country’s reputation and image, and the economic benefit and position in the international trade, it has become one of the hottest issues in the world now. As the continuous growth of world population, the constant changes of human life style and the continued deterioration of natural environment, higher requests for food safety are put forward by human society. Therefore, we should not only ensure the safety of quantity, but also to ensure the safety of quality in the food safety field by 2050. New concepts and technological means should be adopted to ensure the constant production and supply of the “green” and safe agricultural production to meet the people’s great need for food safety, nutrition and health.


Infektiologie


title: Pulmonary Effects of Antineoplastic Therapy

text: Pulmonary toxicity is common after cancer therapy and can result from all therapeutic modalities. The consequential decrease in lung function ranges in severity from subclinical to life-threatening or even fatal and can manifest in the acute setting or many years after completion of therapy. Radiation effects are due to direct insult to the pulmonary parenchyma and, for younger children, impaired thoracic musculoskeletal development. Radiation pneumonitis can occur in the acute/subacute setting, as well as fibrosis with comprised gas exchange as a late effect of direct lung irradiation; thoracic wall malformation can cause restriction of function as a chronic sequela. The pulmonary effects of cytotoxic drugs usually present as acute effects, but there is the potential for significant late morbidity and mortality. Of course, surgical interventions can also cause both acute and/or late pulmonary effects as well, depending on the specific procedure. Although treatment approaches for the management of pediatric cancers are continually adapted to provide optimal therapy while minimizing toxicities, to a varying degree all therapies have the potential for both acute and late pulmonary toxicity. Of note, the cumulative incidence of pulmonary complications rises with increasing time since diagnosis, which suggests that adult survivors of childhood cancer require lifelong monitoring and management of potential new-onset pulmonary morbidity as they age. Knowledge of cytotoxic therapies and an understanding of lung physiology and how it may be altered by therapy facilitate appropriate clinical care and monitoring of long-term survivors.


title: Ergebnisdarstellung: Fallrekonstruktionen und Typisierungen

text: In diesem Kapitel werden die empirischen Befunde der Arbeit vorgestellt. Die nachfolgend präsentierten Interpretationsergebnisse stellen das Resultat einer abstrahierenden Typisierung dar, zu deren Zustandekommen folgendermaßen vorgegangen wurde: Zunächst wurde jeder Fall aus jeder Samplegruppe einzeln betrachtet und anhand des im letzten Kapitels vorgestellten Vorgehens analysiert; infolgedessen zeigte sich, dass sich dabei fallübergreifende Gemeinsamkeiten herausstellten. Indem nach Abschluss der Fallrekonstruktion festgestellt werden konnte, dass sich die Fälle einer Subgruppe unter eine gemeinsame übergreifende Orientierung fassen ließen, wurde eine samplegruppenbezogene Abstrahierung vorgenommen. Dass im Folgenden zwölf generalisierte Orientierungsrahmen präsentiert werden, ist sowohl auf die Sample- als auch auf die dreigeteilte Themenstruktur zurückzuführen.


title: Valuable Secondary Metabolites from Fungi

text: Fungi are amazing producers of natural products, including secondary metabolites. These compounds are crucial to the health and well-being of people throughout the world. They also provide agriculture and livestock with many essential products. Production of secondary metabolites is improved by mutagenesis and recombinant DNA technologies allowing commercial production of these valuable compounds. This chapter centers on these fungal beneficial products, the discovery of which goes back 85 years to the time that penicillin was discovered by Alexander Fleming.


title: Stem Cells and Organ Transplantation: Resetting Our Biological Clocks

text: The human body has only a limited ability to repair itself. Illness, injury, and aging can overwhelm its built-in capability to replace dysfunctional, damaged, or destroyed tissues. We can at best only partly regenerate our organs and cannot grow back a whole limb.


title: Anaesthetic and Perioperative Management for Liver Transplantation

text: This chapter concerns about perioperative anaesthesiologic management of liver transplantation. Liver cirrhosis and its complications often involve different organs whose derangements could severely worsen postoperative outcome; hence, their preoperative diagnosis and treatment are fundamental; the first part of this chapter describes the most frequent complications of cirrhosis and their implications in preoperative care. Liver transplantation is a challenging task for the anaesthesiologist because of the risk of bleeding, cardiovascular derangements, coagulation impairment and metabolic disturbances; the second part of this chapter describes the main anaesthetic and monitoring techniques used for liver transplantations and the most important intraoperative problems which need to be faced by the anaesthesiologist in each phase of the intervention. Early postoperative management of liver transplant recipients is crucial because of their comorbidities and the potential surgical and medical complications of the intervention; the third part of this chapter describes the ICU management after liver transplantation and the main medical complications for every organ system that needs a critical care approach.


title: Hygiene, Mikrobiologie, Virologie

text: Die Mikrobiologie und Infektionsepidemiologie umfasst die Laboratoriumsdiagnostik mikrobiell bedingter Erkrankungen und die Aufklärung ihrer epidemiologischen Zusammenhänge und Ursachen. Weiterhin gehört in dieses Gebiet die Unterstützung der in der Vorsorge, in der Krankenbehandlung und im Öffentlichen Gesundheitsdienst tätigen Ärzte bei der Diagnose von Infektionskrankheiten, ihrer Prophylaxe und Bekämpfung sowie bei der mikrobiologischen Bewertung antimikrobieller Substanzen.


title: Lebererkrankungen

text: Die Leber als größtes inneres Organ des menschlichen Körpers ist ein zentrales Organ in Kohlehydrat- und Fettstoffwechsel, in der Herstellung zahlreicher Eiweiße, Enzyme und Gerinnungsfaktoren und in der Entgiftung und Ausscheidung verschiedenster Substanzen. Dieses Kapitel gibt einen Überblick über angeborene und erworbene Lebererkrankungen, deren Epidemiologie, Pathophysiologie, klinische Symptome, Komplikationen und Verlauf, typische Befunde zur Diagnosestellung und Differentialdiagnosen sowie therapeutische Möglichkeiten und Prognose. Das breite Spektrum der Lebererkrankungen umfasst angeborene Defekte des Eisen- und Kupferstoffwechsels, virale und bakterielle Infektionen, Parasitenbefall, vaskuläre und autoimmune Erkrankungen, Schädigung durch Alkohol oder Verfettung, sowie benigne und maligne primäre und sekundäre Lebertumore.


title: Infektionen des ZNS

text: Durch Bakterien hervorgerufene Meningitis mit der klassischen Trias Kopfschmerzen, Fieber und Meningismus


title: Pathogenität — Infektionsverlauf

text: Die Pathogenität von Viren ist die Voraussetzung für die Entstehung von Krankheiten. Sie kommt durch vielfältige Eigenschaften des Wirts und des Virus zustande. Im Brennpunkt stehen der virusbedingte primäre Zellschaden und die Entzündung mit sekundären immunpathologischen Zellschädigungen.


title: Viral Hepatitis: Other Viral Hepatides

text: Non-hepatotropic viruses cause acute hepatitis and/or acute liver failure, without causing any chronic damage to the liver. These viruses do not primarily target the liver. These viruses include the herpes viruses (Epstein-Barr virus, cytomegalovirus, and herpes simplex virus), parvovirus, adenovirus, influenza, and severe acute respiratory syndrome (SARS)-associated coronavirus. The risk of acquiring infection from any of the non-hepatotropic viruses is specific to each virus. Infection with the herpesviruses is ubiquitous, with clinically significant hepatitis being less common. Considerations for determining the risk of hepatitis from non-hepatotropic viruses include prior exposure (risk of reactivation), host immune status (increase severity in immunosuppressed), and duration of infection in the contact. Diagnosis is made with a combination of serology, polymerase chain reaction, or liver biopsy. Treatment is supportive in the majority. In certain clinical scenarios, such as cytomegalovirus infection in transplant patients, and acute liver failure from herpes simplex virus, specific antiviral therapy is warranted.


title: Role of the Microbial Burden in the Acquisition and Control of Healthcare Associated Infections: The Utility of Solid Copper Surfaces

text: For more than a century, healthcare has been challenged to keep environmental surfaces clean to control microbes and improve patient outcomes. However despite an annual cost exceeding ten billion dollars cleaning with disinfection has done little to reduce the incidence of healthcare-associated infections (HAI). This chapter will review the scientific evidence delineating the role that the environment and healthcare workers play in the acquisition and movement of the microbes implicated in HAI and how through controlling the microbial burden of the built clinical environment it is possible to mitigate the rate of HAI acquisition. Specifically evidence demonstrating the effectiveness of solid copper surfaces for its ability to continuously limit the concentration of bacteria found on surfaces and objects within the built environment will be reviewed in concert with a discussion of how through the mitigation of the environmental burden copper surfaces are able to concomitantly reduce the incidence of HAI. Insights provided by this chapter are intended to facilitate an understanding and importance of the need to use a comprehensive or systems based approach to fight healthcare associated infections.


title: Applications of Multi-Type Branching Processes

text: Two applications of multi-type branching processes to epidemic models are presented. The first application is to an SEIR epidemic model and the second application is to the same epidemic model but with dispersal. The SEIR epidemic is modeled as a two-type branching process. Occurrence of an outbreak depends on the number of exposed and infectious individuals. It is shown that the offspring pgfs for the exposed and infectious populations lead to an explicit formula for the probability of an outbreak.


title: Hygiene auf der IMC-Station

text: Im Kapitel Hygiene auf der IMC-Station wird dargelegt, dass die Einhaltung von Hygienemaßnahmen nach den neuesten wissenschaftlichen Erkenntnissen zu den Basismaßnahmen einer jeden IMC-Station gehört. Neben den Standard-Hygienemaßnahmen einer IMC-Station werden die besonderen Aspekte der hygienischen Körperpflege beschrieben. Die erforderlichen Interventionen zur Vermeidung von Katheterinfektionen werden begründet. Die Vorbereitung, Anlage und Pflege der Katheter werden detailliert dargestellt, sodass jeder Lernende dies als Handlungsanweisung verwenden kann und dem Erfahrenen eine Detailprüfung ermöglicht wird. Wichtige Aspekte der Wund-, Drainagen- und Stomapflege werden besprochen und eine Kurzübersicht zur Pflege von Patienten mit MRE gegeben.


title: Recombinant Human Deoxyribonuclease I

text: Human deoxyribonuclease I (DNase I) is an endonuclease that catalyzes the hydrolysis of extracellular DNA and is just one of the numerous types of nucleases found in nature. The enzymatic mechanism for a single turnover is reasonably well understood based on biochemical and structural studies that are consistent with divalent metal ion dependent nonspecific nicking of a phosphodiester bond in one of the strands of double stranded DNA. Recombinant human DNase I (rhDNase I, rhDNase, Pulmozyme(®), dornase alfa) has been expressed in mammalian cell culture in Chinese hamster ovary cells and developed clinically where it is aerosolized into the airways for treatment of pulmonary disease in patients with cystic fibrosis (CF). rhDNase I hydrolyzes the DNA in purulent sputum of CF patients and reduces sputum viscoelasticity. Reduction of high molecular weight DNA into smaller fragments by treatment with aerosolized rhDNase I has been proposed as the mechanism to reduce the mucus viscosity and improve mucus clearability from obstructed airways in patients. The improved clearance of the purulent mucus enhances pulmonary function and reduces recurrent exacerbations of respiratory symptoms. rhDNase I was approved for clinical use in 1993 and has been widely used as a safe and effective therapy for CF patients. The use of rhDNase I has also been investigated in other diseases where exogenous DNA has been implicated in the disease pathology.


title: Social Dilemma Analysis of the Spread of Infectious Disease

text: Understanding and controlling the spread of infectious disease is a pressing issue for our society. Contemporary globally connected civilization is more at risk from various modern infectious diseases than classical ones such as pests, cholera, and tuberculosis. Over the last few years, pandemic outbreaks of highly virulent influenza, possibly related to avian flu, severe acute respiratory syndrome (SARS), and middle-eastern respiratory syndrome coronavirus (MARSE) have been a threat. Beyond this, the intentional spread of infectious disease, e.g., “bioterrorism”, has come to be recognized as being just as dangerous as nuclear weapons. An infectious disease spreads on human social networks. Each individual can protect himself through several measures. Pre-emptive vaccination is thought to be most effective, although it incurs a partial cost to each individual. This brings about a social dilemma, because an individual may be able to rely on so-called “herd immunity” to avoid his own infection without himself being vaccinated. Also, besides vaccination, there may be several practical ways to protect against contagion, such as wearing a mask, keeping away from crowds, and self-isolation by leaving the home less often, which may be less costly and less effective than vaccination. In any case, there is a human-decision-making process regarding what steps should be taken, while the dynamics of infectious-disease spread can themselves be evaluated as a diffusion problem that has been well-studied in physics for many years. Thus, based on the concept of human–environment–social interaction, a basic-physics model for this diffusion problem that considers evolutionary game theory (EGT) may lead us to obtain some meaningful solutions that can be proposed to our society. Following the previous chapter explaining how EGT can be applied to traffic-flow analysis, this chapter describes this practical problem.


China


title: Humans, Other Animals and ‘One Health’ in the Early Twenty-First Century

text: This chapter explores the history of recent movements for One Health, which argue that because many of today’s pressing health problems lie at the interface of human, animal and environmental health, they can only be managed effectively by breaking down traditional disciplinary silos. It explores how Schwabe’s work influenced, and was reconfigured by, this movement, and locates its early development in several different research and policy networks, which produced not one but several different forms of One Health. The chapter also examines how human–animal health relationships have inspired and shaped One Health, and how they are represented—in sometimes contradictory ways—in the texts and images produced by One Health researchers and advocates. It argues that in foregrounding the roles of animals as transmitters of diseases to humans, and as experimental models of human disease, One Health rebrands existing longstanding research agendas that are more concerned with the health of humans than that of animals.


title: Short- and Long-Term Reaction to Exogenous Demand Shifts

text: In less than 10 years, the liberalization of the European airline industry has placed flag carriers in a highly competitive and dynamic environment. One of the reasons for the demand dynamic clearly results from the peculiarity of the industry: airline carriers have to produce one of the most perishable goods (passenger transport). This fact has forced carriers to implement and refine practices and strategies in order to react promptly to the ups and downs of the demand. In Chap. 2 we described the common practices employed to face short-term demand fluctuations that usually rely on advanced pricing policies, called ‘yield management’. Long-lasting demand shifts require a reaction in terms of capacity supply described in Sect. 2.4.2 as ‘network planning’.


title: We Do Not Live in an Age of Cosmopolitanism but in an Age of Cosmopolitization: The ‘Global Other’ is in Our Midst

text: The collapse of a world order is often a moment for reflection on the dominant social theory and research of the time, but surprisingly this is not the case today. Mainstream social theory still floats loftily above the lowlands of epochal transformations (climate change, financial crisis, nation-states) in a condition of universalistic superiority and instinctive certainty. This universalistic social theory, whether structuralist, interactionist, Marxist, critical or systems-theory, is now both out of date and provincial.


title: Cardiopulmonary Resuscitation Injuries in Children

text: Cardiopulmonary resuscitation (CPR) is an emergency intervention to maintain circulation and breathing in an unresponsive individual suffering from cardiopulmonary arrest. However, CPR is not without its own risks. Injuries secondary to compression and ventilation are well documented in the medical and scientific literature. Most of these injuries are minor, but some can result in significant morbidity and even death. It is important to identify those injuries that could be secondary to CPR versus inflicted traumatic injuries of child maltreatment.


title: General Medicine and Surgery for Dental Practitioners: Infections and Infection Control

text: Infection control and knowledge of common infectious agents are cornerstones of safe dental practice. This paper summarises the measures that need to be taken to control cross infection and discusses some of the infectious agents of concern to dental practitioners.


The Pancreas


title: Human Security in Practice: The Chinese Experience

text: This chapter elaborates on how the idea of human security is defined and understood by the government and various actors in China. As one of the permanent members of the United Nations (UN) Security Council, China, has been supportive of international norms advocated by the UN, and even though the term human security has not been frequently used, in effect it has been vigorously practiced. For both the government and the academic community in China, human security and national security are not necessarily in confrontation but rather can complement and strengthen one another. The purpose is to improve the quality of people’s everyday life and the government is expected to contribute to this end. Chinese people expect the government to extend a parental roof over the people.


title: Case Studies

text: Ms A was a 28 year old woman in her second pregnancy (she had one previous termination of pregnancy) who booked-in at 19 weeks’ gestation. She was known to have sickle cell disease (specifically sickle cell anaemia [HbSS]), and her last crisis had occurred 3 years before this pregnancy.


Bildgebende Verfahren: Röntgen, Ultraschall, CT, Nuklearmedizin


title: Chronic Kidney Disease in the Intensive Care Unit

text: The incidence and prevalence of chronic kidney disease (CKD) and end-stage renal disease are increasing, and these patients have a higher risk of developing critical illness and being admitted to the intensive care unit (ICU) compared to the general population. The higher prevalence of comorbid disease puts this population at higher risk for worse short- and long-term outcomes following ICU admission compared to the general population, although short-term mortality seems to be determined largely by the acute illness severity rather than CKD status per se. The pathophysiologic changes accompanying CKD present unique challenges to the management of acute critical illness most notably volume and metabolic homeostasis and drug dosing adjustment. CKD is an important risk factor for the development of acute kidney injury (AKI) complicating critical illness and can predispose to further accelerated decline in kidney function among ICU survivors. Renal replacement therapy (RRT) support is frequently used in ICU settings, and continuous renal replacement therapy modality remains the most commonly used among critically ill patients.


title: Role of CD14 in Lung Inflammation and Infection

text: Toll-like receptors (TLR) on the surface of cells of the respiratory tract play an essential role in sensing the presence of microorganisms in the airways and lungs. These receptors trigger inflammatory responses, activate innate immune responses, and prime adaptive immune responses to eradicate invading microbes [1]. TLR are members of a family of pattern-recognition receptors, which recognize molecular structures of bacteria, viruses, fungi and protozoa (pathogen-associated molecular patterns or PAMPs), as well as endogenous structures and proteins released during inflammation (damage/danger-associated molecular patterns or DAMPs). To date, ten different TLR have been identified in humans and twelve in mice. TLR are expressed on all cells of the immune system, but also on parenchymal cells of many organs and tissues. The binding of a PAMP to a TLR results in cellular activation and initiates a variety of effector functions, including cytokine secretion, proliferation, co-stimulation or phagocyte maturation. To facilitate microbial recognition and to amplify cellular responses, certain TLR require additional proteins, such as lipopolysaccharide (LPS) binding protein (LBP), CD14, CD36 and high mobility group box-1 protein (HMGB-1). In this chapter, the role of CD14 as an accessory receptor for TLR in lung inflammation and infection is discussed. The central role of CD14 in the recognition of various PAMPs and amplification of immune and inflammatory responses in the lung is depicted in Figure 1.


title: Ocimum Genome Sequencing—A Futuristic Therapeutic Mine

text: Next-generation sequencing (NGS) platforms from the past decade are in the continuous efforts of changing the impact of sequencing on our current knowledge about plant genes, genomes, and their regulation. Holy basil (Ocimum tenuiflorum L. or sanctum L.) genome sequencing has also paved the path for deeper exploration of the medicinal properties of this beneficial herb making it a true ‘elixir of life.’ The draft genome sequence of the holy basil has not only opened the avenues for the drug discovery but has also widened the prospects of the molecular breeding for development of new improved plant varieties.


title: Laryngeal Infections

text: The following chapter is a review of the most common viral and bacterial etiologies of pediatric laryngeal infections. The chapter reviews the diagnostic approach to laryngeal infections, focusing on key points of the history and physical exam, including concerning signs and symptoms suggestive of airway distress. Viral and bacterial laryngitis, croup, epiglottis, recurrent respiratory papillomatosis, as well as some less common causes of bacterial infections are discussed in detail with each etiology’s epidemiology, clinical features, associated diagnostic evaluation, and management reviewed.


title: G-Protein-Coupled Receptors

text: Receptors coupled to heterotrimeric guanine nucleotide-binding proteins, the socalled G-protein-coupled receptors (GPCR), represent the largest set of plasmalemmal receptors


title: Coronavirus

text: Name of Virus: Coronavirus


title: Hematopoietic Stem Cell Transplantation

text: Hematopoietic stem cell transplantation offers patients the only prospect of long-term survival for a substantial variety of otherwise incurable malignant neoplasms as well as selected non-neoplastic conditions. This therapeutic modality, however, carries significant risks and is associated with a wide range of complications affecting not only the bone marrow but many organ systems, in particular by graft-versus-host disease. Patients before, during, and following stem cell transplantation thus require close monitoring and the pathologist is frequently implicated in this process. The aim of this chapter is to provide the pathologist with the tools required to interpret biopsies from these patients at all stages of the transplantation process. Following an overview of hematopoietic stem cell transplantation and graft-versus-host disease, the chapter will focus on the histopathologic findings of graft-versus-host disease and other complications in several organs and tissue including bone marrow, skin, lung, kidney, gastrointestinal tract and liver, with emphasis on the diagnostic criteria and approaches to graft-versus-host disease.


title: Bioinformatics and Nanotechnologies: Nanomedicine

text: In this chapter we focus on the bioinformatics strategies for translating genome-wide expression analyses into clinically useful cancer markers with a specific focus on breast cancer with a perspective on new diagnostic device tools coming from the field of nanobiotechnology and the challenges related to high-throughput data integration, analysis, and assessment from multiple sources. Great progress in the development of molecular biology techniques has been seen since the discovery of the structure of deoxyribonucleic acid (DNA) and the implementation of a polymerase chain reaction (PCR) method. This started a new era of research on the structure of nucleic acids molecules, the development of new analytical tools, and DNA-based analyses that allowed the sequencing of the human genome, the completion of which has led to intensified efforts toward comprehensive analysis of mammalian cell struc ture and metabolism in order to better understand the mechanisms that regulate normal cell behavior and identify the gene alterations responsible for a broad spectrum of human diseases, such as cancer, diabetes, cardiovascular diseases, neurodegenerative disorders, and others.


title: The role of viruses in the etiology and pathogenesis of common cold

text: Numerous viruses are able to cause respiratory tract infections. With the availability of new molecular techniques, the number of pathogens detected in specimens from the human respiratory tract has increased. Some of these viral infections have the potential to lead to severe systemic disease. Other viruses are limited to playing a role in the pathogenesis of the common cold syndrome. This chapter focuses on the viral pathogens that are linked to common cold. It is not the intention to comprehensively review all the viruses that are able to cause respiratory tract infections—this would go beyond the scope of this book. The list of viruses that are briefly reviewed here includes rhinoviruses, respiratory syncytial virus, parainfluenza virus, adenovirus, metapneumovirus and coronavirus. Bocavirus is discussed as one example of a newly identified pathogen with a less established role in the etiology and pathogenesis of common cold. Influenza virus does not cause what is defined as common cold. However, influenza viruses are associated with respiratory disease and the clinical picture of mild influenza and common cold frequently overlaps. Therefore, influenza virus has been included in this chapter. It is important to note that a number of viruses are frequently co-detected with other viruses in humans with respiratory diseases. Therefore, the viral etiology and the role of viruses in the pathogenesis of common cold is complex, and numberous questions remain to be answered.


title: Chirurgische Infektionen

text: Der menschliche Organismus ist von einer unzähligen Menge von Mikroorganismen umgeben. Dringen diese Krankheitserreger in uns ein, dann laufen Wechselbeziehungen zwischen dem Eindringling und dem Wirtsorganismus ab. Krankheit resultiert, wenn die Mikroorganismen aufgrund ihrer verschiedenen Determinanten der Pathogenität und Virulenz den Wettlauf mit der Infektabwehr des Makroorganismus gewonnen haben. Mit diesem Problem hatten sich Chirurgen zu allen Zeiten auseinanderzusetzen und es hat bis heute nicht an Aktualität verloren.


title: Anti-angiogenic Targets: Angiopoietin and Angiopoietin Receptors

text: Tumor blood vessel formation (angiogenesis) is essential for tumor growth and metastasis. Two main endothelial ligand–receptor pathways regulating angiogenesis are vascular endothelial growth factor (VEGF) receptor and angiopoietin-TIE receptor pathways. The angiopoietin-TIE pathway is required for the remodeling and maturation of the blood and lymphatic vessels during embryonic development after VEGF and VEGF-C mediated development of the primary vascular plexus. Angiopoietin-1 (ANGPT1) stabilizes the vasculature after angiogenic processes, via tyrosine kinase with immunoglobulin-like and EGF-like domains 2 (TIE2) activation. In contrast, ANGPT2 is upregulated at sites of vascular remodeling. ANGPT2 is secreted by activated endothelial cells in inflammation, promoting vascular destabilization. ANGPT2 has been found to be expressed in many human cancers. Intriguingly, in preclinical models inhibition of ANGPT2 has provided promising results in preventing tumor angiogenesis, tumor growth, and metastasis, making it an attractive candidate to target in tumors. However, until now the first ANGPT2 targeting therapies have been less effective in clinical trials than in experimental models. Additionally, in preclinical models combined therapy against ANGPT2 and VEGF or immune checkpoint inhibitors has been superior to monotherapies, and these pathways are also targeted in early clinical trials. In order to improve current anti-angiogenic therapies and successfully exploit ANGPT2 as a target for cancer treatment, the biology of the angiopoietin-TIE pathway needs to be profoundly clarified.


title: Nanomaterial-Based Antibacterial Paper

text: Antibacterial materials are widely used in everyday life and plays important roles in the public health system. There are a wide range of materials that have been known to prevent attachment and proliferation of microbes on material surfaces. These include antibiotics, metal ions and quaternary ammonium compounds. Given the availability of these various antibacterial materials, concerns about antibiotics-resistance, environmental pollution, relatively complex processing and high cost have been of much recent interest. Antimicrobial properties of nanomaterials have been explored to meet these challenges. Various nanomaterials including silver nanoparticles (AgNPs), titanium oxide nanoparticles and carbon nanotubes (CNTs) have been found to be highly effective bacterial-killing materials. The most well-known examples are silver and silver-based compounds, which were well known to be antiseptic to a spectrum of bacterium even in ancient times. AgNPs have proven to possess high antibacterial activity with minimal perturbation to human cells. Consequently, widespread applications of AgNPs have been found in medical and environmental areas [1]. More recently, carbon nanomaterials have emerged as a type of novel antibacterial nanomaterials, including CNTs and graphene. In this chapter, we aim to provide a review on the fabrication of nanomaterials-based paper-like films and their antibacterial applications.


title: Disease Spreading in Time-Evolving Networked Communities

text: Human communities are organized in complex webs of contacts that may be represented by a graph or network. In this graph, vertices identify individuals and edges establish the existence of some type of relations between them. In real communities, the possible edges may be active or not for variable periods of time. These so-called temporal networks typically result from an endogenous social dynamics, usually coupled to the process under study taking place in the community. For instance, disease spreading may be affected by local information that makes individuals aware of the health status of their social contacts, allowing them to reconsider maintaining or not their social contacts. Here we investigate the impact of such a dynamical network structure on disease dynamics, where infection occurs along the edges of the network. To this end, we define an endogenous network dynamics coupled with disease spreading. We show that the effective infectiousness of a disease taking place along the edges of this temporal network depends on the population size, the number of infected individuals in the population and the capacity of healthy individuals to sever contacts with the infected, ultimately dictated by availability of information regarding each individual’s health status. Importantly, we also show how dynamical networks strongly decrease the average time required to eradicate a disease.


title: Applications

text: The ability of materials to dramatically change their properties at nanoscale has opened up the possibility of making new devices, instruments and consumer goods to function in a much better way than was possible earlier. We have seen in Chaps. 10.1007/978-3-319-09171-6_10 and 10.1007/978-3-319-09171-6_11 that nanomaterials have enabled us to design new products which were not possible using bulk materials. Rapid progress in the synthesis and understanding of nanomaterials in just a few years has led them to enter the world market in a big way. Figure 12.1 shows an overview of various fields in which nanomaterials have entered or are about to enter. In this chapter we shall briefly discuss some of these applications.


title: Pandemic Influenza: A Comparative Ethical Approach

text: Community-networks such as families and schools may foster and propagate some types of public health disasters. For such disasters, a communitarian-oriented ethical lens offers useful perspectives into the underlying relational nexus that favors the spread of infection. This chapter compares two traditional bioethical lenses—the communitarian and care ethics framework—vis-à-vis their capacities to engage the moral quandaries elicited by pandemic influenza. It argues that these quandaries preclude the analytical lens of ethical prisms that are individual-oriented but warrant a people-oriented approach. Adopting this dual approach offers both a contrastive and a complementary way of rethinking the underlying socioethical tensions elicited by pandemic influenza in particular and other public health disasters generally.


title: Software Support for Common Criteria Security Development Process on the Example of a Data Diode

text: The data diodes are very often used to protect users’ networks and sensitive data and that is why additional assurance of those devices is demanded. This assurance can be obtained by applying the Common Criteria security development process. The process is very difficult and time-consuming specially for those not familiar with the standard. Although there are many guidelines and templates telling how to define the security problem still there is a lack of computer aiding tools. This paper describes the plug-in application which supports identification of protected assets, threats, security objectives and security functions – the main elements of security specification. The tool facilitates and speeds up the security development process of IT products.


title: Extracorporeal Membrane Oxygenation (ECMO)/Extracorporeal Carbon Dioxide Removal (ECCO(2)R)

text: Extracorporeal membrane oxygenation (ECMO) is a means of supporting severe pulmonary and cardiac dysfunction. It stabilizes critical derangements of oxygenation and ventilation, allowing time to diagnose, treat, and recover from the underlying cause of organ failure. The extracorporeal circuit has three main components: large-bore cannulae and circuit tubing to provide access to the native circulation, an artificial membrane lung to provide gas exchange, and an active pump to facilitate perfusion. Multiple clinical studies have evaluated this technology, the strongest evidence to date supporting its use being the Conventional Ventilation or ECMO for Severe Adult Respiratory Failure (CESAR) trial, which showed survival advantage when patients were treated with a protocol that included ECMO. Extracorporeal carbon dioxide removal (ECCO(2)R) is similar in concept to ECMO, but has a lower flow rate and does not significantly oxygenate the patient. It is a primary treatment for hypercarbic respiratory failure or is an adjunct to reduce potentially injurious levels of mechanical ventilator support in hypoxemic respiratory failure. Complications are common occurrences on both types of therapy. Strong institutional commitment and a team approach are critical to successful implementation. Additional randomized trials are needed to clarify the appropriate indications and best practices for these lifesaving therapies.


title: Respiratory Filters and Ventilator-Associated Pneumonia: Composition, Efficacy Tests and Advantages and Disadvantages

text: Respiratory filters are devices with a high capacity to prevent the passage of microorganisms. The use of respiratory filters interposed in respiratory circuits to avoid ventilator-associated pneumonia (VAP) was proposed after reports between 1952 and 1972 of several outbreaks of respiratory infections attributed to contamination of anesthesia machines; however, none of the reports presented a bacteriological demonstration of a cause-and-effect relationship. The use of respiratory filters has not decreased the incidence of VAP in patients on anesthesia machines and in critically ill patients. Besides, respiratory filters could have some undesirable effects such as the increase of resistance to inspiratory airflow, increase of resistance to expiratory airflow and increase of dead space in the breathing circuit. Thus, the use of respiratory filters is not routinely necessary; however, they should be used in patients with suspected or confirmed highly communicable respiratory infections (such as bacillary pulmonary tuberculosis) and who require mechanical ventilation).


title: Transfusion of Blood and Blood Products

text: In transfusion medicine, several blood products can be prepared and used as replacement therapy; however, four of these products are more commonly used in general practice: RBCs, fresh frozen plasma (FFP), platelets and cryoprecipitate. RBC transfusions are mainly administered to improve tissue oxygenation in cases of anaemia or acute blood loss due to trauma or surgery. FFP, platelets and cryoprecipitate are used for the prevention and treatment of bleeding.


title: “Can’t Stop Coughing (But I Need to Get Back to the Shelter by 6)”

text: In this chapter, we will explore a case involving an outbreak of tuberculosis that occurred among men living in a homeless shelter. The case delves into both the public health challenges involved in investigating a disease outbreak in a vulnerable population and the delicate balance of protecting individuals’ autonomy and confidentiality while protecting the public’s health. By the conclusion of the case, learners will be able to apply the socioecological model to tuberculosis, analyze an outbreak of disease using epidemiologic tools, and identify conflicts in balancing autonomy and justice while managing potential public health threats.


title: Diagnosis of Pulmonary Parasitic Diseases

text: The protozoal and helminthic parasites that traverse the respiratory tract during their life cycles can cause lung diseases, though the most common habitats of these parasites are the gastrointestinal tract and the blood or lymphatic circulations. These diseases are commonly encountered in the tropical regions of the world. However, parasitic lung diseases are increasingly being reported from other parts of the world due to an increase in the occurrence of immunosuppression (acquired immunodeficiency syndrome, organ transplantations, the use of immunosuppressive drugs) and transcontinental travel. The lung diseases that may result from these infections range from asymptomatic phase to life-threatening acute respiratory distress syndrome. These diseases can also mimic common respiratory diseases such as bacterial pneumonias, pulmonary tuberculosis, lung cancer, bronchial asthma, interstitial lung disease, and pulmonary hypertension. The diagnosis of parasitic lung diseases is a challenge to physicians, if they are not aware of the entity or these diseases are not investigated properly. The diagnosis of these diseases is based on the identification of the causative organism in the stool, sputum, other body fluids, or tissue specimens. Radiological imaging studies of the thorax including chest radiographs, high-resolution computerized tomograms, and ultrasonograms may aid in the diagnosis. In certain situations, invasive investigations such as fiberoptic bronchoscopic evaluation (transbronchial lung biopsies and bronchoalveolar lavage studies) and thoracic surgical procedures (thoracoscopy and open lung biopsy) may be required for a diagnosis and also to exclude other lung diseases. Serologic and molecular diagnostic methods are being developed for accurate diagnosis of the parasitic diseases.


title: Extraglandular Manifestations of Sjögren’s Syndrome (SS): Dermatologic, Arthritic, Endocrine, Pulmonary, Cardiovascular, Gastroenterology, Renal, Urology, and Gynecologic Manifestations

text: Primary Sjögren’s syndrome (1° SS) is an autoimmune disorder characterized by dry eyes (keratoconjunctivitis sicca) and dry mouth due to lymphocytic infiltrates of lacrimal and salivary glands. However, SS also affects many extraglandular systems. In SS patients, the pattern of extraglandular manifestations may have a close similarity with the vasculitic features seen in SLE patients that are mediated by immune complexes and complement. However, SS patients also have an increased frequency of lymphocytic infiltration into extraglandular tissues, as might be expected by their increased frequency of lymphoma in comparison to SLE patients. For example, SS patients need to be evaluated for interstitial nephritis (in contrast to the glomerulonephritis of SLE) or interstitial pneumonitis (in comparison to pleurisy of SLE). This chapter will focus on the clinical extraglandular manifestations of primary SS that are not specifically covered in other chapters. These extraglandular manifestations have led to a recently introduced “disease activity” and “organ damage index.” The recognition of these extraglandular manifestations is important since they have prognostic and therapeutic implications. The differential diagnosis of these extraglandular manifestations includes overlapping features with other autoimmune diseases (particularly systemic lupus erythematosus (SLE), scleroderma, dermatomyositis, celiac sprue, and small- and medium-sized vessel vasculitis), infectious diseases that mimic autoimmune disease (particularly hepatitis C, HIV, syphilis, tuberculosis), and predisposition to drug toxicities that may involve extraglandular organs (particularly skin rashes, nephritis, pneumonitis, myositis, and hematopoietic abnormalities).


title: Sicherheitspolitische Bedrohungen und Risiken und das „geltende“ Recht in der 2. Hälfte des 2. Jahrzehnts des 21. Jahrhunderts unter besonderer Berücksichtigung der Sicherstellungs- und Vorsorgegesetze. Sicherheitspolitik in Zeiten der Uneindeutigkeit

text: Das Grundgesetz (GG) kennt klare Regelungen zum Spannungs- und Verteidigungsfall, vgl. nur Art. 80a, 115a Abs. 1 GG. Diese Bestimmungen wurden unter den Bedrohungslagen des Kalten Krieges und seiner gefährlichsten Tage in der Kuba- Krise in einer Notstandsverfassung zusammengefasst, bei einer großen Wintex-Übung im Ausweichsitz der Verfassungsorgane in Mariental erprobt und von der ersten großen Koalition „verabschiedet“ (1966–1969, Kabinett Kiesinger/Brandt). Veränderungen folgten.


title: Akute Störungen der Atmung: spezielle Krankheitsbilder

text: Postoperative respiratorische Insuffizienz, Rippenserienfrakturen, Lungenkontusion, akutes Lungenversagen, pulmonale Aspiration von Magensaft, Pneumonie und akut dekompensierte COPD gehören zu den häufigsten Erkrankungen, die eine intensivmedizinische Behandlung mit apparativer Unterstützung der Atmung erfordern. Bei schwersten Formen – v. a. bei ARDS – ist ein erheblicher apparativer und personeller Aufwand erforderlich, nicht selten trotz aller Maßnahmen mit tödlichem Ausgang.


Volume 4 Isolated Compounds (N-S)


title: Life Cycle and Life History Strategies of Parasitic Crustacea

text: Different parasitic life strategies are described including four new life cycles: complex rebrooding, micro-male, mesoparasite and prey-predator transfer. Four new life cycle behaviours are named: nursery hiding, mid-moult stage, positive precursor (intraspecific antagonism) and negative precursor (ambush strategy). Further strategies discussed are opossum attack, double parasitism (doubling of the normal reproductive set), duplex arrangement (separated male-female pairs), simple rebrooding, and describing how displaced parasites and superinfections may partly elucidate life cycles. Proportional stunting masks life history effects of parasitism; cuckoo copepods are true parasites and not just associates; burrowing barnacles (acrothoracicans) are not parasites. Further findings based on life cycle information: branchiurans and pentastomes are possibly not related; firefly seed shrimp are not parasites; copepod pre-adult life cycle stages are common in the western pacific but rare in Caribbean; harpacticoids on vertebrates are not parasites; cuckoo copepods are true parasites; explained the importance of pennellid intermediate hosts. Crustacean parasite life cycles are largely unknown (1% of species). Most crustacean life cycles represent minor modifications from the ancestral free-living mode. Crustacean parasites have less complex and less modified life cycles than other major parasite groups. This limits their exploitation of, and effectiveness, in parasitism. However, these life cycles will be an advantage in Global Change. Most metazoan parasites will be eliminated while crustaceans (and nematodes) will inherit the new world of parasites.


title: The Way Forward: The Power of Diversity

text: This chapter wraps up the discussion of all chapters by incorporating perspectives of JICA practitioners. We can advance the human security practice in the three dimensions: national, regional, and global. In the national dimension, capacity development and empowerment will play a key role. In the regional dimension, the diversity of “ASEAN Plus Three” can be the source of dynamic community formation in East Asia. In the global dimension, human security can effectively supplement the Sustainable Development Goals (SDGs) by means of its emphasis on risks and vulnerability. Finally, the entanglement of human security and responsibility to protest (R2P) is discussed. Making much of national ownership and dignity, human security is expected to reinforce its influence in East Asia and worldwide.


title: Emerging Diseases from Animals

text: December 2013, an outbreak of the deadly Ebola virus began in a small village in southern Guinea, the first outbreak of the Zaire Ebola strain in West Africa. Within a year’s time, the outbreak, which was not officially noticed by health authorities until March 2014, had led to approximately 18,000 known human cases and 6,300 deaths, posing an unprecedented challenge to global public health. Air travel helped the disease leap from West Africa to other continents, including North America and Europe.