SARS McLean, Angela; May, Robert; Pattison, John ...
03/2005
eBook
The sudden appearance and rapid spread of Severe Acute Respiratory Syndrome (SARS) in 2003 alerted the world to the fact that emerging infections are a global problem. Living in affluent societies ...with well-developed healthcare systems does not necessarily protect people from the dangers posed by life-threatening infections. The SARS epidemic tested global preparedness for dealing with a new infectious agent and raised important questions: How did we do, and what did we learn? This book uses the SARS outbreak as a case study to enumerate the generic issues that must be considered when planning the control of emerging infections. Emerging infections are more than just a current biological fashion: the bitter ongoing experience of AIDS and the looming threat of pandemic influenza teach us that the control of infectious disease is a problem that has not been solved. Scientists from a broad range of disciplines — biologists, veterinarians, physicians, and policy makers — all need to prepare. But prepare for what? The book provides an overview of the tasks that must be addressed by a community that wishes to confront emerging infections. While focusing on SARS, the book addresses a whole range of considerations and issues, from the use of new mathematical models to account for the spread of infection across global airline networks, to a discussion of the ethics of quarantining individuals in order to protect communities.
As atrocity has become characteristic of modern history, testimonial writing has become a major twentieth-century genre. Untimely Interventions relates testimonial writing, or witnessing, to the ...cultural situation of aftermath, exploring ways in which a culture can be haunted by its own history.
Ross Chambers argues that culture produces itself as civilized by denying the forms of collective violence and other traumatic experience that it cannot control. In the context of such denial, personal accounts of collective disaster can function as a form of counter-denial. By investigating a range of writing on AIDS, the First World War, and the Holocaust, Chambers shows how such writing produces a rhetorical effect of haunting, as it seeks to describe the reality of those experiences culture renders unspeakable.
Ross Chambers is Professor of Romance Languages at the University of Michigan. His other books includeFacing It: AIDS Diaries and the Death of the Author.
A multifactorial condition associated with a complex genetic predisposition and various, poorly understood, environmental triggers that induce immune responses directed against components of the ...person's own body. Appropriate investigations are critical to correct diagnosis in order to tailor management. Multidisciplinary care is important and should involve the full range of allied health professionals .The majority of cases are cared for long term by dermatologists, rheumatologists, and/or nephrologists, as it is the skin, joints and kidneys that are most often involved.
In silico network-based methods have shown promising results in the field of drug development. Yet, most of networks used in the previous research have not included context information even though ...biological associations actually do appear in the specific contexts. Here, we reconstruct an anatomical context-specific network by assigning contexts to biological associations using protein expression data and scientific literature. Furthermore, we employ the context-specific network for the analysis of drug effects with a proximity measure between drug targets and diseases. Distinct from previous context-specific networks, intercellular associations and phenomic level entities such as biological processes are included in our network to represent the human body. It is observed that performances in inferring drug-disease associations are increased by adding context information and phenomic level entities. In particular, hypertension, a disease related to multiple organs and associated with several phenomic level entities, is analyzed in detail to investigate how our network facilitates the inference of drug-disease associations. Our results indicate that the inclusion of context information, intercellular associations, and phenomic level entities can contribute towards a better prediction of drug-disease associations and provide detailed insight into understanding of how drugs affect diseases in the human body.
Inflammatory bowel disease (IBD) is a chronic inflammatory disorder, primarily of, but not restricted to the gut. Extraintestinal manifestations (EIMs) are frequently observed and involve the joints, ...eyes, hepatobiliary tract, and skin. Areas covered: In this review, we discuss classical EIM focusing on epidemiology, genetics, and pathogenesis, highlighting recent advances in the understanding of EIM. We further discuss treatment-induced immunological phenomena, which are increasingly recognized and might challenge IBD-treating physicians in the era of biological treatment. Expert opinion: EIM considerably contributes to morbidity and mortality. Genetic studies have revealed a common genetic background between EIM and IBD and among specific EIM. Identified protein interactions have been shown to cluster in shared biological pathways. However - despite these recent advances - pathogenesis of EIM is at best partially understood. Several pathogenic mechanisms have been proposed such as upregulation of tumor necrosis factor, aberrant lymphocyte homing, and cross-reactive antigen presentation. It still remains unclear whether EIM is a direct result of the inflammatory process in the gut or rather a consequence of a shared genetic background leading to dysfunctional immune responses to environmental stimuli. Exploration and understanding of EIM genetics and pathophysiology will pave the road for better and more efficacious treatment options in the future.
Public health is a priority for the Chinese Government. Evidence-based decision making for health at the province level in China, which is home to a fifth of the global population, is of paramount ...importance. This analysis uses data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to help inform decision making and monitor progress on health at the province level.
We used the methods in GBD 2017 to analyse health patterns in the 34 province-level administrative units in China from 1990 to 2017. We estimated all-cause and cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), summary exposure values (SEVs), and attributable risk. We compared the observed results with expected values estimated based on the Socio-demographic Index (SDI).
Stroke and ischaemic heart disease were the leading causes of death and DALYs at the national level in China in 2017. Age-standardised DALYs per 100 000 population decreased by 33·1% (95% uncertainty interval UI 29·8 to 37·4) for stroke and increased by 4·6% (–3·3 to 10·7) for ischaemic heart disease from 1990 to 2017. Age-standardised stroke, ischaemic heart disease, lung cancer, chronic obstructive pulmonary disease, and liver cancer were the five leading causes of YLLs in 2017. Musculoskeletal disorders, mental health disorders, and sense organ diseases were the three leading causes of YLDs in 2017, and high systolic blood pressure, smoking, high-sodium diet, and ambient particulate matter pollution were among the leading four risk factors contributing to deaths and DALYs. All provinces had higher than expected DALYs per 100 000 population for liver cancer, with the observed to expected ratio ranging from 2·04 to 6·88. The all-cause age-standardised DALYs per 100 000 population were lower than expected in all provinces in 2017, and among the top 20 level 3 causes were lower than expected for ischaemic heart disease, Alzheimer's disease, headache disorder, and low back pain. The largest percentage change at the national level in age-standardised SEVs among the top ten leading risk factors was in high body-mass index (185%, 95% UI 113·1 to 247·7), followed by ambient particulate matter pollution (88·5%, 66·4 to 116·4).
China has made substantial progress in reducing the burden of many diseases and disabilities. Strategies targeting chronic diseases, particularly in the elderly, should be prioritised in the expanding Chinese health-care system.
China National Key Research and Development Program and Bill & Melinda Gates Foundation.
...other major trends noted in GBD 2013 include a 71% reduction in the number of cases of human African trypanosomiasis (HAT) infection. Because such cases were not included in the current estimates, ...this may have led to an underestimation of the burden of cysticercosis by the GBD 2013. ...this means that part of the disability incurred by other neurological and mental health disorders caused by NCC increases the DALYs of these diseases, making other disorders look less important. ...terms such as prevalence or cases are not always clearly defined in GBD models for individual diseases, which can create some confusion when interpreting the meaning of the results. ...we have not seen meaningful declines in diseases such as hookworm infection, trichuriasis, and schistosomiasis, while for dengue, leishmaniasis, and foodborne trematodiases, we have seen substantial increases 3. ...we need to consider adopting public health policies to address these trends and adapt our current approaches to specifically guide better disease surveillance, improved water quality and sanitation, affordable diagnostic tests, access to healthcare and medications, and further investments in new preventive and disease-control technologies.
Summary
Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe adverse reactions to drugs that cause a life‐threatening eruption of mucocutaneous blistering and epithelial ...sloughing. While the acute complications of SJS/TEN are well described, it is increasingly recognized that survivors may develop delayed sequelae, some of which can be associated with significant morbidity. Studies of long‐term SJS/TEN outcomes mostly focus on mucocutaneous and ocular complications. However, other internal organs, such as the respiratory tract and gastrointestinal tract, can be affected. Psychological sequelae are also frequent following the trauma of widespread epidermal necrolysis. An appreciation of the ‘chronic’ phase of SJS/TEN is needed by clinicians caring for individuals who have survived the acute illness. This review aims to provide an update on the breadth and range of sequelae that can affect patients in the months and years following an acute episode of SJS/TEN.
What's already known about this topic?
Survivors of SJS/TEN suffer from cutaneous and ocular long‐term sequelae.
What does this study add?
This review highlights the spectrum and morbidity of chronic cutaneous, ocular and other systemic complications.
The review proposes a multidisciplinary framework for long‐term follow‐up.
Plain language summary available online