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PubMed2001

Exposure to heavy metals and infectious disease mortality in harbour porpoises from England and Wales.

We investigate whether long-term exposure to heavy metals, including immunosuppressive metals like mercury (Hg), is associated with infectious disease in a wild cetacean. Post-mortem investigations on 86 harbour porpoises, Phocoena phocoena, found dead along the coasts of England and Wales revealed that 49 of the porpoises were healthy when they died as a consequence of physical trauma (most frequently entrapment in fishing gear). In contrast, 37 porpoises died of infectious diseases caused by parasitic, bacterial, fungal and viral pathogens (most frequently pneumonia caused by lungworm and bacterial infections). We found that mean liver concentrations of Hg, selenium (Se), the Hg:Se molar ratio, and zinc (Zn) were significantly higher in the propoises that died of infectious disease compared to healthy porpoises that died from physical trauma. Liver concentrations of lead (Pb), cadmium (Cd), copper (Cu) and chromium (Cr) did not differ between the two groups. Hg, Se, and the Hg:Se molar ratio were also positively correlated with age. The association between Zn concentration and disease status may result from Zn redistribution in response to infection. Further work is required to evaluate whether chronic exposure to Hg may have presented a toxic challenge to the porpoises that succumbed to infectious disease.

Animals↗

PubMed1995

Infectious disease marker testing of the autologous blood donor. A case study in clinical ethics.

OBJECTIVE: The Food and Drug Administration currently requires written authorization from the patient's physician before autologous units of blood that are positive or reactive for hepatitis B surface antigen or anti-human immunodeficiency virus can be shipped from a site of collection different from the site of transfusion. Additionally, the Blood Products Advisory Committee has recommended the universal testing of all autologous units of blood. DESIGN: The case of an autologous blood donor with positive infectious disease markers is presented. The ethics of infectious disease testing of patients who preoperatively donate their own blood is discussed. RESULTS: Many ethical issues are raised by policies requiring infectious disease testing of the autologous blood donor. Blood banking and transfusion medicine specialists should examine the ethical issues raised by regulatory mandates to perform infectious disease testing of the patient who desires to make a preoperative autologous blood donation. CONCLUSION: A policy that protects the rights of the patient as well as the rights and concerns of health care professionals should be pursued.

Blood Donors↗

PubMed1998

The role and importance of veterinary laboratories in the prevention and control of infectious diseases of animals.

Veterinary laboratories which deal with infectious diseases form three groups according to the tasks for which they are responsible. The first group includes central or national veterinary laboratories, national or international reference laboratories, high-security laboratories, district regional or state veterinary diagnostic laboratories. The major role of these laboratories is to assist national Veterinary Services in diagnosing infectious animal diseases. The second group comprises laboratories that produce veterinary diagnostic kits and those that produce veterinary vaccines. The third group is composed of veterinary research laboratories, which generally concentrate on basic research and do not contribute directly to the diagnosis and control of infectious animal diseases. The author describes the objectives of each of the three groups of laboratories.

Animals↗

PubMed2006

Carbohydrates as future anti-adhesion drugs for infectious diseases.

Adhesion of pathogenic organisms to host tissues is the prerequisite for the initiation of the majority of infectious diseases. In many systems, it is mediated by lectins present on the surface of the infectious organism that bind to complementary carbohydrates on the surface of the host tissues. Lectin-deficient mutants often lack the ability to initiate infection. The bacterial lectins are typically in the form of elongated submicroscopic multi-subunit protein appendages, known as fimbriae (or pili). The best characterized of these are the mannose-specific type 1 fimbriae, the galabiose-specific P fimbriae and the N-acetylglucosamine-specific fimbriae of Escherichia coli. Soluble carbohydrates recognized by the bacterial surface lectins block the adhesion of the bacteria to animal cells in vitro. Aromatic alpha-mannosides are potent inhibitors of type 1 fimbriated E. coli, being up to 1000 times more active than MealphaMan, with affinities in the nanomolar range. This is due to the presence of a hydrophobic region next to the monosaccharide-binding site of the fimbriae, as recently demonstrated by X-ray studies. Polyvalent saccharides (e.g., neoglycoproteins or dendrimers) are also powerful inhibitors of bacterial adhesion in vitro. Very significantly, lectin-inhibitory saccharides have been shown to protect mice, rabbits, calves and monkeys against experimental infection by lectin-carrying bacteria. Since anti-adhesive agents do not act by killing or arresting the growth of the pathogens, it is very likely that strains resistant to such agents will emerge at a markedly lower rate than of strains that are resistant to antibiotics. Suitable sugars also inhibit the binding to cells of carbohydrate-specific toxins, among them those of Shigella dysenteriae Type 1, and of the homologous Verotoxins of E. coli, specific for galabiose. Appropriately designed polyvalent ligands are up to six orders of magnitude stronger inhibitors of toxin binding in vitro than the monovalent ones, and they protect mice against the Shigella toxin. The above data provide clear proof for the feasibility of anti-adhesion therapy of infectious diseases, although this has not yet been successful in humans. All in all, however, there is little doubt that inhibitors of microbial lectins will in the near future join the arsenal of drugs for therapy of infectious diseases.

Animals↗

PubMed1986

Postdoctoral fellowship in pediatric infectious disease pharmacotherapy.

The first postdoctoral fellowship program in pediatric infectious disease pharmacotherapy is described. The fellowship program is designed to train a clinical pharmacist to be an independent researcher. The features of this program include: (1) two-year duration; (2) about 80 percent of time devoted to research-related activities and 20 percent to teaching and consultative practice; (3) formal course work; (4) training in in vitro and in vivo animal as well as clinical studies; and (5) interdisciplinary personnel and laboratory resources. This program should help meet the need for clinical scientists in pediatric infectious disease pharmacotherapy.

Education, Pharmacy, Graduate↗

PubMed1993

Role of glucocorticosteroids in the treatment of infectious diseases.

The role of glucocorticosteroids in the management of infectious diseases in man remains controversial, although experimental data obtained both in in vitro systems and in experimental infections in animals provide evidence of a beneficial effect of such treatment. Their use in the treatment of Pneumocystis carinii pneumoniae and severe typhoid fever seems indicated. A beneficial effect on the treatment of bacterial meningitis needs to be confirmed. Sufficient data are now available that argue against steroid treatment in septic shock. However, new treatment modalities such as monoclonal antibodies against endotoxin and inflammatory mediators are currently being developed to modulate infectious inflammation. This could also bring a renaissance of the role of glucocorticosteroids in the treatment of infectious diseases.

Animals↗

PubMed2006

Systematics and emerging infectious diseases: from management to solution.

The crisis of emerging infectious disease stems from the absence of comprehensive taxonomic inventories of the world's parasites, which includes the world's pathogens. Recent technological developments raise hopes that the global inventory of species, including potential pathogens, can be accomplished in a timely and cost-effective manner. The phylogenetics revolution initiated by systematists provides a means by which information about pathogen transmission dynamics can be placed in a predictive framework. Increasingly, that information is widely available in digital form on the Internet. Systematic biology is well positioned to play a crucial role in efforts to be proactive in the arena of emerging parasitic and infectious diseases.

Animals↗

PubMed2000

Changing patterns of infectious disease.

Despite a century of often successful prevention and control efforts, infectious diseases remain an important global problem in public health, causing over 13 million deaths each year. Changes in society, technology and the microorganisms themselves are contributing to the emergence of new diseases, the re-emergence of diseases once controlled, and to the development of antimicrobial resistance. Two areas of special concern in the twenty-first century are food-borne disease and antimicrobial resistance. The effective control of infectious diseases in the new millennium will require effective public health infrastructures that will rapidly recognize and respond to them and will prevent emerging problems.

Animals↗

PubMed1989

[Imported infectious diseases in patients at Blegdam's Hospital and the epidemic diseases department of Rigshospitalet, Copenhagen, during 1975-1986].

Imported infectious diseases in the Departments for Epidemic Diseases in Blegdams Hospital and the University Hospital, Copenhagen, are reviewed for the period 1975-1986. A total of 3,454 cases were diagnosed. 92% were due to parasitic infections. 20.2% of the diagnoses were made i Danes. 38% of these had malaria. Ancylostomiasis, ascariasis and trichuriasis constituted 55% of the diagnoses and were found mainly in boat refugees from Vietnam. Africa, south of Sahara, Asia and the Mediterranean countries were the commonest sources of infection. The number of diagnoses increased tenfold as compared with the period 1965-1974 and this was due mainly to immigration of 3,000 boat refugees from Vietnam during the period 1979-1983. The number of danes averaged 57 annually. Only a slight increase occurred in imported infectious diseases in Danes as compared with the period 1965-1974. Malaria, bacterial and parasitic intestinal infections were the commonest diagnoses in this group. The next largest group of patients consisted of immigrants from Pakistan and Turkey. During the period 1979-1983, 79% of the diagnoses were made mainly in the boat refugees from Vietnam. The individual diseases are reviewed and the possibilities for prevention of imported disease are outlined.

Africa↗

PubMed2000

Assessment of infectious disease surveillance--Uganda, 2000.

In 1998, member states of the African region of the World Health Organization (WHO-AFRO) adopted the integrated disease surveillance (IDS) strategy to strengthen national infectious disease surveillance systems (1). The first step of the IDS strategy is to assess infectious disease surveillance systems. This report describes the results of the assessment of these systems of the Uganda Ministry of Health (UMoH) and indicates that additional efforts are needed to develop the basic elements of an effective surveillance system.

Communicable Diseases↗

PubMed1991

Major infectious diseases causing excess morbidity in the Hispanic population.

Current data indicate that there are a number of infectious diseases, ie, acquired immunodeficiency syndrome/human immunodeficiency virus infections, cysticercosis, hepatitis A, syphilis, tuberculosis, and typhoid fever, among others that cause disproportionately increased morbidity in Hispanics. The greater rate of poverty with its associated socioenvironmental problems, increased barriers to health care, and importation of infectious diseases endemic in the mother country are some of the major reasons that probably account for this disparity in disease burden in Hispanics. This formidable health problem can be addressed by targeting efforts at improving health education of family units and communities, environmental improvements, elimination or reduction of barriers to health care management and disease prevention, and appropriate screening programs. A comprehensive and uniform assessment of the impact of infectious diseases on Hispanics (and other minorities) in this country remains elusive, but is of paramount importance in establishing priorities and effective/efficient strategies to address this issue.

Adult↗

PubMed1999

[Activities at an Infectious Disease Intensive Care Unit (1988-1997)].

The practice of an Infectious Diseases Intensive Care Unit for a period of ten years (1988-1997) is reviewed. In this time 1,191 patients were treated--822 had more than 15 years of age and 369 were younger. The occupation rate ranged between 74.4% and 90.8%, and the mean patient stay in the UCI ranged between 6.7 and 12.5 days. Nine hundred and forty-four patients were discharged cured or improved during the stay and 247 (20.7%) died. The most frequent pathologies were: meningitis--371 patients (33.6%); encephalitis--103 (8.6%); and tetanus 143 (12.0%) patients. The morbidity and mortality of different pathologies admitted to the Intensive Care Unit are presented. The mortality rate of the two most common diseases (meningitis and tetanus) is discussed. The need for Intensive Care in the field of Infectious Diseases is stressed.

Adolescent↗

PubMed1994

Knowledge of infectious disease reporting amongst military and civilian medical officers.

Anecdotally expressed concern over the military/civilian interface regarding infectious disease notification, and the current review of procedures in both civilian and military settings prompted this study. Its aim was to quantify knowledge of doctors involved in the provision of care to Army personnel and their dependants in the United Kingdom regarding infectious disease reporting and make recommendations to improve the process. A questionnaire was sent to all such military and civilian doctors in the Southern Military District of England. The group was no less knowledgeable than others studied previously. Differences were found in the knowledge of reporting procedures between civilian and military doctors, with military hospital doctors demonstrating particularly poor knowledge. It is recommended that specific instruction on all aspects of infectious disease reporting be given to doctors joining the Army and to civilian GPs involved in care of the Military.

Disease Notification↗

PubMed1994

Infectious disease in athletes.

The objective of this article has been to focus on the more common infectious diseases that the physician caring for athletes may encounter in the office practice of sports medicine. Clearly the physician plays a critical role in treatment and prevention through early recognition and intervention when appropriate. Fortunately, being a fairly young, healthy athletic population, these patients respond well to treatment. It is critical that physicians caring for athletes take an active role to educate and counsel their patients on appropriate preventive measures and give clear return to participation recommendations. Advice should be based on consideration of each athlete's unique situation as well as up-to-date knowledge concerning the particular infectious disease process involved and appropriate treatment options.

Communicable Diseases↗

PubMed1978

[Recent developments in the field of infectious diseases].

A résumé is presented of recent developments in the field of infectious diseases of particular interest of practising physicians. Examples are given to illustrate recent discoveries concerning the frequent misuse of antibiotics, the problem of infections developing in hospitalized patients, the biology of microbial infection, the etiology of well-known illnesses, new infectious diseases, and the development of vaccines. It is evident that the rate at which new and important information is evident that the rate at which new and important information is being reported demands particular effort in medical school teaching to ensure that students learn how to acquire and evaluate new information as well as how to discard ideas which are no longer valid.

Anti-Bacterial Agents↗

PubMed1994

Moderate low birth weight and infectious disease mortality during infancy and childhood.

The purpose of this study was to determine whether moderately low birth weight, singleton babies without congenital anomalies are at increased risk for postperinatal infectious disease mortality. The study cohort consisted of 54,795 live births assembled at 12 medical school-affiliated hospitals in different regions of the United States between 1959 and 1966 and followed prospectively. After exclusions of multiple gestation births, very low birth weight (less than 1,500 g) births, births with major congenital anomalies, and first-week deaths, 51,931 children remained for analysis. Postperinatal infectious disease mortality was assessed through age 7 years. Causes of death were classified independently by two pediatricians, blinded to birth weight status, according to an algorithm developed for the study. Moderately low birth weight infants and children were at increased risk of infectious disease mortality (relative risk (RR) = 2.49, 95% confidence interval (CI) 1.74-3.55). The risk persisted among those whose deaths met our strictest criteria for infectious etiology and was sustained beyond infancy throughout the age interval under analysis. Among those with moderate low birth weight, there was an increased risk among those with preterm birth (RR = 2.77, 95% CI 1.19-6.46) but not among those who were born small-for-gestational age (RR = 1.19, 95% CI 0.37-3.83). The data suggest that moderate low birth weight renders individuals vulnerable to infectious disease mortality during both infancy and childhood. Among moderately low birth weight infants and children, this vulnerability appeared to be attributable primarily to preterm birth rather than to intrauterine growth retardation.

Cause of Death↗

PubMed2004

Publication of European Union research on infectious diseases (1991-2001): a bibliometric evaluation.

The study presented here analyzed the contents of 36 international infectious diseases journals from 1991 to 2001 to determine the number of reports prepared by authors in the European Union and to compare the per country scientific productivity. Articles included in the study were identified using the PubMed website. The number of publications in infectious disease journals produced by authors in the European Union experienced an exponential growth from 461 (19.2% of world production) in 1991 to 2,401 (35.9%) in 2001. The mean impact factor increased from 2.259 in 1991 to 3.001 in 2001. The leading countries in the total number of publications were the UK, France, and Germany. After taking population figures into account, Sweden, Denmark, and Finland headed the list, and after correcting for gross domestic product, the greatest producers were Sweden, Finland, and the UK. Overall, the scientific production and repercussion index of European Union research on infectious diseases experienced a notable rise during the last decade of the 20th century.

Bibliometrics↗

PubMed1993

The basic principles of infectious diseases as related to dental practice.

A variety of bacterial, viral, fungal, and protozoan microbes may present hazards to the dental team and to patients. After contamination with a microbe, three major factors determine if an infectious disease results: (1) virulence of the microbe, (2) the dose or number of microbial cells that contaminate the body, and (3) the resistance of the body to the microbe. Because nothing can be done about microbial virulence, prevention of infectious diseases involves decreasing the dose and increasing body resistance, coupled with education about disease spread and modes of prevention. The steps in the development of an infectious disease are (1) source of the microbe, (2) escape of the microbe from the source, (3) spread of the microbe to a new person, (4) entry of the microbe into the new person, and (5) infection and damage. The prevention of infectious disease can be accomplished by interfering with any of the above steps.

Communicable Diseases↗