Infectious diseases importance

Members of the aminoglycoside class of antibacterial antibiotics retain an important role in the control of bacterial infectious disease, especially in... 

These two examples hint at a few of the reasons for the importance of knowledge-based systems. A medical faciHty may handle hundreds of infectious disease cases a year. Speedy, accurate diagnosis of these cases, aided by a system such as Mycin, may help the medical faciHty handle more patients, more effectively. Likewise, configuring large computer systems composed of many components can be a time-consuming and error-prone task. 

In conclusion, the penicillin class of compounds continues to be actively studied by the scientific community. While the penicillins are an important part of the physician s armamentarium against infectious disease and will remain so for a considerable time, there is increasing emphasis on the study and use of fermentable penicillins as starting materials for the production of other /3-lactam antibiotics, leading to a wealth of heterocyclic chemistry. 

The discovery and production of antibiotics has been of tremendous importance to human and animal health care. Prior to their discovery about half a century ago, many bacterial infections caused debilitating diseases and fatalities were high. The discovery of antibiotics was a major step in the treatment of infectious diseases, especially those caused by bacteria. Today about 50,000 tonnes of antibiotics are produced annually. About a third of this consists of penicillins, whilst tetracyclines make up about a quarter of the market. 

Viruses are small infectious agents composed of a nucleic acid genome (DNA or RNA) encased by structural proteins and in some cases a lipid envelope. They are the causative agents of a number of human infectious diseases, the most important for public health today being acquired immunodeficiency syndrome (AIDS), hepatitis, influenza, measles, and vituses causing diarrhoea (e.g., rotavirus). In addition, certain viruses contribute to the development of cancer. Antiviral drugs inhibit viral replication by specifically targeting viral enzymes or functions and are used to treat specific virus-associated diseases. 

The measles vaccine is considered an immunization. Immunization is a form of artificial active immunity and an important metiiod of controlling some of the infectious diseases tiiat are capable of causing serious and sometimes fatal consequences. The immunization schedule for children is given in Figure 54-2. Currentiy, many infectious diseases may be prevented by vaccine... 

Table 2 Most important faecal-orai water-borne infectious diseases with their causal agents...

A variety of other clinically important infections, such as brucellosis, listeriosis, salmonellosis, and various Mycobacterium infections, are of interest as these are often localized in organs rich in MPS cells. Liposome encapsulation has been demonstrated to improve therapeutic indices of several drugs in a number of infectious models. The natural avidity of macrophages for liposomes can also be exploited in the application of the vesicles as carriers of immunomodulators to activate these cells to an microbicidal, antiviral, or tumoricidal state. These studies were recently reviewed by Emmen and Storm (1987), Popescu et al. (1987), and Alving (1988). In addition to the treatment of "old" infectious diseases, the concept of MPS-directed drug delivery is of considerable interest for the therapy AIDS, possibly enabling control of human immunodeficiency virus replication in human macrophages. 

While selection of antimicrobial therapy may be a major consideration in treating infectious diseases, it may not be the only therapeutic intervention. Other important therapies may include adequate hydration, ventilatory support, and other supportive medications. In addition, antimicrobials are unlikely to be effective if the process or source that leads to the infection is not controlled. Source control refers to this process and may involve removal of prosthetic materials such as catheters and infected tissue or drainage of an abscess. Source-control considerations should be a fundamental component of any infectious diseases treatment. It is also important to recognize that there may be many different antimicrobial regimens that may cure the patient. While the following therapy sections... 

If the isolate is determined to be vancomycin-resistant, it is most important to know the exact species because some of the treatment options, such as quinupristin/dalfopristin, are not active against E. faecalis. Currently, the treatment options for vancomycin-resistant enterococci (VRE) are not well established by clinical studies or patient experience. The treatment recommendations for vancomycin-resistant E. faecium include linezolid or quinupristin/dalfopristin for a minimum of 8 weeks. However, newer agents, such as daptomycin, may provide another option for treatment for either enterococci species (E. faecium and E. faecalis). Additionally, guidelines suggest the use of imipenem-cilistatin plus ampicillin or ceftriaxone plus ampicillin for the treatment of E. faecalis with a minimum of 8 weeks of therapy. Consultation with an infectious diseases specialist is recommended. 

Altered release. Tetanus is an infectious disease caused by the bacterium Clostridium tetani. This bacterium produces a neurotoxin active on inhibitory synapses in the spinal cord. Motor neurons, which supply skeletal muscle and cause contraction, have cell bodies that lie in the spinal cord. Under normal circumstances, these motor neurons receive excitatory and inhibitory inputs from various sources. The balance of these inputs results in the appropriate degree of muscle tone or muscle contraction. Tetanus toxin prevents the release of gamma amino butyric acid (GABA), an important neurotransmitter active at these inhibitory synapses. Eliminating inhibitory inputs results in unchecked or unmodulated excitatory input to the motor neurons. The resulting uncontrolled muscle spasms initially occur in the muscles of the jaw, giving rise to the expression lockjaw. The muscle spasms eventually... 

Riley L W, Cohen M L, Seals J E, Blaser M J, Birkness K A, Hargrett N T, Martin S M and Feldman R A (1984), Importance of host factors in human salmonellosis caused by multiresistant strains of Salmonella , Journal of Infectious Diseases, 149, 878-883. 

Vaccination to induce an adaptive immune response is expected for a broad range of infectious diseases and cancers. Traditional vaccines are mainly composed of live attenuated viruses, whole inactivated pathogens, or inactivated bacterial toxins. In general, these approaches have been successful for developing vaccines that can induce an immune response based on antigen-specific antibody and cytotoxic T lymphocyte (CTL) responses, which kill host cells infected with intracellular organisms (Fig. 1) [1,2], One of the most important current issues in vaccinology is the need for new adjuvants (immunostimulants) and delivery systems. Many of the vaccines currently in development are based on purified subunits, recombinant... 

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