Gene/Protein Disease Symptom Drug Enzyme Compound
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Recent advances in travel medicine include the use of computer resources to obtain information on outbreaks and recommendations to travelers, the introduction of atovaquone/proguanil as chemoprophylaxis and treatment for malaria, the use of azithromycin as an alternative in the self-treatment of traveler's diarrhea, and the combination of hepatitis A and hepatitis B vaccines. At the same time, new challenges continue to appear. Shifts in the distribution of infections, such as West Nile virus and dengue fever, underscore the need for up-to-date information. Well-known infectious diseases, such as polio, meningococcal meningitis, and influenza are appearing in unexpected ways and settings. It is increasingly clear that travelers, while at risk for infections, also play a role in the global dispersal of pathogens, such as certain serogroups of Neisseria meningitidis and influenza. Increasing drug resistance affects the choice of drugs for treatment and chemoprophylaxis, and decisions about use of vaccines. Newly identified adverse events associated with yellow fever vaccine have prompted enhanced surveillance after vaccination and careful scrutiny of appropriate indications for the vaccine.
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PMID:Recent Advances and New Challenges in Travel Medicine. 1185 57

The author has divided his work into parts. The first part entitled "Premature Death of Physicians" is dedicated to those who started their research, scientific works and fruitful medical practice but the premature death has stopped their lives and activities. Death causes are presented in ten chapters (groups of causes), i.e. Tuberculosis - Other Lung Diseases - Heart and Vessel Diseases - Septicaemiae - Infectious Diseases in Subgroups: Typhus, Plague, Cholera, Yellow Fever, Diphtheria, Influenza, Malaria, Smallpox, etc. - Encephalopathies and Mental Diseases - Malignant Neoplasms - Noninfectious Unit Diseases - Accidents - Manslaughters - Death Sentences - Suicides - Not Settled Causes of Death. There are in total 283 biographies in the first part. The second part "Longevity of Physicians" is much longer than the first one and contains 509 biographies of doctor, scientists, research workers and practitioners, meritorious in the history of medicine who attained at least 80 years of age. The biographies are arranged in 22 chapters, one for every year from 80 years of age assumed as the beginning of longevity up to 104 years in one of the cases. In each chapter the biographies are arranged in the alphabetical order. In the Epilogue the author presents shortly his conclusions and observations related to the first part and wider commentaries for the second part.
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PMID:[Premature death and longevity of physicians]. 1185 80

Peptide and protein mimetics are potentially of great value in synthetic vaccine design. The mimetics should function by stimulating the immune system to produce antibodies that recognize the intact parasite. Also the mimetics should be presented to the immune system in a way that leads to efficient antibody production. Here we investigate the application of cyclic peptidomimetics presented on immunopotentiating reconstituted influenza virosomes (IRIVs), a form of antigen delivery that is licensed already for human clinical use, in synthetic vaccine design. We focus on the central (NPNA)(n) repeat region of the circumsporozoite (CS) protein of the malaria parasite Plasmodium falciparum as a model system. Cyclic peptidomimetics of the NPNA repeats were incorporated into both an IRIV and (for comparison) a multiple-antigen peptide (MAP). Both IRIV and MAP delivery forms induced mimetic-specific humoral immune responses in mice, but only with the mimetic-IRIV preparations did a significant fraction of the elicited antibodies cross-react with sporozoites. The results demonstrate that IRIVs are a delivery system suitable for the efficient induction of antibody responses against conformational epitopes by use of cyclic template-bound peptidomimetics. Combined with combinatorial chemistry, this approach may have great potential for the rapid optimization of molecularly defined synthetic vaccine candidates against a wide variety of infectious agents.
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PMID:Exploiting conformationally constrained peptidomimetics and an efficient human-compatible delivery system in synthetic vaccine design. 1194 70

Leptospirosis is a globally important zoonotic disease that affects humans on all continents, in both urban and rural contexts, and in temperate and tropical climes. Leptospirosis is a disease of the environment; transmission depends on interactions between humans and mammalian reservoir hosts. A variety of infectious diseases that present as undifferentiated febrile syndromes, such as malaria, dengue and influenza, as well as viral hemorrhagic fevers can mimic leptospirosis. The importance of pulmonary hemorrhage as a lethal complication of leptospirosis has become more widely recognized. In contrast to textbook dogma, population-based studies indicate that there is a poor correlation between infecting leptospiral strain and clinical expression of disease. Genetic transformation of a Leptospira sp. has now been reported, which should allow for detailed analysis of a variety of leptospiral genes. Publication of the whole Leptospira genome is eagerly awaited. Following recent reports of a new, highly effective conjugate typhoid vaccine, new efforts to find leptospirosis vaccines should include the manufacture and testing of conjugate leptospiral lipopolysaccharide vaccines. Recent advances, particularly in epidemiology, molecular genetics and pathogenesis, are placing leptospirosis at the cutting edge of biomedical science.
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PMID:Leptospirosis. 1196 72

An intense process of epidemiological transition due to the change in mortality has superseded the eras of pestilence, pandemic disease, and chronic-degenerative diseases in Mexico. But the change has not been uniformly progressive, for instance, recurrence of malaria after its eradication indicates reverse transition. Enteritis, influenza, and pneumonia ranked among the primary causes of death between 1955 and 1957, whereas by 1980 heart disease became the leading cause followed by accidents, influenza, and enteritis. A polarized epidemiology can be observed in the post-transitional period: the poorest segment of the population continues to have high rates of infections and nutritional deficiencies. According to Mexican health service mortality data gathered in 1981 industrial workers had similar rates of infectious and chronic-degenerative diseases (11.7% and 12.0%, respectively), while agricultural workers had high rates of infectious and parasitic diseases (26.7%) and a low rate of chronic-degenerative diseases (5.6%). Illnesses of perinatal origin were also higher in agricultural workers than in industrial workers (26.1% vs. 13.7%), whereas circulatory diseases were more frequent among industrial workers (14.2% vs. 7.2%). It is the task of the health care system to meet the challenge of the complexity of this epidemiological mosaic.
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PMID:[The health transition in Mexico: a proper model]. 1215 27

The Proceedings here reviewed are those of the meeting held in Geneva in October, 1983, which led to the establishment of the World Health Organization's Program for the Accelerated Development of New Vaccines. These papers reflect the state of the art in the development of vaccines for cholera, leprosy, pertussis, salmonella, shigella, dengue, foot-and-mouth disease, hepatitis B, herpes simplex, influenza, poliomyelitis, Chagas' disease, malaria, and schistosomiasis. The identification and isolation of epitopes and other antigenic fragments is presented, as well as considerations of mucosal immunity, antigenic determinants and antigenic variations, antigen presentation and T-cell activation, the use of anti-idiotypes as antigens, the development of recombinant viruses for use in vaccines, and the use of circumsporozoite antigens in the preparation of a malaria vaccine.
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PMID:New approaches to vaccine development. Proceedings of a meeting organized by the World Health Organization. Book review. 1222 27

The World Health Organization (WHO) estimates of AIDS cases in Africa are based on the results of trials using the two main HIV serodiagnostic tests: the ELISA and the Western Blot. Some AIDS specialists believe that these tests are not accurate enough to confirm HIV positivity. In fact, they may be most meaningless in Africa because the widespread ill-health there contributes to false positive reactions. Malnutrition and associated chronic diseases are the key causes of ill-health in Africa. The US Centers for Disease Control and Prevention considers the ELISA to be only a screening test to detect suspicious blood samples and not a confirmatory test. In the US, the Western Blot is used as a confirmatory test. False positives could be avoided if scientists could use a suitable gold standard (i.e., HIV isolation). Yet HIV has yet to be unequivocally isolated. In fact, according to Neville Hodgkinson, the entire HIV story might be a monumental error. In Africa, due to cost considerations, most people are diagnosed with HIV based on the findings of a single test. Yet many supposedly HIV-infected persons may actually be suffering from influenza, malaria, or malnutrition, all of which can produce positive HIV results. During the second half of the 1980s, there was no public acknowledgment of inadequacies in the HIV test. In 1994, a professor of public health at Harvard, scientists at the University of Kinshasa, and the health ministry in Zaire found that a supposed association with leprosy and HIV infection as detected by the ELISA was actually due to false positives. When they retested using the Western Blot and radioimmunoprecipitation analysis, the number of the 57 leprosy patients found to be HIV positive fell from 37-41 to 2 and the number of contacts found to be HIV positive fell from 9-12 to 0. An non-validated test (i.e., ELISA) has technical problems and pitfalls in interpretation and is vulnerable to shipping, climatic and storage conditions, and subject to unmeasured and immeasurable cross-reactivities, and may give false positive results.
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PMID:AIDS -- how false positives affect Africa. 1229 88

According to an article in the May 27, 1998, issue of the Times of India, Dr. Menno Jan Bouma, an epidemiologist from the London School of Hygiene and Tropical Medicine, has suggested spraying India's cows, goats, and buffaloes with insecticide in a bid to combat malaria. This strategy, however, fails to fully consider what is currently known about insect behavior, insecticides' modes of action, and the interaction between the two in the environment. A population of insects can ultimately develop resistance and adapt to the repeated onslaught of insecticides. Furthermore, each type of insecticide which could potentially be used has its own set of problems with regard to the environment, the products into which they break down, and how they affect wildlife and humans. The once commonplace spraying of livestock in the West led to Mad Cow Disease, Chicken Flu, and other problems. India's meat and dairy products will definitely be contaminated should the country's livestock be sprayed with insecticides. In the long-term interest of humankind, efforts must be made to contain, not eradicate, mosquitoes and malaria.
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PMID:Healthy malaria control. 1234 80

This document presents an interview with Dr. Anthony Fauci on the development of a new generation of vaccines to prevent and possibly eradicate a legion of deadly diseases ranging from tuberculosis to AIDS. Infections that have caused major devastations in the world today include tuberculosis, malaria, schistosomiasis, filariasis, pneumococcal pneumonia, influenza, AIDS, and Ebola. Agencies should be making sure that the basic research base in microbiology, immunology, antimicrobials, and vaccinology is at the very highest level. The integration of research efforts between countries depends on collaboration between the investigators of home countries with foreign investigators. Among new developments in vaccinology are an acellular pertussis vaccine for pertussis/whooping cough (an extremely contagious disease that causes death), DNA immunization (a new technique applicable to all types of diseases), and transgenic plants for immunization against hepatitis, pertussis, and polio. As of now, AIDS in Western countries has declined, while in Africa and Asia its spread has accelerated. Combination therapy for AIDS has had a profound impact on the level of the virus in the body; however, the treatment is still vague. The good news with regard to AIDS is that education is having an impact; this is exemplified by the situation in Thailand, where the government together with nongovernmental organizations and the military has begun a crash education campaign regarding prostitutes and the use of condoms. Progress is being made in the search for better vaccine candidates. AIDS-like epidemics involving new diseases are bound to emerge at some future point, though, given the long-term historical trend.
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PMID:New drugs, new vaccines, new diseases. An interview with Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID). 1234 52

A variety of newly discovered pathogens and new forms of older infectious agents threaten to reemerge. Typical symptoms of acute infection are fever, headache, malaise, vomiting, and diarrhea. Some of the better-known emerging viral infections include dengue, filoviruses (Ebola, Marburg), hantaviruses, hepatitis B, hepatitis C, HIV, influenza, lassa fever, measles, rift valley fever, rotavirus, and yellow fever. Emerging bacterial infections include cholera, Escherichia coli 0157:H7, legionnaires disease (Legionella), lyme disease, streptococcus infections (group A), tuberculosis, and typhoid. Emerging parasitic infections include cryptosporidium and other waterborne pathogens and malaria. The causes of many diseases are still shrouded in mystery; thus, treatments and cures for them are as yet unknown.
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PMID:The threat of emerging infections. 1234 57


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