...School of Dental Medicine Inflammation • Introduction • Acute inflammation – Vascular changes – Cellular events – Hereditary defects • Chronic inflammation – Cellular mediators – Granulomatous inflammation • Tissue Repair Inflammation • Chronic inflammation – Cellular mediators – Granulomatous inflammation • Tissue repair – Cell and tissue regeneration – Scar formation – Factors influencing repair Chronic Inflammation • Inflammation of prolonged duration (weeks-years) – Continuing inflammation – Tissue injury – Healing Chronic Inflammation • Characterized by – Lymphocytes, plasma cells, and macrophages – Tissue destruction – Repair Chronic Inflammation • Arises in setting of – Persistent infections • Treponema pallidum • Mycobacterium, viruses, and fungi – Immune-mediated disease • Hypersensitivity reactions • Autoimmune diseases – Prolonged exposure to toxins • Silica • Crystal Macrophages Dominant cells of chronic inflammation Tissue cells derived from blood monocytes Fusion of activated macrophages forms multinucleated giant cells Mononuclear phagocyte system (reticuloendothelial system) includes cells scattered in connective tissue, liver (Kupffer cells), spleen and lymph nodes (sinus histiocytes), CNS (microglial cells), and lungs (alveolar macrophages) Macrophages Activated by either classical (induced by microbial products, cytokines, or foreign material) or alternative (other cytokines...
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...countries worldwide, predominately in humid tropical areas of Asia, Latin America and Africa. (Infection, 2003) The disease may also occur in temperate climates like those found in the coastal regions of southeastern Australia. It is the third most common mycobacterial infection in immunocompetent people in the endemic regions. There are an increasing number of cases in West Africa, where the disease has surpassed leprosy and tuberculosis in some regions. Buruli ulcer is caused by an infection with Mycobacterium ulcerans that involves the skin and subcutaneous adipose tissue that mainly affects children between the ages of 5 and 15. (Wansbrough-Jones & Phillips, 2006). It typically presents itself as a painless subcutaneous nodule that ulcerates approximately 70-100% of the time. (World Health Organization, 2007) There are other pre-ulcerative forms of the disease such as papules that affect the skin, plaques, which are large, firm, painless raised lesions and oedema, which is the severe form of the disease. The first reported case of Buruli ulcer is thought to have been as far back as 1897 in Uganda. Sir Albert Cook described cases of chronic ulceration in Africa at that time but the disease was not published until 1948. It was then reported in two Australian children and four adults in an area in Bairnsdale, Victoria that demonstrated the lesions in several different stages of infection. (Wansbrough-Jones & Phillips, 2006) It was not until 1965 that it was discovered that there...
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...Clinical guidelines Diagnosis and treatment manual for curative programmes in hospitals and dispensaries guidance for prescribing 2010 EDITION © Médecins Sans Frontières – January 2010 All rights reserved for all countries. No reproduction, translation and adaptation may be done without the prior permission of the Copyright owner. ISBN 2-906498-81-5 Clinical guidelines Diagnosis and treatment manual Editorial Committee: I. Broek (MD), N. Harris (MD), M. Henkens (MD), H. Mekaoui (MD), P.P. Palma (MD), E. Szumilin (MD) and V. Grouzard (N, general editor) Contributors: P. Albajar (MD), S. Balkan (MD), P. Barel (MD), E. Baron (MD), M. Biot (MD), F. Boillot (S), L. Bonte (L), M.C. Bottineau (MD), M.E. Burny (N), M. Cereceda (MD), F. Charles (MD), M.J de Chazelles (MD), D. Chédorge (N), A.S. Coutin (MD), C. Danet (MD), B. Dehaye (S), K. Dilworth (MD), F. Fermon (N), B. Graz (MD), B. Guyard-Boileau (MD), G. Hanquet (MD), G. Harczi (N), M. van Herp (MD), C. Hook (MD), K. de Jong (P), S. Lagrange (MD), X. Lassalle (AA), D. Laureillard (MD), M. Lekkerkerker (MD), J. Maritoux (Ph), J. Menschik (MD), D. Mesia (MD), A. Minetti (MD), R. Murphy (MD), J. Pinel (Ph), J. Rigal (MD), M. de Smet (MD), S. Seyfert (MD), F. Varaine (MD), B. Vasset (MD) (S) Surgeon, (L) Laboratory technician, (MD) Medical Doctor, (N) Nurse, (AA) Anaesthetist-assistant, (Ph) Pharmacist, (P) Psychologist We would like to thank the following doctors for their invaluable help:...
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...Preface A well-developed knowledge of clinical microbiology is critical for the practicing physician in any medical field. Bacteria, viruses, and protozoans have no respect for the distinction between ophthalmology, pediatrics, trauma surgery, or geriatric medicine. As a physician you will be faced daily with the concepts of microbial disease and antimicrobial therapy. Microbiology is one of the few courses where much of the "minutia" is regularly used by the practicing physician. This book attempts to facilitate the learning of microbiology by presenting the information in a clear and entertaining manner brimming with memory aids. Our approach has been to: 4) Create a conceptual, organized approach to the organisms studied so the student relies less on memory and more on logical pathophysiology. The text has been updated to include current information on rapidly developing topics, such as HIV and AIDS (vaccine efforts and all the new anti-HIV medications), Ebola virus, Hantavirus, E. coli outbreaks, Mad Cow Disease, and brand-new antimicrobial antibiotics. The mnemonics and cartoons in this book do not intend disrespect for any particular patient population or racial or ethnic group but are solely presented as memory devices to assist in the learning of a complex and important medical subject. We welcome suggestions for future editions. 1) Write in a conversational style for rapid assimilation. 2) Include numerous figures serving as "visual memory tools" and summary charts...
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...Antiretroviral Therapy Guidelines for HIV-Infected Adults and Adolescents Including Post-exposure Prophylaxis May 2007 NACO Ministry of Health & Family Welfare Government of India Assessment and Management of HIV-Infected Person No Is HIV infection confirmed? Send to ICTC for confirmation of HIV status Yes Perform history taking and physical examination (see p 9 ) Evaluate for signs and symptoms of HIV infection or OIs and WHO clinical staging (see p 10) Provide appropriate investigations/treatment of OIs (see p 13 ) If pregnant, refer to PPTCT Screen for TB Screen for STI Identify need for: CTX prophylaxis (see p 16 ) ART (see p 18 ) No Pre ART care (see p 15 ) Yes Give patient education on treatment and adherence (see p 54 ) Arrange psychosocial, nutrition and community support (see p 56) Start ART, (see p 19 ) Arrange follow-up + monitoring (see p 25 ) Assess adherence every visit Provide positive prevention advice and condoms Provide patient information sheet on the ART regimen prescribed (see annex 7, 8) Antiretroviral Therapy Guidelines for HIV-Infected Adults and Adolescents Including Post-exposure Prophylaxis May 2007 NACO National AIDS Control organisation Ministry of Health and Family Welfare Government of India with support from CDC . Clinton Foundation . WHO TAble of T A b l e o f Acronyms and Abbreviations Introduction....... ..........................................................................................
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