Survival medicine

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  • Ditch Medicine describes advanced medical procedures in a field setting. Should the Pre-Hospital Care Provider (PHCP) find himself in the middle of a medical disaster, his ability to use the procedures in this book can mean the difference between life and death.

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  • Diabetes Mellitus The success of islet cell and pancreas transplantation provides proof of concept for a cell-based approach for type I diabetes. However, the demand for donor pancreata far exceeds the number available, and maintenance of long-term graft survival remains a problem. The search for a renewable source of stem cells capable of regenerating pancreatic islets has therefore been intensive. Pancreatic βcell turnover occurs in the normal pancreas, although the source of the new βcells is controversial.

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  • The Dichotomy of Inpatient and Outpatient Internal Medicine The hospital environment has transformed dramatically over the past few decades. In more recent times, emergency departments and critical care units have evolved to identify and manage critically ill patients, allowing them to survive formerly fatal diseases. There is increasing pressure to reduce the length of stay in the hospital and to manage complex disorders in the outpatient setting.

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  • Accumulating evidence indicates that G protein signaling plays an active role in the regulation of cell survival. Our previous study demonstrated the regulatory effects of Gi⁄ o proteins in nerve growth factor-induced activa-tion of pro-survival Akt kinase. In the present study we explored the role of various members of the Gs,Gq⁄ 11 and G12⁄ 13 subfamilies in the regula-tion of Akt in cultured mammalian cells.

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  • Ceramide (Cer) is known to be a lipid mediator in apoptosis and to have an important role in cell fate, via control of intracellular Cer levels. Recently, ceramide kinase (CerK) was identified as an enzyme that converts Cer to ceramide 1-phosphate (C1P). We examined potential functions of CerK in the regulation of keratinocyte survival, and the possible involve-ment of peroxisome proliferator-activated receptor beta (PPARb).

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  • The newestmember of themitogenactivatedprotein (MAP) kinase family of proteins, extracellular signal regulated kinase 5 (ERK5; also known as big-mitogen activated kinase 1 or BMK1) is widely expressed in many tissues including the brain. Although growth factor activation of ERK5 innon-neuronal cells has been shown to contribute to cell proliferation, differentiation and transformation, until recently no information was available on the role of ERK5 in neuronalsurvival.

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  • Extracellular signal regulated kinases 1 and 2 (ERK1/2) regulate cellular responses to a varietyof extracellular stimuli. In the nervous system, ERK1/2 is critical for neur-onal differentiation, plasticityand mayalso modulate neuronal survival. In this minireview, we present evidence that supports prosurvival activityof ERK1/2 in neurons. Several reports suggest that ERK1/2 mediates neuropro-tective activityof extracellular factors, including neurotro-phins. In addition, ERK1/2 is activated byneuronal injury....

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  • The genome data of bacteriumXylella fastidiosastrain 9a5c has identified severalorfsrelated to its phytopathogenic adaptation and survival. Among these genes, the surEcodifies a survival protein E (XfSurE) whose function is not so well understood, but functional assays in Escherichia colirevealed nucleotidase and exopolyphosphate activity.

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  • B REAST CANCER is the most common malignancy in women. At least 180,000 new cases were diagnosed in 1997, more than double that of the next most common neoplasm, lung cancer. According to the American Cancer Society over 40,000 American women succumb to this disease each year. Early detection of breast cancer by routine mammographic screening of women without clinical signs or symptoms facilitates earlier treatment and has enhanced survival. As pointed out by Dr.

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  • Nutrition is one of the most important factors that impact health in all areas of the lifecycle. Pregnant women need adequate food and health care to deliver a healthy baby who has a good birth weight and a fighting chance for survival. In many regions of the world, the infant mortality rate is very high, meaning that many infants will not live to see their first birthday. Breastfeeding is the ideal method of feeding and nurturing infants, because breast milk contains many immunologic agents that protect the infant against bacteria, viruses, and parasites.

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  • Immune Response The innate and acquired immune responses to L. monocytogenes have been studied extensively in mice. Shortly after IV injection, most bacteria are found in Kupffer cells in the liver, with some organisms in splenic macrophages. Listeriae that survive the bactericidal activity of initially infected macrophages grow in the cytosol and spread from cell to cell. In the liver, the result is infection of hepatocytes. Neutrophils are crucial to host defense during the first 24 h of infection, while influx of activated macrophages from the bone marrow is critical subsequently.

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  • Harrison's Internal Medicine Chapter 68. Hematopoietic Stem Cells Hematopoietic Stem Cells: Introduction All of the cell types in the peripheral blood and some cells in every tissue of the body are derived from hematopoietic (hemo: blood; poiesis: creation) stem cells. If the hematopoietic stem cell is damaged and can no longer function (e.g., due to the nuclear accident at Chernobyl), a person would survive 2–4 weeks in the absence of extraordinary support measures. With the clinical use of hematopoietic stem cells, tens of thousands of lives are saved each year (Chap. 108).

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  • Currently, where business and management topics are included in the veterinary curriculum, they tend to be incorporated under the banner of ‘Professional Studies’, a strand of education running though most veterinary degrees, which, as its label suggests, covers the professional behaviour aspects of veterinary medicine.

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  • Lung cancer is the leading cause of cancer death among men and women in the United States with 170,000 deaths per year. This exceeds the sum of the next three leading causes of death due to cancer: breast, colon, and prostate. There are over 1 million deaths worldwide due to lung cancer, making it truly an epidemic. Fewer than 15% achieve a 5-yr survival. The vast majority (85%) present with advanced disease, although stage I patients may have a 5-yr survival approaching 70% (1).

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  • Harrison's Internal Medicine Chapter 80. Cancer Cell Biology and Angiogenesis Cancer Cell Biology and Angiogenesis: Introduction Two characteristic features define a cancer: unregulated cell growth and tissue invasion/metastasis. Unregulated cell growth without invasion is a feature of benign neoplasms, or new growths. Cancer is a synonym for malignant neoplasm. Cancers of epithelial tissues are called carcinomas; cancers of nonepithelial (mesenchymal) tissues are called sarcomas. Cancers arising from hematopoietic or lymphoid cells are called leukemias or lymphomas.

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  • Randomized studies comparing standard-dose therapy to high-dose melphalan therapy (HDT) with hematopoietic stem cell support have shown that HDT can achieve high overall response rates and prolonged progression-free and overall survival; however, few, if any, patients are cured.

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  • Other Nonmelanoma Cutaneous Malignancies Neoplasms of cutaneous adnexa and sarcomas of fibrous, mesenchymal, fatty, and vascular tissues make up 1–2% of NMSC (Table 83-6). Some can portend a poor prognosis such as Merkel cell carcinoma, which is a neural crestderived, highly aggressive malignancy that exhibits a metastatic rate of 75% and a 5-year survival rate of 30–40%. Others, such as the human herpes virus 8-induced, HIV-related Kaposi's sarcoma, exhibit a more indolent course.

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  • Non-Small Cell Lung Cancer NSCLC Stages I and II Surgery In patients with NSCLC stages IA, IB, IIA and IIB (Table 85-2) who can tolerate operation, the treatment of choice is pulmonary resection. If a complete resection is possible, the 5-year survival rate for N0 disease is about 60–80%, depending on the size of the tumor. The 5-year survival drops to about 50% when N1 (hilar node involvement) disease is present. The extent of resection is a matter of surgical judgment based on findings at exploration.

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  • Serum β2-microglobulin is a protein of 11,000 mol wt with homologies with the constant region of immunoglobulins that is the light chain of the class I major histocompatibility antigens (HLA-A, -B, -C) on the surface of every cell. Serum β2-microglobulin is the single most powerful predictor of survival and can substitute for staging. Patients with β2-microglobulin levels 0.004 g/L only 12 months. Serum β2-microglobulin and albumin levels are the basis for a three-stage International Staging System (ISS).

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  • VEGF and its receptors are required for vasculogenesis (the de novo formation of blood vessels from differentiating endothelial cells, as occurs during embryonic development) and angiogenesis under normal (wound healing, corpus luteum formation) and pathologic processes (tumor angiogenesis, inflammatory conditions such as rheumatoid arthritis).

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