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For example buy discount vantin 200mg online zinc antibiotic resistance, you might health information from being used or shared want to begin getting mammograms or other without your knowledge purchase vantin infection 1 mind games. If cancer is found the New Genetics I 21stCentury Genetics 79 very early purchase vantin overnight infection you get in the hospital, it is usually more treatable, and the this gene can cause the disease, and those are odds for a cure are much higher. Currently, diagnostic laboratories across the How can there be 30 different variants of United States offer genetic tests for almost 2,000 one gene? Perhaps the most wellknown example of nucleotides produces one variant, a change in a chromosome problem is Down syndrome, in another produces another variant, and so on. So the standard chromosome abnormality, or even by one gene genetic screening test for this disease scans for variant. Cystic ﬁbrosis, for example, is due to a all of the more than 30 variants known to cause faulty gene, but more than 30 different variants of cystic ﬁbrosis. Scientists are developing genetic tests that will help doctors diagnose and treat diseases. Think about what you would do Patients and doctors face these tough issues with the information. Even years from now, when One thing you might consider is whether you researchers know more about the molecular could do something with what you learn from roots of disease, genetic tests will rarely provide a genetic test. In most cases, they won’t even You’ve already read about what you could provide “yes” or “no” answers. But what about a predict whether a person’s risk of getting a disease condition that shows up in middleaged or older is relatively high, low or somewhere in between. Good Advice Since the story of genes and health is so complicated and is likely to stay that way for a while, it is very important to consider genetic information in context. Health care professionals known as genetic counselors can be a big help to people who are thinking about getting a genetic test. In addition to identifying suspects Genetic ﬁngerprinting is not limited who leave traces at the scene of a crime to people. It can ﬁnd small but poten (for example, strands of hair, drops of tially deadly traces of diseasecausing bacteria in food or water, determine whether an expensive horse was sired by a Kentucky Derby winner or ﬁgure out whether a puppy’s parents were ﬁrst cousins. Scientists read the sequence in a dozen or so places to create a molecular proﬁle. The chances of a molecular ﬁngerprint being the same in two people or two organisms are vanishingly small. Genetic counselors do their work Is a person who gave a blood or tissue sample in many different settings, including hospitals, entitled to proﬁts from a company that develops private clinics, government agencies and uni a drug based on genetic information in her sam versity laboratories. An interesting aspect of the job is that genetic Can a blood or tissue sample that was donated counselors address the needs of entire families, for one purpose be used for an entirely different rather than just individual patients. Many of the most Field Study the word most often used to refer to This usually involves transferring genetic mate applications of genetic research, espe rial from one kind of organism into another. Using cially those leading to products for the same techniques that were developed for put human use, is biotechnology. It ting genes into animals for research purposes, involves techniques that use living scientists can create crop plants with desirable organisms—or substances derived traits, such as improved ﬂavor or better resistance from those organisms—for various to insect pests. Transferring speciﬁc genes is practical purposes, such as making a faster and more efﬁcient than traditional breeding biological product. One major application of biotech the United States is home to far more geneti nology is in agriculture. Actually, this is cally modiﬁed crops than anywhere else in the hardly new: Humanity has engaged in world. In 2009, 85 percent of the country’s corn, agricultural biotechnology for 10,000 88 percent of its cotton and 91 percent of its soy years or more. Many traditional farming beans were cultivated from seeds genetically practices, from plant breeding to animal modiﬁed to resist plant pests and certain herbi husbandry, are really forms of biotech cides used to control weeds. Many believe that agricultural biotechnology is But in today’s agricultural industry, an important driver for improving world health. Traditionally, when an inventor comes up with a new idea and wants to sell it—whether it’s a radiocontrolled toy boat or a customized laboratory chemical—he or she submits an appli cation to the U. By issuing patents, the Federal Government gives an inventor ownership of his or her cre ation. Patents give inventors time to optimize their products and control how their inventions are used, allowing them to make money from their creativity. But opposition from farmers and consumers within and outside the United States has clouded agricultural biotechnology’s future. Some object to the development of plants that are naturally resistant to herbicides, partly out of concern that the trait might jump to weeds, making them impossible to destroy. Environmental advocacy groups worry that genetically modiﬁed plants may impact the future biodiversity of our planet by harming beneﬁcial insects and possibly other organisms. Environmental Protection Agency has stated that there is no evidence to date that indicates that biotech crops have any adverse effects on nontargeted wildlife, plants or beneﬁcial insects. Biotechnology helps agricultural scientists create Of course, careful ﬁeld tests of newly created, crops with desired traits. The majority of cotton and soybeans in the United States are grown with genetically modiﬁed plants and animals are genetically modiﬁed seeds that resist viruses and essential to be sure that they cause no harm to other plant pests. But patents have been issued to use patented genetic information may need to for speciﬁc medical uses of genetic information. Patent and Trademark Ofﬁce to establish guidelines for what kind of genetic information can be patented. Since this area of medical research is an evermoving target, government scientists, policymakers and the courts continue to clarify patent and licensing issues in the hope of keeping data that is valuable for research in the public domain. The New Genetics I 21stCentury Genetics 85 Careers in Genetics Opportunities to be part of genetic and genomic research have never been greater or more exciting. In addition to studying human genes, scientists are gathering information about the genes of many other living things, from microbes that cause disease to model organisms like mice and Drosophila, livestock and crop plants. Although computers do some of the work, this avalanche of information has to be analyzed by thousands and thousands of human brains. In addition to identifying genes, scientists must generated by life scientists, is especially short ﬁgure out what the genes do and—even more of qualiﬁed workers. We need laboratory scientists, doctors to do Many careers in genetics and genomics clinical research and treat patients, genetic coun require advanced degrees such as a Ph. In especially high demand are people with For more career information, see expertise in mathematics, engineering, computer http:/www. By contrast, today’s to store the huge volume of data from experi genetic research creates too much data for one ments with the fruit ﬂy Drosophila melanogaster. Called FlyBase, it has grown into a huge, New technologies are needed to manage this comprehensive, international electronic reposi huge amount of data.
If that protein is the a little bit every day and give us But they also play the role of match one that keeps a set of cells from energy to text our friends or ace a maker order cheap vantin online antibiotic 500mg, bringing together starting multiplying out of control vantin 200mg with amex antibiotics for sinus infection cipro, you can geometry test buy vantin 200 mg lowest price treatment for uti keflex. Inside the body, enzymes are up the chemical reactions in our Most enzymes reside inside cells. Because they make reactions If cells get damaged, they break forming vibrant networks and path go faster than they would on apart and spill their contents into ways. And so our metabolism is their own, enzymes are biological neighboring body fluids, like blood. That is why higher-than-normal levels catalyzed reactions that build and Consider this: Without the help of enzymes in blood—revealed in break down organic molecules in of enzymes, the conversion of a simple blood test—can signify food, producing or consuming nutrients and minerals into usable trouble in tissues or organs where energy in the process. The chemical reactions of metab essential to life, since our bodies For example, cancer can develop olism occur over and over again. By understanding the language of better able to capture its substrate the body’s metabolic communication and make a chemical reaction systems, scientists can find ways to happen. Sort of like rearranging patch the circuits when they become seats in a room to accommodate broken from injury and disease. This helper molecules called cofactors Folic acid does its good deeds molecular embrace triggers chemical are necessary ingredients for many by improving the fit between various changes, shuffling attractive forces enzyme reactions. Thus, folic acid Many proteins need help from the first few weeks after conception. Along Outside the Cell with giving us energy, they help cells move around the body and Glycoprotein Glycolipid communicate. But a certain amount of fat is really necessary: All humans need lipids, called essential fatty Plasma acids, from food because our bodies membrane can’t make them from scratch. Some body fat is also necessary as insu Cholesterol lation to prevent heat loss and to Protein protect vital organs from the strain Inside the Cell of routine activities. The plasma membrane is a perfect example of the rule that oil and water don’t mix. Lipids in adipose tissue (fat cells) are a major form of energy storage Membranes are a hallmark of how organisms evolved in animals and people. Triglycerides, another type of lipid, are especially the lipid molecule cholesterol the membrane forms more or suited for stockpiling energy because is a key part of the plasma mem less automatically when the lipid of their high caloric content. When brane, a coating that wraps around end of each glycolipid or phospho we need energy, our bodies use every cell in the human body. The other down stored triglycerides into smaller tive barrier, the plasma membrane matchstick end, containing a sugar pieces that participate directly is less like a rigid wall and more or phosphate molecule, drifts natu in metabolism. In addition to rally toward the watery environment the mitochondria in our cells lipids, the plasma membrane con typical of the areas inside or ultimately create energy from these tains sugars that stick out from its between cells. Membranes allow cells In addition to providing and of ball-and-stick molecules called to keep proteins and other mole storing energy, lipids do many other glycolipids (lipid chains with sugars cules in different compartments so things. They act as messengers, attached) and phospholipids that more than one set of reactions helping proteins come together in (lipids marked with cellular tags can occur at the same time. In addition to the plasma mem start chemical reactions that help When aligned “tail-to-tail,” these branes around cells, organelles control growth, immune function, fat-containing molecular assemblies inside cells are wrapped by similar, reproduction and other aspects of resemble a double array of match lipid-containing membranes that basic metabolism. Jutting out from How do our bodies make bio the surface of nearly all cells, these polymers? Every type of virus we Proteins are strings of amino encounter can only grip a “I volunteer to teach in Asia acids that can only fit together one certain set of glycans with way, head-to-tail. In this my experiences with the next oligosaccharides can fit together in manner, the types of gly dozens of different ways. Chemists cans that a virus latches generation of world health onto can determine how sleuths! Using tools made Chemists want to use tiny devices dots enable the study of molecules from the building blocks of life, to deliver drugs to specific sites in in a cell as a group, rather than chemists can spy on the move the body, allowing for highly tar in isolation. Other devices could glow in different fluorescent colors— up trace levels of contaminants in measure cholesterol, sugar and larger dots shine red, while slightly food and the environment. Researchers atoms within a molecule is about Small tools also allow scientists can create up to 40,000 labels by one-tenth of a nanometer. Often, these experi that measure a physical quantity and A nanometer is one-billionth ments are done in simple organisms convert it into a signal that can be the length of a meter—or about like bacteria and yeast, which consist read by an observer or instrument. Some say it is researchers have tagged cancer pansion and contraction of a liquid chemistry by a different name. Another is a touch- chemistry “labs” are extremely They mark insulin-producing cells sensitive elevator button. Such mini-machines contain Using another technology, called materials, from microbes, enzymes an expansive network of miniature quantum dots, scientists use and antibodies to pollutants. The output, or signal, varies widely as well, ranging from color to light to electricity. One of the most common examples of a health-related bio- sensor is a blood glucose monitor. This miniature device uses the enzyme glucose oxidase to break down blood glucose and produce a readable signal, which indicates how much sugar is present in a person’s blood. It is a vital tool for people with diabetes who must check their blood sugar several Quantum dots are nanocrystals that radiate brilliant colors when exposed to ultraviolet light. Some biosensors rely on mod ified microorganisms that detect toxic substances at very low levels. They can give us early warning of Nanodevices Nanopores environmental contaminants, poi Dendrimers sonous gases and even bioterror Nanotubes Quantum dots agents, such as ricin or anthrax. Nanoshells Chemistry also plays a central role in making biomaterials such Water Glucose Antibody Virus Bacterium Cancer cell A period Tennis ball as artificial joints, implants, heart valves and skin patches filled with hormones or other medicines. Efforts to engineer artificial organs—like a liver, pancreas or 10-1 1 10 102 103 104 105 106 107 108 Nanometers bladder—also hinge on chemistry. Nanotechnology is the study of the control of matter on an And some, like artificial skin for the treatment of severe burns atomic and molecular scale. Bach, Tom Waits, the Beatles, John Coltrane, Lee Morgan Explore more @ http:/www. These adverse drug reactions are one of the leading causes of hospital ization and death in the United States. Gus Rosania thinks that the precise location of a drug within a cell is a key clue to its effectiveness and safety. Computerized microscopes scanned the treated cells, analyzing more than 15,000 individual molecular pictures. The experiment was a test to see if such a “high throughput” approach—beginning with thousands of different potential molecules—could be used in the process researchers use to look for would-be medicines. Rosania concluded that his machine-vision technique was successful in automatically analyzing where the dye mole cules traveled inside cells. One advantage this technique has over manual labor— a person sitting at a microscope—is scale. The process can be done quickly and efficiently, saving time and money and enabling many more molecules to be tested in the search for new and safer medicines. She did this recently with an iron, nickel and sulfur- containing enzyme that converts carbon dioxide first into carbon monoxide, then into acetyl CoA, a key molecule in energy production. Drennan was quite surprised to find that metals help this enzyme twist itself in a way that creates a molecular tunnel for the carbon monoxide to travel through.
Initiate feeding within 2 hours of admission and feed every 2 or 3 hours throughout the 24-hour period until the child is out of danger buy vantin 100mg with mastercard antibiotic 127. Mouth ulcers: Clean mouth with normal saline (or salt water) and apply gentian violet order discount vantin online antibiotic vancomycin. After stabilization: Gradually increase intake to 150–200kcal/kg/day; protein 2– 4g/kg/day order vantin paypal 15 antimicrobial drugs. Correct micronutrient deficiencies: • Multivitamins • Folic acid • Zinc • Vitamin A • Ferrous sulphate 3mg/kg/day after child has started gaining weight Monitoring Response to Therapy Weigh child daily: • Child with oedema: Weight loss initially, then weight gain of >10g/kg/day is expected. If weight gain is less than that, check feeding, re-examine for possible missed infection. Step 3 Check for dehydration – use Diarrhoea/Dehydration flowchart to classify then use Fluid Plans for Severe Malnutrition. Ideally add mineral mix to feeds, but at least give 4mmol/kg/day extra of oral potassium. Step 8, Ensure appetite and weight are monitored and start catch-up 9, & 10 feeding (usually day 3–7). Start educating the family so they help in the acute treatment and are ready when child is discharged. Counsel on feeding Advice to Mothers Explain the problems and involve the mother in the care of the child. Nutrition counselling: Advise mother on how to mix nutritious food from the 3 food groups. Show her how to provide sensory stimulation once child is over acute phase and takes interest in surroundings. Health education to parents attending all health facilities and in the community on appropriate child rearing and feeding practices. Admit to hospital if there is a history of illness and either of: Visible severe wasting (buttocks), or oedema and low weight for age and other signs of kwashiorkor (flaky paint skin/hair changes) 31. The failure to thrive may be due to maternal emotional problems, the child may have been unwanted, or there may be severe poverty. Clinical Features Besides the size, child is often unkempt, has delayed social motor and speech development, and there is poor parent–child interaction. A complete history including nutritional, social and growth monitoring is essential. Treat the cause if known and treatable and counsel the mother on how to cope and manage at home. Most child abusers (90%) are related caretakers who tend to be lonely, unhappy, angry and under heavy stress. Many of them experienced child abuse of one form of another during their own childhood. Abused children may have certain provocative characteristics, negativity, difficult temperament, offensive behaviour, or disability. It manifests as physical injuries that include bruises, burns, head injuries, and bone fractures. Emotional abuse: This type of abuse is characterized by intentional verbal acts, criticisms, and lack of nurturing. Nutritional neglect or deliberate underfeeding: This is associated with failure to thrive. Sexual abuse: This usually occurs with family members and is the most overlooked (or under reported) form of abuse. Others: These include intentional drugging (or poisoning) or neglect of medical care. Sexual abuse may remain concealed for fear of reprisal from the perpetrator; often the victim (in this case the abused child) does not know what to do or where and how and to whom to report. Children with nutritional neglect present with failure to thrive, poor hygiene, delayed immunizations, delayed development in speech, mental status and social interaction. Most abused children are shy with expressionless faces and tend to avoid eye-to-eye contact. In physical abuse, total skeletal survey (x-ray – may find fractures at various healing stages) is recommended. The need to remove the child from the source of the abuse in order to protect the child until the evaluation of the family with respect to the safety of the child is completed. For children who experience rape or sodomy, the following needs to be done: Sedate as necessary with phenobarbitone 5–8mg/kg/day or diazepam at 0. Carry out surgical repair of injuries (sphincter injury, which may require colostomy with secondary repair). Older children should be encouraged not to keep “secrets” and to refuse any enticement to have what could be sexual abuse. Children who are in a high-risk situation should be removed from that environment and not left there. Referral for these children is necessary for long-term psychological and psychiatric care. Among these are hookworm disease, ascariasis, enterobiasis, trichuriasis, trichostrongyliasis, anisakiasis, capillariasis, and gnathostomiasis. In general, the following measures should be instituted: Providing safe water Washing hands and trimming fingernails Changing innerwear and sheets frequent Using latrines 245 Clinical Guidelines Table 32. By inhaling and swallowing eggs in the dust Main presentation: perianal and perineal itching. Migrating larvae may cause: Vaginitis, vulvitis, salpingitis, and peritonitis Irritation, insomnia may occur Taenia saginata Non-specific symptoms, irritability Stool for ova (beef tapeworm) Segment may be passed with (motile stools proglottides) Egg in stools 246 Levels 4–6 – Hospitals Table 32. Most of the people infected by Entamoeba histolytica are asymptomatic cyst carriers. Clinical Features Two diseases that are caused by Entamoeba histolytica are amoebic dysentery and amoebic liver abscess. Amoebic dysentery: This presents as bloody diarrhoea, and depending on the severity of infection there may be varying degrees of dehydration. Amoebic liver abscess: This presents as intermittent fevers, night sweats, and tenderness in the right hypochondrium. The abscess may rupture into the chest, causing empyema or into the abdomen causing peritonitis. Admit if liver abscess is suspected and start treatment for amoebic liver abscess: 247 Clinical Guidelines • Metronidazole 30–50mg/kg/day in 3 divided doses for 7–10 days • Aspiration or surgical drainage of pointing liver abscesses is indicated to prevent spontaneous rupture in pointing abscesses. Prevention Provision of safe drinking water and sanitary disposal of faeces are important preventive measures. Regular examination of food handlers and appropriate treatment when necessary are needed, including in schools. Adult flukes are white worm-like creatures that inhabit parts of the venous system of man.