{"title":"Cestodes (tapeworms)","authors":"R. Knight","doi":"10.1093/med/9780198746690.003.0179","DOIUrl":"https://doi.org/10.1093/med/9780198746690.003.0179","url":null,"abstract":"Adult tapeworms maintain anchorage to the host small-gut mucosa by means the scolex, a holdfast structure. The rest of the body forms the strobila and consists of a chain of flattened proglottids, which proliferate just behind the scolex. The life cycle then includes larval stages in one or more intermediate hosts. Many species of tapeworm, all zoonoses, infect humans as adult worms or larval stages. Serious disease can result when larval stages occur accidentally in humans, whereas infections by the adult stages often cause little harm. Two groups of cestode infect humans: the Cyclophyllidea and the Pseudophyllidea. The former have a terrestrial life cycle and cystic larvae; the latter have an aquatic cycle and worm-like larvae.","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"123 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124593897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Parvovirus B19","authors":"K. Brown","doi":"10.1093/med/9780198746690.003.0095","DOIUrl":"https://doi.org/10.1093/med/9780198746690.003.0095","url":null,"abstract":"Parvovirus B19 (B19V) is a small DNA virus that replicates in erythroid progenitor cells, with virus-induced cytotoxicity stopping red cell production. It only infects humans, is endemic in most places, and is transmitted predominantly by the respiratory route. In healthy people it causes the rash illness, erythema infectiosum, also known as ‘fifth disease’ or ‘slapped cheek disease’, associated with minimal drop in haemoglobin, but in patients with increased red cell turnover (e.g. haemolytic anaemia or haemoglobinopathy), it causes transient aplastic crisis; in immunocompromised patients it causes chronic anaemia; and following maternal infection it leads to hydrops fetalis or fetal loss. Treatment is supportive in most instances, but reduction in iatrogenic immunosuppression and/or intravenous immunoglobulin may be appropriate in some cases. No vaccine is available.","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128578626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Tuberculosis","authors":"R. Chaisson, J. Nachega","doi":"10.1093/med/9780198746690.003.0130","DOIUrl":"https://doi.org/10.1093/med/9780198746690.003.0130","url":null,"abstract":"Tuberculosis is caused by organisms of the Mycobacterium tuberculosis complex, including M. tuberculosis (the most important), M. bovis, and M. africanum. It has been present since antiquity and is the leading infectious cause of death ahead of HIV infection. An estimated 2 billion people worldwide carry latent infection, when M. tuberculosis persists within cells and granulomas, with the potential to reactivate to cause disease decades later. Tubercle bacilli are transmitted between people by aerosols generated when an infectious person coughs. Proximity to an infectious person determines the risk of infection. Host immunity and factors affecting it—most importantly HIV infection but also diabetes, cigarette smoking, and alcohol and drug abuse—determine the risk of active disease following infection.","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"130 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128668826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Poisonous fungi","authors":"H. Persson, D. Warrell","doi":"10.1093/med/9780198746690.003.0215","DOIUrl":"https://doi.org/10.1093/med/9780198746690.003.0215","url":null,"abstract":"This chapter covers poisoning by members of the fungal subkingdom Dikarya that includes most of the ‘higher fungi’. The phylum Ascomycota contains the medically important toxic fungi Claviceps purpurea, the cause of ergotism, Aspergillus flavus, a source of hepatotoxic and carcinogenic aflatoxins, the edible but potentially toxic morel mushrooms (Morchella species), Gyromitra species, and Podostroma cornudamae that has caused multisystem symptoms and signs. The phylum Basidiomycota includes the order Agaricales (gilled mushrooms/toadstools or agarics) to which most of the medically important larger fungi belong. ‘Mushroom’ and ‘toadstool’ may suggest ‘edible’ and ‘poisonous’ respectively, but these terms are not strictly applied. Poisonous species must be distinguished from field (Agaricus campestris) and cultivated (A. bisporus) mushrooms and from the many other mushrooms that are considered to be delicious and are passionately sought after by mycophiles worldwide.","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127076401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The upper respiratory tract","authors":"P. Shah, J. Stradling, S. Craig","doi":"10.1093/med/9780199204854.003.180101","DOIUrl":"https://doi.org/10.1093/med/9780199204854.003.180101","url":null,"abstract":"The upper respiratory tract extends from the anterior nares to the larynx and comprises (1) the nose—with the main function as first-line defence against problems with incoming air, acting as a coarse particle filter and a conditioner (temperature and humidity) of the air, and with the sense of smell helping to detect noxious substances that are best avoided. (2) The pharynx—this has to act as a rigid tube when used for breathing, but during swallowing it has to be a collapsible tube capable of peristalsis, a combination of functions which is achieved by complex innervation and musculature. Subepithelial collections of lymphoid tissue in the pharynx are ideally suited to process inhaled and swallowed antigens. (3) The larynx—this has three important functions: communication, protection of the airway, and dynamic control of lung volume.","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"299 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132418013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pulmonary amyloidosis","authors":"S. Bourke","doi":"10.1093/med/9780198746690.003.0428","DOIUrl":"https://doi.org/10.1093/med/9780198746690.003.0428","url":null,"abstract":"Pulmonary amyloidosis is characterized by the deposition of monoclonal immunoglobulin light chain (AL) amyloid protein locally or diffusely in lung tissue. Local amyloid deposits in the airways, produced by B-cell clones within local tissues, may cause stridor, wheeze, cough, and haemoptysis. Diffuse alveolar deposition can occur as a complication of systemic amyloidosis. Local deposits of amyloid in the larynx, trachea, or bronchi may require treatment by endoscopic interventions, with mechanical debulking by forceps resection or laser therapy. Stenting may also be used to maintain airway patency. Radiotherapy has also been deployed successfully, and in certain circumstances may be a better option with less risk of bleeding or recurrence. Systemic AL amyloidosis may be treated by chemotherapy, while diffuse alveolar amyloidosis has a poor prognosis, particularly because it is associated with cardiac and renal amyloidosis.","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132022256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Large vessel vasculitis","authors":"R. Luqmani, C. Ponte","doi":"10.1093/med/9780198746690.003.0458","DOIUrl":"https://doi.org/10.1093/med/9780198746690.003.0458","url":null,"abstract":"Large vessel vasculitis describes a group of primary vasculitides predominantly affecting the aorta and its major branches. The two major subtypes of large vessel vasculitis are giant cell arteritis (GCA) and Takayasu arteritis (TA), which have distinctive features. GCA occurs predominantly in white European women aged above 50 years, while TA affects women below 40 years from the Middle East and Asia. However, there are many similarities between GCA and TA, particularly in pathogenic mechanisms, histopathology, and clinical manifestations related to large vessel involvement. It remains unclear whether GCA and TA are distinct entities or represent different phenotypes of the same disease.","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"182 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132082096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karolina Griffiths, C. Eldin, D. Raoult, P. Parola
{"title":"Rickettsioses","authors":"Karolina Griffiths, C. Eldin, D. Raoult, P. Parola","doi":"10.1093/med/9780198746690.003.0144","DOIUrl":"https://doi.org/10.1093/med/9780198746690.003.0144","url":null,"abstract":"Rickettsioses are mild to life-threatening zoonoses caused by obligate intracellular bacteria of the order Rickettsiales (family Rickettsiaceae). Arthropods, including ticks, fleas, and mites, are implicated as their vectors, reservoirs, or amplifiers. With an increasing number of new pathogens and recognition of new pathogenicity and affected geographical areas over the past few decades, there is a better understanding of the scope and importance of these pathogens, particularly as a paradigm to understanding emerging and remerging infections. The taxonomy has undergone numerous changes, with now three main groups classified as rickettsioses according to morphological, antigenic and metabolic characteristics: (1) Rickettsioses due to the bacteria of the genus Rickettsia, including the spotted fever group, typhus groups (Rickettsiaceae), (2) Ehrlichioses and Anaplasmoses due to bacteria of the Anaplasmataceae and (3) scrub typhus due to Orientia tsutsugamushi.\u0000","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"193 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132165289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Blood disorders in pregnancy","authors":"D. Perry, K. Lowndes","doi":"10.1093/med/9780198746690.003.0279","DOIUrl":"https://doi.org/10.1093/med/9780198746690.003.0279","url":null,"abstract":"Plasma volume increases by more during pregnancy than does red cell mass, leading to haemodilution and a fall in the haematocrit from about 40% to 33%, with a nadir usually reached at 24–32 weeks’ gestation. Anaemia during pregnancy is defined as a haemoglobin concentration of below 105 g/L during the second and third trimesters and below 110 g/L in the first trimester. The commonest haematological problem encountered in pregnancy is iron-deficiency anaemia. Routine iron supplementation in all pregnant women is probably not justified in developed countries, but if iron deficiency is detected it is advisable to treat as early as possible. Normal pregnancy is associated with marked changes in all aspects of haemostasis, the overall effect of which is to generate a state of hypercoagulability. These changes in haemostasis, while reducing the risks of excessive blood loss at delivery, significantly increase the risk of venous thromboembolic disease in pregnancy.","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130966923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Disorders of the neuromuscular junction","authors":"D. Hilton‐Jones, Jacqueline A Palace","doi":"10.1093/med/9780199204854.003.2423_update_001","DOIUrl":"https://doi.org/10.1093/med/9780199204854.003.2423_update_001","url":null,"abstract":"This chapter looks at how two fundamentally different pathological processes are associated with disease at the neuromuscular junction: acquired disorders in which autoantibodies are directed against nerve or muscle receptor or ion channels; rare inherited conditions in which the defect may be pre- or postsynaptic. The acquired neuromuscular junction disorders are associated with antibodies directed against one of the ion channels. The fact that there are three autoimmune disorders known to affect such a small region may be explained by the neuromuscular junction, unlike the peripheral nerve, not being contained within the blood–nerve barrier, which stops just short of the nerve terminal, and thus being potentially exposed to circulating humoral attack. The inherited disorders may affect presynaptic processes (acetylcholine resynthesis, packaging, or release), acetylcholinesterase binding, or postsynaptic function (acetylcholine receptor numbers or localization). Pathogenic mechanisms are considered in more detail when discussing individual disorders.","PeriodicalId":347739,"journal":{"name":"Oxford Textbook of Medicine","volume":"126 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131735894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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