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Books on the topic 'Multiple resistance mechanisms'

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Author: Grafiati

Published: 10 December 2022

Last updated: 28 January 2023

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Kellen, John A. Alternative Mechanisms of Multidrug Resistance in Cancer. Birkhauser, 2012.

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A, Kellen John, ed. Alternative mechanisms of multidrug resistance in cancer. Boston: Birkhäuser, 1995.

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Kellen, John A. Alternative Mechanisms of Multidrug Resistance in Cancer. Birkhauser Verlag, 2012.

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Torra, Joel, Maria D. Osuna, Aldo Merotto Junior, and Martin Vila-Aiub, eds. Multiple Herbicide-Resistant Weeds and Non-target Site Resistance Mechanisms: A Global Challenge for Food Production. Frontiers Media SA, 2021. http://dx.doi.org/10.3389/978-2-88971-908-2.

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Aslanian, Ara M. Multiple nutrient adaptive mechanisms affect asparaginase resistance in MOLT-4 human leukemia cells. 2000.

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Levy, Jerrold H., and David Faraoni. Pathophysiology and causes of severe hypertension. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0162.

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Hypertension affects multiple groups of patients characterized by different clinical presentations and a spectrum of potential causes. The pathophysiology is complex and multifactorial. Although most patients are labelled ‘essential hypertension’, multiple mechanisms are involved in blood pressure regulation. Factors that influence blood pressure homeostasis include endothelial function, the renin-angiotensin system, and the sympathetic nervous system. In elderly patients, hypertension is common as the vascular system and arterial stiffness also contribute. Other important factors include inflammatory processes as part of systemic diseases, including atherosclerosis,which may contribute to renal and vascular injury. Hypertension is also associated with metabolic disturbances including dyslipidaemia that manifests in obese patients who also have insulin resistance. These different pathways all represent potential targets for treatment, but also increase the challenge of multimodal pathophysiology.

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Hube, Bernhard, and Oliver Kurzai. Candida species. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0011.

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Most pathogenic Candida species are members of the microbiota, but also cause superficial or invasive infections. C. albicans is predominant, followed by C. glabrata, C. parapsilosis, and C. tropicalis. C. albicans is polymorphic and grows as yeast, pseudohyphae, or hyphae. The cell wall has multiple functions in pathogenesis. Metabolism and nutrient up-take strategies facilitate growth in multiple niches within the host. Drug resistance is an intrinsic property of C. glabrata and C. krusei, but can be developed by C. albicans and other Candida species during antifungal therapy. Pathogenicity mechanisms include host cell attachment, invasion, and destructive activities; immune evasion; and biofilm production. A disbalanced microbiota and impaired immunity favour superficial infections, and disturbance of the mucosal barriers, together with compromised immunity, enables Candida to invade the human bloodstream and cause invasive infection. Even with antifungal therapy (e.g. azoles or echinocandins), disseminated candidiasis has a high mortality (40–50%).

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Sentissi, Kinza, and Stephanie Yacoubian. Physiologic Airflow Disruption. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0017.

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Airflow disruption can be triggered through multiple mechanisms. The obstruction can stem from within the airway lumen, airway walls, or the tissues surrounding it. This section focuses on airflow disruption initiated by bronchospasm, obstructive lung disease, asthma and status asthmaticus. Bronchospasm presents with increased airway resistance secondary to airway hyperreactivity or anaphylaxis. Asthma and chronic obstructive pulmonary disease (COPD) are obstructive and inflammatory lung pathologies. Airflow disruption in asthma is reversible between exacerbations. The airway obstruction in COPD is not fully reversible. Status asthmaticus is the most severe presentation of asthma and can be life threatening. Poorly controlled obstructive lung disease can result in perioperative complications. Patients should therefore be medically optimized before undergoing operative procedures.

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Dussaule, Jean-Claude, Martin Flamant, and Christos Chatziantoniou. Function of the normal glomerulus. Edited by Neil Turner. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0044_update_001.

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Glomerular filtration, the first step leading to the formation of primitive urine, is a passive phenomenon. The composition of this primitive urine is the consequence of the ultrafiltration of plasma depending on renal blood flow, on hydrostatic pressure of glomerular capillary, and on glomerular coefficient of ultrafiltration. Glomerular filtration rate (GFR) can be precisely measured by the calculation of the clearance of freely filtrated exogenous substances that are neither metabolized nor reabsorbed nor secreted by tubules: its mean value is 125 mL/min/1.73 m² in men and 110 mL/min/1.73 m² in women, which represents 20% of renal blood flow. In clinical practice, estimates of GFR are obtained by the measurement of creatininaemia followed by the application of various equations (MDRD or CKD-EPI) and more recently by the measurement of plasmatic C-cystatin. Under physiological conditions, GFR is a stable parameter that is regulated by the intrinsic vascular and tubular autoregulation, by the balance between paracrine and endocrine agents acting as vasoconstrictors and vasodilators, and by the effects of renal sympathetic nerves. The mechanisms controlling GFR regulation are complex. This is due to the variety of vasoactive agents and their targets, and multiple interactions between them. Nevertheless, the relative stability of GFR during important variations of systemic haemodynamics and volaemia is due to three major operating mechanisms: autoregulation of the afferent arteriolar resistance, local synthesis and action of angiotensin II, and the sensitivity of renal resistance vessels to respond to NO release.

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O’Neal, M. Angela. Multiple Ovarian Cysts in a Woman with Epilepsy. Edited by Angela O’Neal. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190609917.003.0007.

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This chapter explores how epilepsy can affect reproductive function. The National Institute of Health consensus definition of PCOS includes the presence of menstrual dysfunction, clinical evidence of hyperandrogenism, and exclusion of other endocrinopathies, such as Cushing’s syndrome and hypothyroidism. The etiology of PCOS is felt to be heterogenous, related to a complex interaction between both genetic and environmental factors. PCOS develops when the ovaries are stimulated to produce excessive testosterone. The diagnosis and pathogenesis of polycystic ovarian syndrome is explored; in particular, how valproate contributes to the condition in women with epilepsy. Valproate is the AED most associated with PCOS, as it can directly increase ovarian testosterone production. It can also cause weight gain leading to insulin resistance, another mechanism contributing to PCOS.

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Olex, Stephen, and Krista Olex. Effects of Exercise on Mental Health. Edited by Anthony J. Bazzan and Daniel A. Monti. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190690557.003.0003.

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While the beneficial effects of exercise on the body are well established, there is now substantial evidence that physical activity has significant benefits on brain function and mental health as well. Physical activity including aerobic exercise, resistance exercise, yoga, and Tai Chi can influence mental health through numerous mechanisms on multiple levels, ranging from the microscopic to the level of human connection. A large body of clinical data suggests that exercise has beneficial effects on mood and cognition. While the evidence is strongest for the effects of aerobic exercise on cognitive dysfunction and depression, there is promising data in the use of aerobic exercise in other populations with mental illness as well as for the use of the other types of movement for mental health. Clinicians should be aware of physical activity as a powerful tool in their clinical toolbox with the potential for tremendous benefit on mind and body.

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Walker, Matthew C., and Robin S. B. Williams. Identifying the Molecular Mechanism of the Medium Chain Triglyceride (Ketogenic) Diet. Edited by Dominic P. D’Agostino. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190497996.003.0033.

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The medium chain triglyceride (MCT) ketogenic diet provides a highly effective and commonly used approach for treating drug-resistant epilepsy. It is associated with elevated levels of two MCT-derived fatty acids, decanoioc and octanoic acids. Researchers have identified a role for decanoic acid and a range of novel related chemicals in seizure control in multiple acute in vitro and in vivo models. A principal mechanism of decanoic acid is direct inhibition of AMPA receptors, key excitatory neurotransmitter receptors widely recognized as a target for seizure control. These data suggest a therapeutic mechanism of the MCT ketogenic diet through a direct fatty acid–dependent mechanism, independent of ketosis. This discovery will enable the development of an improved and, potentially, better-tolerated diet and the generation of a corresponding pharmaceutical approach. The diet should be termed the MCT diet, as the consequent ketosis may not be necessary for seizure control.

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Anderson, James A. An Engineer’s Introduction to Neuroscience. Oxford University Press, 2018. http://dx.doi.org/10.1093/acprof:oso/9780199357789.003.0006.

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When building something, it is essential to know the hardware. This chapter contains key things to know about the active components of the brain: nerve cells (aka neurons). Neurons have severe performance limitations. Problems include high energy consumption, mechanical and physiological sensitivity, unreliability, limited connectivity, and difficulty in wiring neurons together. Neurons are at least a million times slower to “compute” than a modern electronic device. This slow speed cannot be avoided because the neuron has to deal with high electrical capacity and resistance and slow conduction times to move information from neuron to neuron. A specialization called the action potential serves as a long-distance communications mechanism. However, the neuron also has major virtues including the ability to integrate, communicate, and process information from multiple sources, and it acts like a tiny electrochemical analog computer.

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Marks, Lawrence E. Synesthesia, Then and Now. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780199688289.003.0002.

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Puzzling in its diversity and resistant to simple theoretical accounts, synesthesia has been a subject of scrutiny and investigation for more than a century. Long treated as a cross-modal perceptual phenomenon in which stimuli presented in one modality produce additional sensations in another, modern research has highlighted the roles of learning and cognition in many kinds of synesthesia, not all of them cross-modal. Common approaches to understanding synesthesia include monism, which treats synesthesia as one pole of a continuous trait, and dualism, which distinguishes synesthesia from nonsynesthesia and searches for synesthesia’s common denominators. A third approach, pluralism, posits multiple distinct categories of synesthesia: One category (or more) may be prototypical, a good candidate being cross-modal synesthesia. Principles that characterize cross-modal synesthesia also characterize cross-modal perception in nonsynesthetes, and mechanisms that underlie prototypical cross-modal synesthesia may serve as the wellspring for the development of synesthesia’s diverse other forms.

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Steinberg, Martin. Treatment of Depression. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199959549.003.0006.

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Most depression in the elderly can be effectively treated in the primary care setting. Psychiatric referral should be considered in the setting of severe depression, suicidal ideation, prior suicide attempts, multiple risk factors, psychotic symptoms, bipolar disorder, poor response to prior treatment, or high medical comorbidity. Combining pharmacological and psychosocial interventions is most likely to be effective. Available antidepressants include serotonin-specific reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, novel mechanism agents, tricyclic antidepressants, and monoamine oxidase inhibitors. Antidepressant selection should take into account adverse effects, medical comorbidities, potential medication interactions, and patient preferences. Additional strategies (e.g. augmentation) are available for treatment resistant depression. Available psychotherapies include supportive, cognitive-behavioral, interpersonal, and problem solving. Lifestyle interventions (e.g. exercise) may be helpful adjuncts. Given limited evidence for antidepressant treatment in cognitive impairment, for those with mild to moderate depression severity, non-pharmacological interventions should be attempted first.

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Carlucci, Annalisa, and Paolo Navalesi. Weaning failure in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0103.

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Weaning failure has been defined as failure to discontinue mechanical ventilation, as assessed by the spontaneous breathing trial, or need for re-intubation after extubation, so-called extubation failure. Both events represent major clinical and economic burdens, and are associated with high morbidity and mortality. The most important mechanism leading to discontinuation failure is an unfavourable balance between respiratory muscle capacity and the load they must face. Beyond specific diseases leading to loss of muscle force-generating capacity, other factors may impair respiratory muscle function, including prolonged mechanical ventilation, sedation, and ICU-acquired neuromuscular dysfunction, potentially consequent to multiple factors. The load depends on the mechanical properties of the respiratory system. An increased load is consequent to any condition leading to increased resistance, reduced compliance, and/or occurrence of intrinsic positive-end-expiratory pressure. Noteworthy, the load can significantly increase throughout the spontaneous breathing trial. Cardiac, cerebral, and neuropsychiatric disorders are also causes of discontinuation failure. Extubation failure may depend, on the one hand, on a deteriorated force-load balance occurring after removal of the endotracheal tube and, on the other hand, on specific problems. Careful patient evaluation, avoidance and treatment of all the potential determinants of failure are crucial to achieve successful discontinuation and extubation.

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