RESUMO
The authors performed a cross-sectional epidemiological survey to investigate the source of a hospital Legionella outbreak originating in contaminated water. Water temperature and air humidity were measured around possible contamination sources. A dead-end pipe was found to contain Legionella pneumophila serogroup 1. All individuals who acquired legionellosis had spent at least 30 min within 2 m of the contamination source. Among staff, 41 of 71 were exposed, and 31 of these fell ill. All 7 patients exposed to the contaminated water acquired legionellosis. None of the 94 bed-ridden patients from the same units developed the disease. An aerosol with 60% relative air humidity was formed near the suspect water faucets, but the humidity fell rapidly farther from the water source, suggesting that desiccation decreased the risk of infection. The healthy personnel and patients closest to the source acquired legionellosis, suggesting that risk was related less to compromised patients than to exposure.
Assuntos
Infecção Hospitalar/epidemiologia , Surtos de Doenças , Doença dos Legionários/epidemiologia , Abastecimento de Água , Adulto , Infecção Hospitalar/microbiologia , Estudos Transversais , Feminino , Humanos , Umidade , Pacientes Internados , Legionella pneumophila/isolamento & purificação , Doença dos Legionários/microbiologia , Masculino , Pessoa de Meia-Idade , Recursos Humanos em Hospital , Temperatura , Microbiologia da ÁguaRESUMO
Cancer is a major European public health issue and represents the second most important cause of death and morbidity in Europe. Moreover, as a result of constant advances in medicine, medical technology and other sciences, and due to improvements in economic circumstances, cancer survival rates are increasing in Europe and prevalent cases (i.e. number of subjects who have experienced cancer) represent a growing proportion of the population. In order to tackle cancer efficiently throughout the European Member states, the European Commission launched the Joint Action (JA) 'European Partnership for Action Against Cancer' (EPAAC) facilitated by the Community Health Programme, in September 2009. EPAAC is designed to fill a gap in cooperation, collaboration and shared experiences for countries with similar needs and diverse experience in the area of their national cancer control policies. Activities and studies are tackling the main challenges of cancer control in Europe as a whole and in the Member states, including the provision of services and health system responses, human resources and research. In contrast with previous European actions in the field of cancer, EPAAC joins different partners and stakeholders at various levels ranging from Member states (including Iceland and Norway) and Regions to patient representatives.
RESUMO
The main conclusion is that systems biology approaches can indeed advance cancer research, having already proved successful in a very wide variety of cancer-related areas, and are likely to prove superior to many current research strategies. Major points include: Systems biology and computational approaches can make important contributions to research and development in key clinical aspects of cancer and of cancer treatment, and should be developed for understanding and application to diagnosis, biomarkers, cancer progression, drug development and treatment strategies. Development of new measurement technologies is central to successful systems approaches, and should be strongly encouraged. The systems view of disease combined with these new technologies and novel computational tools will over the next 5-20 years lead to medicine that is predictive, personalized, preventive and participatory (P4 medicine).Major initiatives are in progress to gather extremely wide ranges of data for both somatic and germ-line genetic variations, as well as gene, transcript, protein and metabolite expression profiles that are cancer-relevant. Electronic databases and repositories play a central role to store and analyze these data. These resources need to be developed and sustained. Understanding cellular pathways is crucial in cancer research, and these pathways need to be considered in the context of the progression of cancer at various stages. At all stages of cancer progression, major areas require modelling via systems and developmental biology methods including immune system reactions, angiogenesis and tumour progression.A number of mathematical models of an analytical or computational nature have been developed that can give detailed insights into the dynamics of cancer-relevant systems. These models should be further integrated across multiple levels of biological organization in conjunction with analysis of laboratory and clinical data.Biomarkers represent major tools in determining the presence of cancer, its progression and the responses to treatments. There is a need for sets of high-quality annotated clinical samples, enabling comparisons across different diseases and the quantitative simulation of major pathways leading to biomarker development and analysis of drug effects.Education is recognized as a key component in the success of any systems biology programme, especially for applications to cancer research. It is recognized that a balance needs to be found between the need to be interdisciplinary and the necessity of having extensive specialist knowledge in particular areas.A proposal from this workshop is to explore one or more types of cancer over the full scale of their progression, for example glioblastoma or colon cancer. Such an exemplar project would require all the experimental and computational tools available for the generation and analysis of quantitative data over the entire hierarchy of biological information. These tools and approaches could be mobilized to understand, detect and treat cancerous processes and establish methods applicable across a wide range of cancers.
Assuntos
Pesquisa Biomédica/métodos , Neoplasias , Biologia de Sistemas/métodos , Biomarcadores , Biologia Computacional/métodos , Educação , Europa (Continente) , Humanos , Estados UnidosRESUMO
Eighty years after the first national public health institution was founded in Slovenia, the Institute of Public Health of the Republic of Slovenia (IPHRS) endeavors to meet ever-growing national demands. With the independence of Slovenia in 1991, new tasks had to be tackled, many of which were initially coupled with typical difficulties of a postcommunist country in transition. Also, increasing demands of the European Union (EU) and other international partners had to be met. The IPHRS monitors the health of the Slovenian population and its determinants and contributes to planning and implementation of population-based interventions for the better health of the whole nation. The diversity of the IPHRS activities is mirrored by the organization's internal complexity, multi-disciplinary approach, and links to various sectors. Currently, activities are organized within five centers: Center for Population Health Research; Center for Health Care Organization, Economics and Informatics; Center for Environmental Health; Center for Communicable Diseases; and Center for Health Promotion. The IPHRS is the key national institution in public health research, which is an integral part of all the areas covered by the Institute. The IPHRS also provides education programs in the field of public health. In the near future, it will be important to sustain current activities while integrating into the new program of Community action in the field of public health as well as contributing to the response to challenging public health issues in the wider context of the whole European region. Our aim is to integrate the Institute's activities in the programs relevant to public health issues of outstanding importance in this European sub-region. The IPHRS, given the geographic position and recent history, can act as an intermediate between the public health networks in EU and other countries in the sub-region.