BIOE 301PowerPoint PresentationReview of Lecture Two: Leading Causes of Mortality, Birth-Age 41. Perinatal ConditionsSlide 52. Lower Respiratory InfectionsSlide 73. Diarrheal DiseasesSlide 94. Malaria4. MalariaSlide 12Slide 13Slide 14Leading Causes of Mortality Ages 15-441. HIV/AIDSBurden of HIV/AIDSAIDS has Reduced Life ExpectancySlide 19Burden of HIV/AIDS in the U.S.Slide 21Pathophysiology of HIV/AIDSSlide 23Slide 24Clinical Course of HIV/AIDSSlide 26Slide 27Slide 28Slide 29Slide 30HIV/AIDS TherapySlide 32Slide 33Slide 34Slide 35HIV/AIDS Historical PerspectiveSlide 37Slide 38Discussion2. Unintentional InjuriesSlide 41Burden of Unintentional InjuriesBurden of Road Accidents in the USAccident PhysicsSlide 45Slowed Driver Reaction TimeSlide 47Slide 48Prevention of Road AccidentsSlide 50Slide 513. Cardiovascular DiseasesTuberculosis4. TuberculosisBurden of TuberculosisSlide 56Slide 57Natural History of TB InfectionSlide 59Slide 60Slide 61Diagnosis of TuberculosisDrug ResistanceSlide 64Slide 65Tuberculosis: TreatmentSlide 67Slide 68Directly Observed Therapy (DOT)Slide 70Directly Observed Therapy (DOT)Slide 72TB in the Last CenturyOverlapping EpidemicsDiscussion: Pandemic control in CubaSlide 763. Cancer4. Self-Inflicted InjuriesBurden of Self-Inflicted InjuriesRisk Factors Associated with SuicideMethods of SuicideScreening and PreventionSlide 83Slide 84Slide 85Selected Preventable Causes of DeathWho is helping?Slide 88The Global Fund ARVsDisease Burden and FundingSummary of Lecture 3Assignments Due Next TimeBIOE 301Geoff PreidisMD/PhD candidateBaylor College of [email protected] Three:Leading Causes of Mortality, Ages 15-44Review of Lecture Two:Leading Causes of Mortality, Birth-Age 4Developing world1. Perinatal conditions2. Lower respiratory infections3. Diarrheal diseases4. MalariaDeveloped world1. Perinatal conditions2. Congenital anomalies3. Lower respiratory infections4. Unintentional injuries1. Perinatal ConditionsQuestion: What is the #1 way to prevent septicemia in a newborn in the developing world?1. Perinatal Conditionshttp://www.path.org/projects/clean-delivery_kit.php2. Lower Respiratory InfectionsQuestion: How can a busy health worker (or a parent) quickly screen for pneumonia in a child?2. Lower Respiratory Infections3. Diarrheal DiseasesQuestion: What is the #1 way to prevent diarrheal illness in a newborn?3. Diarrheal Diseases4. MalariaQuestions: 1. Why has malaria been eradicated from the southern U.S.? How can these principles be applied to less developed countries?4. MalariaReduced human/insect contactPrevent mosquito breedingUse insect repellents, mats, coilsResidual treatment of interior wallsWear long sleeves/pantsInsecticide-treated mosquito bed netsTreatment of those who have malariaprevent its spread!Questions: 2. What are the challenges for implementing this technology in developing countries?What are the challenges for implementing this technology in developing countries?Mapping areas that are difficult to accessPoor communication Direction – Transfer of vector control efforts from malaria control authorities to local primary health care centerFinancial support – decreased standard of living from wars, environmental factors, migrationCorruption, graftQuestions: 3. Where is the malaria vaccine?4. Malaria4. MalariaWhere is the malaria vaccine?FundingThousands of antigens presented to the human immune system -> which ones are useful targets?Plasmodium has many life stages -> different antigens at each stagePlasmodium has several strategies to confuse, hide, and misdirect the human immune systemMultiple malaria infections of the different species and different strains of the same species may occur in one host!http://www.cdc.gov/malaria/images/graphs/malaria_lifecycle.gifQuestions: 4. How does Chloroquine protect you when you travel?4. Malariahttp://sickle.bwh.harvard.eduLeading Causes of Mortality Ages 15-44Developing World1. HIV/AIDS2. Unintentional injuries3. Cardiovascular diseases4. TuberculosisDeveloped World1. Unintentional injuries2. Cardiovascular diseases3. Cancer4. Self-inflicted injuries1. HIV/AIDSBurden of HIV/AIDSPathophysiology of HIVClinical course of HIV/AIDSHighly Active Antiretroviral TherapyHistorical Perspective of HIV/AIDSDiscussion: Is HAART really feasible in developing countries?Burden of HIV/AIDSWorldwide39.5 million people are living with HIV/AIDS20 million people have been killed by the disease2006:2.9 million deaths4.3 million new HIV infections (400,000 more than in 2004)40% of new infections occurred in young people (ages 15-24)2/3 of those with AIDS and 3/4 of all AIDS deaths are in sub-Saharan AfricaIn the past 2 years, the number of HIV-infected people rose in every region in the worldSource: 2006 AIDS Epidemic Update, UNAIDS/WHOAIDS has Reduced Life ExpectancyBurden of HIV/AIDSUnited States1.2 million people have HIV/AIDS (prevalence)30,000-40,000 new infections per year (incidence)Only 7 countries in the world have more people living with HIV than the U.S.Routes of transmission:Unsafe sex between men (44%)Unprotected heterosexual intercourse (34%)Non-sterile drug injection equipment (17%)Burden of HIV/AIDS in the U.S.Racial and ethnic minorities are disproportionately affected:50% of AIDS diagnoses are in African-Americans (12% pop)20% of AIDS diagnoses are in Hispanics (14% pop)The rate of new HIV diagnoses was 21x higher in African-American women than in white womenWomen are increasingly affected:The proportion of of women among new HIV/AIDS diagnoses have risen from 15% to 27% in 10 yearsQuestion: Why is the total number of HIV infected people in the U.S. continuing to increase?Burden of HIV/AIDS in the U.S.Anti-retroviral therapy has accounted for an 80% decrease in AIDS death rates in the last decadeAnnual cost to treat: $15 billionPathophysiology of HIV/AIDSHIV StructureEnvelopeRTRNAIntegraseProteasep14p17gp41gp120 Matrix Proteins Core ProteinsEnvelope Proteinshttp://bayloraids.org/curriculum/Pathophysiology of HIV/AIDShttp://bayloraids.org/curriculum/Pathophysiology of HIV/AIDShttp://bayloraids.org/curriculum/Clinical Course of HIV/AIDSHIV InfectionSpread by sexual contact with infected person or sharing needles with infected person or by transmission from mother to childVirus deposited on mucosal
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