TG13 diagnostic criteria for acute cholecystitis.
\\n\\n
IntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\\n\\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\\n\\nLaunching 2021
\\n\\nArtificial Intelligence, ISSN 2633-1403
\\n\\nVeterinary Medicine and Science, ISSN 2632-0517
\\n\\nBiochemistry, ISSN 2632-0983
\\n\\nBiomedical Engineering, ISSN 2631-5343
\\n\\nInfectious Diseases, ISSN 2631-6188
\\n\\nPhysiology (Coming Soon)
\\n\\nDentistry (Coming Soon)
\\n\\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\\n\\nNote: Edited in October 2021
\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/132"}},components:[{type:"htmlEditorComponent",content:'With the desire to make book publishing more relevant for the digital age and offer innovative Open Access publishing options, we are thrilled to announce the launch of our new publishing format: IntechOpen Book Series.
\n\nDesigned to cover fast-moving research fields in rapidly expanding areas, our Book Series feature a Topic structure allowing us to present the most relevant sub-disciplines. Book Series are headed by Series Editors, and a team of Topic Editors supported by international Editorial Board members. Topics are always open for submissions, with an Annual Volume published each calendar year.
\n\nAfter a robust peer-review process, accepted works are published quickly, thanks to Online First, ensuring research is made available to the scientific community without delay.
\n\nOur innovative Book Series format brings you:
\n\nIntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\n\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\n\nLaunching 2021
\n\nArtificial Intelligence, ISSN 2633-1403
\n\nVeterinary Medicine and Science, ISSN 2632-0517
\n\nBiochemistry, ISSN 2632-0983
\n\nBiomedical Engineering, ISSN 2631-5343
\n\nInfectious Diseases, ISSN 2631-6188
\n\nPhysiology (Coming Soon)
\n\nDentistry (Coming Soon)
\n\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\n\nNote: Edited in October 2021
\n'}],latestNews:[{slug:"intechopen-supports-asapbio-s-new-initiative-publish-your-reviews-20220729",title:"IntechOpen Supports ASAPbio’s New Initiative Publish Your Reviews"},{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"}]},book:{item:{type:"book",id:"5450",leadTitle:null,fullTitle:"Polymerase Chain Reaction for Biomedical Applications",title:"Polymerase Chain Reaction for Biomedical Applications",subtitle:null,reviewType:"peer-reviewed",abstract:"Do you want to know the details that should be taken into consideration in order to have accurate conventional and real-time PCR results? If so, this book is for you. Polymerase Chain Reaction for Biomedical Applications is a collection of chapters for both novice and experienced scientists and technologists aiming to address obtaining an optimized real-time PCR result, simultaneous processing of a large number of samples and assays, performing PCR and RT-PCR on cell lysate without extraction of DNA or RNA, detecting false-positive PCR results, detecting organisms in viral and microbial diseases and hospital environment, following safety assessments of food products, and using PCR for introduction of mutations. This is a must-have book for any PCR laboratory.",isbn:"978-953-51-2796-3",printIsbn:"978-953-51-2795-6",pdfIsbn:"978-953-51-4133-4",doi:"10.5772/62968",price:119,priceEur:129,priceUsd:155,slug:"polymerase-chain-reaction-for-biomedical-applications",numberOfPages:184,isOpenForSubmission:!1,isInWos:1,isInBkci:!0,hash:"fcc7a13834f2748241be560e9c512a76",bookSignature:"Ali Samadikuchaksaraei",publishedDate:"December 14th 2016",coverURL:"https://cdn.intechopen.com/books/images_new/5450.jpg",numberOfDownloads:26255,numberOfWosCitations:41,numberOfCrossrefCitations:28,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:62,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:131,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"April 12th 2016",dateEndSecondStepPublish:"May 3rd 2016",dateEndThirdStepPublish:"August 7th 2016",dateEndFourthStepPublish:"November 5th 2016",dateEndFifthStepPublish:"December 5th 2016",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6,8,9",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"187501",title:"Prof.",name:"Ali",middleName:null,surname:"Samadikuchaksaraei",slug:"ali-samadikuchaksaraei",fullName:"Ali Samadikuchaksaraei",profilePictureURL:"https://mts.intechopen.com/storage/users/187501/images/system/187501.jpeg",biography:"Professor Samadikuchaksaraei has received his MD degree from Iran University of Medical Sciences in 1998 and his Ph.D. degree from Imperial College London in 2005. His expertise is mainly focused on regenerative niche engineering for skeletal, integumentary and respiratory systems using stem cells and biomimetic materials. His publications, including book chapters, editorials, abstracts and original articles are published in collaboration with more than 300 scientists from more than 60 institutes in 10 different countries around the world. Some of his research outputs have been patented for commercial purposes. Prof. Samadikuchaksaraei serves on the editorial boards of several journals and regularly reviews for many high-profile publishers. Additionally, he reviews for granting bodies and patent and intellectual properties state organizations.",institutionString:"Iran University of Medical Sciences",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"2",institution:{name:"Iran University of Medical Sciences",institutionURL:null,country:{name:"Iran"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"384",title:"Chemical Biology",slug:"chemical-biology"}],chapters:[{id:"53176",title:"Guidelines for Successful Quantitative Gene Expression in Real- Time qPCR Assays",doi:"10.5772/65850",slug:"guidelines-for-successful-quantitative-gene-expression-in-real-time-qpcr-assays",totalDownloads:3609,totalCrossrefCites:3,totalDimensionsCites:4,hasAltmetrics:0,abstract:"This chapter was developed to provide some important guidelines for studies with quantitative PCR (qPCR) using either dyes or probes, citing several essential components necessary for a good PCR assay. The efficiency and specificity of quantitative PCR (qPCR) depend on several parameters related to mRNA quantification that must be controlled to avoid mistakes in data interpretation. Avoiding contamination with proteins, carbohydrate and phenolic compounds during RNA extraction and purification processes will improve RNA quality and provide reliable results. Specific primers and sensible probes are also crucial to intensify efficiency, specificity and fluorescence. Other parameters such as the optimization of primer concentrations and efficiency primer curves must be done. During gene-expression profile quantification, qPCR assays using reference genes are required to normalize the target gene expression data. These reference genes are checked for stability to identify the most stable genes among a group of candidate genes that will be used to normalize the qPCR data, using programs such as geNorm, BestKeeper and NormFinder. Additionally, the choice of appropriate reference genes for a specific experimental condition is fundamental. The main aim of this chapter is to provide guidelines and highlight precautions to obtain a successful qPCR assays.",signatures:"Antônio José Rocha, Rafael de Souza Miranda, Antônio Juscelino\nSudário Sousa and André Luis Coelho da Silva",downloadPdfUrl:"/chapter/pdf-download/53176",previewPdfUrl:"/chapter/pdf-preview/53176",authors:[{id:"188806",title:"Dr.",name:"Antônio",surname:"Rocha",slug:"antonio-rocha",fullName:"Antônio Rocha"}],corrections:null},{id:"52927",title:"High-Throughput Platforms in Real-Time PCR and Applications",doi:"10.5772/65760",slug:"high-throughput-platforms-in-real-time-pcr-and-applications",totalDownloads:2302,totalCrossrefCites:8,totalDimensionsCites:19,hasAltmetrics:0,abstract:"The miniaturization of reactions by designing nanoliter-scale PCR platforms, as Taqman® OpenArray®, Dynamic Array™, or SmartChip, has been a big step forward in real-time PCR. Each platform has some particular characteristics that differentiate them. These nanoliter-scale PCR platforms enable substantial savings in the amount of reagents and sample because the reaction volumes are at nanoliter levels. In addition, it is possible to perform thousands of reactions in a few hours. Therefore, high-throughput real-time PCR platforms result in promising systems that are capable of processing a large number of samples simultaneously and also to perform a large number of assays per sample. All of this can be translated in the amazing applicability of this technology in all kinds of analytical fields, such as medical research, animal science, and food safety, among others.",signatures:"Alexandre Lamas, Carlos Manuel Franco, Patricia Regal, José\nManuel Miranda, Beatriz Vázquez and Alberto Cepeda",downloadPdfUrl:"/chapter/pdf-download/52927",previewPdfUrl:"/chapter/pdf-preview/52927",authors:[{id:"127648",title:"Ms.",name:"Patricia",surname:"Regal",slug:"patricia-regal",fullName:"Patricia Regal"},{id:"171990",title:"Dr.",name:"José Manuel",surname:"Miranda",slug:"jose-manuel-miranda",fullName:"José Manuel Miranda"},{id:"189907",title:"Dr.",name:"Carlos",surname:"Franco",slug:"carlos-franco",fullName:"Carlos Franco"},{id:"194841",title:"Dr.",name:"Alexandre",surname:"Lamas",slug:"alexandre-lamas",fullName:"Alexandre Lamas"},{id:"194842",title:"Dr.",name:"Beatriz",surname:"Vázquez",slug:"beatriz-vazquez",fullName:"Beatriz Vázquez"},{id:"194843",title:"Dr.",name:"Aberto",surname:"Cepeda",slug:"aberto-cepeda",fullName:"Aberto Cepeda"}],corrections:null},{id:"52692",title:"Hot Cell-Direct PCR Aimed at Specific Cell Detection",doi:"10.5772/65806",slug:"hot-cell-direct-pcr-aimed-at-specific-cell-detection",totalDownloads:1593,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:1,abstract:"Since the polymerase chain reaction (PCR) was proposed, it has become an essential method in the field of biological gene analysis, providing a method to amplify DNA sequences of interest. To detect and/or analyze genes in cells, the gene or expressed gene must first be extracted before PCR. This procedure takes time and may result in the loss of samples. In order to avoid such drawbacks, two methods, hot cell-direct PCR and reverse transcription-PCR (RT-PCR), were invented, to detect genes in cells. Using hot cell-direct PCR, specific genes in microbial cells such as invA in Salmonella enterica have been easily detected and applied to discriminate Archaea from bacteria. As hot cell-direct PCR and RT-PCR are fairly simple processes, they can be applied to detect genes in single cells. We developed an original compact disc (CD)-shaped microfluidic device with microchambers for single-cell isolation and a detection system for expressed genes in isolated single cells in a microchamber on the device. We succeeded in the detection of PCR and RT-PCR products in individual cells and successfully detected S. enterica cells by hot cell-direct PCR. Expressed genes in Jurkat cells—human leukemia T cells—were analyzed by this method.",signatures:"Izumi Kubo, Yuko H. Itoh and Shunsuke Furutani",downloadPdfUrl:"/chapter/pdf-download/52692",previewPdfUrl:"/chapter/pdf-preview/52692",authors:[{id:"190351",title:"Prof.",name:"Izumi",surname:"Kubo",slug:"izumi-kubo",fullName:"Izumi Kubo"}],corrections:null},{id:"52932",title:"Regulatory Concern of Polymerase Chain Reaction (PCR) Carryover Contamination",doi:"10.5772/66294",slug:"regulatory-concern-of-polymerase-chain-reaction-pcr-carryover-contamination",totalDownloads:3317,totalCrossrefCites:4,totalDimensionsCites:13,hasAltmetrics:1,abstract:"Currently, DNA amplification techniques have become important detection tools. However, the extreme sensitivity of such techniques can easily result in contamination. This is a major problem in using these techniques routinely in a regulatory agency such as the Food and Drug Administration (FDA) because false-positive polymerase chain reaction (PCR) results will fail our mission. Preventing PCR carryover contamination and a capacity to rapidly determine false PCR positives are crucial. In the past, several methods have been used to prevent amplicon carryover contamination. In this chapter, we provide practical suggestions for PCR carryover contamination detection and prevention that work well with most PCR applications in our laboratory.",signatures:"Yuan Hu",downloadPdfUrl:"/chapter/pdf-download/52932",previewPdfUrl:"/chapter/pdf-preview/52932",authors:[{id:"189420",title:"Dr.",name:"Yuan",surname:"Hu",slug:"yuan-hu",fullName:"Yuan Hu"}],corrections:null},{id:"52768",title:"Multiplex Polymerase Chain Reaction Assay for Early Diagnosis of Viral Infection",doi:"10.5772/65771",slug:"multiplex-polymerase-chain-reaction-assay-for-early-diagnosis-of-viral-infection",totalDownloads:1938,totalCrossrefCites:3,totalDimensionsCites:6,hasAltmetrics:0,abstract:"Viral reactivation is one of the most serious complications for immunocompromised patients. Under immunosuppressive conditions, some viruses can be reactivated solely or simultaneously and may thus cause life-threatening infection. Therefore, the prompt and proper diagnosis of viral reactivation is important for the initiation of preemptive therapy. For this purpose, we recently developed a multiplex-virus polymerase chain reaction (PCR) assay. The multiplex PCR assay is designed to qualitatively measure the genomic DNA of 12 viruses at once: cytomegalovirus (CMV), human herpesvirus type 6 (HHV-6), HHV-7, HHV-8, Epstein-Barr virus (EBV), varicella-zoster virus (VZV), BK virus (BKV), JC virus (JCV), parvovirus B19 (ParvoB19), herpes simplex virus type 1 (HSV-1), HSV-2, and hepatitis B virus (HBV). When a specific PCR signal is obtained, the viral load is determined by a quantitative real-time PCR. The qualitative multiplex and quantitative real-time PCR procedures take only 3 hours to complete. With this assay system, we can identify viremia at the early stage and thereby prevent it from progressing to overt and symptomatic viral infection in immunocompromised patients, such as those receiving hematopoietic stem cell transplantation.",signatures:"Hiroko Tsunemine, Yuriko Yoshioka, Miho Nagao, Yasuhiro\nTomaru, Toshiharu Saitoh, Souichi Adachi, Norio Shimizu and\nTakayuki Takahashi",downloadPdfUrl:"/chapter/pdf-download/52768",previewPdfUrl:"/chapter/pdf-preview/52768",authors:[{id:"175658",title:"Dr.",name:"Hiroko",surname:"Tsunemine",slug:"hiroko-tsunemine",fullName:"Hiroko Tsunemine"}],corrections:null},{id:"52716",title:"The Advantages of Using Multiplex PCR for the Simultaneous Detection of Six Sexually Transmitted Diseases",doi:"10.5772/65901",slug:"the-advantages-of-using-multiplex-pcr-for-the-simultaneous-detection-of-six-sexually-transmitted-dis",totalDownloads:2466,totalCrossrefCites:2,totalDimensionsCites:2,hasAltmetrics:1,abstract:"Sexually transmitted diseases (STDs) are among the most common infections. Their clinical identification is difficult because STDs are often asymptomatic. Untreated infections with these pathogens can in time lead to serious consequences. It is documented that isolation of some of these bacteria from cultures is very difficult. Because there is a large number of STD pathogens which can generate coinfections, their simultaneous detection in a unique sample is very important. Multiplex polymerase chain reaction (PCR) is an advanced method of molecular biology which allows for simultaneous detection of multiple pathogens in the same sample. The advantages of the multiplex PCR method were assessed by various researchers by comparing the diagnosis results obtained with different other conventional methods. The sensitivity and specificity of these methods were analyzed on different specimens in comparison to traditional methods, such as culture media or direct microscopic examination. These studies demonstrated beyond any doubt that the multiplex PCR system is highly effective in the detection of each of multiple STD pathogens depicted from a single specimen and argued for multiplex PCR superiority in terms of sensitivity and rapidity.",signatures:"Mihaela L. Vică, Horea V. Matei and Costel V. Siserman",downloadPdfUrl:"/chapter/pdf-download/52716",previewPdfUrl:"/chapter/pdf-preview/52716",authors:[{id:"189561",title:"Dr.",name:"Mihaela Laura",surname:"Vica",slug:"mihaela-laura-vica",fullName:"Mihaela Laura Vica"},{id:"192251",title:"Dr.",name:"Horea Vladi",surname:"Matei",slug:"horea-vladi-matei",fullName:"Horea Vladi Matei"},{id:"192252",title:"Dr.",name:"Costel Vasile",surname:"Siserman",slug:"costel-vasile-siserman",fullName:"Costel Vasile Siserman"}],corrections:null},{id:"52654",title:"A Real-Time PCR-Based Diagnostic Test for Organisms in Respiratory Tract Infection",doi:"10.5772/65740",slug:"a-real-time-pcr-based-diagnostic-test-for-organisms-in-respiratory-tract-infection",totalDownloads:2037,totalCrossrefCites:3,totalDimensionsCites:7,hasAltmetrics:0,abstract:"Respiratory tract infection, especially pneumonia, is a significant cause of morbidity and mortality worldwide. Although rapid and accurate identification of the pathogens and the corresponding treatment, which is based on the microbiological results, is required in the healthcare setting, the current clinical tests lack high sensitivity and flexibility. As of yet, a comprehensive approach has not been able to work these issues out. Meanwhile, the development of molecular techniques enables the detection of organisms from respiratory specimens speedily as well as precisely and aids the settlement of such issues. With our novel approach that employs relative quantification, we successfully set the cutoff value to discriminate the causative pathogen from colonizing commensal organisms by real-time PCR. In this way, a diagnostic system for respiratory pathogens was devised and validated through clinical sample testing. In this chapter, a real-time PCR-based test capable of differentiating causative pathogens in respiratory specimens is described, and also its principle and the utility of this approach are illustrated.",signatures:"Takashi Hirama",downloadPdfUrl:"/chapter/pdf-download/52654",previewPdfUrl:"/chapter/pdf-preview/52654",authors:[{id:"189067",title:"Dr.",name:"Takashi",surname:"Hirama",slug:"takashi-hirama",fullName:"Takashi Hirama"}],corrections:null},{id:"52868",title:"PCR Technique for the Microbial Analysis of Inanimate Hospital Environment",doi:"10.5772/65742",slug:"pcr-technique-for-the-microbial-analysis-of-inanimate-hospital-environment",totalDownloads:1970,totalCrossrefCites:4,totalDimensionsCites:7,hasAltmetrics:0,abstract:"Discipline of molecular ecology and molecular techniques such as polymerase chain reaction (PCR) offers a possibility to study and reveal the microbial diversity in environmental settings with complicated mixed communities, non-culturable organisms, interfering contaminants and low levels of target DNA. Hospital environment represents a new ecological niche for clinically important nosocomial pathogens and antibiotic-resistant microorganisms, which have been commonly found on various hospital surfaces. Accurate characterization of microbial communities depends on several factors, starting with sample collection and conditional enrichment step. In the step of nucleic acid isolation and purification, the DNA, as a dominant signature molecule, is extracted followed by removing co-extracted impurities. PCR target sequences are often 16S rDNA gene, functional gene probes or species-specific probes, depending on the objective of the study. Furthermore, properly prepared PCR amplicons can serve as a basis for characterizing microbial community. The PCR technique is a powerful tool for the analysis of microbial diversity of environmental ecosystems. In a hospital environment, advantages of detecting pathogens and antibiotic-resistant bacteria need to be pointed out.",signatures:"Urška Rozman and Sonja Šostar Turk",downloadPdfUrl:"/chapter/pdf-download/52868",previewPdfUrl:"/chapter/pdf-preview/52868",authors:[{id:"189776",title:"Ph.D.",name:"Urška",surname:"Rozman",slug:"urska-rozman",fullName:"Urška Rozman"}],corrections:null},{id:"52972",title:"PCR: A Powerful Method in Food Safety Field",doi:"10.5772/65738",slug:"pcr-a-powerful-method-in-food-safety-field",totalDownloads:2417,totalCrossrefCites:1,totalDimensionsCites:4,hasAltmetrics:1,abstract:"In this chapter, application of the polymerase chain reaction (PCR) technique in food safety, considering all the branches of this concept, is presented. The area of interest contains important analysis for both human health and the identification of food adulteration. PCR techniques used for detection of genetically modified organisms (GMO) in different matrices, identification of different animal species in meat and dairy products, as well as the detection of food infection with food-borne pathogens and toxicogenic fungi are described. The working methods and result analysis are exemplified, starting with DNA isolation adjusted to different matrices, detection of target genes, and validation for all of these methods. Techniques of simplex PCR, primer multiplexing, primer design, validation of the laboratory methods, optimization of the PCR results, and result interpretation through the analysis of the electrophoresis gels and sequencing data are studied. At the same time, the obtained results, the obstacles encountered, and how they were overcome could be an example for specific analysis developed with less resources and also for adapting the existent validated methods to the new laboratory conditions. The practical applicability and the consumer’s demands are of great importance and always must be considered in developing and validating those methods.",signatures:"Oana-Maria Boldura and Sorina Popescu",downloadPdfUrl:"/chapter/pdf-download/52972",previewPdfUrl:"/chapter/pdf-preview/52972",authors:[{id:"189429",title:"Prof.",name:"Oana-Maria",surname:"Boldura",slug:"oana-maria-boldura",fullName:"Oana-Maria Boldura"},{id:"189451",title:"Prof.",name:"Sorina",surname:"Popescu",slug:"sorina-popescu",fullName:"Sorina Popescu"}],corrections:null},{id:"52975",title:"Site‐Directed Mutagenesis by Polymerase Chain Reaction",doi:"10.5772/66429",slug:"site-directed-mutagenesis-by-polymerase-chain-reaction",totalDownloads:4608,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Since genomic data are widely available, many strategies have been implemented to reveal the function of specific nucleotides or amino acids in promoter regions or proteins, respectively. One of the methods most commonly used to determine the impact of mutations is the site‐directed mutagenesis using the polymerase chain reaction (PCR). There are different published protocols to develop single or multiple site‐directed mutagenesis. In this chapter, we reviewed the enzymes commonly used in site‐directed mutagenesis, the methods for simple and multiple site‐directed mutagenesis in large constructs, mediated by insertion of restriction sites. Other methods reviewed include high‐throughput site‐directed mutagenesis using oligonucleotides synthesized on DNA chips, and those based on multi‐site‐directed mutagenesis, based on recombination. Software tools to design site‐directed mutagenesis primers are also presented.",signatures:"Fabiola Castorena‐Torres, Katia Peñuelas‐Urquides and Mario\nBermúdez de León",downloadPdfUrl:"/chapter/pdf-download/52975",previewPdfUrl:"/chapter/pdf-preview/52975",authors:[{id:"188810",title:"Dr.",name:"Mario",surname:"Bermúdez De León",slug:"mario-bermudez-de-leon",fullName:"Mario Bermúdez De León"},{id:"188821",title:"Dr.",name:"Fabiola",surname:"Castorena Torres",slug:"fabiola-castorena-torres",fullName:"Fabiola Castorena Torres"},{id:"198351",title:"Dr.",name:"Katia",surname:"Peñuelas Urquides",slug:"katia-penuelas-urquides",fullName:"Katia Peñuelas Urquides"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"7639",title:"Bioinformatics Tools for Detection and Clinical Interpretation of Genomic Variations",subtitle:null,isOpenForSubmission:!1,hash:"94f9f01b510ca80812f0eee467f9428b",slug:"bioinformatics-tools-for-detection-and-clinical-interpretation-of-genomic-variations",bookSignature:"Ali Samadikuchaksaraei and Morteza Seifi",coverURL:"https://cdn.intechopen.com/books/images_new/7639.jpg",editedByType:"Edited by",editors:[{id:"187501",title:"Prof.",name:"Ali",surname:"Samadikuchaksaraei",slug:"ali-samadikuchaksaraei",fullName:"Ali Samadikuchaksaraei"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2553",title:"Lipid Peroxidation",subtitle:null,isOpenForSubmission:!1,hash:"b39734aa940b2d63ae5e8773d3dd5280",slug:"lipid-peroxidation",bookSignature:"Angel Catala",coverURL:"https://cdn.intechopen.com/books/images_new/2553.jpg",editedByType:"Edited by",editors:[{id:"196544",title:"Prof.",name:"Angel",surname:"Catala",slug:"angel-catala",fullName:"Angel Catala"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2323",title:"Carbohydrates",subtitle:"Comprehensive Studies on Glycobiology and Glycotechnology",isOpenForSubmission:!1,hash:"f7c2e6a3566eee14c9884ad0820a6416",slug:"carbohydrates-comprehensive-studies-on-glycobiology-and-glycotechnology",bookSignature:"Chuan-Fa Chang",coverURL:"https://cdn.intechopen.com/books/images_new/2323.jpg",editedByType:"Edited by",editors:[{id:"145728",title:"Prof.",name:"Chuan-Fa",surname:"Chang",slug:"chuan-fa-chang",fullName:"Chuan-Fa Chang"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"372",title:"Aflatoxins",subtitle:"Biochemistry and Molecular Biology",isOpenForSubmission:!1,hash:"b7f7359995dc5ee04e12df282495f77e",slug:"aflatoxins-biochemistry-and-molecular-biology",bookSignature:"Ramón Gerardo Guevara-González",coverURL:"https://cdn.intechopen.com/books/images_new/372.jpg",editedByType:"Edited by",editors:[{id:"62559",title:"Dr.",name:"Ramon G.",surname:"Guevara-Gonzalez",slug:"ramon-g.-guevara-gonzalez",fullName:"Ramon G. 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There are ten common types of rubber Natural Rubber, Styrene-butadiene rubber, Butyl, Nitrile, Neoprene®, Ethylene Propylene Diene Monomer, Silicone, Polyurethane, and Hydrogenated Nitrile. Their properties and applications are important for domestic and industrial applications.
\r\n\r\n\tThe scope of this book covers four areas of rubber material as its properties and characterizations of them. Their mechanical, optical, and acoustic properties and kinetics are covered in the book. Firstly, their elasticity, toughness, modulus, compression, and extension parameters are significant concerning their mechanical properties. Secondly, their optical properties of them can be characterized by spectroscopic techniques such as fluorescence and UV measurements. Thirdly, their swelling, drying, diffusion, and release parameters are obtained as their kinetics of them. Lastly, the parameters such as transmission loss, sound absorption coefficient, and acoustic impedance are given as acoustical performance of them in this book.
\r\n\t
Biliary tract infections, such as biliary colic, cholangitis, cholecystitis, and cholelithiasis, are the most commonly encountered health disorders globally as a result of bile duct obstruction. Gallstones are relatively prevalent in the United States and many other industrialized countries, and they are usually asymptomatic. Gallstones are projected to affect 25 million adults in the United States (Everhart et al.) [1]. Bacterial infection of the bile can result in severe morbidity and mortality [Sifri and Madoff] [2]. Bile stasis, inflammation, and the loss of mechanical barriers can all lead to bacterial infection of the bile, which can end in severe morbidity and death. Obstruction is hypothesized to cause increased intraluminal pressure, impaired blood supply and lymphatic drainage, and acute inflammation in the presence of supersaturated bile (Indar and Beckingham) [3]. The pathogenesis of biliary tract infections, the microbial pathogens involved, and antibiotic treatment options are discussed in this article.
Gallstone disease is a substantial health problem in developed countries, according to existing literature. Gallstones are believed to affect 10–15% of the general population, with considerable variations across nations. Gallstone-related problems affect between 20 and 40% of individuals with gallstones, with an annual incidence of 1–3%; acute calculus cholecystitis (ACC) is the first clinical manifestation in 10–15% of cases [4].
The gallbladder is a part of the digestive system. The gallbladder is a thin-walled sac with three anatomic parts: the fundus, corpus, and infundibulum [1]. It is normally located between both hepatic lobes. Figure 1 depicts the gall bladder location in the human body, and Figure 2 represents the gall bladder anatomy. The gallbladder empties into the cystic duct, a passive conduit with a mucosa comprising spiral valves and with a diameter of about 7 mm in humans (Valves of Heister). This duct has no sphincteric structure and empties into the common bile duct. As it enters the duodenal wall and forms the ampulla of Vater, the common bile duct passes through the head of the pancreas, finishing in the sphincter of Oddi [6].
Gallbladder lies beneath the lower liver edge at the bottom of the rib cage. (Jan Modric, 2017) [
Gallbladder parts and bile ducts (Jan Modric, 2017) [
Approximately, 10% of individuals are estimated to have one or more biliary duct abnormalities; however, not all of them are difficult to identify during surgery. The so-called triple confluence, which is an abnormality defined by simultaneous emptying of the right posterior duct, right anterior duct, and left hepatic duct into the common hepatic duct [Mortele and Ros] [7], is a frequent variation of the major hepatic biliary branching. The right hepatic duct is almost non-existent in individuals with this variation. The right posterior duct and its union with the right anterior or left hepatic duct are two more common anatomic variations of the biliary tree branching.
As previously stated, the right posterior duct connects to the right anterior duct and unites it from the left to produce the right hepatic duct, which then connects to the left hepatic duct to form the common hepatic duct. The most prevalent anatomic variant of the biliary system is drainage of the right posterior duct into the left hepatic duct before its confluence with the right anterior duct.
Furthermore, various less common and usually more difficult anatomic variants of the bile ducts, which include both aberrant and auxiliary bile ducts, have been described. In a clinical setting, knowing the difference between an aberrant bile duct and an accessory bile duct is vital since an aberrant bile duct is the only bile duct draining a specific hepatic segment, whereas an accessory bile duct drains the same portion of the liver. Failure to recognize certain of these bile duct irregularities can lead to bile leakage and peritoneal membrane irritation (bile peritonitis). Endoscopic retrograde cholangiopancreatography is used to treat these leaks by inserting stents (ERCP). They can stop these leaks that arise from the common bile or cystic ducts [8, 9, 10].
The human sphincter of Oddi is approximately 10 mm in length and has a well-defined and strong musculature. The Oddi sphincter is physically and functionally distinct from the duodenum. Its myoelectrical and contractile patterns are distinct from those of the duodenum in terms of character and timing. The contractions of the human sphincter of Oddi occur at the same time; however, there may be minor variations in configuration that look peristaltic at times. Its principal function of serving as a bile flow resistor is compatible with the occurrence of synchronous contractions. Because of the sphincter of Oddi resistance, the constant hepatic production of bile is largely directed into the cystic duct and gallbladder during the fasting state, where it is stored and concentrated. During the diastolic phase, sphincter of Oddi phasic contractions and, during phase II, migrating motor complex occur when there is modest gallbladder contraction; hence, a tiny amount of bile escapes into the duodenum. The gallbladder contracts during digestion, emptying the majority of its contents, and bile is delivered to the duodenum
Patients with sphincter of Oddi (SO) dyskinesia have biliary-like symptoms, which are frequently noticed after a cholecystectomy. The symptoms and signs of bile duct sphincter dysfunction are similar to those of temporary bile duct blockage, whereas pancreatic sphincter of Oddi dysfunction is linked to elevated pancreatic enzymes and even full-blown pancreatitis. Patients with sphincter of Oddi dysfunction are assessed with quantitative choledochoscintigraphy and/or sphincter of Oddi manometry tests to confirm the diagnosis, even if the preliminary investigation is defined by this functional entity by sphincter of Oddi manometry.
The most commonly stated hypothesis in the etiology of chronic and acute cholecystitis is that it is caused by gallstones migrating from the gallbladder obstructing the cystic duct or, in the event of big gallstones, that they intermittently obstruct the gallbladder’s neck (Jose Behar) [6]. The inability to see the gallbladder in patients with acute cholecystitis has been attributed to a cystic duct occlusion. This observation has been validated clinically and pathologically in up to 97% of individuals with acute cholecystitis [Pare and Shaffer et al.] [11].
However, other explanations for this failure are more likely that.
A cystic duct obstruction would be caused by the gallbladder’s acute inflammation and edema spreading to the cystic duct, or.
Because it is clogged with inflammatory fluids, an atonic gallbladder obstructs the entry of the bulk of the isotope-labeled agent. Furthermore, the severely inflamed gallbladder may be unable to distend passively due to edema or actively due to a faulty relaxation found in gallbladders with lithogenic bile containing high cholesterol contents [Xiao and Chen et al.] [12].
The appearance of cholecystitis associated only with lithogenic bile (acalculous gallbladder) or a single huge stone several times larger than the normal width of the cystic duct lumen further challenges the idea of cystic duct obstruction. Furthermore, the presence of acute inflammation on top of a chronically inflamed or atrophic fibrotic gallbladder has proven difficult to explain because it would imply recurring cystic duct obstruction events. It is more likely that the development of acute inflammation as a result of a chronic process had been in the works for a long time. Mucosal thickening, hypertrophic muscle layers, and macrophage infiltration of the lamina propria are common in gallbladders. In the absence of gallstones, chronic cholecystitis is commonly found histopathologically. They arise in people who are morbidly obese and have lithogenic bile but no gallstones. When compared with the normal mucosa in nonobese people, these gallbladders exhibit mucosal abnormalities consistent with chronic cholecystitis [Csendes et al.] [13]. The pathogenesis of chronic cholecystitis is shown in Figure 3. The gallbladder motility and cytoprotective functions are impaired by lithogenic hepatic bile with excess cholesterol, allowing the hydrophobic bile salts to induce chronic cholecystitis.
Pathogenesis of chronic cholecystitis.
Finally, the results of the aforementioned human and animal studies strongly suggest that cholecystitis develops in the presence of lithogenic bile with high cholesterol concentrations, which creates a permissive environment for hydrophobic bile salts to increase oxidative stress levels and initiate the inflammatory process. Continuous entrance of hydrophobic bile salts into the diseased gallbladder is required for this inflammatory process [14].
Chronic cholecystitis patients may be asymptomatic or experience recurring episodes of epigastric and right upper quadrant (RUQ) discomfort that radiates often around the waist and toward the scapula. The pain is moderate to severe, and it is not postprandial but rather nocturnal in nature. It does not happen every day; instead, it happens every two to 3 weeks. Ultrasonography is usually used to make the diagnosis. Gallstones and gallbladder wall thickening can be detected using this test. Laboratory tests are normal. Gallstones are often asymptomatic, but because they are easily discovered in gallbladders by imaging investigations, they are blamed for a range of upper gastrointestinal problems. Gallstones are frequently blamed for nonspecific gastrointestinal symptoms such as persistent dyspepsia, gastroparesis, and irritable bowel syndrome. Patients with these functional disorders typically experience everyday upper gastrointestinal symptoms, which are often postprandial and triggered by fatty foods or large meals. Epigastric pain, nausea, and bloating are common complaints among these patients. Even while pathological investigations may indicate gallstones and histological evidence of persistent cholecystitis, cholecystectomy does not relieve these symptoms. Gallstones can go unnoticed for lengthy periods of time, according to several investigations, including autopsy studies. Most patients with asymptomatic gallstones remained symptom free for the whole 8-year follow-up period in a prospective Italian research [15, 16, 17, 18, 19].
In acute cholecystitis, chronic cholecystitis is the most prevalent risk factor. These patients often have abrupt onset of severe pain, which is commonly accompanied by nausea in 90% of instances and vomiting in 50% of cases.
Physical examination indicates epigastric, right upper quadrant, and positive Murphy sign pain, with rebound soreness in severe instances. However, doctors must rule out other acute abdominal diseases such as acute appendicitis, particularly with a retrocecal appendix, acute pancreatitis, localized perforated peptic ulcer, intestinal perforation, or ischemia before considering this diagnosis. These clinical entities exhibit comparable characteristics in terms of demographics and risk factors. Physical examination indicates abdominal pain that can be localized or widespread, as well as a significant decrease in bowel sounds, in these individuals who complain of severe stomach pain, nausea, and vomiting.
Acute cholecystitis is defined as an acute inflammation of the gall bladder. Chronic cholecystitis, acute pancreatitis, diverticulitis, colitis, appendicitis, Fitz-Hugh-Curtis syndrome, ureteral stone, and omental infarction are all illnesses that can cause acute right upper quadrant (RUQ) discomfort [20, 21]. It can occur abruptly in conjunction with gallstones (acute calculous cholecystitis) or less frequently without gallstones (acute calculous cholecystitis) (acalculous cholecystitis). Gallstones affect more than 80% of persons who are asymptomatic. Acute cholecystitis is a complication of gallstone disease that usually arises in people who have had symptomatic gallstones in the past. Delayed management can lead to increased morbidity, due to progression to severe cholecystitis, such as gangrenous change, abscess formation, and gallbladder perforation [4].
The majority of cases of acute cholecystitis are caused by an impacted gallstone blocking the gallbladder outlet, resulting in an increase in intraluminal pressure, gallbladder distension, and wall edema, and eventually gallbladder necrosis. During the early stages of acute cholecystitis, bile is normally sterile, and infection occurs as a side effect.
Biliary tract infection is a prevalent cause of bacteremia and is linked to a high rate of morbidity and mortality, especially in elderly individuals with comorbid conditions or when diagnosis and treatment are delayed. Enterobacteriaceae, which climb from the gastrointestinal system, are the most prevalent infectious organisms. Complications such as acute renal failure and septic shock are more likely in patients with bacteremia.
The most frequently identified pathogens are Gram-negative microorganisms, primarily
All of the microbiological studies that led to the selection of these antibiotic regimens were carried out using standard culture methods. Recent studies of microbial detection by culture- vs. culture-free identification of microbial DNA by next-generation sequencing (NGS) for various purulent diseases have shown that traditional culture only identifies a portion of the bacteria present. Additionally, in some Asian countries, the presence of
Bile has bactericidal activity. However, many pathogens are known to resist the bactericidal activity of bile and utilize this host component as a localization signal to regulate virulence gene expression and enhance infection. Furthermore, strategies employed by pathogens to resist bile align with antibiotic resistance mechanisms. The efflux pump genes,
The ESKAPE group of pathogens (
Berinson et al. [30] reported one rare case of AC caused by
Deering et al. [31] reported a rare case of acute cholecystitis caused by
Vogt et al. [32] reported isolated Serogroup O1
In comparison with bacterial infections, viral infections of the biliary tract are less common and less discussed. Viral infections frequently occur as a result of a liver infection or as part of a systemic viral illness. Viruses seldom cause primary liver infection. Cholangitis, or inflammation of the bile duct, is a very frequent symptom. Despite the fact that hepatotropic viruses (A, B, C, and E) are commonly thought of as hepatocellular pathogens, cholangitic symptoms are now widely documented in conjunction with these disorders [10, 14, 23, 33]. Cholangitis is also due to systemic viral infections in different proportions to hepatitis. The human immunodeficiency virus (HIV) is linked to a variety of liver problems, including cholangitis. Other systemic viruses, most notably members of the herpes virus family, can induce hepatic illness in both immunocompromised and immunocompetent individuals, including cholangitis and potentially ductopenia [34].
Cholangitis can be caused due to a variety of reasons, including biliary calculi, strictures, parasites, post-endoscopic retrograde cholangiopancreatography (ERCP), postoperative, and so on. Biliary parasitoses, in contrast to other causes, are more prevalent in many nations. Ascaris lumbricoides, liver flukes, and Echinococcus are common parasites that affect the biliary system. The trematodes (flukes) that commonly infect the human biliary tract include
The diagnostic criteria include examining for signs of local inflammation, such as Murphy’s sign, the presence of a mass, pain, or tenderness located in the upper right quadrant of the abdomen. The local inflammation is often accompanied by systemic inflammation, indicated by signs of fever, increased white blood cell (WBC) counts, and elevated levels of C-reactive protein. The severity of acute cholecystitis can range from mild and self-limiting to severe and potentially life threatening [36, 37]. Several imaging techniques such as ultrasonography, magnetic resonance imaging (MRI), computed tomography (CT) are necessary to accurately diagnose both the typical and atypical cases of acute cholecystitis. Recently, Amini et al. had used high mobility group box protein 1 (HMGB1) biomarker for acute cholecystitis diagnosis [38].
For the consensus in diagnosis of cholecystitis in 2007, the Tokyo guidelines for the management of acute cholangitis and cholecystitis (TG07) were formed and widely adopted. In 2013, the updated Tokyo guidelines (TG13) for acute cholangitis and acute cholecystitis were released for severity grading of acute cholecystitis [37] (Table 1).
Local signs of inflammation, etc. Murphy’s sign RUQ Mass/pain/tenderness |
Systemic signs of inflammation, etc. Fever Elevated CRP Elevated WBC count |
Imaging findings Imaging findings characteristic of acute cholecystitis |
Suspected diagnosis: One item in A + one item in B Definitive diagnosis: One item in A + one item in B + C |
TG13 diagnostic criteria for acute cholecystitis.
The severity assessment criteria were first presented throughout the world in TG07 by Hirota and Takada, [37] where the severity grading of acute cholecystitis was classified into the following three categories: “mild (Grade I),” “moderate (Grade II),” and “severe (Grade III).”
Mild (Grade I) acute cholecystitis occurred in a patient with no signs of organ failure and mild gallbladder illness, allowing cholecystectomy to be performed safely and with minimal risk. The severity score for these individuals in TG07 does not fulfill the criteria for “moderate (Grade II)” and “severe (Grade III)” acute cholecystitis.
Acute cholecystitis, in which the degree of acute inflammation is expected to be linked with greater operating difficulties in completing cholecystectomy, was classified as moderate (Grade II) acute cholecystitis [8, 9, 16].
Severe (Grade III) acute cholecystitis was defined as acute cholecystitis associated with organ dysfunction (Table 2).
Associated with dysfunction of any one of the following organ/systems | |
---|---|
Cardiovascular dysfunction | Hypotension requiring treatment with dopamine >5 ub/kg per min, or any dose of norepinephrine |
Neurologic dysfunction | Decreased level of consciousness |
Respiratory dysfunction | Pa2O/FiO2 ratio < 300 |
Renal dysfunction | Oluguria, creatinine >2.0 mg/dl |
Hepatic dysfunction | PT – INR > 1.5 |
Hematological dysfunction | Platelet count <100,000/mm3 |
Associated with any one of the following conditions: 1. Elevated white blood cell count ([18,000/mm3) 2. Palpable tender mass in the right upper abdominal quadrant 3. Duration of complaints (72 h) 4. Marked local inflammation (gangrenous cholecystitis, pericholecystic abscess, hepatic abscess, biliary peritonitis, and emphysematous cholecystitis) | |
Does not meet the criteria of “Grade III” or “Grade II” acute cholecystitis. Grade I can also be defined as acute cholecystitis in a healthy patient with no organ dysfunction and mild inflammatory changes in the gallbladder, making cholecystectomy a safe and low-risk operative procedure. |
TG 13 severity grading for acute cholecystitis.
Reference: Masamichi et al. [19].
Acute cholecystitis is often treated promptly by cholecystectomy or percutaneous cholecystostomy and antibiotic therapy in high-risk patients. Antimicrobial treatment has a different role depending on the severity of the illness and its etiology. Because it is unclear if bacteria have a role in grade I acute cholecystitis, antimicrobial treatment is used to prevent infection before cholecystectomy. Antimicrobial treatment is therapeutic and necessary for grade II acute cholecystitis until the gallbladder is removed. Most patients with bacteremia might have clinical deterioration and can be classified as grade III acute cholecystitis and are therefore not suitable for surgery. A recent meta-analysis reported that cholecystography has the highest diagnostic accuracy for detection of acute cholecystitis [39].
Previous studies have found bile to be infected in 9–42% of patients who underwent elective laparoscopic cholecystectomy, but the incidence of culture-positive bile increased to 35–65% of patients with acute cholecystitis [40]. Antimicrobial treatment is critical for reducing both the systemic septic response and local inflammation following cholecystectomy in individuals with moderate-to-severe acute cholecystitis [41]. Those with septic shock should get appropriate antibiotic treatment within 1 hour of diagnosis, and patients who are less severely sick should receive it within 6 hours. Bile culture results, however, cannot be acquired promptly after admission, and bile culture necessitates percutaneous gallbladder puncture. As a result, the most successful empiric antibiotics described in the literature are used as the basis for first antimicrobial treatment [42].
Because most infections in acute cholecystitis are limited to the gallbladder, sampling should be done directly from the infection site in order to identify the true causative pathogen. Bile specimens collected from the biliary tract using percutaneous transhepatic biliary drainage (PTBD) or endoscopic nasobiliary drainage (ENBD) are potentially associated with microbial contamination [43].
Bacterial infection is commonly reported in 50 to 90% of the cases. Most of the studies reported the involvement of polymicrobial infections in AC, which were often treated with antibiotic regimens with two or more antibiotics, but only one study had reported that monomicrobial growth was involved in AC. The most common presumptive antibiotics used in AC are ceftriaxone (2gm, IV, OD) or piperacillin/tazobactam (4.5 gm, IV, 8 hourly) or cefoperazone/sulbactam (3gm, IV, 12 hourly) for 7 to 10 days. The second-line or alternative antibiotics is imipenem (500 mg, IV, 6 hourly) or meropenem (1gm, IV, 8hourly) for 7 to 10 days. The most commonly isolated microorganisms among pathogens in positive bile cultures are Enterococci species, non-
Broad-spectrum β-lactam and β-lactamase inhibitors, such as ampicillin-sulbactam, have been recommended as the first-line drugs to treat Enterococci and non-
Piperacillin-tazobactam and third- or fourth-generation cephalosporins are indicated as first-line antibiotics for Gram-negative bacteria, with fluoroquinolones and carbapenems as second-line antibiotics, depending on the severity of the infection and antimicrobial susceptibility patterns. According to Gomi et al. [48], most identified strains were resistant to ciprofloxacin due to widespread use of the antibiotic by the community, whereas 20% of pathogenic bacteria were resistant to ceftriaxone. As a result, in such circumstances, piperacillin-tazobactam or cefepime, which have larger spectra and lower resistance rates, are indicated. Carbapenem and tigecycline are advised for patients who are taking antibiotics on a regular basis. However, because of widespread medication resistance and associated high morbidity and mortality rates, carbapenem-resistant strains (CRE) species have emerged as major healthcare-related diseases [49].
The most important approach in controlling the CA-BTI is the primary source controls such as biliary drainage, removal of biliary tract stones, and cholecystectomy. The primary source control can help the antibiotics to penetrate the biliary tract, resulting in a better bactericidal effect when biliary obstruction is present. While it comes to medical therapy, there are two crucial variables to consider when choosing empiric antibiotics. Administration of antibiotics is essential for the treatment of BTI, in addition to primary source control. As the BTI is caused by endogenous etiological agents, that is, gastrointestinal tract flora, such as Escherichia coli, Klebsiella spp., Enterococci spp., Bacteroides spp., antibiotics that are effective against these organisms are usually used empirically to treat BTI rather than definite therapy. However, the usage of inappropriate empiric antibiotics may also incur fatal outcomes. To elicit positive treatment responses, >80% of the presumed causative microorganisms should be sensitive to antibiotics, and for patients with septic shock, the susceptibility rates should even exceed 100% [50]. Next, the antibiotics must be present in adequate concentrations at the infection sites to have the desired antimicrobial action [51, 52]. Table 3 shows the antibiotics usually used to treat biliary tract infections based on their biliary penetration ability (indicated by the ratio of bile-to-serum concentrations [53, 54, 55].
Good penetration efficiency (>1) | Low-penetration efficiency (<1) | ||
---|---|---|---|
Antibiotics | Bile/serum | Antibiotics | Bile/serum |
Tazocin | 60 | Cefotaxime | 0.75 |
Tigecycline | 38 | Meropenem | 0.75 |
Augmentin | 30 | Ceftazidime | 0.5 |
Ciprofloxacin | 30 | Vancomycin | 0.5 |
Unasyn | 9 | Amikacin | 0.3 |
Ceftriaxone | 5 | Gentamycin | 0.3 |
Levofloxacin | 5 | Cefipime | 0.1 |
Penicillin G | 5 | Imepenem | 0.01 |
Cefazolin | 3 | ||
Clindamycin | 3 | ||
Doripenem | 1.17 | ||
Cefuroxime | 1 | ||
Metronidazole | 1 |
Antibiotics frequently used to treat biliary tract infections and their biliary penetration ability (indicated as the ration of bile to serum concentrations).
Augmentin = amoxicillin + clavulanate; Bile/serum = bile concentration/serum concentration; Tazocin: Piperacillin + tazobactum; Unasyn = ampicillin + sulbactum.
As a result, when choosing empiric antibiotics for the treatment of BTI, both susceptibility rates and the potential of biliary penetration should be taken into account. Table 3 lists the antibiotics often used to treat BTI, as well as their biliary penetration ability (measured as the ratio of bile-to-serum concentrations). Only individuals with a reasonable ratio (>1) of bile-to-serum concentrations (Table 3) could be candidates for empiric antibiotics for BTI, according to the criteria outlined earlier. The local antimicrobial susceptibility patterns of the usual causative agents for BTI should also be considered when prescribing appropriate empiric antibiotics. To ensure a positive outcome, only those with a 20% resistance rate should be used as empirical antibiotics.
Patients with severe cholecystitis are unfortunately difficult to identify effectively, both clinically and radiologically, because clinical presentations are unpredictable, and imaging findings are frequently ambiguous. However, there are significant differences in morbidity and fatality rates between patients with uncomplicated cholecystitis and those with severe cholecystitis. Preventing related consequences requires early detection and careful management of patients at risk of severe cholecystitis.
When acute cholecystitis is suspected, bile samples are taken for microbiology culture and sensitivity testing, and antibiotics are prescribed once the diagnosis has been established. The antibiotics of choice are parenteral cephalosporin or ampicillin, as well as aminoglycosides. The antibiotic regimen chosen is based on the severity of the clinical presentation. Because acute suppurative cholangitis with biliary blockage has a high pre- and postoperative mortality rate, comprehensive antimicrobial therapy is required following biliary decompression. Bile microbiological analysis is an expedient diagnostic tool for determining more suitable medication and generating local antibiotic guidelines for the treatment of biliary tract infections.
No potential conflict of interest was reported by the authors.
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Egypt",slug:"an-updated-seismic-source-model-for-egypt",totalDownloads:3414,totalCrossrefCites:11,totalDimensionsCites:21,abstract:null,book:{id:"4488",slug:"earthquake-engineering-from-engineering-seismology-to-optimal-seismic-design-of-engineering-structures",title:"Earthquake Engineering",fullTitle:"Earthquake Engineering - From Engineering Seismology to Optimal Seismic Design of Engineering Structures"},signatures:"R. Sawires, J.A. Peláez, R.E. Fat-Helbary, H.A. Ibrahim and M.T. García\nHernández",authors:[{id:"77194",title:"Dr.",name:"José",middleName:"A.",surname:"Peláez",slug:"jose-pelaez",fullName:"José Peláez"},{id:"171273",title:"Dr.",name:"Rashad",middleName:null,surname:"Sawires",slug:"rashad-sawires",fullName:"Rashad Sawires"},{id:"171274",title:"Dr.",name:"María Teresa",middleName:null,surname:"García Hernández",slug:"maria-teresa-garcia-hernandez",fullName:"María Teresa García Hernández"},{id:"171275",title:"Dr.",name:"Raafat El-Shafey",middleName:null,surname:"Fat-Helbary",slug:"raafat-el-shafey-fat-helbary",fullName:"Raafat El-Shafey Fat-Helbary"},{id:"171276",title:"Dr.",name:"Hamza Ahmed",middleName:null,surname:"Ibrahim",slug:"hamza-ahmed-ibrahim",fullName:"Hamza Ahmed Ibrahim"}]},{id:"47961",doi:"10.5772/59641",title:"Seismic Reliability-Based Design Optimization of Reinforced Concrete Structures Including Soil-Structure Interaction Effects",slug:"seismic-reliability-based-design-optimization-of-reinforced-concrete-structures-including-soil-struc",totalDownloads:1339,totalCrossrefCites:4,totalDimensionsCites:10,abstract:null,book:{id:"4488",slug:"earthquake-engineering-from-engineering-seismology-to-optimal-seismic-design-of-engineering-structures",title:"Earthquake Engineering",fullTitle:"Earthquake Engineering - From Engineering Seismology to Optimal Seismic Design of Engineering Structures"},signatures:"Mohsen Khatibinia, Sadjad Gharehbaghi and Abbas Moustafa",authors:[{id:"94191",title:"Prof.",name:"Abbas",middleName:null,surname:"Moustafa",slug:"abbas-moustafa",fullName:"Abbas Moustafa"},{id:"173876",title:"Dr.",name:"Sadjad",middleName:null,surname:"Gharehbaghi",slug:"sadjad-gharehbaghi",fullName:"Sadjad Gharehbaghi"}]},{id:"67102",doi:"10.5772/intechopen.85322",title:"Impacts of the 2015 Gorkha Earthquake: Lessons Learnt from Nepal",slug:"impacts-of-the-2015-gorkha-earthquake-lessons-learnt-from-nepal",totalDownloads:2249,totalCrossrefCites:5,totalDimensionsCites:9,abstract:"Nepal is highly vulnerable to a number of disasters for example: earthquakes, floods, landslides, fires, epidemics, avalanches, windstorms, hailstorms, lightning, glacier lake outburst floods, droughts and dangerous weather events. Among these disasters—earthquake is the most- scary and damaging. The effects of a disaster, whether natural or human induced, are often long lasting. The Gorkha earthquake of 25 April 2015 enormously affected human, socio-economic and other multiple sectors and left deep scars mainly in the economy, livelihood and infrastructure of the country. Besides the natural factors, the damages from disasters in Nepal are in increasing trend due to the human activities and inadequate proactive legislations. Fundamentally, the weak structures have been found as the major cause of damage in earthquakes. This underlines the need for strict compliance of building codes. Thus, proactive disaster management legislation focusing on disaster preparedness is necessary. This paper analyses and shows the critical gaps and responsible factors that would contribute towards seismic risk reduction to enable various stakeholders to enhance seismic safety in Nepal. Additionally, this chapter aims to pinpoint the deficiencies in disaster management system in Nepal with reference to the devastating Gorkha earthquake and suggest appropriate policy and advanced technical measures for improvement.",book:{id:"7660",slug:"earthquakes-impact-community-vulnerability-and-resilience",title:"Earthquakes",fullTitle:"Earthquakes - Impact, Community Vulnerability and Resilience"},signatures:"Shiva Subedi and Meen Bahadur Poudyal Chhetri",authors:[{id:"285969",title:"Mr.",name:"Shiva",middleName:null,surname:"Subedi",slug:"shiva-subedi",fullName:"Shiva Subedi"},{id:"293220",title:"Dr.",name:"Meen",middleName:null,surname:"Paudyal Chhetri",slug:"meen-paudyal-chhetri",fullName:"Meen Paudyal Chhetri"}]},{id:"60778",doi:"10.5772/intechopen.76014",title:"The Earthquake Disaster Risk in Japan and Iran and the Necessity of Dynamic Learning from Large Earthquake Disasters over Time",slug:"the-earthquake-disaster-risk-in-japan-and-iran-and-the-necessity-of-dynamic-learning-from-large-eart",totalDownloads:1102,totalCrossrefCites:4,totalDimensionsCites:7,abstract:"This book chapter targets how learning from large earthquakes disasters occurred and developed in Japan and Iran in the last 100 years. As research case studies, large earthquake disasters in Japan and Iran were investigated and analyzed. Normal distribution was found to be a good estimate of the magnitude distribution for earthquakes, in both the countries. In Japan, there is almost a linear correlation between magnitude of earthquakes and number of dead people. However, such correlation is not present for Iran. This lack of correlation in Iran and existence of linear correlation in Japan highlights that the magnitude of earthquakes directly affects the number of fatalities and extent of destruction in Japan, while in Iran, there is an increased complexity with regard to the factors affecting earthquake consequences. A correlation is suggested between earthquake culture and learning from large earthquake disasters in both Japan and Iran. Learning from large earthquake disasters is impacted by a multitude of factors, but the rhythm of learning in Japan is much higher if compared with Iran. For both Japan and Iran, a reactive learning approach based on past earthquake disasters needs to be constantly backed up by a proactive approach and dynamic learning.",book:{id:"6564",slug:"earthquakes-forecast-prognosis-and-earthquake-resistant-construction",title:"Earthquakes",fullTitle:"Earthquakes - Forecast, Prognosis and Earthquake Resistant Construction"},signatures:"Michaela Ibrion and Nicola Paltrinieri",authors:[{id:"209369",title:"Ph.D.",name:"Michaela",middleName:null,surname:"Ibrion",slug:"michaela-ibrion",fullName:"Michaela Ibrion"},{id:"244752",title:"Dr.",name:"Nicola",middleName:null,surname:"Paltrinieri",slug:"nicola-paltrinieri",fullName:"Nicola Paltrinieri"}]},{id:"28219",doi:"10.5772/28044",title:"Recent Landslide Damming Events and Their Hazard Mitigation Strategies",slug:"recent-landslide-damming-events-and-their-hazard-mitigation-strategies",totalDownloads:2232,totalCrossrefCites:4,totalDimensionsCites:6,abstract:null,book:{id:"2049",slug:"advances-in-geotechnical-earthquake-engineering-soil-liquefaction-and-seismic-safety-of-dams-and-monuments",title:"Advances in Geotechnical Earthquake Engineering",fullTitle:"Advances in Geotechnical Earthquake Engineering - Soil Liquefaction and Seismic Safety of Dams and Monuments"},signatures:"Ahsan Sattar and Kazuo Konagai",authors:[{id:"72541",title:"MSc.",name:"Ahsan",middleName:null,surname:"Sattar",slug:"ahsan-sattar",fullName:"Ahsan Sattar"},{id:"121222",title:"Prof.",name:"Kazuo",middleName:null,surname:"Konagai",slug:"kazuo-konagai",fullName:"Kazuo Konagai"}]}],mostDownloadedChaptersLast30Days:[{id:"47538",title:"An Updated Seismic Source Model for Egypt",slug:"an-updated-seismic-source-model-for-egypt",totalDownloads:3414,totalCrossrefCites:11,totalDimensionsCites:21,abstract:null,book:{id:"4488",slug:"earthquake-engineering-from-engineering-seismology-to-optimal-seismic-design-of-engineering-structures",title:"Earthquake Engineering",fullTitle:"Earthquake Engineering - From Engineering Seismology to Optimal Seismic Design of Engineering Structures"},signatures:"R. Sawires, J.A. Peláez, R.E. Fat-Helbary, H.A. Ibrahim and M.T. García\nHernández",authors:[{id:"77194",title:"Dr.",name:"José",middleName:"A.",surname:"Peláez",slug:"jose-pelaez",fullName:"José Peláez"},{id:"171273",title:"Dr.",name:"Rashad",middleName:null,surname:"Sawires",slug:"rashad-sawires",fullName:"Rashad Sawires"},{id:"171274",title:"Dr.",name:"María Teresa",middleName:null,surname:"García Hernández",slug:"maria-teresa-garcia-hernandez",fullName:"María Teresa García Hernández"},{id:"171275",title:"Dr.",name:"Raafat El-Shafey",middleName:null,surname:"Fat-Helbary",slug:"raafat-el-shafey-fat-helbary",fullName:"Raafat El-Shafey Fat-Helbary"},{id:"171276",title:"Dr.",name:"Hamza Ahmed",middleName:null,surname:"Ibrahim",slug:"hamza-ahmed-ibrahim",fullName:"Hamza Ahmed Ibrahim"}]},{id:"47738",title:"Earthquakes and Dams",slug:"earthquakes-and-dams",totalDownloads:3261,totalCrossrefCites:2,totalDimensionsCites:2,abstract:null,book:{id:"4488",slug:"earthquake-engineering-from-engineering-seismology-to-optimal-seismic-design-of-engineering-structures",title:"Earthquake Engineering",fullTitle:"Earthquake Engineering - From Engineering Seismology to Optimal Seismic Design of Engineering Structures"},signatures:"Hasan Tosun",authors:[{id:"79083",title:"Dr.",name:"Hasan",middleName:null,surname:"Tosun",slug:"hasan-tosun",fullName:"Hasan Tosun"}]},{id:"47881",title:"Simplified Multi-Block Constitutive Model Predicting the Seismic Displacement of Saturated Sands along Slip Surfaces with Strain Softening",slug:"simplified-multi-block-constitutive-model-predicting-the-seismic-displacement-of-saturated-sands-alo",totalDownloads:1163,totalCrossrefCites:0,totalDimensionsCites:0,abstract:null,book:{id:"4488",slug:"earthquake-engineering-from-engineering-seismology-to-optimal-seismic-design-of-engineering-structures",title:"Earthquake Engineering",fullTitle:"Earthquake Engineering - From Engineering Seismology to Optimal Seismic Design of Engineering Structures"},signatures:"Constantine A. Stamatopoulos",authors:[{id:"171228",title:"Dr.",name:"Constantine",middleName:null,surname:"Stamatopoulos",slug:"constantine-stamatopoulos",fullName:"Constantine Stamatopoulos"}]},{id:"67102",title:"Impacts of the 2015 Gorkha Earthquake: Lessons Learnt from Nepal",slug:"impacts-of-the-2015-gorkha-earthquake-lessons-learnt-from-nepal",totalDownloads:2248,totalCrossrefCites:5,totalDimensionsCites:9,abstract:"Nepal is highly vulnerable to a number of disasters for example: earthquakes, floods, landslides, fires, epidemics, avalanches, windstorms, hailstorms, lightning, glacier lake outburst floods, droughts and dangerous weather events. Among these disasters—earthquake is the most- scary and damaging. The effects of a disaster, whether natural or human induced, are often long lasting. The Gorkha earthquake of 25 April 2015 enormously affected human, socio-economic and other multiple sectors and left deep scars mainly in the economy, livelihood and infrastructure of the country. Besides the natural factors, the damages from disasters in Nepal are in increasing trend due to the human activities and inadequate proactive legislations. Fundamentally, the weak structures have been found as the major cause of damage in earthquakes. This underlines the need for strict compliance of building codes. Thus, proactive disaster management legislation focusing on disaster preparedness is necessary. This paper analyses and shows the critical gaps and responsible factors that would contribute towards seismic risk reduction to enable various stakeholders to enhance seismic safety in Nepal. Additionally, this chapter aims to pinpoint the deficiencies in disaster management system in Nepal with reference to the devastating Gorkha earthquake and suggest appropriate policy and advanced technical measures for improvement.",book:{id:"7660",slug:"earthquakes-impact-community-vulnerability-and-resilience",title:"Earthquakes",fullTitle:"Earthquakes - Impact, Community Vulnerability and Resilience"},signatures:"Shiva Subedi and Meen Bahadur Poudyal Chhetri",authors:[{id:"285969",title:"Mr.",name:"Shiva",middleName:null,surname:"Subedi",slug:"shiva-subedi",fullName:"Shiva Subedi"},{id:"293220",title:"Dr.",name:"Meen",middleName:null,surname:"Paudyal Chhetri",slug:"meen-paudyal-chhetri",fullName:"Meen Paudyal Chhetri"}]},{id:"63029",title:"An Estimation of “Energy” Magnitude Associated with a Possible Lithosphere-Atmosphere-Ionosphere Electromagnetic Coupling Before the Wenchuan MS8.0 Earthquake",slug:"an-estimation-of-energy-magnitude-associated-with-a-possible-lithosphere-atmosphere-ionosphere-elect",totalDownloads:1161,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"A large scale of abnormities from ground-based electromagnetic parameters to ionospheric parameters has been recorded during the Wenchuan MS8.0 earthquake. All these results present different anomalous periods, but there seems one common climax leading to a lithosphere-atmosphere-ionosphere electromagnetic coupling (LAIEC) right on May 9, 3 days prior to the Wenchuan main shock. Based on the electron-hole theory, this chapter attempts to estimate the “energy source” magnitude driving this obvious coupling with the Wenchuan focus zone parameters considered. The simulation results show that the total surface charges fall in ~107–108 C, and the related upward electric field is ~108–109 V/m. These corresponding parameters are up to 109 C and 1010 V/m when the main rupture happens, and the order of the output current is up to 107 A. The electric field increasing in the interface between the Earth’s surface and the atmosphere, on one hand, can cause electromagnetic parameter abnormities of ground-based observation, with the range beyond 1000 km. On the other hand, it can accumulate air ionization above pre-earthquake zone and lead to ionospheric anomaly recorded by some spatial seismic monitoring satellites.",book:{id:"6564",slug:"earthquakes-forecast-prognosis-and-earthquake-resistant-construction",title:"Earthquakes",fullTitle:"Earthquakes - Forecast, Prognosis and Earthquake Resistant Construction"},signatures:"Mei Li, Wenxin Kong, Chong Yue, Shu Song, Chen Yu, Tao Xie and\nXian Lu",authors:[{id:"236284",title:"Dr.",name:"Mei",middleName:null,surname:"Li",slug:"mei-li",fullName:"Mei Li"},{id:"243785",title:"MSc.",name:"Chen",middleName:null,surname:"Yu",slug:"chen-yu",fullName:"Chen Yu"},{id:"243786",title:"MSc.",name:"Chong",middleName:null,surname:"Yue",slug:"chong-yue",fullName:"Chong Yue"},{id:"243788",title:"Dr.",name:"Tao",middleName:null,surname:"Xie",slug:"tao-xie",fullName:"Tao Xie"},{id:"243789",title:"MSc.",name:"Wenxin",middleName:null,surname:"Kong",slug:"wenxin-kong",fullName:"Wenxin Kong"},{id:"243790",title:"BSc.",name:"Shu",middleName:null,surname:"Song",slug:"shu-song",fullName:"Shu Song"}]}],onlineFirstChaptersFilter:{topicId:"778",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:108,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:140,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:123,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:22,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:11,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. Received the CSIR-SRF (Senior Research Fellow) award-2018, FIMSA (Federation of Immunological Societies of Asia-Oceania) Travel Bursary award to attend the IUIS-IIS-FIMSA Immunology course-2019',institutionString:"Nirma University",institution:{name:"Nirma University",country:{name:"India"}}},{id:"334383",title:"Ph.D.",name:"Simone",middleName:"Ulrich",surname:"Ulrich Picoli",slug:"simone-ulrich-picoli",fullName:"Simone Ulrich Picoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334383/images/15919_n.jpg",biography:"Graduated in Pharmacy from Universidade Luterana do Brasil (1999), Master in Agricultural and Environmental Microbiology from Federal University of Rio Grande do Sul (2002), Specialization in Clinical Microbiology from Universidade de São Paulo, USP (2007) and PhD in Sciences in Gastroenterology and Hepatology (2012). She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"333753",title:"Dr.",name:"Rais",middleName:null,surname:"Ahmed",slug:"rais-ahmed",fullName:"Rais Ahmed",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/333753/images/20168_n.jpg",biography:null,institutionString:null,institution:{name:"University of Agriculture Faisalabad",country:{name:"Pakistan"}}},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). He was also awarded 'Outstanding Clinician in General Medicine” by Venus International Foundation for his extensive research expertise and services, perform over and above the standard expected in the advancement of healthcare, patient safety and quality of care.",institutionString:"Interfaith Medical Center",institution:{name:"Interfaith Medical Center",country:{name:"United States of America"}}},{id:"93517",title:"Dr.",name:"Clement",middleName:"Adebajo",surname:"Meseko",slug:"clement-meseko",fullName:"Clement Meseko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/93517/images/system/93517.jpg",biography:"Dr. Clement Meseko obtained DVM and PhD degree in Veterinary Medicine and Virology respectively. He has worked for over 20 years in both private and public sectors including the academia, contributing to knowledge and control of infectious disease. Through the application of epidemiological skill, classical and molecular virological skills, he investigates viruses of economic and public health importance for the mitigation of the negative impact on people, animal and the environment in the context of Onehealth. \r\nDr. Meseko’s field experience on animal and zoonotic diseases and pathogen dynamics at the human-animal interface over the years shaped his carrier in research and scientific inquiries. He has been part of the investigation of Highly Pathogenic Avian Influenza incursions in sub Saharan Africa and monitors swine Influenza (Pandemic influenza Virus) agro-ecology and potential for interspecies transmission. He has authored and reviewed a number of journal articles and book chapters.",institutionString:"National Veterinary Research Institute",institution:{name:"National Veterinary Research Institute",country:{name:"Nigeria"}}},{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",country:{name:"India"}}},{id:"94928",title:"Dr.",name:"Takuo",middleName:null,surname:"Mizukami",slug:"takuo-mizukami",fullName:"Takuo Mizukami",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94928/images/6402_n.jpg",biography:null,institutionString:null,institution:{name:"National Institute of Infectious Diseases",country:{name:"Japan"}}},{id:"233433",title:"Dr.",name:"Yulia",middleName:null,surname:"Desheva",slug:"yulia-desheva",fullName:"Yulia Desheva",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/233433/images/system/233433.png",biography:"Dr. Yulia Desheva is a leading researcher at the Institute of Experimental Medicine, St. Petersburg, Russia. She is a professor in the Stomatology Faculty, St. Petersburg State University. She has expertise in the development and evaluation of a wide range of live mucosal vaccines against influenza and bacterial complications. Her research interests include immunity against influenza and COVID-19 and the development of immunization schemes for high-risk individuals.",institutionString:'Federal State Budgetary Scientific Institution "Institute of Experimental Medicine"',institution:null},{id:"238958",title:"Mr.",name:"Atamjit",middleName:null,surname:"Singh",slug:"atamjit-singh",fullName:"Atamjit Singh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/238958/images/6575_n.jpg",biography:null,institutionString:null,institution:null},{id:"252058",title:"M.Sc.",name:"Juan",middleName:null,surname:"Sulca",slug:"juan-sulca",fullName:"Juan Sulca",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/252058/images/12834_n.jpg",biography:null,institutionString:null,institution:null},{id:"191392",title:"Dr.",name:"Marimuthu",middleName:null,surname:"Govindarajan",slug:"marimuthu-govindarajan",fullName:"Marimuthu Govindarajan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/191392/images/5828_n.jpg",biography:"Dr. M. Govindarajan completed his BSc degree in Zoology at Government Arts College (Autonomous), Kumbakonam, and MSc, MPhil, and PhD degrees at Annamalai University, Annamalai Nagar, Tamil Nadu, India. He is serving as an assistant professor at the Department of Zoology, Annamalai University. His research interests include isolation, identification, and characterization of biologically active molecules from plants and microbes. He has identified more than 20 pure compounds with high mosquitocidal activity and also conducted high-quality research on photochemistry and nanosynthesis. He has published more than 150 studies in journals with impact factor and 2 books in Lambert Academic Publishing, Germany. He serves as an editorial board member in various national and international scientific journals.",institutionString:null,institution:null},{id:"274660",title:"Dr.",name:"Damodar",middleName:null,surname:"Paudel",slug:"damodar-paudel",fullName:"Damodar Paudel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/274660/images/8176_n.jpg",biography:"I am DrDamodar Paudel,currently working as consultant Physician in Nepal police Hospital.",institutionString:null,institution:null},{id:"241562",title:"Dr.",name:"Melvin",middleName:null,surname:"Sanicas",slug:"melvin-sanicas",fullName:"Melvin Sanicas",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241562/images/6699_n.jpg",biography:null,institutionString:null,institution:null},{id:"117248",title:"Dr.",name:"Andrew",middleName:null,surname:"Macnab",slug:"andrew-macnab",fullName:"Andrew Macnab",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of British Columbia",country:{name:"Canada"}}},{id:"322007",title:"Dr.",name:"Maria Elizbeth",middleName:null,surname:"Alvarez-Sánchez",slug:"maria-elizbeth-alvarez-sanchez",fullName:"Maria Elizbeth Alvarez-Sánchez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Universidad Autónoma de la Ciudad de México",country:{name:"Mexico"}}},{id:"337443",title:"Dr.",name:"Juan",middleName:null,surname:"A. Gonzalez-Sanchez",slug:"juan-a.-gonzalez-sanchez",fullName:"Juan A. Gonzalez-Sanchez",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico System",country:{name:"United States of America"}}},{id:"337446",title:"Dr.",name:"Maria",middleName:null,surname:"Zavala-Colon",slug:"maria-zavala-colon",fullName:"Maria Zavala-Colon",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Puerto Rico, Medical Sciences Campus",country:{name:"United States of America"}}}]}},subseries:{item:{id:"8",type:"subseries",title:"Bioinspired Technology and Biomechanics",keywords:"Bioinspired Systems, Biomechanics, Assistive Technology, Rehabilitation",scope:'Bioinspired technologies take advantage of understanding the actual biological system to provide solutions to problems in several areas. Recently, bioinspired systems have been successfully employing biomechanics to develop and improve assistive technology and rehabilitation devices. The research topic "Bioinspired Technology and Biomechanics" welcomes studies reporting recent advances in bioinspired technologies that contribute to individuals\' health, inclusion, and rehabilitation. Possible contributions can address (but are not limited to) the following research topics: Bioinspired design and control of exoskeletons, orthoses, and prostheses; Experimental evaluation of the effect of assistive devices (e.g., influence on gait, balance, and neuromuscular system); Bioinspired technologies for rehabilitation, including clinical studies reporting evaluations; Application of neuromuscular and biomechanical models to the development of bioinspired technology.',coverUrl:"https://cdn.intechopen.com/series_topics/covers/8.jpg",hasOnlineFirst:!0,hasPublishedBooks:!0,annualVolume:11404,editor:{id:"144937",title:"Prof.",name:"Adriano",middleName:"De Oliveira",surname:"Andrade",slug:"adriano-andrade",fullName:"Adriano Andrade",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRC8QQAW/Profile_Picture_1625219101815",biography:"Dr. Adriano de Oliveira Andrade graduated in Electrical Engineering at the Federal University of Goiás (Brazil) in 1997. He received his MSc and PhD in Biomedical Engineering respectively from the Federal University of Uberlândia (UFU, Brazil) in 2000 and from the University of Reading (UK) in 2005. He completed a one-year Post-Doctoral Fellowship awarded by the DFAIT (Foreign Affairs and International Trade Canada) at the Institute of Biomedical Engineering of the University of New Brunswick (Canada) in 2010. Currently, he is Professor in the Faculty of Electrical Engineering (UFU). He has authored and co-authored more than 200 peer-reviewed publications in Biomedical Engineering. He has been a researcher of The National Council for Scientific and Technological Development (CNPq-Brazil) since 2009. He has served as an ad-hoc consultant for CNPq, CAPES (Coordination for the Improvement of Higher Education Personnel), FINEP (Brazilian Innovation Agency), and other funding bodies on several occasions. He was the Secretary of the Brazilian Society of Biomedical Engineering (SBEB) from 2015 to 2016, President of SBEB (2017-2018) and Vice-President of SBEB (2019-2020). He was the head of the undergraduate program in Biomedical Engineering of the Federal University of Uberlândia (2015 - June/2019) and the head of the Centre for Innovation and Technology Assessment in Health (NIATS/UFU) since 2010. He is the head of the Postgraduate Program in Biomedical Engineering (UFU, July/2019 - to date). He was the secretary of the Parkinson's Disease Association of Uberlândia (2018-2019). Dr. Andrade's primary area of research is focused towards getting information from the neuromuscular system to understand its strategies of organization, adaptation and controlling in the context of motor neuron diseases. 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Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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