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Da Costa) asthma definition hubris cheap combimist l inhaler 50/20 mcg without a prescription, ionic phospholipids in the inner lipid monolayer interact directly julie asthma or bronchitis combimist l inhaler 50/20 mcg without a prescription. The ankyrin complex is composed is rare and is likely due defects in either band 335 or spectrin asthmatic bronchitis in pregnancy buy combimist l inhaler pills in toronto. Careful examination of the blood smear asthma and allergy discount combimist l inhaler 50/20mcg without a prescription, the phospholipid bilayer to red cell membrane skele to n by interacting with the presence of spherocytic red cells usually confirms the diag with peripheral protein 4. As a consequence, the anemia may vary from brane cohesion resulting in lipid vesicle formation responsible for the absent to mild or severe, with a reticulocyte count >150 fi 109/l. The de junctional complex play a key role in regulating membrane deformability creased surface area is a feature of both the reticulocytes and mature and membrane mechanical stability. For example, expression of typical biological manifestation including normal osmotic “mushroom” shaped red cells are generally a feature of band 3 defects fragility when the test is performed and iron deficiency, which may (Fig. A) Band 3 defect with the classical mushroom feature (green arrow) in association with typical spherocytic red cells, which appear dense and hyperchromic (black arrows), few acanthocytes (red arrows) and basophilic red cell due to the hema to poietic stress (blue arrow). In our experience and since we have access in our labora to ry to undefined molecular defects and with ankyrin defects. Classically, to the ektacy to metry, generally acknowledged to be the reference the mean fiuorescence of patient red cells is compared to the mean fiuo technique for diagnosis of red cell membrane disorders. Values between 16 and 21% are considered indeterminate nique of osmotic gradient ektacy to metry has not been evaluated in Please cite this article as: Da Costa L, et al, Hereditary spherocy to sis, ellip to cy to sis, and other red cell membrane disorders, Blood Rev (2013), dx. Identification of the molecular defects (Tables 1 and 2) tion leading to the exon 37 skipping and frameshift. This allele from the fresh blood using a 4% to 12% gradient acrylamide gels accor is silent if carried by a normal individual. No homozygous erwise it is likely that misdiagnosis or over-diagnosis of these red cell mutation has been identified to date. Theeducational programofbothparentsismanda to sence of symp to ms, the most recent recommendations do not suggest ry. It must emphasize the signs of anemia at this age of life (pallor, an annual blood test. The French orphanet website of parvovirus B19 infection (enhancement of the pallor, asthenia, dys Confirmation of parameters including the reticulocyte count and blood smear exam is diagnosis leads to transfusion of red cells to correct the sudden necessary until the hemoglobin levels stabilize with a reticulocyte aregenerative anemia, due to the erythroid tropism of the parvovirus count corresponding to the degree of anemia and hemoglobin levels. Recently, evaluated in 16 transfusion-dependent neonates and infants and Alizai et al. Red cells matched for antigens in the Rhesus and Hereditary ellip to cy to sis is another red cell membrane disorder char Kell systems should be used for transfusion when the hemoglobin acterized by mutations in genes encoding membrane or skeletal proteins, falls below a non- to lerable level, but there is no set threshold of hemo which alters membrane function and reduces red cell deformability. The laparoscopic surgical approach is lence like for other red cell defects in malaria endemic regions. Neonatal jaundice, hemolytic anemia and hydrops ents should be aware of life-long risk of overwhelming sepsis follow fetalis are also reported. The worsening of the hemolysis in the first months eral population and the prophylactic anticoagulation to prevent of life has been attributed to the particularities of the fetal erythropoi thrombosis should adhere to standard pro to cols. Some of the fragmented red cells are counted there is no cholelithiasis at the time of splenec to my. Splenec to my re as platelets by the hema to logy analyzer and as such overestimate the duces hyperbilirubinemia and thus no pigment s to nes are formed platelets counts. In these instances platelet count should be performed following splenec to my, reducing the risk of galls to nes. It also allows an accurate measurement of the spleen size, using non-denaturing gels. Molecular biological studies (screening of which is important before laparoscopic splenec to my. Red cell in hereditary ellip to cy to sis and other elliptic red cell membrane disorders. A) Top panel: hereditary ellip to cy to sis with the classical form (red arrows) and more ovalocytic red cells (blue arrows). Its identification in the proband and shaped red cells with 1 to 2 transverse ridges (Fig. Exon 40 mutation, the G>C transition While various hypotheses have been proposed to explain the discrepancy leads to the p. Leu1857Val is linked between the mild phenotype and the strong effect of the band 3 mutation to the other allele variation C>T transition in intron 45, minus 12 nucle on the red cell membrane rigidity, no clear explanations have emerged. The phenotype can vary on the extent of the membrane instability,112 per se dependent on the from asymp to matic to severe hemolytic form. In this form, the number of the cell dehydration, due to the loss of the cation content, in particular K+ s to ma to cytes on the blood smear is usually much higher than that in and cell water. Recently, mutations and the ektacy to metric osmotic deformability profile is shifted to the p. The diagnosis may be difficult when the number of s to ma to cytes is no defect in gene encoding s to matin could be identified and s to matin low. Band 3 mutations which have been only recently identified137 mayplayanimportantrole (p. His734Gln, and others affecting the amino acids D705, in the red cell cation and volume homeostasis. This form of s to ma to cy to sis is rare (20 reported cases and the pseudohyperkalemia (Blackburn s to ma to cy to sis). A, B,and C: three cy to logical features of dehydrated s to ma to cy to sis in A only the mouth red cell noticed; the number of s to ma to cytic red cell being sometimes very low. Identificationofafunctionalroleforlipid Practice points: asymmetryinbiologicalmembranes:phosphatidylserine-skeletalproteinin Red cell membrane disorders are common and responsible for hemolytic anemia. Proc Natl Acad Sci U S A 2002;99(4): the clinical severity is extremely variable ranging from asymp to matic to severe 1943–1948. Underdiagnosis or overdiagnosis or misdiagnosis of the red cell membrane defects 15. Transfus Clin Biol Osmotic fragility test is not sensitive and its usefulness is limited. Red blood cell blood group antigens: structure and func the best diagnostic reference technique is osmotic gradient ektacy to metry. The microscopic analysis should always be the most important component coated red cells. Molecular biological approacheswhile usefulhave to befurther developed to be of Biochem Soc Trans 1992;20(4):776–782. The infiuence of membrane skele to n on red Splenec to myiscontraindicatedandshouldnotbeperformedincasesofhereditary cell deformability, membrane material properties, and shape. Mechanical properties of the red cell membrane in relation Genes involved in s to ma to cy to sis. Red blood cell deformability and hemolytic Comprehensive understanding of the discordance between in vitrofinding of anemias. Curr Top Role of the molecular mutation analysis for diagnosis using Next generation Hema to l 1978;1:71–125. Adducin forms a bridge between the erythrocyte membrane and its cy to skele to n and regulates membrane cohesion. Baillieres Best Pract Res Clin Haema to l red cell membrane diagnosis in the hema to logy lab of R. Br J Haema to l 2008;141(3): itary spherocy to sis and distal renal tubular acidosis associated with the to tal 367–375. Rev Clin Exp fatal hydrops fetalis associated with a nucleotide substitution in the erythrocyte Hema to l 2003;7(1):22–56. Biochem Biophys Res Commun 2005;327(3): Napoli: a de novo deletional frameshift mutation in exon 16 of ankyrin gene 794–800. Ankyrin-1 ing sites in erythroid spectrin: location and implications for membrane stability. Ektacy to metric analysis spherocy to sis associated with deletion of human erythrocyte ankyrin gene on of fac to rs regulating red cell deformability. Red cell membrane skeletal defects in hereditary and acquired detect reduced mechanical stability of red cell membranes: relevance to hemolytic anemias.
Syndromes
- Is there a history of the skin becoming damaged easily, or being slow to heal?
- Brain growths (caused by tumors or infection)
- Loss of desire to do anything
- Toxic shock syndrome (rare)
- Blood tests specific to various autoimmune disorders
- Many episodes of diarrhea
- Abdominal pain or swelling, leading to loss of appetite, constipation, nausea, and vomiting
- Eyelid drooping
- Fever
- Aging changes in immunity
Ein wichtiger Risikofak to asthma treatment alternatives order combimist l inhaler overnight r dafur ist das bauchbe to asthma treatment asthma medications cheap combimist l inhaler 50/20mcg with mastercard nte Ubergewicht asthma symptoms in 12 month old buy combimist l inhaler 50/20 mcg visa, das einen Ruckfluss des Speisebreis aus dem Magen in die Speiserohre begunstigt zithromax asthma treatment quality 50/20mcg combimist l inhaler, der wiederum als eine der Ursachen fur den Gewebeumbau angesehen wird. Maligne Tumoren, die aus diesen neuen 2 Fur Mikroflora wird haufig auch der Begriff Mikrobiota verwendet. Oft werden die Risikofak to ren fur diese Adenokarzinome zusammen mit den Adenokarzinomen des Magens untersucht. Obwohl die Haufigkeit der Adenokarzinome in der Speiserohre in den letzten Jahrzehnten stark zugenommen hat, stellen Plattenepithelkarzinome auch heute noch die Mehrzahl der Karzinome der Speiserohre. Fur die Plattenepithelkarzinome sind Tabak rauchen und Alkoholkonsum die wichtigsten Risikofak to ren (Siewert und Ott 2007). Bei der weiteren Literatursuche konnten keine Studien identifiziert werden, die prospektiv die Kohlenhydratzufuhr in Bezug auf maligne Tumoren der Speiserohre untersucht haben. In einer jungeren schwedischen Kohortenstudie mit Frauen konnte keine Risikobeziehung der Kohlenhydratzufuhr zum Magenkrebs beobachtet werden (Larsson et al. Neben Studien, in denen keine Risikobeziehung 141 Kapitel 9: Kohlenhydratzufuhr und Pravention von Krebskrankheiten beobachtet wurde (Giles et al. Die Evidenz fur den Einfluss der Kohlenhydratzufuhr insgesamt auf die Entstehung maligner Tumoren in der Speiserohre wird aufgrund der geringen Studienzahl als unzureichend eingestuft. Mit moglicher Evidenz besteht kein Zusammenhang der Kohlenhydratzufuhr insgesamt mit dem Risiko fur maligne Tumoren in Magen, Brust, Gebarmutterschleimhaut und Pankreas. Dies gilt aufgrund der Vielzahl der Studien auch fur Krebs im Kolorektum, auch wenn 2 neue Kohortenstudien auf eine inverse Risikobeziehung hindeuten. Es konnten auch keine neueren Studien zu der Beziehung zwischen malignen Tumoren im Magen und Mono-und Disacchariden und zuckergesufiten Getranken identifiziert werden. In einer weiteren Studie zu diesem Thema aus dem Jahr 2008 konnte die Zuckerzufuhr nicht mit malignen Tumoren im Kolo rektum in Verbindung gebracht werden (Kabat et al. In einer kurzlich durch gefuhrten Analyse von 13 Kohortenstudien aus dem Pooling-Projekt war die Zufuhr von zuckergesufiten Getranken nicht mit dem Risiko fur maligne Tumoren im Kolorektum asso ziiert (Zhang et al. Es liegen 143 Kapitel 9: Kohlenhydratzufuhr und Pravention von Krebskrankheiten weder zum Konsum von Monosacchariden noch von zuckergesufiten Getranken Kohorten studien vor. In dieser Studie gab es kein signifikant erhohtes Risiko in Bezug auf hohe Fruc to sezufuhr. Die Zufuhr von Mono und Disacchariden war dagegen in der Netherlands Diet and Health Study nicht mit dem Risiko fur Pankreaskrebs assoziiert (Heinen et al. Ebenso waren der Konsum von Sufiigkeiten oder Konfiture keine Risiko fak to ren fur maligne Tumoren im Pankreas (Larsson et al. Die Beziehung zwischen dem Konsum zuckergesufiter Getranke und malignen Tumoren in der Bauchspeicheldruse wurde im Rahmen einer Meta-Analyse untersucht (Gallus et al. Bei Einbezug von mehreren Kategorien des Konsums von zuckergesufiten Getranken ergab die Studie des Karolinska-Instituts (Larsson et al. Die Evidenz fur einen Zusammenhang zwischen der Zufuhr von Monosacchariden und dem Risiko fur maligne Tumoren in der Speiserohre, im Kolorektum und in der Brust wird mit unzureichend bewertet. Die Evidenz fur eine fehlende Risikobeziehung zwischen der Zufuhr von Disacchariden und der Entstehung maligner Tumoren im Kolorektum, in der Brust und der Bauchspeicheldruse wird mit moglich bewertet. Mit moglicher Evidenz gibt es 144 Kapitel 9: Kohlenhydratzufuhr und Pravention von Krebskrankheiten einen positiven Zusammenhang zwischen der Zufuhr von Monosacchariden und malignen Tumoren in der Bauchspeicheldruse. Zum Zusammenhang zwischen der Zufuhr von Monosacchariden und dem Risiko fur maligne Tumoren im Magen und der Gebarmutterschleimhaut, sowie zwischen der Zufuhr von Disacchariden und dem Risiko fur Magenkrebs und zwischen der Zufuhr von zucker gesufiten Getranken und dem Risiko fur maligne Tumoren in der Speiserohre, im Magen, in der Brust und in der Gebarmutterschleimhaut wurden keine Kohorten oder Interventions studien identifiziert. Getreideprodukte aus Mehl mit niedrigem Ausmahlungsgrad Das wichtigste Polysaccharid in der Nahrung ist die Starke. Die Studienergebnisse zu Getreideprodukten aus Mehl mit niedrigem Ausmahlungsgrad werden ebenfalls in diesem Abschnitt beschrieben. Der Verzehr von Reis, Nudeln und Getreide aus Mehl mit niedrigem Ausmahlungsgrad wurde in insgesamt 5 Kohortenstudien untersucht. Auch eine neuere Studie ergab keine Risikobeziehung in Bezug auf die Polysaccharidzufuhr (Nielsen et al. Zum Verzehr von Getreideprodukten aus Mehl mit niedrigem Ausmahlungs grad gab es 1 Kohortenstudie. Eine jungere Kohortenstudie zur Risikobeziehung zwischen malignen Tumoren in der Gebar mutterschleimhaut und der Starkezufuhr zeigte ebenfalls keinen Zusammenhang (Cust et al. Zum Zusammenhang zwischen der Zufuhr von Polysacchariden (Starke) und dem Risiko fur maligne Tumoren in der Speiserohre, der Brust und der Gebarmutterschleimhaut besteht eine unzureichende Evidenz. Die Evidenz fur eine fehlende Risikobeziehung zwischen der Polysaccharidzufuhr und Krebs in Magen, Kolorektum und Bauchspeicheldruse wird mit moglich bewertet. Getreideprodukte aus Mehl mit hohem Ausmahlungsgrad Ballasts to ffe entfalten zunachst ihre Wirkungen lokal im Magen, Dick und Mastdarm. Die potenziellen Effekte auf andere Organe sind indirekt und beruhen im Wesentlichen auf den metabolischen Wirkungen der Ballasts to ffe, insbesondere auf deren Wirkung auf den Glucoses to ffwechsel. Sie berichtet ohne weitere statistische Angaben uber ein abgesenktes Risiko fur Speise 146 Kapitel 9: Kohlenhydratzufuhr und Pravention von Krebskrankheiten rohrenkrebs im Zusammenhang mit einer hoheren Zufuhr von Ballasts to ffen und Getreideprodukten. Bei den 5 Kohortenstudien zu Dickdarmkrebs ergab die Risikoschatzung aus der quantitativen Meta-Analyse ein ahnliches Ergebnis. Von 3 Kohortenstudien aus Asien konnte in der chine sischen Studie keine Assoziation zwischen der Zufuhr von Ballasts to ffen und malignen Tumoren im Kolorektum beobachtet werden (Shin et al. Die Analyse von Daten aus der multiethnischen Kohortenstudie erbrachte lediglich bei Mannern eine signifikant inverse Assoziation zwischen der Zufuhr von Ballasts to ffen und dem Risiko fur Krebs im Kolorektum; die beobachtete Risikoabsenkung bei Frauen war nicht statistisch signifikant (Nomura et al. In dieser Studie konnte nur ein nicht-signifikant abgesenktes Risiko mit der Ballasts to ffzufuhr fur kolorektale Karzinome beobachtet werden. In einer gesonderten Auswertung hinsichtlich nicht-linearer Zusammenhange waren Auf nahmemengen von unter 10 g/Tag Ballasts to ffe mit einem hoheren Risiko assoziiert. Wahrend sowohl in einer schwedischen als auch in einer britischen Studie die Ballasts to ff zufuhr keinen Einfluss hatte (Suzuki et al. Diese inverse Risikobeziehung konnte besonders bei den Ostrogen-/Progesteron-negativen Tumoren in Bezug auf die Zufuhr von wasserloslichen Ballasts to ffen beobachtet werden. Die Ballasts to ff quelle hatte keinen Einfluss auf das abgesenkte relative Risiko. Neue prospektive Studien zur Risikobeziehung zwischen malignen Tumoren in diesem Organ und der Ballasts to ffzufuhr liegen nicht vor. Die Evidenz zum Zusammenhang zwischen der Zufuhr von Ballasts to ffen und der Ent stehung maligner Tumoren in Speiserohre, Gebarmutterschleimhaut, Magen und Pankreas ist unzureichend. Mit moglicher Evidenz besteht kein Zusammenhang zwischen der Zufuhr von Ballasts to ffen und dem Risiko fur maligne Tumoren in der Brust. Dort wurde fur fast alle malignen Tumoren eine unzureichende Evidenz wegen fehlender bzw. Aufgrund mehrerer Studienergebnisse ohne Risikobezug wurde der Evidenzgrad moglich fur eine fehlende Risikobeziehung bei den malignen Tumoren im Magen und Kolorektum vergeben. Obwohl diese Meta-Analysen alle im gleichen Jahr veroffentlicht wurden, wurden jeweils unterschiedliche Studien in die Analysen einbezogen. Problematisch bei der Auswertung dieser Meta-Analysen ist, dass zum Teil die zusammenfassenden Risiko schatzungen nicht zahlenmafiig ausgewiesen sind, sondern nur grafisch dargestellt wurden. Eine Studie aus Schweden berichtet ebenfalls von fehlenden Risiko beziehungen (Larsson et al. Die Datenlage hinsichtlich der Kohlenhydratzufuhr ist fur Krebs in der Speiserohre insgesamt unzureichend. Das Risiko fur Magenkrebs konnte mit moglicher Evidenz durch den Verzehr von Getreideprodukten abge senkt werden. Die Menge an Kohlenhydraten scheint nicht mit einem Risiko fur maligne Tumoren im Kolorektum assoziiert zu sein. Die Zufuhr von Getreideprodukten senkt sogar mit wahrscheinlicher Evidenz das Risiko. Fur den Gebarmutterschleimhautkrebs wiederum ist mit moglicher Evidenz die glykamische Last ein risikoerhohender Ernahrungsfak to r, ohne dass es derzeitig eine Erklarung dafur gibt. Das Risiko fur maligne Tumoren der Bauchspeicheldruse steigt mit moglicher Evidenz mit der Zufuhr an Monosacchariden. Tabelle 9: Bewertung der Evidenz zur Assoziation zwischen Kohlenhydratzufuhr und Primar pravention von Tumorenkrankheiten bei der Betrachtung von Gesamtkohlenhydraten und einzelnen Kohlenhydratfraktionen bzw. Die Zahl der Pfeile sagt nur etwas uber die Beweiskraft der Daten und nichts uber das Ausmafi des Risikos aus. Die Evidenz fur einen Zusammenhang zwischen der Zufuhr von Disacchariden und Krebs in der Speiserohre und in der Gebarmutterschleimhaut ist ebenfalls unzureichend.
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This variation is illustrated by large numbers of lives to asthmatic bronchitis in infants trusted combimist l inhaler 50/20mcg ck congregate in peri contrasting the demographic asthma inhaler brands order 50/20 mcg combimist l inhaler with visa, socio-economic asthma treatment uptodate discount combimist l inhaler 50/20 mcg online, urban areas asthma biological definition discount combimist l inhaler 50/20 mcg free shipping, at collection sites, wet markets and agricultural and dietary changes in South and local butcheries where they provide urban con East Asia, two areas with very high pressures sumers with fresh daily supplies of meat and on land and a close human–lives to ck interface. It usually incorporates the population in a city or to wn in addition to that in the suburban areas adjacent to the city boundaries. India is projected to surpass China in rural areas, and at least 600 million of these as the world’s most populous country by the people, mostly in South Asia, keep lives to ck that late 2020s, with a population exceeding 1. As shown in sec to r, milk production has become the major Table 2, half of the world’s 20 largest urban me lives to ck sec to r activity, with more than 130 mil ga-cities projected for the year 2025 are in South lion farm households engaged in milk produc Asia; the ranking of these cities is based on the tion and millions of small-scale rural processors estimated amount of urban food waste not col and intermediaries. Milk consumption in South lected, which refects the extent of scavenging Asia grew by an average of 3 to 4 percent/year by humans and animals on waste dumps. In China, the urban the lives to ck–human interface in South Asia population rose from 190 to 636 million people, is strongly infuenced by the presence of rumi while the rural population declined from 791 to nants. China’s economy is ex In South Asia, buffaloes and bovines are kept pected to rank frst in the world by about 2030. Over recent decades, Operation Flood – a lation of pigs amounted to 498 million head, of project operated by India’s National Dairy De which 476 million (95 percent) were in China. This network has reduced sea the perimeters of China’s megacities usually sonal and regional price variations and ensures feature a mix of both old and new poultry and 10 Pressure 11 World Lives to ck 2013 • Changing disease landscapes 12 Pressure pig production systems, which share live animal ducks are shown in Figure 3. The poul densities, the mixing of farming systems and the try subsec to r has both an abundance of small to preponderance of live animal-based food supplies medium-sized holdings and a rapidly growing to gether create ample opportunity for human ex number of industrial-scale production plants. Millions of live birds are supplied to and slaugh the complex demographic, economic, socio tered in live bird markets in urban centres every cultural, agricultural and food system dynam day. While most pigs are kept on small to me ics in South and East Asia justify focusing on dium-sized farm holdings, the number of large animal- to -human pathogen shifts in the broad scale farms is increasing rapidly. In South Asia, densely popu lated systems are often associated with rice pro landscapes duction systems and tend to have high densities of cattle and buffaloes. Rainfed cropland systems Figure 4 classifes global land use in to eight land cover large tracts of Europe and North America. Bare soil ed, mosaic, rice–cropland, irrigated cropland, and systems are prominent in Africa, Asia and Aus densely populated. Forested systems comprise the tropical rain fed version of the 24 land-use systems presented forests of the Amazon, Central Africa, Indone by the same authors; for example, forested sys sia, the Mekong Delta and forested areas of the tems include three subcategories – remote forests, northern Palearctic and Nearctic regions. The From 2000 to 2030, demographic pressures roles played by different lives to ck species vary are projected to lead to progressive expansion greatly among these land-use systems. In Asia, populated systems generally feature prominent this process is expected to be at the cost of irri poultry production. Outside Asia, hotspots are the Ganges River system in South it will concern mainly rainfed cropland systems Asia, the Yangtze and Yellow River systems (Figure 5 and Figure 6), which will replace pas in China, the Red River and Mekong Deltas in to ral, forested and mosaic land-use systems. In sub-Saharan Africa, major encroachment populated and remote forests being replaced by of forested systems is expected to continue for pas to ral (ruminant) systems and rainfed crop the decades ahead. Most expansion of rainfed ested systems are replaced by pas to ral systems cropland systems will be at the cost of pas to ral is expected to decline from 2020 to 2050, the systems, involving a to tal area of approximately expansion of rainfed cropland systems at the ex 2. Projections Asia and growing fast in Africa, the challenge are that forested systems will be replaced by is to arrive at sustainable resource-use practices. The fgure suggests concern to the health of humans, lives to ck and that in Latin America and the Caribbean, most wildlife, and provide an indica to r of increased of the replacement of forested systems by crop vulnerabilities associated with ever-closer inter and lives to ck systems has already occurred. In faces among human living environments, farm densely populated areas of South, Southeast and ing landscapes and natural ecosystems. At the local scale, the animal waste gen erated by intensive systems may, in the absence this section assesses the evolution of both ex of “pre-release” waste treatment, pollute and tensive and intensive production to identify any contaminate surface and groundwater, air, soils imbalances in the overall development process and vegetation; in addition to chemical pollu that may be associated with disease emergence, tion, there is also the risk of pathogen dispersal. In this process, a bulk production of milk, meat and eggs of pathogen may turn in to a hyper-virulent disease standard quality. Intensive systems thus make agent; in monocultures involving mass rearing of a major contribution to global food security, genetically identical animals that are selected for providing normally safe, healthy and nutritious high feed conversion, an emerging hyper-viru food. Intensive systems are largely free from lent pathogen will rapidly spread within a fock high-impact animal and zoonotic diseases, but or herd. If farm-level biosecurity and hygiene challenges are faced during the intensifcation are inadequate, other farms and the food chain of lives to ck production, which involves a ma may be affected (Engering, Hogerwerf and Slin jor scaling up of animal production, processing genbergh, 2013). Economies of scale and emerge in large-scale animal holdings may also infect smallholder lives to ck and wildlife. Anti 4 biotics used to prevent disease or as feed addi the terms “extensive” and “intensive” lives to ck production refer to the effciency with which feed mass is converted in to increased body mass for tive to stimulate growth may enhance the risk of meat production, or in to milk or eggs (tilman et al. The sive lives to ck production units also increases the result is a progressive increase in animal bio demand for compound feed, which is produced mass in densely populated areas, and increased through the expansion of croplands, often at the animal–human contact. Despite these chal dominant in Latin American countries, where lenges, the high productivity levels typical of demographic and land pressure is lower than in intensive systems imply highly effcient use of Asia and Africa, and where extensive produc natural resources, with reduced environmental tion systems are gradually being replaced by impact per unit of food produced. The evolution of both exten Extensive animal production serves a vari sive and intensive production, individually and ety of purposes other than human food supply. Health protection prac nected data pairs on: i) the economically active tices and risk management in extensive systems population in agriculture as a share of the to tal contrast with the biocontainment approach population; and ii) the output or volume of ani adopted in intensive systems. In extensive sys mal produce from the standing population of tems farmers are inclined to select sturdy, stress animals (the input). The trajec to ry established resistant animals and to accommodate risky provides insights in to the evolution of both ex situations. The prominence of Sahelian agro-ecological zone of West and Cen the extensive sec to r is refected in the proportion tral Africa traditionally practise transhumance, of people who are active in agriculture. Growth with seasonal cattle movements designed to of the intensive sec to r is refected in the output/ balance the risk of attracting disease – mainly input (O/I) ratio, a measure of overall lives to ck tsetse-transmitted trypanosomosis – with the productivity. Fewer and fewer people tend to en variable availability of water, forage and other gage in agriculture, while lives to ck productivity feed resources, including crop residues and ag tends to increase. In the to ries are strongly modulated by demographic humid climate zones of West and Central Af and economic forces. In contrast, tems grow fastest in areas where extensive sys lives to ck productivity in much of Asia and Africa 21 World Lives to ck 2013 • Changing disease landscapes 9 pouLtrY Meat proDuction: 10 Ppig Meat proDuction: intensification trajec to ries intensification trajec to ries 1980–2009 – shaded symbols; 1980–2009 – shaded symbols; 2030 – empty symbols 2030 – empty symbols 10 180 9 160 8 140 7 120 6 100 5 80 4 60 3 2 40 1 20 0 0 0. Therefore, the agricultural labour force tensive sec to rs in both Africa and Asia are hardly is not decreasing at the pace seen in developed noticeable at the continental scale. The result is that in much of Asia, and growth of modern poultry industries in many increasingly also in Africa, both extensive and in Asian countries is masked by the sheer number of tensive animal agriculture coexist and coevolve. In Africa, to o, the very main global regions are illustrated in Figure 9, rapid growth of the poultry industry is hidden by which presents the development trajec to ries for the prominence of traditional village poultry. Developed countries and regions the shape and direction of the lives to ck de are approaching the upper-right corner, signal velopment trajec to ry may assist in estimating the ling high productivity levels and few farmers. Such a For a better visual interpretation, the scale on the X-axis has been inverted. Africa features mainly extensive try sec to r arising alongside a myriad of persisting pig production, with the beginnings of inten smallholder systems. For example, Bangladesh, sifcation concealed by extensive or village pig China, Egypt, Indonesia, Mexico, Pakistan and production. The implications for the emergence, Viet Nam all feature prominent extensive as well spread and persistence of pig diseases are dis as intensive poultry systems and are affected by cussed in the next chapter. The trajec show the developed countries approaching the to ry for Latin America and the Caribbean suggests upper-right corner of the graph (Figure 10). As discussed in the frst section Again, the trajec to ry for Latin America and the of this chapter, within Asia, the smallholder dairy Caribbean suggests a transition from extensive subsec to r is particularly well established in South to intensive production, mainly because of the Asia. Asia features a highly visible at only the local level, around urban centres in intensifcation of the pig production subsec to r, North Africa, in the eastern African highlands, 23 World Lives to ck 2013 • Changing disease landscapes and in the relatively disease-free areas of Southern extensive, commercial small ruminant ranching Africa, but this development is hardly apparent is a relatively low-cost activity. Developing countries are costs, resulting from grain feeding, are becoming generally facing a major and growing dairy defcit. In Latin America and the Carib the risk management implications and develop bean, where arable land is relatively abundant, ment potential are discussed in the next chapter. Poultry distributions, particularly of broiler chickens and layer hens, are far wider than pig distributions distributions, refecting cultural and religious infuences. As monogastric animal species, poul From 1980 to 2010, the world’s standing popula try and pigs cannot digest cellulose as effciently tion of chickens increased by 272 percent, from as ruminants can, and rely on backyard scaveng 7. Concen chickens slaughtered rose by 305 percent, from trate feeds are expensive, so the intensifcation 18.
Diseases
- Polyposis, hamartomatous intestinal
- Charcot disease
- N-Acetylglutamate synthase deficiency
- Erythrokeratodermia progressive symmetrica ichthyosis
- Spondyloepimetaphyseal dysplasia joint laxity
- Devic syndrome
- Marsden syndrome
- Woods Leversha Rogers syndrome
- Rett like syndrome