E. Rasul. Willamette University.
He eventually settled in Kirksville generic 500mg antabuse with mastercard medicine grinder, the efcacy of osteopathic medicine and citing patient tes- Missouri 250 mg antabuse sale medications causing tinnitus, a small town with a population of 1 order 500 mg antabuse overnight delivery medicine 230,800. Still compiled these articles and ever, because the patient population of Kirksville was lim- published them in a Journal of Osteopathy, whose reader- ited, Dr. Still took his practice all around the state in order to ship increased from a few hundred in 1894 to more than make ends meet and support his wife and children. However, the osteopathic profes- seemingly miraculous treatment of diseases via osteopathy, sion’s early success was not without opposition. Still began to gain a reputation as the so-called “light- Numerous eforts were made to halt Dr. Still’s prac- ning bone-setter,” and people began to travel many miles tices, which were viewed as conficting with the tradi- hoping to be cured of various ailments. For instance, the Missouri obvious that Still needed to establish a permanent place of State Medical Association and other medical soci- practice. Still opened an infrmary in Kirksville, attempted to take legal action to limit the reach of osteo- and in 1892, he founded the American School of Osteop- pathic medicine. Still more emphasis on rural and underserved populations, expanded his curriculum to four terms, totaling 20 months more part-time faculty, and fewer afliated hospitals, to of study, in subjects that included anatomy, physiology, name a few), but it ultimately led to lower pass rates on surgery and obstetrics. The curriculum was later further allopathic state licensing board exams and basic science expanded to include classes such as histology, pathology board exams. Rapid growth mandatory fourth year of study, and integrated biological followed this legislation, and the student population of the and chemical agents into the curriculum. However, it was also welcomed several new faculty, all of whom had per- not until 1929 that osteopathic schools began to include sonal experience with osteopathic medicine and many of pharmacology in their curricula. Still’s school grew, so did the osteopathic pro- toward keeping up with standards set by their allopathic fession. All the accredited osteopathic institutions had raised their pre- while, osteopathic medicine remained as pure in its phi- requisite admissions requirements to two years of college losophy as it was when it was frst conceived. Commitment to the enhancement of a basic science curriculum was also a theme during this period, Higher Standards with signifcant increases in laboratory time, upgrades to laboratory facilities and equipment, and appointment of more qualifed, full-time faculty. Much of this progress ical schools were founded, but most closed for fnan- would not have been possible without fnancial backing cial reasons, or merged with other schools. The ques- from tuition increases, the Osteopathic Progress Fund, tion of whether or not to include pharmaceutical agents greater federal support, and the Hill-Burton Act of 1946. Still was decidedly set against phar- composite as well as basic science board examinations maceuticals, mainly because of his deep-seated mistrust also made impressive strides. In the case of basic science of drugs being used during that time and his desire to keep exams, pass rates rose from 52. A statue in his honor was erected in the However, despite this commendable progress, there Kirksville courthouse square; it still stands there today. In addi- forced many sub-standard medical schools, osteopathic, tion to small numbers, other barriers to widespread recog- allopathic, eclectic and homeopathic alike, to change their nition included disproportionate geographic distribution curricula or even close in the decades that followed. The reasons behind the apparent inferiority state and local health ofces, was also a common theme of osteopathic education were complex (limited funding, during this time. During the 1960s and of the two professions, thereby stripping osteopathic medi- 1970s, increasing federal and state support of profes- cine of its distinctive qualities. Student qualifcations resulting reports concluded that osteopathic medicine also continued to improve in the fve established osteo- was not, in fact, a cultist art, and that further eforts should pathic colleges, and by 1978, 95 percent of their matricu- be made by the allopathic community to generate greater lants held at least a Bachelor’s degree. At the current rate of growth, it is estimated that students Chapter 2: The Philosophy and History of Osteopathic Medicine there will be more than 100,000 total osteopathic physicians in the U. The following year, the California State Supreme In the late 1800s, Andrew Taylor Still identifed the Court overturned the merger legislation from over a neuromusculoskeletal system as the key element in health decade prior, thus allowing the reinstatement of an osteo- maintenance and stressed preventive aspects of medi- 24%pathic licensing board, a medical society, and a new cine in place of drug therapy. During that time, osteop- school, now known as Western University of Health Sci- athy was truly separate and distinct from the world of allo- Average growth every 5 years ences College of Osteopathic Medicine of the Pacifc. The phrase “osteopathic cally severely underrepresented in the decisions regarding medicine” is now the accepted term for the profession Medicare and Medicaid reimbursement for osteopathic over “osteopathy,” a now-antiquated term that represents medical services. Since its conception, osteopathic med- Commission, which advised Congress on policy con- icine has adapted its body of knowledge to incorporate cerning such reimbursements. Korr, PhD: An accomplished researcher who integrated accepted physiologic models • John W. It involves the use of the hands as the pri- nents of the somatic (body framework) system: mary diagnostic, treatment, and therapeutic tool. The neurons in a facilitated area are in a partial, Some are similar to those used by chiropractors, phys- sub-threshold excited state, meaning it takes less ical therapists, and/or massage therapists, while other 2 methods are completely unique to osteopathic medicine. Indirect Treatment Modalities • Ligamentous Articulatory Release – ligaments or joints are placed into a state of balanced tension until a • Strain/Counterstrain – focused on specifc tender release is felt. Treatment Modalities ese can be treated in a variety of ways, including muscle energy and myofascial release. After entifc manner that they learn pharmacology and other gaining this palpatory literacy, they move on to more com- treatment regimens. For each osteopathic treatment plex topics, such as osteopathic diagnoses, charting, phys- modality, there are physiologic mechanisms of action, ical exams, techniques and treatments. T is was a randomized physicians to perform the research tasks is necessary to study that stratifed participants by age and number of pre- account for inter-operator variability. Some cells were Many factors contribute to the prevalence of such lim- then placed in a strain-free setting to simulate an indirect itations in osteopathic research. In 2001, the Osteo- In this section we have presented a few studies dem- pathic Research Center (http://www. T us, we encourage colleges of osteopathic medicine, including Michigan State you to read the full articles of the research we have pre- University College of Osteopathic Medicine, Ohio Uni- sented, the articles listed at the end of the chapter, and to versity Heritage College of Osteopathic Medicine, and the conduct further research of your own. In addition, there are now conferences, courses cialty distribution of Ohio osteopathic physicians. While there is some overlap is section was meant to give you a better sense of between the two types of practitioners, they represent dis- what “osteopathic manipulative medicine” entails, and tinct professions and separate schools of thought. With that said, it is an important practic philosophy is historically focused on the nervous core discipline and primary distinction of the osteopathic system, the original notion of osteopathic medicine was profession. Licensed to Licensed to to practice practice the practice the chiropractic complete complete manipulation. Efect of pedal Licensure/Scope spectrum spectrum pump and thoracic pump techniques on intracranial pres- of Practice of medical of medical sure in patients with traumatic brain injuries. Can Prescribe Yes Yes No Medications International Journal of Osteopathic Medicine. A randomized, Manual 1 and 2; controlled trial of osteopathic manipulative treatment Medicine over 100 Training for acute low back pain in active duty military personnel. An Introduction to Clinical Research in Pizzolorusso G, Turi P, Barlafante G, et al. Osteopathic Manipulative Treatment on Pediatric Patients With Asthma: A Randomized Controlled Trial.
Ischemic heart disease and stroke dominate the bur- regions]; unsafe water order antabuse in united states online symptoms heart attack, sanitation order online antabuse medicine on time, and hygiene [3 generic 250mg antabuse overnight delivery medicine dispenser. Injuries primarily affect young adults and often result in An estimated 45 percent of global mortality and 36 per- severe, disabling sequelae. All forms of injury accounted for cent of the global burden of disease were attributable to the 16 percent of the adult burden in 2001. Road traffic accidents, vio- mortality in Sub-Saharan Africa; cardiovascular risks, lence,and self-inflicted injuries are all among the top 10 lead- including smoking and alcohol use in Europe and Central ing causes of burden in these regions. Note that mortality and disease burden attributable to individual risk factors cannot be added due to multi-causality. The relatively small number of risk factors that al health agencies such as the World Health Organization account for a large fraction of the disease burden under- attest to the critical need for objective and systematic assess- scores the need for policies, programs, and scientific ments of the disease burden for priority setting in health. Mathers, Majid Ezzati, and others importance of some conditions, particularly psychiatric equally valid today and needs to be addressed more system- disorders, and drew global public health attention to the atically if the burden of disease framework is to gain greater unrecognized burden of injuries. The methodological devel- acceptance as the international tool for health accounting. This volume will provide scholars today national burden of disease studies have dramatically and in the future with a definitive historical record of the improved the methodological armamentarium and the leading causes of the burden of disease for major regions of empirical base for disease burden assessment, in particular, the world at the start of the 21st century. An account of the comparability of the estimated contributions of diseases, global health at the beginning of the 20th century, or earlier, injuries, and risk factors to this burden. The wide- age, and sex were carried out separately for 226 countries spread use of disease burden concepts by national and inter- and territories, drawing on a total of 770 country-years of national bodies since the first results were published and the death registration data, 535 additional sources of informa- heightened interest in improving the basic descriptive tion on levels of child and adult mortality, and more than epidemiology of diseases, injuries, and risk factors by both 2,600 data sets providing information on specific causes of countries and agencies has laid the foundations for future death in regions not well covered by death registration sys- population health assessments. This represents newglobalinstitutions,arerequiredtomeasuretheburdenof one of the largest syntheses of global information on popu- disease worldwide and how it is changing, more reliably than lation health carried out to date. This book provides the baseline against which such Much of the research on the burden of disease undertak- progress with global health development will be measured. Cape Town: South African Medical decade ago (Murray, Lopez and Jamison, 1994) remains Research Council. Measuring the Global Burden of Disease and Risk Factors, 1990–2001 | 11 Bundhamcharoen, K. Disease Assessment and Health System Reform: Results of a Study in Bangkok: Ministry of Public Health. Hyderabad, India: Institute of Reform: Verifying the Causes of Death between July 1997 and Health Systems. Canberra: Australian Institute of Health and “Disease Burden in Sub-Saharan Africa: What Should We Conclude in Welfare. Quantification of Health Risks: The Global and Regional Burden of Disease Attributable to Selected Major Risk Factors. Global Health Statistics: A Compendium of Incidence, Assessing the Health Impact of Different Diseases in Less Developed Prevalence, and Mortality Estimates for over 200 Conditions. NewYork:Oxford Summary Measures of Population Health: Concepts, Ethics, Measure- University. World Mortality in 2000: Life Tables for 191 Empirical Validation, and Application. Mauritius Health Sector Reform, National Burden of from Tobacco in Developed Countries: Indirect Estimates from Disease Study, Final Report of Consultancy. Report of the Ad Hoc Committee on Health Research United States Department of Health and Human Services. World Health Report Collaboration with the Pan-American Health Organization, Department 2002. Measuring the Global Burden of Disease and Risk Factors, 1990–2001 | 13 Part I Global Burden of Disease and Risk Factors Chapter 2 Demographic and Epidemiological Characteristics of Major Regions, 1990–2001 Alan D. Lopez, Stephen Begg, and Ed Bos Health status is both a determinant of population change, between age and mortality and morbidity. Second, each largely through population aging, and a consequence of of the dynamic processes inﬂuencing population size and population growth, with smaller family size associated with growth, structure, and distribution, namely, fertility, lower mortality, and of economic and social development. Thus, Studies of the interrelationship between demographic any discussion of disease control priorities and of the trends and health have typically focused on health as the health system for delivering interventions requires an independent or determining variable. Indeed, a population’s understanding of the demographic context and how it is health status inﬂuences all components of population changing. In addition to the obvious direct effect of individual This chapter begins by providing an overview of global health status on mortality and morbidity, it has a direct population trends in each major region of the world and the impact on fertility, largely through improved child survival, current size and composition of the population. Given this but also through the biological capability of a sick woman volume’s focus on the descriptive epidemiology of diseases, to bear children. Processes such as screening potential injuries, and risk factors, we then examine trends in mortal- migrants for disease are also mechanisms whereby health ity over the past decade in more detail as background status exerts a direct impact on population change, and thus against which the current assessment of the disease burden on population size and composition. This includes both an In contrast, demographic variables inﬂuence health assessment of trends in age-speciﬁc mortality and summary through two interrelated phenomena. First, a population’s measures of the age schedule of mortality, such as life size, composition by age and sex, and geographical distribu- expectancy and the probability of dying within certain age tion have a direct inﬂuence on overall health status. Age has ranges, as well as a speciﬁc discussion of trends in the main a particularly marked effect on the pattern and extent of ill- causes of child mortality. In addi- child mortality should remain a priority for global health tion to total population, the baseline assessment includes a development efforts, and the moral imperative to do so breakdown of population by sex and age (in ﬁve-year aggre- remains as relevant today as it was 30 years ago, when efforts gates). Fertility is speciﬁed as age-speciﬁc fertility rates for to improve child survival became increasingly organized females and mortality rates are based on survival probabili- and focused; and (c) the resulting emphasis by the global ties from life tables. Age-speciﬁc patterns of migration are public health community on reducing child mortality has also incorporated for countries in which migration ﬂows are yielded vastly more epidemiological information that can be observed or are thought to occur. It does and sex structure of the population and its rate of growth not provide information about the adjustments made to and comparative measures of fertility and mortality. Basic information on population size and composi- tion is available for most countries for 1990, and with the Sources of Population Data and Methodology exception of Sub-Saharan Africa, for 2000 (or thereabouts) as well (table 2. Around both dates, censuses covered The population and mortality estimates for various regions more than 90 percent of populations in all the regions summarized here are based on different data sources and except Sub-Saharan Africa. Lopez, Stephen Begg, and Ed Bos the model pattern, in which case the country-speciﬁc pat- size, with East Asia and the Paciﬁc accounting for about tern is followed (United Nations 2003). Thus,abouthalf theworld’spopulation on the basis of the cohort component methodology. This live in the low- and middle-income countries of these two approach applies estimated trends in birth and death rates regions. The smallest region in terms of population size is the and migration by age and sex to a baseline age and sex struc- Middle East and North Africa, with just 5 percent of the ture. Just over 10 percent of the world’s popu- age-speciﬁc fertility and mortality rates and migration and lation live in Sub-Saharan Africa. Another 15 percent live in the size of the initial age groups (base year population) high-income countries, a proportion that is declining. While many other factors contribute to mortality gates are thus weighted by the different population sizes of and fertility levels, the age distribution of a population is an individual countries. As a result, the with almost 45 percent of the population of Sub-Saharan age and sex structures reported here, as well as any indica- Africa being younger than 15, compared with 20 percent of tors derived from them (such as crude birth and death rates) the population in high-income countries, where fertility are not strictly internally consistent.
Binding of Candida organisms to purified small intestinal mucin showed a close correlation with their hierarchy of virulence purchase cheapest antabuse symptoms appendicitis, with C order antabuse overnight denivit intensive treatment. Adherence is achieved by a combination of specific buy antabuse overnight delivery medications with sulfa, ligand-receptor interactions and nonspecific mechanisms such as electrostatic charge and van der Waals forces. These include epithelial and bacterial cell-surface molecules, extracellular matrix proteins, and dental acrylic. In addition, saliva molecules, including basic proline-rich proteins, adsorbed to many oral surfaces promote C. Candidal vulvovaginitis occurs after a three-stage process of adhesion, blastopore germination, and epithelium invasion. Vaginal defense factors such as lactobacilli, cellular and humoral immunity, control and limit fungal growth. Women with recurrent vulvovaginal candidiasis have reduced and fluctuating epithelial cell anticandidal activity. Cytokines and chemokines produced constitutively by vaginal and oral epithelial cells in response to C. Recently, the potential of immunotherapy to control candidal vaginitis has included investigation of the use of antibodies against well-defined cell-surface adhesins or enzymes, the generation of yeast killer toxin–like candidacidal anti-idiotypic antibodies, and the generation of therapeutic vaccines and immunomodulators. Sourdough may be accept- able in certain patients, but cheeses such as gorgonzola are not. Other potentially helpful measures are wearing cotton underwear, avoid- ing pantyhose, and using mild nonperfumed soap to minimize the risk of allergy. Inhibition was due to hydrogen per- oxide and was trypsin-stable, heat-sensitive, and antagonized by catalase. Growth of probi- otics to restore gut flora is facilitated by prebiotics in the diet. Although correction of iron deficiency may be protective, excess iron supplementation may cause problems. In vitro, human milk 256 Part Two / Disease Management showed a potent inhibitory effect on growth of Candida organisms. Ueta E, Tanida T, Doi S, Osaki T: Regulation of Candida albicans growth and adhesion by saliva, J Lab Clin Med 136:66-73, 2000. Calderone R, Suzuki S, Cannon R, et al: Candida albicans: adherence, signaling and virulence, Med Mycol 38(suppl 1):125-37, 2000. Eaton K: Position statement on fungal-type dysbiosis, J Nutr Env Med 12:5-9, 2002. Cotter G, Kavanagh K: Adherence mechanisms of Candida albicans, Br J Biomed Sci 57:241-9, 2000. Ferrer J: Vaginal candidosis: epidemiological and etiological factors, Int J Gynaecol Obstet 71(suppl 1):S21-S27, 2000. Magliani W, Conti S, Cassone A, et al: New immunotherapeutic strategies to control vaginal candidiasis, Trends Mol Med 8:121-6, 2002. Weig M, Werner E, Frosch M, Kasper H: Limited effect of refined carbohydrate dietary supplementation on colonization of the gastrointestinal tract of healthy subjects by Candida albicans, Am J Clin Nutr 69:1170-3, 1999. Andersson Y, Lindquist S, Lagerqvist C, Hernell O: Lactoferrin is responsible for the fungistatic effect of human milk, Early Hum Dev 59:95-105, 2000. Mills S, Bone K: Principles and practice of phytotherapy, Edinburgh, 2000, Churchill Livingstone. Factors contributing to cataract formation include a family history, more than 22% body fat, central obesity, diabetes, dietary factors, and oxidative stress secondary to aging, smoking, and expo- sure to ultraviolet B light. Cataracts are located in the posterior subcapsular area, the superficial cortex, and the center of the lens (nuclear cataract). Nuclear cataracts often cause myopia, and posterior subcapsular cataracts tend to be most noticeable in bright light. During oph- thalmoscopy, small cataracts appear as dark defects against the red reflex. Compared with normal lenses, cataracts contain less glutathione and high levels of hydrogen peroxide. Glutathione protects the lens by preventing oxidative damage from hydrogen peroxide and disulfide cross-linkage by maintaining sulfhydryl groups on proteins in their reduced form. By protect- ing sulfhydryl groups on proteins, which are important for active transport and membrane permeability, glutathione prevents increased permeability and protects the Na+/K+ adenosine triphosphatase–mediated active trans- port. These polyols cannot diffuse passively out of the lens and accumulate or are converted to fructose. The accumulation of polyols results in an osmotic gradient, which encourages diffusion of fluids from the aqueous humor. The water drags sodium with it, and swelling and electrolyte imbalance result in blurred vision. The reaction of lens proteins with sugars over time results in the formation of protein- bound advanced glycation end products. Glycoxidation products are formed from glucose by sequential glycation and auto-oxidation reactions. Flavonoids can bind to aldose reductase and inhibit polyol production; whereas avoidance of increased blood glucose, by reducing passive diffusion of glucose into the lens, can deplete the substrate for polyol production. Epidemiologic evi- dence suggests that it is prudent to consume diets high in vitamins C and E and carotenoids, particularly the xanthophylls. Regular consumption of spinach, kale, and broccoli also decreases the risk of cataracts. An increased risk of cataract formation was found in people with the highest intakes of butter, total fat, salt, and oil, with the exception of olive oil. Carotenoids may reduce the risk of posterior subcapsular cataracts in women who have never smoked. Observational studies have shown that regular users of vitamin E supple- ments may halve the risk of cataracts. In a longitudinal study researchers found that lens opacities were 30% less in regular users of a multiple vitamin, 57% less in regular users of supplemental vitamin E, and 42% less in those with higher plasma levels of vitamin E. A statistically significant relationship has been found between past vitamin E supplementation and prevention of cortical but not nuclear cataracts. Riboflavin and niacin supplements exert a weaker protec- tive influence on cortical cataracts. Folate 262 Part Two / Disease Management appears to be protective against nuclear cataracts, whereas both folate and vitamin B12 supplements are strongly protective against cortical cataracts. Despite data from experimental and observational studies suggesting that micronutrients with antioxidant capabilities may retard the development of age-related cataracts, overall, results of prospective trials have been disap- pointing. An uncontrolled clinical trial suggested that up to 1 g of vitamin C daily com- bined with riboflavin, 15 to 25 mg/day, and zinc, 30 mg/day, decreased the risk of senile cataracts. Diabetic cataracts are the result of prolonged sorbitol accumulation, oxidation and glycation. Flavonoids, particularly quercetin and its derivatives, are potent inhibitors of aldose reductase. Lipoic acid, with its potent antioxidant effect, may protect both vitamin C and E and reduce the risk of cataract for- mation in these patients.
This process can be fully or partially reduced by using a suitable cultivation system discount antabuse online visa medications or drugs. Proliferation purchase generic antabuse pills medications via g-tube, migration purchase antabuse 250 mg with amex pretreatment, differentiation and apoptosis are in vivo regulated with reciprocal cells interactions and extracellular matrix, through various signal molecules (e. Under in vitro conditions previous processes are regulated only by the autocrinne and paracrine regulation, which limits the use of cell and tissue cultures. For this reason a special culture media are used, which are enriched by various exogenous factors (e. The last important factor in the biology of cultured cells is their energetic metabolism. In most cultivation systems main source of energy is anaerobic glycolysis, which can operate without the presence of atmospheric oxygen. Source of carbon is amino acids, mostly glutamine, dipeptides glutamyl–alanine and glutamyl–glycine. Precondition for eukaryotic cells of multicellular organisms cultivation is creating conditions that imitate the environment in the organism. The important factor is ensurance of appropriate culture conditions: • sterility – prevents contamination of cultures by viruses, bacteria or fungi. Sterilization of the working place, materials, tools and solutions is necessary (hot air sterilization, autoclave, filtration, ionizing radiation, etc. The temperature is ensured by using special culture boxes – incubators; • pH – the optimum concentration of hydrogen ions in the range 7. In some cases, the substrate itself is also the culture medium (suspension cultures). When cultured cells reach to approximately 80% of confluence (confluent layer), a passage is necessary – harvesting of the cell population and its transfer to the new cultivation dishes. Passaging runs in four steps – releasing the cells from the cultivation surface (substrate), mechanically by scraping or enzymatically by trypsin; inactivation of trypsin by adding serum containing antitrypsin; re-suspension in fresh culture medium and finally platting cell suspension into new culture vessels. In regard to the duration of cultivation short and long term primary cultures are recognized. The population of cells derived from the primary culture by passaging is called cell line. After reaching 50 passages, if the culture has still the ability for further cultivation (other passages) it is called stabilized (immortalized) cell line (e. These cultures can be also obtained by the transformation of cells by various viruses (e. In virology the cell culture are used as a culture environment for virus multiplication, titration and identification. It is also used in the preparation of vaccines and monitoring of cytopathic effect depending on the type and concentration of the virions (titer) of virus. In experimental oncology in vitro cell lines are commonly prepared from biopsies of patients who suffer from cancer for testing sensitivity or resistance of cancer cells to cytostatics. In gynecology and obstetrics, in vitro cultivation is used for ova for in vitro fertilization. In the last few years, cell cultivation is applied also for the therapeutic purposes. A new bio-medical branch – tissue engineering has been developed, which widely uses the techniques of cell and tissue cultivation. The aim of the tissue engineering is to create a functional anatomical unit (graft) suitable for the application in regenerative and reconstructive medicine. Nowadays tissue engineering is being successful not only in preparation of functional skin substitutes (used for the burned skin) but also cartilage (e. Relationship between microorganism and macroorganism Single-cellular and multi-cellular organisms relate to each other in very complicated relationships which can seriously influence their vital manifestations. According to mutual influence the following types of relationships between microorganisms (viruses, bacterias, and protozoa) and macroorganisms (human) are distinguished: • indifferent – most of these organisms live outside of the human body, which is not their host. For example phytotropic viruses (multiplicated in plants) don‘t parasite in animal and human bodies; • symbiotes and commensals do live on the surface and cavities of the human body. They are necessary for a proper functioning of the human organism, forming biocoenoses and are named as “human flora”. They mainly involve bacteria as Staphylococcus epidermidis on the skin, Streptococcus salivarius in the mouth cavity, Escherichia coli in the intestine and Lactobacillus doederleini in the vagina. In biocoenosis – under normal condition – proportional ratio of microorganism phyla and species is balanced and dominant species (symbiont or commensal) makes conditions, that are suitable for it and our organism (sc. When their living conditions are disturbed, for example by antibiotics, dominant microbe is weakened – the dysmicrobiotia can develop. It means the overgrowth of other (ordinarily suppressed by dominant symbiotic bacteria) pathogenic microorganisms with the pathological side effects. The commonly dymicrobiotias are digestion problems (obstipations or diarrhea) or the development of candidosis in the vagina, potentially in the mouth cavity (soor); • pathogenic microorganisms cause inflammatory diseases. They use the macroorganism as a source of nutrition and an environment where they are relatively safe. The ability to cause a disease is called pathogenic and it is a characteristic of the species or phyla of microorganisms. The level of pathogenecity of a specific phyla for certain a host is called virulence. Besides the virulence, the development of a disease and its course also depends on the immunity (protection mechanism) of the infected host, for example a human. Obligatory pathogens cause a disease after the first infection (primo-infection) almost in all people (e. Staphylococcus aureus, Vibrio cholerae, Salmonella typhi, plasmodia, trypanosomes etc. This is enabled by their genetic predisposition and the unreadiness of the immunity system of the host. Opportune pathogens cause a disease if they get to a place in the organism where the body isn’t able to tolerate them (for example E. From a epidemiological point of view, to understand the spread of pathogens (mainly parasitic elements) it is important to recognize the term infestation. It informs about the proportion of the population (in %) which has specific antibodies against certain pathogen (parasite). Only some of them reach the size of several or a hundred micrometres (for example Thiomargarita namibiensis). They are present in two main shapes – globular, spherical to ovoid (coccus) and rod to thread- like (bacillus). If they are in pairs we label them as diplococcus, if in four tetracoccus, if they are more then eight they assemble as sarcina. The streptococcus assembles into a chain (the layout of the cocci depends on the number of plains where division takes place) (Fig. The second major form of bacteria is the shape of a simple rod named as bacillus (Fig. Sometimes they reproduce parasexually (conjugation), or by other forms of recombination of genomes.