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Human population growth and urbanization have accelerated dramatically in recent centuries, providing unprecedented opportunities for microbes that use our bodies as vehicles for their own propagation and transmission. These conditions have led to the emergence of virulent new pathogens and the increased prevalence of “classic” scourges, such as Mycobacterium tuberculosis. This tenacious microbe is transmitted via infectious aerosols produced by individuals with pulmonary tuberculosis. Infection is lifelong and symptomatic tuberculosis may develop following a period of clinical latency lasting for months, years, or decades. The first part of this lecture provides an overview of the natural history of TB infection and the global impact of TB on human health. Tuberculosis remains one of the most important causes of human disease and death despite the introduction of vaccination in 1921 and chemotherapy in 1952. Although these interventions are inexpensive and widely available their impact is limited. The effectiveness of vaccination is unclear; in clinical trials, the protection conferred by vaccination has been variable and generally poor. Although chemotherapy can be highly effective, multiple drugs must be administered for 6-9 months to provide a reliable cure; the majority of tuberculosis patients are unable or unwilling to complete such a demanding regimen unless closely supervised. The second part of this lecture will discuss the challenges facing development of more effective vaccines and drugs for prevention and treatment of tuberculosis. The principal obstacle to successful treatment of tuberculosis is the lengthy duration of current regimens, which require administration of multiple drugs for 6-9 months. The requirement for prolonged therapy is attributed to sub-populations of bacillary “persisters” that are refractory to antimicrobials. The persisters are not drug-resistant in the conventional (heritable) sense and it is a mystery why they are spared whilst their genetically identical siblings are killed. The third part of this lecture describes recent work in our laboratory using microfluidics and time-lapse microscopy to analyze the behavior of drug-stressed bacteria at single-cell resolution. These studies challenge conventional views of how antimicrobials kill (or fail to kill) bacteria. All pathogens must acquire and assimilate nutrients from their hosts in order to grow and multiply — our tissues are literally their food — yet surprisingly little is known about this fundamental aspect of the pathogenic lifestyle. Accumulating evidence suggests that M. tuberculosis might utilize fatty acids as its principal carbon and energy source during infection. The fourth part of this lecture describes work in our laboratory that is focused on identifying the metabolic pathways that are essential for growth and persistence of M. tuberculosis in vivo. Some of these pathways are potentially interesting targets for antimicrobial drug development, as they are not found in human cells.
- Subjects:
- Public Health and Health Sciecnes
- Keywords:
- Tuberculosis Public health
- Resource Type:
- Video
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Video
What if we incentivized doctors to keep us healthy instead of paying them only when we're already sick? Matthias Müllenbeck explains how this radical shift from a sick care system to a true health care system could save us from unnecessary costs and risky procedures -- and keep us healthier for longer.
- Subjects:
- Management of Health Care Services and Public Health
- Keywords:
- Medical care Medical economics Medical care Cost of
- Resource Type:
- Video
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Video
Karen DeSalvo, the chief health officer at Google, explains the partnership between big tech and public health in slowing the spread of COVID-19 -- and discusses a new contact tracing technology recently rolled out by Google and Apple that aims to ease the burden on health workers and provide scientists critical time to create a vaccine.
- Subjects:
- Public Health and Health Technology and Informatics
- Keywords:
- Contact tracing (Epidemiology) COVID-19 (Disease) -- Prevention
- Resource Type:
- Video
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Video
How can Africa, a continent that has 54% of the world's communicable diseases but only 2% of the world's doctors, develop a healthcare system that is both efficient and effective? Healthcare consultant Mathieu Lamiuex believes emerging economies could outperform developed nations' healthcare systems by "leapfrogging" over their inefficiencies and deeply embedded mistakes. By creating an innovative and adaptive system based on modern innovations, Lamiuex believes we could do much more with much less.
- Subjects:
- Public Health and Management of Health Care Services
- Keywords:
- Medical care -- Africa
- Resource Type:
- Video
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Video
How does your genetic inheritance, culture and history influence your health? Biological anthropologist Lara Durgavich discusses the field of evolutionary medicine as a gateway to understanding the quirks of human biology -- including why a genetic mutation can sometimes have beneficial effects -- and emphasizes how unraveling your own evolutionary past could glean insights into your current and future health.
- Subjects:
- Health Sciences, Public Health, and Human Biology
- Keywords:
- Human genetics Health
- Resource Type:
- Video