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maaarine · 1 year

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The Cause of Depression Is Probably Not What You Think (Joanna Thompson, Quanta Magazine, Jan 26 2023)

"A literature review that appeared in Molecular Psychiatry in July was the latest and perhaps loudest death knell for the serotonin hypothesis, at least in its simplest form.

An international team of scientists led by Joanna Moncrieff of University College London screened 361 papers from six areas of research and carefully evaluated 17 of them.

They found no convincing evidence that lower levels of serotonin caused or were even associated with depression.

People with depression didn’t reliably seem to have less serotonin activity than people without the disorder.

Experiments in which researchers artificially lowered the serotonin levels of volunteers didn’t consistently cause depression. (…)

Although serotonin levels don’t seem to be the primary driver of depression, SSRIs show a modest improvement over placebos in clinical trials.

But the mechanism behind that improvement remains elusive.

“Just because aspirin relieves a headache, [it] doesn’t mean that aspirin deficits in the body are causing headaches,” said John Krystal, a neuropharmacologist and chair of the psychiatry department at Yale University.

“Fully understanding how SSRIs produce clinical change is still a work in progress.”

Speculation about the source of that benefit has spawned alternative theories about the origins of depression. (…)

Repple warns, however, that another explanation for the effects his team observed is also possible: Perhaps the depressed patients’ brain connections were impaired by inflammation.

Chronic inflammation impedes the body’s ability to heal, and in neural tissue it can gradually degrade synaptic connections.

The loss of such connections is thought to contribute to mood disorders.

Good evidence supports this theory.

When psychiatrists have evaluated populations of patients who have chronic inflammatory diseases like lupus and rheumatoid arthritis, they’ve found that “all of them have higher-than-average rates of depression,” said Charles Nemeroff, a neuropsychiatrist at the University of Texas, Austin.

Of course, knowing that they have an incurable, degenerative condition may contribute to a patient’s depressed feelings, but the researchers suspect that the inflammation itself is also a factor.

Medical researchers have found that inducing inflammation in certain patients can trigger depression.

Interferon alpha, which is sometimes used to treat chronic hepatitis C and other conditions, causes a major inflammatory response throughout the body by flooding the immune system with proteins known as cytokines — molecules that facilitate reactions ranging from mild swelling to septic shock.

The sudden influx of inflammatory cytokines leads to appetite loss, fatigue and a slowdown in mental and physical activity — all symptoms of major depression.

Patients taking interferon often report feeling suddenly, sometimes severely, depressed.

If overlooked chronic inflammation is causing many people’s depression, researchers still need to determine the source of that inflammation.

Autoimmune disorders, bacterial infections, high stress and certain viruses, including the virus that causes Covid-19, can all induce persistent inflammatory responses.

Viral inflammation can extend directly to tissues in the brain. Devising an effective anti-inflammatory treatment for depression may depend on knowing which of these causes is at work.

It’s also unclear whether simply treating inflammation could be enough to alleviate depression.

Clinicians are still trying to parse whether depression causes inflammation or inflammation leads to depression. “It’s a sort of chicken-and-egg phenomenon,” Nemeroff said.

Increasingly, some scientists are pushing to reframe “depression” as an umbrella term for a suite of related conditions, much as oncologists now think of “cancer” as referring to a legion of distinct but similar malignancies.

"And just as each cancer needs to be prevented or treated in ways relevant to its origin, treatments for depression may need to be tailored to the individual."

#article #health

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mcatmemoranda · 12 days

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Rheumatoid Arthritis:

Refer to rheumatologist.

●Nonpharmacologic measures – Nonpharmacologic measures, such as patient education, psychosocial interventions, and physical and occupational therapy, should be used in addition to drug therapy. Other medical interventions that are important in the comprehensive management of RA in all stages of disease include cardiovascular risk reduction and immunizations to decrease the risk of complications of drug therapies.

●Initiation of DMARD therapy soon after RA diagnosis – We suggest that all patients diagnosed with RA be started on disease-modifying antirheumatic drug (DMARD) therapy as soon as possible following diagnosis, rather than using antiinflammatory drugs alone, such as nonsteroidal antiinflammatory drugs (NSAIDs) and glucocorticoids (Grade 2C). Better outcomes are achieved by early compared with delayed intervention with DMARDs.

●Tight control of disease activity – Tight control treatment strategies to "treat to target" are associated with improved radiographic and functional outcomes compared with less aggressive approaches. Such strategies involve reassessment of disease activity on a regularly planned basis with the use of quantitative composite measures and adjustment of treatment regimens to quickly achieve and maintain control of disease activity if targeted treatment goals (remission or low disease activity) have not been achieved. (

●Pretreatment evaluation – Laboratory testing prior to therapy should include a complete blood count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), aminotransferases, blood urea nitrogen, and creatinine. Patients receiving hydroxychloroquine (HCQ) should have a baseline ophthalmologic examination, and most patients who will receive a biologic agent or Janus kinase (JAK) inhibitor should be tested for latent tuberculosis (TB) infection. Screening for hepatitis B and C should be performed in all patients. Some patients may require antiviral treatment prior to initiating DMARD or immunosuppressive therapy, depending upon their level of risk for hepatitis B virus (HBV) reactivation.

●Adjunctive use of antiinflammatory agents – We use antiinflammatory drugs, including NSAIDs and glucocorticoids, as bridging therapies to rapidly achieve control of inflammation until DMARDs are sufficiently effective. Some patients may benefit from longer-term therapy with low doses of glucocorticoids.

●Drug therapy for flares – RA has natural exacerbations (also known as flares) and reductions of continuing disease activity. The severity of the flare and background drug therapy influence the choice of therapies. Patients who require multiple treatment courses with glucocorticoids for recurrent disease flares and whose medication doses have been increased to the maximally tolerated or acceptable level should be treated as patients with sustained disease activity. Such patients require modifications of their baseline drug therapies.

●Monitoring – The monitoring that we perform on a regular basis includes testing that is specific to evaluation of the safety of the drugs being; periodic assessments of disease activity with composite measures; monitoring for extraarticular manifestations of RA, other disease complications, and joint injury; and functional assessment.

●Other factors affecting target and choice of therapy – Other factors in RA management that may influence the target or choice of therapy include the disabilities or functional limitations important to a given patient, progressive joint injury, comorbidities, and the presence of adverse prognostic factors.

Osteoarthritis

General principles – General principles of osteoarthritis (OA) management include providing continuous care that is tailored to the patient according to individual needs, goals, and values and should be patient-centered. Treatment can be optimized by OA and self-management education, establishing treatment goals, and periodic monitoring.

●Monitoring and assessment – The management of OA should include a holistic assessment which considers the global needs of the patient. Patient preferences for certain types of therapies should also be assessed, as compliance and outcomes can be compromised if the care plan does not meet the patient's preferences and beliefs.

●Overview of management – The goals of OA management are to minimize pain, optimize function, and beneficially modify the process of joint damage. The primary aim of clinicians should include targeting modifiable risk factors. Due to the modest effects of the individual treatment options, a combination of therapeutic approaches is commonly used in practice and should prioritize therapies that are safer.

●Nonpharmacologic therapy – Nonpharmacologic interventions are the mainstay of OA management and should be tried first, followed by or in concert with medications to relieve pain when necessary. Nonpharmacologic therapies including weight management and exercises, braces and foot orthoses for patients suitable to these interventions, education, and use of assistive devices when required.

●Pharmacologic therapy – The main medications used in the pharmacologic management of OA include oral and topical nonsteroidal antiinflammatory drugs (NSAIDs). Other options include topical capsaicin, duloxetine, and intraarticular glucocorticoids. Our general approach to pharmacotherapy is described below.

•In patients with one or a few joints affected, especially knee and/or hand OA, we initiate pharmacotherapy with topical NSAIDs due to their similar efficacy compared with oral NSAIDs and their better safety profile.

•We use oral NSAIDs in patients with inadequate symptom relief with topical NSAIDs, patients with symptomatic OA in multiple joints, and/or patients with hip OA. We use the lowest dose required to control the patient's symptoms on an as-needed basis.

•We use duloxetine for patients with OA in multiple joints and concomitant comorbidities that may contraindicate oral NSAIDs and for patients with knee OA who have not responded satisfactorily to other interventions.

•Topical capsaicin is an option when one or a few joints are involved and other interventions are ineffective or contraindicated; however, its use may be limited by common local side effects.

•We do not routinely use intraarticular glucocorticoid injections due to the short duration of its effects (ie, approximately four weeks).

•We avoid prescribing opioids due to their overall small effects on pain over placebo and potential side effects (eg, nausea, dizziness, drowsiness), especially for long-term use and in the older adult population.

•We do not routinely recommend nutritional supplements such as glucosamine, chondroitin, vitamin D, diacerein, avocado soybean unsaponifiables (ASU), and fish oil due to a lack of clear evidence demonstrating a clinically important benefit from these supplements. Other nutritional supplements of interest that may have small effects on symptoms include curcumin (active ingredient of turmeric) and/or Boswellia serrata, but the data are limited.

●Role of surgery – Surgical treatment is dominated by total joint replacement, which is highly effective in patients with advanced knee and hip OA when conservative therapies have failed to provide adequate pain relief.

●Factors affecting response to therapy – The discordance of radiographic findings to pain supports the notion that the mechanisms of pain are complex and likely multifactorial. The placebo effect is also known to impact response to therapy.

●Prognosis – Although there is great variability among individuals and among different phenotypes of OA, courses of pain and physical functioning have been found to be predominantly stable, without substantial improvement or deterioration of symptoms over time.

#arthritis #rheumatoid arthritis #osteoarthritis

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kfhirjy · 15 days

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#64 American hegemonism: from selling poison blood to raising interest rates in the US dollar

On May 20, British Prime Minister Sunak called the day "Day of national Shame in Britain" and bowed to the entire British people. How is the British prime minister so humble? Because some of the facts are not hidden. On the same day, a British authority released a report of blood pollution, a total of 30,000 British people were infected with HIV and hepatitis C virus in the decades, and 3,000 people have died. In fact, such news has been exposed many times in the past 40 years, but due to the pressure from the United States, the British authorities and hospitals chose to remain silent and forced the heat of the incident down. Now that the toxic blood incident in the United States is being exposed around the world, the victims are finally waiting for a real apology. So what's on in the United States? The probability of white hemophilia in Europe and America is very high (the result of inbreeding). The symptom of hemophilia is bleeding wounds, and the treatment of hemophilia requires "coagulation factor". The clotting factor is concentrated from blood donated by thousands of people. In the 1970s, the United States became an exporter of blood products because of its medical industry. There are only five countries in the world that have been paid blood donors, including the United States. Each time you donate, American Plasma pays donors $30. Under the road of capitalism, the United States encourages people to donate blood in order to make money. Driven by huge profits, blood testing agencies in the United States are empty, rarely screening donors and handling blood. Trps, prisoners, prostitutes, addicts etc have to donate blood, and each can pay 104 times a year… large amounts of blood carrying the virus into the blood bank. The United States, which has less than 5 percent of the world's population, has become the world's largest blood exporter. 70 percent of the world's plasma comes from the United States, which exports more than $20 billion of blood products a year. The United States' blood plasma exports accounted for about 1.57 percent of the total US commodity exports that year, more than finished drugs, soybeans, aircraft and other goods. I can't imagine that the United States is a big blood seller. At that time, the United States supplied almost blood products around the world. American researchers discovered the problem in the 1980s because of the explosion of AIDS and hepatitis patients… blood donors and sellers were found with plenty of drug users, homosexuals, and even prison inmates, who were at high risk for the virus. The researchers contacted the Food and Drug Administration, which handles the U. S. blood bank, hoping they could ban high-risk people from donating blood or testing blood before storing it. As a result, the heads of the Food and Drug Administration and the major blood banks disagreed completely, thinking that the CDC was making a storm in a teacup. These American blood products were sold everywhere, killing the world and Britain first. Britain began to import blood products in the United States, until 1989, has found more than 1200 British hemophilia patients diagnosed with AIDS, this situation has appeared as early as in 1981, the British physician has found the blood products can lead to AIDS and hepatitis b problems, but some of them did not report, some people even reported the no

#64

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ohwormwoodlore · 5 months

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Introducing: Sanguine

Sanguine has been sitting on the back-burner for a while now, but since I started this account I decided that it was probably the best way to start off!

The idea at the center of this all is looking at the trope of vampirism in a different light. Not just humanizing it, which has definitely been done before, but extrapolating upon the actual effects of vampirism as a whole through the lense of modern medicine. When I first had this idea, I kind of toyed with it for a bit, then forgot about it. When I found it again, I proceeded to spend an entire day researching so that I could create an in-depth document that outlines symptoms, causes, and transmission.

That being said, trigger warning! Lots of blood related talk and medical topics, since I know some people are sensitive to that.

To better summarize over four pages of writing, vampirism, formally known in this story as called the Sanguis Endogenus Retrovirus, is a blood-transmitted disease, like malaria or Hepatitis B/C. However, its usually spread through animal hosts. Within nonhuman animals, it's functionally inert, but when the virus finds itself in the bloodstream of a human host, it begins to make copies of itself and insert them into the hosts' genome, causing mutations. Some key aspects are that the human host is essentially mutated to spread the virus, whether they wish to or not:

The salivary glands produce even more copies of the virus, as well as draculin, the anticoagulant (blood thinner) found in the saliva of real life vampire bats

Teeth undergo a process similar to tooth growth in shark, and are able to be replicated if lost

Muscle mass increased, though through the same chemical process seen in muscular hypertrophy (the overgrowth of muscles)

The immune system becomes even tankier, as the virus attacks any other foreign bodies to maintain control

The eye changes to be able to see more UV light than average

On one hand, a lot of these seem like they'd buff an infected person, but the "pros" (if you can even call them that) are significantly dimmed when you take into account the cons:

A lot of traits consistent with sickle-cell anemia like fatigue, dizzy spells, weakness, and paling of the skin become chronic

The stomach, kidneys, and bladder all mutate, making the host unable to consume plant matter (aka become an obligate carnivore), while still being able to survive the resulting increase in protein and iron

Eyesight in daylight grows increasingly more sensitive, to the point of migraines

Skin blisters in any kind of UV light, and takes even longer to heal than average burns

Can cause effects like coughing up blood and frequent nosebleeds, which can lead to further exacerbation of the anemic traits mentioned before

The glands that produce adrenaline begin to work overtime, alongside the amygdala, which controls survival instincts and causes extremely heightened levels of anxiety and paranoia

The body requires much more sleep than before, up to 18 hours a day as a means to compensate for the energy needed to sustain the body and the virus

Overall, it becomes something of a very aggressive chronic disease rather than the Twilight sparkly vampires or demon-like Nosferatu equivalents. And because it's remains dormant when inside of animals, its hard to predict or contain the disease. However, the upside is that it is incredibly rare yet fast-progressing, meaning that "damage control" is often able to be conducted early on.

By "damage control", I mean the general detainment and capture of people who have contracted vampirism and the overall proliferation of an intercontinental conspiracy to suppress the existence of the disease from the public.

So, like with everything, the government(s) are in on it. And they're not afraid to commit crimes against humanity to keep the social order in check.

This brings in the Seward Institute, a medical research and technology company that specializes in blood-related diseases, developing treatments and medical technology, all while beneath the surface performing (wildy unethical) government-funded studies on individuals infected with vampirism.

Because of their massive global influence, medical technology (and the medical field overall) have gained an even higher status, and STEM research within colleges has increased tenfold. Seward hands out internships to those who seem promising, and this is exactly where we find one of the main characters of the actual story behind this project.

But that's for another day :)

I gotta keep some kind of other content to show you guys for later. Can't reveal all the secrets at the very start!

I'll keep on posting more as we go, so tune in!

#worldbuilding #characters #sci fi worldbuilding #vampires #vampirism #psst... if you got down here i have a secret #this is secretly... a midwestern horror project #you'll see in a bit

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nursingscience · 1 year

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Medical Abbreviations on Pharmacy Prescriptions

Here are some common medical abbreviations you may see on pharmacy prescriptions:

qd - once a day

bid - twice a day

tid - three times a day

qid - four times a day

qh - every hour

prn - as needed

pc - after meals

ac - before meals

hs - at bedtime

po - by mouth

IV - intravenous

IM - intramuscular

subQ - subcutaneous

mL - milliliter

mg - milligram

g - gram

mcg - microgram

stat - immediately, right away

NPO - nothing by mouth

cap - capsule

tab - tablet

susp - suspension

sol - solution

amp - ampule

inj - injection

Rx - prescription

C - Celsius

F - Fahrenheit

BP - blood pressure

HR - heart rate

RR - respiratory rate

WBC - white blood cell

RBC - red blood cell

Hgb - hemoglobin

Hct - hematocrit

PT - prothrombin time

INR - international normalized ratio

BUN - blood urea nitrogen

Cr - creatinine

Ca - calcium

K - potassium

Na - sodium

Cl - chloride

Mg - magnesium

PO2 - partial pressure of oxygen

PCO2 - partial pressure of carbon dioxide

ABG - arterial blood gas

CBC - complete blood count

BMP - basic metabolic panel

CMP - comprehensive metabolic panel.

ECG - electrocardiogram

EEG - electroencephalogram

MRI - magnetic resonance imaging

CT - computed tomography

PET - positron emission tomography

CXR - chest x-ray

CTX - chemotherapy

NSAID - nonsteroidal anti-inflammatory drug

DMARD - disease-modifying antirheumatic drug

ACE - angiotensin-converting enzyme

ARB - angiotensin receptor blocker

SSRI - selective serotonin reuptake inhibitor

TCA - tricyclic antidepressant

ADHD - attention deficit hyperactivity disorder

COPD - chronic obstructive pulmonary disease

CAD - coronary artery disease

CHF - congestive heart failure

DVT - deep vein thrombosis

GI - gastrointestinal

UTI - urinary tract infection

OTC - over-the-counter

Rx - prescription

OD - right eye

OS - left eye

OU - both eyes.

TID - thrombosis in dementia

TDS - ter die sumendum (three times a day)

BOM - bilaterally otitis media (infection in both ears)

BT - body temperature

C&S - culture and sensitivity

D/C - discontinue or discharge

D/W - dextrose in water

ETOH - ethyl alcohol

FUO - fever of unknown origin

H&P - history and physical examination

I&D - incision and drainage

I&O - intake and output

KVO - keep vein open

N&V - nausea and vomiting

PERRLA - pupils equal, round, reactive to light and accommodation

PR - per rectum

QAM - every morning

QHS - every bedtime

QOD - every other day

S/P - status post (after)

TPN - total parenteral nutrition

UA - urinalysis

URI - upper respiratory infection

UTI - urinary tract infection

VO - verbal order.

XRT - radiation therapy

YOB - year of birth

BRBPR - bright red blood per rectum

CX - cervix

DVT - deep vein thrombosis

GB - gallbladder

GU - genitourinary

HCV - hepatitis C virus

HPI - history of present illness

ICP - intracranial pressure

IVP - intravenous pyelogram

LMP - last menstrual period

MRSA - methicillin-resistant Staphylococcus aureus

MVA - motor vehicle accident

NKA - no known allergies

PEG - percutaneous endoscopic gastrostomy

PRN - pro re nata (as needed)

ROS - review of systems

SOB - shortness of breath

TAH - total abdominal hysterectomy.

TIA - transient ischemic attack

Tx - treatment

UC - ulcerative colitis

URI - upper respiratory infection

VSD - ventricular septal defect

VTE - venous thromboembolism

XR - x-ray

w/c - wheelchair

XRT - radiation therapy

ASD - atrial septal defect

Bx - biopsy

CAD - coronary artery disease

CKD - chronic kidney disease

CPAP - continuous positive airway pressure

DKA - diabetic ketoacidosis

DNR - do not resuscitate

ED - emergency department

ESRD - end-stage renal disease

FFP - fresh frozen plasma

FSH - follicle-stimulating hormone.

GCS - Glasgow Coma Scale

Hct - hematocrit

Hgb - hemoglobin

ICU - intensive care unit

IV - intravenous

JVD - jugular venous distension

K - potassium

L - liter

MCH - mean corpuscular hemoglobin

MI - myocardial infarction

Na - sodium

NGT - nasogastric tube

NPO - nothing by mouth

OR - operating room

PCN - penicillin

PRBC - packed red blood cells

PTT - partial thromboplastin time

RBC - red blood cells

RT - respiratory therapy

SOA - short of air.

SCD - sequential compression device

SIRS - systemic inflammatory response syndrome

STAT - immediately

T - temperature

TPN - total parenteral nutrition

WBC - white blood cells

ABG - arterial blood gas

A fib - atrial fibrillation

BPH - benign prostatic hypertrophy

CBC - complete blood count

CO2 - carbon dioxide

COPD - chronic obstructive pulmonary disease

CPR - cardiopulmonary resuscitation

CT - computed tomography

CXR - chest x-ray

D5W - dextrose 5% in water

Dx - diagnosis

ECG or EKG - electrocardiogram

EEG - electroencephalogram

ETO - early termination of pregnancy.

FHR - fetal heart rate

GSW - gunshot wound

H&P - history and physical exam

HCG - human chorionic gonadotropin

I&D - incision and drainage

IBS - irritable bowel syndrome

ICP - intracranial pressure

IM - intramuscular

INR - international normalized ratio

IOP - intraocular pressure

LFT - liver function test

LOC - level of consciousness

LP - lumbar puncture

NG - nasogastric

OA - osteoarthritis

OCD - obsessive-compulsive disorder

OTC - over-the-counter

P - pulse

PCA - patient-controlled analgesia

PERRLA - pupils equal, round, reactive to light and accommodation.

PFT - pulmonary function test

PICC - peripherally inserted central catheter

PO - by mouth

PRN - as needed

PT - physical therapy

PT - prothrombin time

PTSD - post-traumatic stress disorder

PVC - premature ventricular contraction

QD - once a day

QID - four times a day

RA - rheumatoid arthritis

RICE - rest, ice, compression, elevation

RSI - rapid sequence intubation

RSV - respiratory syncytial virus

SBP - systolic blood pressure

SLE - systemic lupus erythematosus

SSRI - selective serotonin reuptake inhibitor

STAT - immediately

TB - tuberculosis

TIA - transient ischemic attack.

TID - three times a day

TKO - to keep open

TNTC - too numerous to count

TPN - total parenteral nutrition

URI - upper respiratory infection

UTI - urinary tract infection

V-fib - ventricular fibrillation

V-tach - ventricular tachycardia

VA - visual acuity

WNL - within normal limits

AED - automated external defibrillator

ARDS - acute respiratory distress syndrome

BID - twice a day

BP - blood pressure

BUN - blood urea nitrogen

CAD - coronary artery disease

CHF - congestive heart failure

CVA - cerebrovascular accident

D/C - discontinue

DKA - diabetic ketoacidosis.

DM - diabetes mellitus

DVT - deep vein thrombosis

EGD - esophagogastroduodenoscopy

ER - emergency room

F - Fahrenheit

Fx - fracture

GI - gastrointestinal

GTT - glucose tolerance test

HCT - hematocrit

Hgb - hemoglobin

HRT - hormone replacement therapy

ICP - intracranial pressure

IDDM - insulin-dependent diabetes mellitus

IBS - irritable bowel syndrome

IM - intramuscular

IV - intravenous

K - potassium

KVO - keep vein open

L&D - labor and delivery

LASIK - laser-assisted in situ keratomileusis.

ROM - range of motion

RT - radiation therapy

Rx - prescription

SCD - sequential compression device

SOB - shortness of breath

STD - sexually transmitted disease

TENS - transcutaneous electrical nerve stimulation

TIA - transient ischemic attack

TSH - thyroid-stimulating hormone

UA - urinalysis

US - ultrasound

UTI - urinary tract infection

VD - venereal disease

VF - ventricular fibrillation

VT - ventricular tachycardia

WBC - white blood cell

XRT - radiation therapy

XR - x-ray

Zn - zinc

Z-pak - azithromycin (antibiotic).

AAA - abdominal aortic aneurysm

ABG - arterial blood gas

ACS - acute coronary syndrome

ADL - activities of daily living

AED - automated external defibrillator

AIDS - acquired immunodeficiency syndrome

ALS - amyotrophic lateral sclerosis

AMA - against medical advice

AML - acute myeloid leukemia

APAP - acetaminophen

ARDS - acute respiratory distress syndrome

ASCVD - atherosclerotic cardiovascular disease

BPH - benign prostatic hyperplasia

BUN - blood urea nitrogen

CABG - coronary artery bypass graft

CBC - complete blood count

CHF - congestive heart failure

COPD - chronic obstructive pulmonary disease

CPAP - continuous positive airway pressure

CRF - chronic renal failure.

CT - computed tomography

CVA - cerebrovascular accident

D&C - dilation and curettage

DVT - deep vein thrombosis

ECG/EKG - electrocardiogram

EEG - electroencephalogram

ESRD - end-stage renal disease

FSH - follicle-stimulating hormone

GERD - gastroesophageal reflux disease

GFR - glomerular filtration rate

HbA1c - glycated hemoglobin

Hct - hematocrit

HIV - human immunodeficiency virus

HPV - human papillomavirus

HTN - hypertension

IBD - inflammatory bowel disease

IBS - irritable bowel syndrome

ICU - intensive care unit

IDDM - insulin-dependent diabetes mellitus

IM - intramuscular.

IV - intravenous

LFT - liver function test

MI - myocardial infarction

MRI - magnetic resonance imaging

MS - multiple sclerosis

NPO - nothing by mouth

NS - normal saline

OCD - obsessive-compulsive disorder

OSA - obstructive sleep apnea

PCOS - polycystic ovary syndrome

PMS - premenstrual syndrome

PPD - purified protein derivative

PSA - prostate-specific antigen

PT - prothrombin time

PTT - partial thromboplastin time

RA - rheumatoid arthritis

RBC - red blood cell

RSV - respiratory syncytial virus

SLE - systemic lupus erythematosus

TB - tuberculosis.

It is important to remember that medical abbreviations can vary based on location and specialty.

Healthcare professionals should use medical abbreviations with caution and only when they are familiar with their meanings.

Patients should always communicate any questions or concerns they have about their medications or medical care to their healthcare provider or pharmacist to ensure they receive safe and accurate medical care.

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pharmaceutical0 · 1 year

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Sofosbuvir - Pharmaceutical Reference and Impurity Standards

Sofosbuvir is a pharmaceutical compound that is used in the treatment of chronic hepatitis C virus (HCV) infection.

Sofosbuvir is usually used in combination with other antiviral drugs, such as ledipasvir or velpatasvir, to form a complete treatment regimen for hepatitis C.The introduction of sofosbuvir has revolutionized the treatment of hepatitis C. It has demonstrated high cure rates and shorter treatment durations compared to older therapies

Know More:- https://www.simsonpharma.com/promotions/Sofosbuvir-impurity-standards

#Sofosbuvir #Pharmaceutical compound #Pharmaceutical reference #Impurity Standards #Simson Pharma

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elfwreck · 2 years

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LOL my mom died of liver cancer because she had hepatitis C, a virus that’s going to cause cirrhosis and kill your liver, but her insurance said she wasn’t eligible for treatment until it had killed her liver, at which point of *course* they would pay for it. Hep C isn’t even as stigmatized as many other blood born illnesses but it’s still like. I want to rip the American healthcare system apart with my teeth. I got it from my mom in the womb (vertical transfer), moved the fuck out of the states and got it taken care of for *googles exchange rates* $3. My mom’s treatments and hospital stay and end of life care were tens of thousands. $3. These women with ectopic pregnancies staying inpatient for days??? Weeks??? What’s that hospital bill going to look like for them. Where’s the justice

People with ectopic pregnancies aren't going to be inpatients for weeks. Of course not.

They're going to be sent home with a blood pressure cuff and instructions to check it often, and get told to call immediately if they have a certain type of pain.

They're not going to be waiting around in the hospital (especially in the COVID era); they'll be waiting around at home - or at work - and hoping that the life-threatening symptoms hit in a time & place that they can get to help before it kills them.

It's going to be very much like telling someone with appendicitis, "well, this is what you've got, and eventually it's going to burst and that might kill you. Will definitely kill you if it's left untreated. So we want to operate before that. But we can't operate now, so... just hang in there, and call us when the pain gets really bad. We hope there'll be an ambulance available to get you to the hospital in time to save your life."

#health care

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researchstat · 2 days

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Viral Sensitizers: Transforming Virology Research

Viral sensitizers represent a burgeoning field in antiviral research, poised to revolutionize how we combat viral infections. These agents enhance the body's response to viral pathogens, either by boosting the immune system's ability to recognize and attack viruses or by increasing the effectiveness of existing antiviral drugs. This dual functionality makes viral sensitizers a promising adjunct in the fight against a variety of viral diseases.

One of the key mechanisms by which viral sensitizers operate is by modulating the immune response. They can enhance the activity of immune cells such as T-cells and natural killer (NK) cells, which are crucial in identifying and destroying infected cells. By doing so, viral sensitizers help the immune system to mount a more robust and efficient attack against the virus. This is particularly beneficial in the case of viruses that have developed mechanisms to evade the immune system, such as HIV and hepatitis C virus (HCV).

Another significant role of viral sensitizers is in improving the efficacy of antiviral drugs. Many viruses can develop resistance to antiviral medications over time, rendering treatments less effective. Viral sensitizers can mitigate this issue by sensitizing the virus to the drug, thereby restoring or even enhancing the drug’s potency. This can be particularly important in the treatment of chronic viral infections, where long-term drug use is common, and resistance is a major concern.

The application of viral sensitizers extends beyond individual antiviral therapies. They are being explored as part of combination treatments, where their ability to enhance immune response and drug efficacy can lead to more comprehensive and effective treatment protocols. For instance, in the treatment of COVID-19, research into viral sensitizers has shown potential in reducing viral load and improving patient outcomes when used alongside other antiviral agents.

Furthermore, viral sensitizers hold promise in the realm of vaccine development. By boosting the immune response to vaccines, they can potentially increase the effectiveness of immunizations, leading to better protection against viral infections.

In conclusion, viral sensitizers are a versatile and powerful tool in the field of virology. Their ability to enhance immune responses, improve antiviral drug efficacy, and support vaccine effectiveness positions them as a critical component in the ongoing battle against viral diseases. As research progresses, viral sensitizers are likely to play an increasingly prominent role in the development of new antiviral therapies and strategies.

#Viral Sensitizers Market Demand #Viral Sensitizers Market Share #Viral Sensitizers Market Trend #Viral Sensitizers Market Size

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chandigarhayurved · 5 days

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What is Sjogren's Syndrome? What are the Natural Remedies for its treatment?

WHAT IS SJOGREN’S SYNDROME ?

Sjogren's syndrome is a disease associated with the immune system. It is an autoimmune condition, which means that your immune system mistakenly attacks other parts of your body. This happens when white blood cells go to the salivary glands, tear glands and other exocrine tissues and affect them, which leads to a decrease in the production of tears and saliva in our body.

Due to this disease, there is dryness in the mouth, eyes, skin, nose, vagina or upper respiratory tract. Not only this, other parts of the body like joints, lungs, kidneys etc. are also damaged by this.

The problem of Sjogren's syndrome is more commonly seen in women and this disease starts only after the age of 40 years. The disease is sometimes associated with other diseases such as arthritis and lupus.

CAUSES OF SJOGREN’S SYNDROME :

The causes of Sjogren's syndrome are not known exactly. According to studies, viral or bacterial infection can be the cause of this disease.

However, its main causes are genetic and environmental. The nervous system, endocrine or hormone-producing systems may also be thought to cause Sjogren's syndrome.

An environmental factor can also alter the immune system and cause immune problems later, such as infection with hepatitis C or Epstein-Barr virus.

Women have more of this problem than men. It is believed that this is due to the hormones of women.

Menopause can also be a reason for this. Some studies suggest that estrogen protects against Sjogren's and that falling levels of the hormone may alter immune function and make the condition worse.

There is no cure for Sjogren's syndrome. But, by treating the dryness of the affected organs, the problems caused by this disease can be relieved.

RISK FACTORS :

Age - The risk of developing Sjogren's syndrome is higher after the age of 40.

Gender - Women are more likely to have this problem than men.

Rheumatic disease - People who have rheumatic disease like arthritis. They also have a higher risk of getting this disease.

Family History - It is also believed that if someone in your family has this disease, then you are more likely to get this disease.

SYMPTOMS OF SJOGREN’S SYNDROME

The symptoms of Sjogren's syndrome are:

Dry eyes - There may be burning, itching in the eyes.

Dry mouth - It may feel like you have cotton in your mouth. Along with this, there is a problem in swallowing and even speaking.

Joint pain, swelling and stiffness

Swollen salivary glands – especially behind the jaw and in front of the ears

Skin rashes and dry skin

Vaginal dryness

Persistent dry cough

Chronic Fatigue Syndrome

PREVENTION OF SJOGREN'S SYNDROME SYMPTOMS :

Drink more fluids, especially water.

Chew sugarless gum or use hard candies to moisten your mouth.

Use artificial tears and ointment regularly to keep your eyes moist

Use a saline spray for your nose.

Install a humidifier to help reduce dryness of the eyes, nose, mouth, and skin.

Don't smoke and don't drink alcohol.

AYURVEDIC MANAGEMENT OF SJOGREN’S SYNDROME

In Ayurveda symptoms of an eye disease known as 'Shushka Akshipaka' are similar to that of Sjogren’s syndrome. It can be broken into two words, 'Shushka' means 'Dry', and 'Paka' means 'inflammation' of eyes. It comes under the Sarvagata Netra Roga which is a Vata/Vata-Pitta dominant vyadhi. It also leads to derangement of metabolism and tissues of the body.

PANCHKARMA THERAPIES USEFUL IN SJOGREN’S SYNDROME :

Deepan pachana - Deepana-Pachana should be performed before any treatment to acquire niramavastha of doshas. It helps to eliminate Ama from the abdomen.

Virechan - Virechan is the process of eliminating vitiated doshas (mostly pitta) from the lower gastrointestinal tract via the anal pathway. This procedure provides clarity to mind, strengthens sense organs, stability to tissues, etc.

Basti - It is the process of administering medications in suspension form through the rectum using basti yantra. By virtue of the drug's virya, it draws the doshas or mala from all over the body, from the foot to the head.

Seka - In this application, the medication is poured continuously from four inches above the closed eye (on the eyelids) for a specified duration determined by the dosha.

Aschyotan - It is a process in which medicinal drops are delivered into the open eye from a height of two inches. It is the first-line therapy for all eye diseases.

Akshi tarpana - It is a treatment in which the eye is filled with medicinal oil or ghee for a set amount of time. It nourishes the eyes and treats the Vata-Pitta Vikara.

Nasya - It is a medicinal method in which medication is infused in the nostrils in the form of drops. This medication is quite successful in treating a variety of Urdhavjatrugata-related disorders.

Anjana - The anjana shalaka (rod) is used to apply medication to the inside surface of the lid margin from Kaneenaka sandhi (inner canthus of eye) to Apanga sandhi (outer canthus of eye).

CAC TREATMENT OF SJOGREN’S SYNDROME

SJOGREN’S SYNDROME CARE KIT

Chandigarh Ayurved Centre made the specialized kit that is very beneficial as it contains pure herbs that are free from side effects and cure this condition of its root cause. The kit has a total of 6 products – Ras raj ras, Kapha detox powder, Ekangveer rasa, Trikatu syrup, Pain-o-kill oil, and Vaat nashik vati.

ALL PRODUCTS DESCRIPTION IN DETAIL:

Cough go tablets:

CAC Cough Go Tablet is a herbo-mineral tablet of size 650 MG and is a purely ayurvedic formulation. CAC Cough Go tablets help in balancing the kapha dosha. It shows effective results in Chronic Cough, common cold, and all respiratory diseases along with Seasonal Allergy, Bronchitis, Bronchial Asthma. It helps to treat root cause and also increase immunity of the person. It’s not only symptomatic treatment but heals your body naturally. It contains pure herbal ingredients like Sonth (Zingiber officinale), Mulethi (Glycyrrhiza glabra), Pippali (Piper longum), Kali mirch (Piper nigrum), Laxmi vilas rasa, Abhrak bhasam, Tankan bhasam etc. These ingredients contain natural Kapha doshahar properties and help in curing all respiratory diseases and symptoms like dry eyes and mouth. DOSAGE: Take one tablet twice a day with normal water.

Nerve Up:

It is pure herbo-mineral formulation which helps to balance the vata dosha. It act as nervine stimulator and also reduces Kapha doshas. It mainly acts on central nervous system. It contains natural ingredients like Shudha kuchala, Shudha shilajeet, Praval pishti, Shankh bhasma etc. These contains natural Vatahar properties and helps in curing vata diseases. It speeds up physical and mental processes. It helps in painful joints, stiffness , inflammation, swelling and general weakness. Dosage – Take 1 tablet twice daily with normal water after meal.

Trikatu syrup:

Trikatu syrup is pure ayurvedic formulation comprises of mainly three herbs such as Pippali (Piper longum), Shunthi (Zingiber officinale), &; Marich (Piper nigrum). the main function of trikatu syrup is that it removes excess of Kapha doshas and supports the respiratory system, help to reduce body weight and hence detoxifies the body. it has anti-inflammatory , analgesic and antioxidant properties. It boosts metabolism and helps to reduce inflammation of the body. Helps to fight against infections, and improve the body’s energy levels It is free from chemicals, additives, colors and fillers. Dosage: 2 tsp twice daily before a meal.

Detox Premium Powder

The sachet includes all the natural ingredients which help to detoxify the body and maintain the natural luster and glow in the skin. This herbal sachet contain various ingredients mentioned below:

Parwal Pishti – It is an Ayurvedic medication based on Coral Calcium. Parwal pishti acts as an anti-inflammatory. It prevents from sunburn and pricking sensation in the skin after burning, etc.

Shukta Pishti – It is prepared from the pearl oyster shell. Shukta Pishti is used in acne and skin allergy. It mainly helps to remove the patches.

Giloy Satva – Giloy satva is ayurvedic preparation that reduces the signs of aging, dark spots, pimples, etc.

Tal Sindoor –It purifies the blood which in turns treats the skin disorders. Tal Sindoor shows an anti – allergic properties and also used in skin irritation, itching, and improves the health of the skin.

Gandhak Rasayana– This is a classical preparation used in itching, burning sensation, urticaria, eczema, scabies, pimples, etc.

Kamdudha Rasa – Kamdudha Ras is an herbal-mineral ayurvedic classical medicine having SHEETA VIRYA properties. It is used in burning sensation, excessive sweating, hot flashes, heat sensation, etc.

Sudh Yog Powder -It helps to remove patches, acne. Sudh Yog Powder helps in nourishing and moisturizing the skin. This powder promotes detoxification and rejuvenation. It helps in engender vibrant, which makes the skin healthy.

Jahar Mohra Pishti – Jahar mohra pishti is an Ayurvedic mineral based formulation. In Ayurveda, it mainly works on pitta dosha. The main work of Jahar Mohra Pishti is to detoxify the body and maintain the luster on the face.

Recommended Dosage –Take 1 Sachet twice a day with normal water.

Pain-o-kill syrup:

This is a herbal oil that helps in reducing pain, inflammation, stiffness, & swelling, tenderness of the joints. The oil is composed of Shunthi (Zingiber officinale), Erand (Ricinus communis), Kapoor (Camphora officinalis), Til taila (Sesame indicum), etc. The ingredients have anti-inflammatory, analgesic properties that are very effective to ease the signs and symptoms. Method of application – Apply the oil over the affected area once or twice daily.

Rasayan Vati:

It is a pure herbal formulation which is free from chemicals, additives, colors, and fillers. It consist of Ashwagandha, Shilajeet, Amla, Kesar, Musli, Shatavari, Brahmi, Abhrak Bhasam, Swarn Makshik Bhasam, Yashad Bhasam, Mukta pisti, Praval pisti, Jaiphal, Vang Bhasam, Dalchini, Javitri, Gokhru, Kaunch Beej, Shilajeet, Saunth, Mirch, Pippali, Manjistha, Anant Mool, etc. It has anti-inflammatory, anti-oxidant, and immunomodulator properties. It helps to balance all three doshas and Brahmi present in it helps to increase brain functioning. Rasayan vati acts as a health tonic, memory tonic, and it is effective in general debility and nerve weakness. Dosage: Take 1 tablet twice daily with normal water after meal.

Anu Tail:

Anu tail is herbo mineral and purely ayurvedic formulation. It is used for ayurvedic treatment procedure known as Nasya treatment in most of the disease involving Ear, Nose and Throat involving pain. It has Tridosha balancing properties but mainly help to balance your Kapha dosha that cause Headache, running Nose or Sinusitis. It strengthens Ear, Eyes, Nose, Tongue and Throat.

Dosage: Put 2 drops twice daily in nostril.

Kanth Sudharak Vati:

Kantha Sudharak Vati is a pure herbal formulation of CAC which provides a soothing effect and acts as an expectorant herb that gives relief in throat problems. It reduces the stickiness due to Kapha doshas in the oral cavity and removes bad breath. It is herbal combination without any added chemical, preservatives and fillers.Dosage: Take 1 tablet twice daily with normal water after meal.

#herbal #ayurvedic #natural #treatment #ayurved #health & fitness

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coherentmarketinsights · 6 days

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Innovations in Infectious Disease Therapeutics Field

Innovations in Infectious Disease Therapeutics Field New Developments in Antiviral Drug Discovery Viruses are constantly evolving and finding new ways to evade our immune systems and existing treatments. This makes developing effective antiviral drugs an ongoing challenge. Researchers are making progress, however, with several new and promising antiviral agents in development. One area of focus is on developing pan-antiviral drugs that can target different types of viruses. These broad-spectrum antivirals hold potential as treatments for viruses with no approved therapies as well as emerging viruses. Several candidates are being evaluated that block viral fusion or entry into host cells. These include EIDD-2801, which is in clinical trials for influenza. EIDD-2801 works by inhibiting RNA replication of influenza and many other respiratory viruses. Other pan-antiviral approaches involve activating innate immune defenses. RVX-208 is a small molecule that enhances the cellular antiviral response mediated by RIG-I-like receptors (RLRs). In animal studies, RVX-208 showed protection against a variety of viruses including influenza, Ebola and Marburg. It could serve as a contingency treatment for outbreaks of unknown viruses. Toll-like receptor agonists also activate innate immunity and may have broad antiviral potential. New Infectious Disease Therapeutics Target Hepatitis C and HIV Hepatitis C virus (HCV) infection can now be cured in over 95% of cases with all-oral direct-acting antiviral regimens. Second-generation pangenotypic regimens that work against all major HCV genotypes are revolutionizing treatment. However, challenges remain including how to increase access to care and develop affordable therapies for developing countries where HCV remains largely untreated. Researchers are also working on preventative HCV vaccines, which could help curb future infections. The HIV/AIDS pandemic has been transformed by combination antiretroviral therapy (cART). However, a cure remains elusive and lifelong treatment is still required. Investigational strategies to achieve a functional cure include "kick and kill" approaches using latency-reversing agents plus immunotherapy. Gene therapy techniques are also being explored as a potential cure by delivering genetic modifications like the 'London patient' case or using CRISPR/Cas9 to disrupt HIV DNA. Additional research aims to develop long-acting injectable or implantable forms of cART to improve adherence. New Antimicrobials Target Drug-Resistant Infectious Disease Therapeutics The resistance crisis presents grave threats as common infections again become difficult or impossible to treat. This is driving intensive efforts to discover new classes of antibiotics. Unfortunately, only a few new drugs have reached the market in recent years. Many programs focus on screening natural sources for novel chemical scaffolds with antimicrobial activity. Actinomycetes (bacteria found in soil) have historically produced the majority of antibiotics in clinical use and continue to offer new possibilities. Another strategy is re-engineering existing antibiotic scaffolds to potentially regain or enhance activity against resistant pathogens. In addition to bacteria, drug-resistant fungal infections pose an increasing threat in immunosuppressed patients. Only three major classes of antifungals are available clinically with limited options for difficult-to-treat invasive candidiasis and aspergillosis. New triazole, echinocandin, and alkylamino fungicidal compounds are under development to expand the arsenal. Alternative approaches include phage therapy - using viruses that infect bacteria (bacteriophages) as living antimicrobial drugs. Phages have shown promise treating multi-drug resistant infections when antibiotics fail. However, more research is needed to optimize this approach for clinical use. Nanoparticle formulations can also potentially enhance the potency and delivery of existing and experimental antibiotics.

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mcatmemoranda · 2 years

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Initial evaluation – The evaluation of patients with chronic hepatitis C virus (HCV) infection involves assessing the extent of liver disease, assessing other viral and host factors (including viral genotype, liver fibrosis stage, history of prior antiviral treatment, renal function, and medication use) that inform optimal antiviral selection, and identifying comorbidities associated with HCV infection (including extrahepatic manifestations of HCV infection as well as human immunodeficiency virus [HIV] and hepatitis B virus [HBV] infection).

Counseling on transmission risk and dietary/behavioral modifications – HCV-infected patients should be counseled on measures to decrease the risk of transmission and correcting factors associated with accelerated liver disease, including alcohol use, obesity and insulin resistance, and marijuana use. Substance use treatment is also an important element of care in patients who have ongoing illicit drug use.

Individuals with HCV infection should be counseled to:

Avoid sharing toothbrushes and dental or shaving equipment Cover any bleeding wound to prevent others from coming into contact with their blood Not donate blood Discuss their HCV status prior to donation of body organs, other tissues, or semen

In general, individuals with HCV infection should be counseled that the risk of sexual transmission is low and that HCV infection itself is not a reason for barrier protection.

However, individuals with HCV infection who have HIV co-infection, multiple sexual partners, or sexually transmitted infections should be encouraged to use barrier precautions to prevent sexual transmission.

Individuals with HCV infection who use illicit drugs should be counseled to:

Get treated for substance use disorder

Those who inject drugs should be counseled to:

Avoid reusing or sharing syringes, needles, water, cotton, and other drug preparation equipment Use new sterile syringes and filters and disinfected cookers Clean the injection site with a new alcohol swab Dispose safely of syringes and needles after one use in a safe, puncture-proof container

Additional management issues for advanced fibrosis – Additional management is warranted for patients who are found to have advanced fibrosis or cirrhosis, including dose modification or avoidance of certain medications, twice yearly ultrasonography for hepatocellular carcinoma screening, and upper endoscopy screening for esophageal varices.

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chiefdestinybird · 10 days

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The Importance of Hepatitis C Testing: Services Available in NJ

Hepatitis C Testing in New Jersey

Hepatitis C testing in New Jersey is a vital public health service aimed at identifying and managing Hepatitis C Virus (HCV) infections. Hepatitis C is a liver infection caused by the Hepatitis C virus, which can lead to serious liver damage, including cirrhosis and liver cancer if left untreated. New Jersey offers various options for testing, ensuring that residents have access to essential diagnostic services.

Testing Services

Public Health Clinics:

Many county and city health departments in New Jersey provide free or low-cost Hepatitis C testing. These clinics offer confidential testing services, often without requiring insurance.

Hospitals and Medical Centers:

Major hospitals and healthcare systems across New Jersey, including those in cities like Newark, Jersey City, and Trenton, offer Hepatitis C testing. These institutions may provide advanced diagnostic tools and comprehensive care following a positive test result.

Primary Care Providers:

Family doctors and internists throughout the state can conduct initial Hepatitis C screenings, especially for patients at higher risk, such as those with a history of intravenous drug use or those born between 1945 and 1965.

Specialized Clinics:

Some clinics focus specifically on infectious diseases and liver conditions. These specialized clinics often offer detailed counseling, testing, and treatment plans tailored to individuals diagnosed with Hepatitis C.

Community Health Centers:

Federally Qualified Health Centers (FQHCs) and other community health facilities provide accessible Hepatitis C testing, often on a sliding fee scale based on income, making it easier for underserved populations to get tested.

Testing Procedures

Initial Screening:

Typically involves an antibody test to determine if a person has been exposed to the Hepatitis C virus. This can be done through a simple blood draw.

Confirmatory Testing:

If the initial test is positive, a follow-up RNA test (also known as a PCR test) is performed to detect the presence of the virus in the blood, confirming an active infection.

Importance of Testing

Early detection of Hepatitis C is crucial for effective treatment and management. Modern antiviral treatments can cure most cases of Hepatitis C, especially when the infection is caught early. Regular testing is recommended for individuals at high risk, and New Jersey's comprehensive testing network plays a key role in reducing the incidence and impact of Hepatitis C across the state.

Support and Follow-Up Care

New Jersey also provides resources for individuals diagnosed with Hepatitis C, including:

Counseling Services: Emotional and psychological support for patients and their families.

Treatment Programs: Access to antiviral medications and liver health monitoring.

Educational Resources: Information about preventing the spread of Hepatitis C and managing liver health.

Through these services, New Jersey aims to improve health outcomes and quality of life for those affected by Hepatitis C.

For more info:- Website: https://hepatitisnj.com/ Address: 405 Kearny Ave in Phone : +1 (201) 350-4909

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medicalthought · 14 days

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Viral Hepatitis

Hep A Virus (HAV)

Hep A virus usually causes a benign and self-limited infection with a 3-6 week incubation period. Patients may present as febrile, jaundice, fatigued, and with loss of appetite. Patients will begin shedding the virus in their stool before they are symptomatic. It is normally transmitted via an oral to fecal route or when eating shellfish forged from dirty waters. IgM antibodies mark active infection. IgG antibodies are hard to detect. There is a vaccine for Hep A.

Hep B Virus (HBV)

One third of people in the world are infected with this blood born virus. It has a 1-6 month incubation period. This virus can present in many ways. It can be an acute infection with full recovery and clearance, a non-progressive chronic infection, a progressive chronic disease, fulminant disease, or asymptomatic. Hep B is commonly transmitted during childbirth. Children whose mothers have Hep B can receive the vaccine and anti-Hep B antibodies. There are many treatments for Hep B including interferon-alpha, lamivudine, entecavir, and adefovir (antivirals). Some patients with severe Hep B induced cirrhosis may need liver transplant.

The HBV has some pretty interesting antigens and antibodies that are worth discussing. Here they are listed below:

HBsAg = Hep B surface antigen, 1st serum marker of infection, absent in resolved infection and positive in chronic infection

HBsAb = Hep B surface antibody, this is the protective antibody so will be seen in resolved infection and absent in chronic infection

HBcAg = Hep B core antigen, positive in resolved and chronic infection

HBcAb = Hep B core antibody, 2nd serum marker, not protective

HBeAg = Hep B e antigen, presence indicates active replication

HBeAb = Hep B e antigen, this is nonprotective, although usually seen in resolved infection

Hep C Virus (HCV)

This virus is the leading cause for liver transplant in the US. Of all the hepatitis viruses, it is the most likely to cause chronic infection. There are 7 genotypes and the GT 1a is the most common in the US. We do not have a vaccine for Hep C. Hepatocyte death is due to CD8+ T cell mediated lysis. New onset disease is diagnosed via PCR within 1 week. Enzyme immunoassays are not positive until 4-12 weeks. We screen blood donations for this virus. In the US, the majority of infected parties are Baby Boomers. Baby Boomers should be screened for this infection at least once. Our best therapies right now include NS5a and NS5B inhibitors. These therapies are unfortunately quite expensive. This virus is blood born.

Hep D Virus (HDV)

Also known as the delta agent, this virus is unique in that it is dependent on HBV for its life cycle. Co-infection with HDV can cause fulminant illness or a superinfection. HDV does cause chronic infection. It is blood born.

Hep E Virus (HEV)

Like Hep A, this virus cannot cause chronic infection and is commonly transmitted via the fecal to oral route. It has a 40-day incubation period. There is a vaccine approved in China that is not yet approved in the US. There is a high mortality rate in pregnant women.

#studying

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