Viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation
In the United States, an estimated 1.2 million Americans are living with chronic Hepatitis B and 3.2 are living with chronic Hepatitis C
Many do not know they are infected
Each year an estimated 21,000 persons become infected with Hepatitis A; 35,000 with Hepatitis B, and 17,000 with Hepatitis C
Hepatitis A – fecal/oral, contaminated food, vaccine available
Hepatitis B – blood, semen, vertical (mother-child), vaccine available
Hepatitis C – blood (IV drug use, transfusion, organ donation, unsterile injecting equipment, sexual intercourse)
Hepatitis D – survives only in cells co-infected with hepatitis B
Hepatitis E* – contaminated food or water, fecal/oral
*causes short-term disease and is not a chronic carrier state
The primary treatment goals for patients with hepatitis B (HBV) infection are to prevent progression of the disease, particularly to cirrhosis, liver failure, and hepatocellular carcinoma (HCC).
Risk factors for progression of chronic HBV include the following :
Persistently elevated levels of HBV DNA and, in some patients, alanine aminotransferase (ALT), as well as the presence of core and precore mutations seen most commonly in HBV genotype C and D infections
Male sex
Older age
Family history of HCC
Alcohol use
Elevated alpha-fetoprotein (AFP)
Coinfection with hepatitis D (delta) virus (HDV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV)
A synergistic approach of suppressing viral load and boosting the patient’s immune response with immunotherapeutic interventions is needed for the best prognosis. The prevention of HCC often includes the use of antiviral treatment using pegylated interferon (PEG-IFN) or nucleos(t)ide analogues.
HBV infection can be self-limited or chronic. No specific therapy is available for persons with acute hepatitis B; treatment is supportive.
The primary treatment goals for patients with hepatitis B (HBV) infection are to prevent progression of the disease, particularly to cirrhosis, liver failure, and hepatocellular carcinoma (HCC).
Risk factors for progression of chronic HBV include the following :
Persistently elevated levels of HBV DNA and, in some patients, alanine aminotransferase (ALT), as well as the presence of core and precore mutations seen most commonly in HBV genotype C and D infections
Male sex
Older age
Family history of HCC
Alcohol use
Elevated alpha-fetoprotein (AFP)
Coinfection with hepatitis D (delta) virus (HDV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV)
A synergistic approach of suppressing viral load and boosting the patient’s immune response with immunotherapeutic interventions is needed for the best prognosis. The prevention of HCC often includes the use of antiviral treatment using pegylated interferon (PEG-IFN) or nucleos(t)ide analogues.
HBV infection can be self-limited or chronic. No specific therapy is available for persons with acute hepatitis B; treatment is supportive.
Hepatitis" means inflammation of the liver and also refers to a group of viral infections that affect the liver .
The most common types are Hepatitis A, Hepatitis B, and Hepatitis C.
Viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation.
An estimated 4.4 million Americans are living with chronic hepatitis; most do not know they are infected
Hepatitis" means inflammation of the liver and also refers to a group of viral infections that affect the liver .
The most common types are Hepatitis A, Hepatitis B, and Hepatitis C.
Viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation.
An estimated 4.4 million Americans are living with chronic hepatitis; most do not know they are infected
Hepatitis B virus HBV infection in detailsHassn Aljubory
Presentation
serological markers
Laboratory test
vaccinations
Chronic hepatitis B
Approach
Harrison
Davidsons
Step up medicine
Mksap
Notes & notes
Gastrointestinal disease
Hepatology
Risk group
Management
Hepatitis in pregnancy
Hepatitis b virus (hbv) infection a silent epidemicAung Zayar Paing
Myanmar is one of the countries with high HBV prevalence. Compared to other diseases like TB, HIV and malaria, HBV received less attention than it should to be educated, tested, vaccinated and treated.
Hepatitis is generally refer to inflammation of liver, it is resulted from infectious causes (such as viral, bacterial and fungal causes ) or noninfectious ( such as alcohol drugs, autoimmune diseases and metabolic diseases) , in this research , I’m going to focus on viral hepatitis because it is the most common cause of acute hepatitis in USA ( 50% of cases ).
The commonness and important viruses that cause viral hepatitis are (A,B,C,D,E) types, approximately 4.4 million Americans are currently living with chronic hepatitis B and C.
WHAT ARE THE BEST MEASURES TO REDUCE THE EFFECTS OF HOUSE-DUST MITES ON ASTHMATIC PATIENTS?
DUST MITES PROTECTION IN ASTHMA
are very small, insect-like pests that feed on dead human skin cells and thrive in warm, humid settings. Any swelling (also called inflammation) of the nasal passages caused by dust mites is considered a dust allergy.
Uterus Transplantation Utx (obstetric and gynecology) D.A.B.M
Is the surgical procedure whereby a healthy uterus is transplanted into an organism of which the uterus is absent or diseased.
As part of normal mammalian sexual reproduction, a diseased or absent uterus does not allow normal embryonic implantation, effectively rendering the female infertile.
This phenomenon is known as Absolute Uterine Factor Infertility (AUFI).
Uterine transplant is a potential treatment for this form of infertility.
Uterus is a dynamic, complex organ. It is hugely blood-flow dependent.
More than 116,000 Number of men, women and children on the national transplant waiting list as of August 2017.
33,611 transplants were performed in 2016.
20 people die each day waiting for a transplant.
every 10 minutes another person is added to the waiting list.
Pertussis : Highly contagious respiratory infection caused by Bordetella pertussis
Outbreaks first described in 16th century
Bordetella pertussis isolated in 1906
Estimated >300,000 deaths annually worldwide
Before the availability of pertussis vaccine in the 1940s, public health experts reported more than 200,000 cases of pertussis annually.
Since widespread use of the vaccine began, incidence has decreased more than 75% compared with the pre-vaccine era.
In 2012, the last peak year, CDC reported 48,277 cases of pertussis.
Extremely contagious-attack rate 100%
Immunity is never complete
Protection begins to wane in 3-5 yrs after vaccination
is an upper respiratory tract bacterial infection associated with a characteristic rash, which is caused by an infection with pyrogenic exotoxin (erythrogenic toxin) -producing GAS in individuals who do not have antitoxin antibodies In the past.
scarlet fever was thought to reflect infection of an individual lacking toxin-specific immunity with a toxin-producing strain of GAS.
Subsequent studies have suggested that development of the scarlet fever rash may reflect a hypersensitivity reaction requiring prior exposure to the toxin.
FA is a very rare, genetic, recessive disease, affecting 1/50,000 people.
Originates from mutations in the “coding” of the mitochondria.
Discovered by Nicholaus Friedreich in the early 1860’s.
Both parents must have the dominant trait for a 25% chance of an offspring possessing the disease.
Not necessarily a disease that kills you, but eventually a wheelchair and regular assistance will be required.
Onset before age 20-25 year.
Propranolol is the most common beta-blocker involved in severe beta-blocker poisoning. It is nonselective and can lead to CNS depression, seizures, and prolongation of the QRS complex.
Beta blocker toxicity is notably distinguished by bradycardia, low respiratory
rate and hypoglycemia
Seizures and other CNS effects can occur with beta blockers that can cross the blood brain barrier (more rarely with the other beta blockers)
Overdoses of beta blockers with a combination of other drugs can have wide
ranging systemic effects
If within a short time after ingestion, give activated charcoal
Treat with glucagon to raise blood glucose levels
Widely used treatment is currently Atropine though it is considered less effective
Treat bronchospasm with beta agonists like Albuterol
Treat Seizures with Benzodiazepines like Valium
If the patient is still unresponsive or the condition is still deteriorating, treat with epinephrine
More than 5.7 million new cases of TB (all forms, both pulmonary and extra-pulmonary) were reported to the World Health Organization (WHO) in 2013; 95% of cases were reported from developing countries
Latest figures from 20151 indicate an estimated 10.4 million people had TB, and 1.8 million people died (1.4 million HIV negative and 400 000 HIV positive).
Of further concern is that 480 000 cases of multidrug-resistant (MDR) TBa and a further 100 000 that were estimated to be rifampicin-resistant (RR) TB have occurred in the same period.
The most common non-cancerous tumours in women .
The most common indication for hysterectomy.
Apparent in up to 25% of women.
More common in a higher body mass index women.
3 times more common in black American women than white women.
Asian women have a lower incidence .
Symptoms appear at age of 30s or 40s .
The incidence increases with age up to the menopause.
Women over the age of 30 are commonly affected by fibroid uterine.
50% of all women are affected by fibroid uterine.
Most common solid pelvic tumors.
Develop in 20~25% of women during reproductive years.
Multiple pregnancies consists of two or more fetuses ,there are exceptions to this such as twins gestations made of a singleton viable fetus & a complete mole.
Is characterized by the sudden loss of blood circulation to an area of the brain, resulting in a corresponding loss of neurologic function. Acute ischemic stroke is caused by thrombotic or embolic occlusion of a cerebral artery and is more common than hemorrhagic stroke.
It can occur
in the carotid
artery of the
neck as well as
other arteries.
When an artery is acutely occluded by thrombus or embolus, the area of the CNS supplied by it will undergo infarction if there is no adequate collateral blood supply.
Surrounding a central necrotic zone, an ‘ischemic penumbra’ remains viable for a time, i.e. it may recover function if blood flow is restored.
CNS ischemia may be accompanied by swelling for two reasons:
● cytotoxic oedema – accumulation of water in damaged glial cells and neurones,
● vasogenic oedema – extracellular fluid accumulation as a result of breakdown of the blood–brain barrier.
In the brain, this swelling may be sufficient to produce clinical deterioration in the days following a major stroke, as a result of a rise in intracranial pressure and compression of adjacent structures.
• The Facial nerve is the 7th of twelve paired cranial nerves.
• It is a mixed nerve with motor and sensory roots.
• It also supplies pre-ganglionic parasympathetic fibres to several
head and neck ganglia
Branches
1. Greater superficial petrosal – arises from the geniculate ganglion.
2. Branches within the facial canal:
• i) nerve to stapedius
• ii) Chorda tympani
3. After exit from stylomastoid foramen:
• i) Posterior auricular
• ii) Nerve to posterior belly of digastric
• iii) Nerve to stylohyoid.
4. On the face - Five major branches:
• i) Temporal
• ii) Zygomatic
• iii) Buccal
• iv) Marginal mandibular
• v) Cervical
The stomach J-shaped. It has two surfaces (the anterior & posterior), two curvatures (the greater & lesser), two orifices (the cardia & pylorus). It has fundus, body and pyloric antrum.
Blood supply
The left gastric artery
Right gastric artery
Right gastro-epiploic artery
Left gastro-epiploic artery
Short gastric arteries
Stomach cancer begins when cancer cells form in the inner lining of your stomach. These cells can grow into a tumor. Also called gastric cancer, the disease usually grows slowly over many years.
It could be:
malignant or benign
primary or secondary
What is a Pet Scan : Nuclear 3-D imaging test that uses a radioactive substance called a tracer to look for disease in the body.
Shows how organs and tissues are working at a molecular and cellular level. Scan is non-invasive, but does involve exposure to ionizing radiation.
Best known for its role in detecting cancer imaging.
A small amount of a radioactive sugar molecule, 18 fluoro-2-deoxyglucose (FDG), is injected into the bloodstream (can also be inhaled as gas or swallowed in pill form).
A PET Scan is used to detect and generate images that indicate areas of high FDG uptake.
Many cancers require more energy than normal cells, and the FDG tracer accumulates in these cells.
This allows cancers to be seen on the Pet images as hot spots.
Use focusing Shock Waves to breakdown
a stone into small pieces.
Shock waves are acoustic pulses.
Pass through better in water and solid but
not in air.
Introduce in 1980 by Dornier which is a supersonic aircraft company
Somatoform disorders
A disorder in which people have physical illnesses or complaints that cannot be fully explained by actual medical conditions
Dissociative disorders
A personality disorder marked by a disturbance in the integration of identity, memory, or consciousness.
Historically, both somatoform and dissociative disorders used to be categorized as hysterical neurosis
in psychoanalytic theory neurotic disorders result from underlying unconscious conflicts, anxiety that resulted from those conflicts and ego defense mechanisms
"schizophrenia" "split mind" but it refers to a disruption of the usual balance of emotions and thinking.
Schizophrenia is chronic and a severe brain disorder in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior .
Breast cancer :-
is a disease in which cells in the breast grow out of control. There are different kinds of breast cancer. The kind of breast cancer depends on which cells in the breast turn into cancer.
Breast cancer can begin in different parts of the breast:
1- Lobule (the glands that produce milk).
2- Ducts (tubes that carry milk to the nipple).
3- Connective tissue (which consists of fibrous and fatty tissue)( surrounds and holds everything together) .
*Most breast cancers begin in the ducts or lobules.
*Breast cancer can spread outside the breast through blood vessels and lymph vessels.
Zika virus disease is a mosquito-borne viral infection that primarily occurs in tropical and subtropical areas of the world.
It is related to other pathogenic vector borne flaviviruses including dengue, West-Nile and Japanese encephalitis viruses but produces a comparatively mild disease in humans
Genre: Flavivirus
Vector: Aedes mosquitoes (which usually bite during the morning and late afternoon/evening hours)
Reservoir: mosquitoes (gut, blood, saliva )
human ( blood, prostate, semen and testes )
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Viral hepatitis B and C
1. DONE BY :
MUSTAFA KHALIL IBRAHIM
TBILISI STATE MEDICAL UNIVERSITY
5th year, 1nd semester, 1st group
2. Viral hepatitis is the leading cause of liver
cancer and the most common reason for liver
transplantation
In the United States, an estimated 1.2 million
Americans are living with chronic Hepatitis B
and 3.2 are living with chronic Hepatitis C
Many do not know they are infected
Each year an estimated 21,000 persons become
infected with Hepatitis A; 35,000 with Hepatitis
B, and 17,000 with Hepatitis C
3. Hepatitis A – fecal/oral, contaminated food, vaccine
available
Hepatitis B – blood, semen, vertical (mother-child), vaccine
available
Hepatitis C – blood (IV drug use, transfusion, organ
donation, unsterile injecting equipment, sexual intercourse)
Hepatitis D – survives only in cells co-infected with hepatitis
B
Hepatitis E* – contaminated food or water, fecal/oral
*causes short-term disease and is not a chronic carrier state
4. When they occur, the signs and symptoms of viral
hepatitis can include:
Fever
Fatigue
Loss of appetite
Nausea
Vomiting
Abdominal pain
Jaundice
Dark urine
Clay-colored stool
Joint pain
5.
6. Hepatitis B is caused by infection with the
Hepatitis B virus (HBV), the prototype member of
the hepadnavirus family
HBV is the only human representative of this family.
It has a circular DNA genome of 3.2 kb
Currently, eight genotypes (A−H) are identified by
a divergence of >8% in the entire genome
7. A Hepadnaviridae – partially double-stranded
DNA virus
HBsAg – stimulates protective antibodies, a
marker for current infection
HBcAg – localized within liver cells, identifies
acute infection, anti-HBcAg persists for life and is
a marker of past infection
HBeAG – a marker of active replication and
infectivity
8. Worldwide, HBV is the primary cause of liver
cancer
For males, it is the third leading cause of cancer
mortality
For females, it is the sixth leading cause of cancer
mortality
9. Source: J Viral Hepat. 2010 Apr;17(4):229-35. Hepatitis B virus: origin and evolution.
10. An estimated 800,000–1.4 million persons in the
United States have chronic HBV infection.
Chronic infection is an even greater problem
globally, affecting approximately 350 million
persons.
An estimated 620,000 persons worldwide die from
HBV-related liver disease each year.
11. The incubation period from the time of exposure
to onset of symptoms is 6 weeks to 6 months.
HBV is found in highest concentrations in blood
and in lower concentrations in other body fluids
(e.g., semen, vaginal secretions, and wound
exudates).
HBV infection can be self-limited or chronic.
12. In adults, only approximately half of newly acquired
HBV infections are symptomatic, and approximately 1%
of reported cases result in acute liver failure and death.
13. Persons born in places where hepatitis B infection is
common (especially China, Southeast Asia, the Pacific Islands,
sub-Saharan Africa, and the Amazon basin in South America).
Children of parents born in those places.
Injecting drug users
Hemodialysis patients
Health care and public safety workers who may have contact with
blood
People having sex with an HBV-infected partner
Men who have sex with men
Those living in the same household with an HBV-infected person
Travelers to places where hepatitis B infection is common who will
have extended, close contact with the local population.
14.
15. During the chronic phase (> 6 months after
infection) hepatitis B usually progresses silently,
with no symptoms at all during the first 10-20
years. Signs of severe liver scarring (cirrhosis) may
include:
Ascites
Star-shaped vein pattern developing on the swollen
belly
Jaundice
Itching
Easy bruising and bleeding
16. Hepatitis B is detected by looking for a number
of different antigens and antibodies:
Hepatitis B surface antigen (HBsAg):
A protein on the surface of HBV; it can be detected in high
levels in serum during acute or chronic HBV infection.
The presence of HBsAg indicates that the person is
infectious.
The body normally produces antibodies to HBsAg as part of
the normal immune response to infection.
HBsAg is the antigen used to make Hepatitis B vaccine.
17. Hepatitis B is detected by looking for a number
of different antigens and antibodies:
Hepatitis B surface antibody (anti-HBs):
The presence of anti-HBs is generally interpreted as
indicating recovery and immunity from HBV infection.
Anti-HBs also develops in a person who has been
successfully vaccinated against Hepatitis B.
Total Hepatitis B core antibody (anti-HBc):
Appears at the onset of symptoms in acute Hepatitis B and
persists for life.
The presence of anti-HBc indicates previous or ongoing
infection with HBV in an undefined time frame.
18. Hepatitis B is detected by looking for a number
of different antigens and antibodies:
IgM antibody to Hepatitis B core antigen (IgM
anti-HBc):
Positivity indicates recent infection with HBV (≤6 months).
Its presence indicates acute infection.
Hepatitis B e antigen (HBeAg):
A secreted product of the nucleocapsid gene of HBV that is
found in serum during acute and chronic Hepatitis B.
Its presence indicates that the virus is replicating and the
infected person has high levels of HBV.
19. Hepatitis B is detected by looking for a number
of different antigens and antibodies:
Hepatitis B e antibody (HBeAb or anti-HBe):
Produced by the immune system temporarily during acute
HBV infection or consistently during or after a burst in viral
replication.
Spontaneous conversion from e antigen to e antibody (a
change known as seroconversion) is a predictor of long-term
clearance of HBV in patients undergoing antiviral therapy
and indicates lower levels of HBV.
20. Aminotransferase elevations tend to be modest for chronic
hepatitis B but may fluctuate in the range of 100–1,000
units.
(ALT) tends to be more elevated than aspartate
aminotransferase (AST); however, once cirrhosis is
established, AST tends to exceed ALT.
Levels of alkaline phosphatase activity tend to be normal
or only marginally elevated. In severe cases, moderate
elevations in serum bilirubin [51.3–171 mol/L (3–10 mg/
dL)] occur.
Hypoalbuminemia and prolongation of the prothrombin
time occur in severe or end-stage cases.
Hyperglobulinemia and detectable circulating
autoantibodies are absent in chronic hepatitis B (in
contrast to autoimmune hepatitis).
21.
22.
23.
24. For acute infection, no medication is available;
treatment is supportive.
For chronic infection, several antiviral drugs
(adefovir dipivoxil, interferon alfa-2b, pegylated
interferon alfa-2a, lamivudine, entecavir, and
telbivudine) are available.
Persons with chronic HBV infection require medical
evaluation and regular monitoring to determine
whether disease is progressing and to identify liver
damage or hepatocellular carcinoma.
25. CDC’s national strategy to eliminate
transmission of HBV infection includes:
Prevention of perinatal infection through routine
screening of all pregnant women for HBsAg and
immunoprophylaxis of infants born to HBsAg-
positive mothers and infants born to mothers with
unknown HBsAg status
Routine infant vaccination
Vaccination of previously unvaccinated children and
adolescents through age 18 years
Vaccination of previously unvaccinated adults at
increased risk for infection
26.
27.
28.
29.
30.
31. Hepatitis C virus (HCV) infection is the most
common chronic blood-borne infection in the
United States; approximately 3.2 million persons are
chronically infected
By contrast to Chronic HBV, patients with chronic
hepatitis C almost always develop HCC in the
presence of established cirrhosis
The annual risk of HCC development in HCV
patients with cirrhosis is in the range of 1–4%, and an
estimated 1–3% of patients chronically infected with
HCV will develop HCC after 30 years
32. Flavivirus – small, enveloped, single-stranded RNA
virus, six genotypes
Replicates in liver cells, lymphocytes and monocytes
Replicates >1 trillion progeny per day
Mutates rapidly (error-prone RNA polymerase)
Down-regulates stimulatory receptors on NK cells
Increases inhibitory receptors on NK and CD8+
killer cells
Produces TGF-beta, which blocks activation of T
cells and inhibits production of IFN-gamma
33. Transmission of HCV occurs through:
Percutaneous
Injecting drug use
Clotting factors before viral inactivation
Transfusion, transplant from infected donor
Therapeutic (contaminated equipment, unsafe injection
practices)
Occupational (needlestick)
Permucosal
Perinatal
Sexual
34. The following persons are at known to be at
increased risk for HCV infection:
Current or former injection drug users, including
those who injected only once many years ago
Recipients of clotting factor concentrates made
before 1987, when more advanced methods for
manufacturing those products were developed
Recipients of blood transfusions or solid organ
transplants before July 1992, when better testing of
blood donors became available
Chronic hemodialysis patients
Persons with HIV infection
Children born to HCV-positive mothers
36. Although only 850 cases of confirmed acute
Hepatitis C were reported in the United States
in 2010, CDC estimates that approximately
16,000 new HCV infections occurred that year,
after adjusting for asymptomatic infection and
underreporting.
Persons newly infected with HCV are usually
asymptomatic, so acute Hepatitis C is rarely
identified or reported.
40. During the acute phase (first 6 months after infection) most persons
have no symptoms or might experience a mild illness. Symptoms of
acute HCV infection, when present, may include:
Jaundice (yellowing of the skin and eyes)
Dark-colored urine, light-colored stools
Fatigue
Abdominal pain
Loss of appetite
Nausea
Diarrhea
Fever
41. During the chronic phase (> 6 months after infection)
hepatitis C usually progresses silently, with no symptoms at
all during the first 10-20 years. Signs of severe liver scarring
(cirrhosis) may include:
Ascites (accumulation of fluid and swelling of the
abdominal cavity)
Star-shaped vein pattern developing on the swollen belly
Jaundice
Itching
Easy bruising and bleeding
42.
43.
44.
45. Sixty to 70% of persons newly infected with
HCV typically are usually asymptomatic or have
a mild clinical illness.
HCV RNA can be detected in blood within 1–3
weeks after exposure.
The average time from exposure to antibody to
HCV (anti-HCV) seroconversion is 8–9 weeks,
and anti-HCV can be detected in >97% of
persons by 6 months after exposure.
46. 75-85% of those infected with HCV will develop
chronic infection.
60-70% of those infected with HCV will develop
chronic liver disease.
5-20% of those infected will develop cirrhosis over a
period of 20-30 years
1-5% will die from the consequences of chronic
infection (liver cancer or cirrhosis)
47. Interferon-based therapy is currently the standard
of care for patients with chronic HCV, and has been
proven to be effective in eliminating HCV.
Both conventional and pegylated interferon (IFN)
therapy have been used widely, with the aim of
achieving a sustained virological response (SVR).
48. Unlike HBV, there is currently no vaccine for HCV.
However, with the screening of HCV in blood
transfusion services, transfusion-related HCV
infection has been lowered to almost zero.
49. It may be possible to develop a preventive
vaccine for HCV:
30% of persons clear the virus spontaneously
The genome of HCV is not integrated into the host
genome
After HCV infection, CD-8 CTL responses and
antibodies appear, but the “protective immune
response” or critical epitopes are not known
Persons who clear HCV and become re-infected have
low viral loads and are more likely to clear HCV