The hepatitis E virus, responsible for major epidemics of viral hepatitis in subtropical and tropical countries, was cloned only 7 years ago.1 Hepatitis E was found to belong to the family of Caliciviridae, which includes the Norwalk virus—a common cause of gastroenteritis in humans—and consists of a single, plus-strand RNA genome of approximately 7.2 kb without an envelope (Fig. 1). The virus contains at least three open reading frames encoding viral proteins against which antibodies are made on exposure. These antibodies, especially those against the capsid protein derived from the second open reading frame2 and a protein of unknown function derived from the third open reading frame, are detected by currently available serologic assays. Retrospective studies on stored sera of past epidemics of viral hepatitis in Mexico, Africa, Afghanistan, Pakistan, India, Bangladesh, Burma, Nepal, and Borneo have revealed that all were caused by strains of hepatitis E. In addition, hepatitis E was found to be responsible for the hepatitis epidemic in the southern part of Xinjiang, China, in which 120,000 persons became infected between September 1986 and April 1988.3 Hepatitis E predominantly affects young adults (15 to 40 years old). The symptoms of hepatitis E are similar to those of hepatitis A. Frequently, a prodrome consisting of anorexia, nausea, low-grade fever, and right upper abdominal pain is present 3 to 7 days before jaundice develops. Aminotransferase levels peak (usually between 1,000 and 2,000 U/L) near the onset of symptoms; bilirubin levels (10 to 20 mg/dL) peak later. Jaundice usually resolves after 1 to 2 weeks. In about 10% of cases, the disease is fulminant—especially in pregnant women, among whom mortality rates as high as 20% due to hemorrhagic and thrombotic complications have been reported. No evidence has suggested that hepatitis E can cause chronic infection. Transmission is by the fecal-oral route, predominantly through fecally contaminated drinking water supplies. In addition, however, preliminary reports have suggested transmission of the hepatitis E virus through blood transfusions. Volunteer studies confirmed the presence of the virus in serum and feces before and during clinical disease.4 The virus is shed into feces approximately 1 week before symptoms develop. The incubation period varies from 2 to 9 weeks (mean duration, approximately 45 days). Until now, a few reports had described symptomatic hepatitis E acquired in Europe;5, 6 all patients with symptomatic hepatitis E in the United States were travelers returning from Mexico, Africa, or the Far East, in whom hepatitis E developed after their return home.7 In this issue of the Mayo Clinic Proceedings (pages 1133 to 1136), Kwo and associates describe a case of hepatitis E in a man who had not left the United States during the previous 10 years. Specific serologic tests for hepatitis E virus IgG (enzyme immunoassays and a fluorescent antibody blocking assay) and IgM8 (US strain-specific enzyme-linked immunosorbent assay with use of synthetic polypeptides deduced from the viral genome, as shown in Figure 1), developed at Abbott Laboratories (IgG and IgM) as well as at the Centers for Disease Control and Prevention (IgG), were used to prove that the patient indeed had acute hepatitis E. Researchers at Abbott Laboratories have prepared a report that describes most of the viral genome in this patient (Fig. I).8 Their results are interesting because this strain from the United States differs considerably from hepatitis E strains isolated in Mexico, Burma, Pakistan, or China. Furthermore, the sequence of the US strain is highly homologous (98% and 94% homology at the amino acid level to the second and third open reading frames, respectively) to a recently isolated hepatitis E strain from American swine.9 This finding suggests that, in the United States, hepatitis E is a zoonosis with the swine population as one of its hosts. This relationship would confirm earlier studies in Asia, where swine were also found to carry variants of the hepatitis E virus.10 Why are these two recent discoveries important for medicine in the United States? First, other sporadic, locally acquired cases of acute hepatitis may be caused by hepatitis E. Second, these back-to-back discoveries strongly suggest that a common natural host for hepatitis E is present in countries with more moderate climates. Because swine do not seem to experience any symptoms associated with infection and because symptoms in humans can be minor or absent, we now may also have an explanation for the 1 to 2% of positive hepatitis E serologic results in blood donors in the United States,11 Netherlands,12 and Italy,6 countries with large swine staples. Clearly, more research needs to be done to confirm this hypothesis. Third, in countries with more moderate climates, hepatitis E may often result in a subclinical infection. Is this variation in manifestation due to less virulent strains, and do sequence variations determine virulence? Fourth, swine may be used as an animal model for study of the disease as well as vaccine development.

wearable dialysis - and we expect to begin clinical trials in 2018 see more http://www.kidneymy.com/

Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. There are many types of anemia. Pernicious anemia is a decrease in red blood cells that occurs when the intestines cannot properly absorb vitamin B12.

Clonidine lowers blood pressure by decreasing the levels of certain chemicals in your blood. This allows your blood vessels to relax and your heart to beat more slowly and easily. The Catapres brand of clonidine is used to treat hypertension (high blood pressure). The Kapvay brand is used to treat attention deficit hyperactivity disorder (ADHD). Clonidine is sometimes given with other medications

Haemorrhoids is one of the most common problems seen in surgical OPD. Open haemorrhoidectomy has remained the gold standard for a long time with a high post-operative morbidity. The quest for a better understanding of the pathology of haemorrhoids resulted in the evolvement of stapler haemorrhoidopexy. Our aim is to study the efficacy of stapler haemorrhoidopexy with regards to role of immediate post-operative morbidity. A prospective study of 50 patients (n = 50) with the second- and third-degree symptomatic haemorrhoids was done. The mean age of the patients was 44.1 years. Fourteen patients had co-morbid conditions. The average duration of the operation was 29 min. Patients with the second-degree haemorrhoids had higher rate of complication. The complication rate was 32%. Three patients had urinary retention. Two patients had minor bleeding, and one patient experienced transient discharge. The mean analgesic requirement was 2.4 tramadol, 50 mg injections. Ten patients had significant post-operative pain. Average length of hospital stay was 2.7 days. There were no symptomatic recurrences till date.

Not every person who is missing a hand or upper limb might be eligible to receive a transplant. Many people are able to live full lives and accomplish everything they desire with the aid of a prosthetic device and sometimes without the aid of anything. However, some people find prosthetics difficult to use and the lack of sensory “feedback” from their prosthesis can significantly limit their function. These persons may consider reconstructive transplantation. We find that those patients who have either bilateral (both hands) amputations or those who have had their dominant hand amputated are likely to receive the most benefit from the procedure. However, we will provide information to any interested person regardless of the nature of their amputation.

Presence of abdominal pain and distension. Presence of urinary symptoms - Such as dysuria, oliguria, flank pain, and hematuria. Occurrence of any symptoms of hypocalcemia - Such as anorexia, vomiting, cramps, seizures, spasms, altered mental status, and tetany. Symptoms of hyperkalemia - Such as weakness and paralysis.

In an autologous transplant, a patient's own blood-forming stem cells are collected. He or she is then treated with high doses of chemotherapy, or a combination of chemotherapy and radiation. The high-dose treatment kills cancer cells, but also eliminates the blood-producing cells that are left in the bone marrow.

The brachial plexus is the network of nerves that sends signals from your spine to your shoulder, arm and hand. A brachial plexus injury occurs when these nerves are stretched, compressed, or in the most serious cases, ripped apart or torn away from the spinal cord. Minor brachial plexus injuries, known as stingers or burners, are common in contact sports, such as football. Babies sometimes sustain brachial plexus injuries during birth. Other conditions, such as inflammation or tumors, may affect the brachial plexus. The most severe brachial plexus injuries usually result from auto or motorcycle accidents. Severe brachial plexus injuries can leave your arm paralyzed, with a loss of function and sensation. Surgical procedures such as nerve grafts, nerve transfers or muscle transfers can help restore function.

http://123-paleo.info-pro.co Gesunde Ernährung, Ernährung Umstellen, Marcumar Ernährung, Paleo Lebensmittel, Paleo Rezept. Wahrscheinlich wirst du dich als Paleo-Anhänger schon einmal gefragt haben, warum die Steinzeiternährung Getreide meidet wie die Pest. Gut, die Begründung, dass Menschen vor Tausenden von Jahren ebenfalls kein Getreide hatten, ist ja schön. Aber das kann ja nicht alles sein. Ist es auch nicht. Wie immer liegt der Teufel im Detail. Hauptverantwortlich für die große „Angst“ vor Getreideprodukten sind vor allem Gluten, sogenannte Anti-Nährstoffe. Bereits dieser Name ist angsteinflößend. Und das durchaus zu Recht. Denn Gluten besitzen nur wenige positive, dafür jedoch umso mehr negative Eigenschaften, die sich längerfristig schlecht auf deine Gesundheit auswirken können. Was ist Gluten und welche Lebensmittel enthalten Gluten? Gluten ist ein Eiweiß mit besonders starken Klebeeigenschaften. Dies ist auch der Grund, weswegen beispielsweise Brotteig so gut zusammenklebt. Gluten findet sich hauptsächlich in Getreide, beispielsweise ein Roggen oder Gerste, Dinkel oder Weizen und Hafer. Hieraus ergibt sich zwangsläufig, dass auch viele Lebensmittel des täglichen Lebens jede Menge Gluten enthalten. Hierzu gehören nicht nur Schokolade oder Bier, Reis oder Nudeln, sondern auch Pommes oder Milcherzeugnisse. Auch in den meisten Fertiggerichten ist Gluten vorzufinden.

HPV is a different virus than HIV and HSV (herpes). HPV is so common that nearly all sexually active men and women get it at some point in their lives. There are many different types of HPV. Some types can cause health problems including genital warts and cancers.

Birth

An AV fistula is a connection, made by a vascular surgeon, of an artery to a vein.Vascular surgeons specialize in blood vessel surgery. The surgeon usually places an AV fistula in the forearm or upper arm. An AV fistula causes extra pressure and extra blood to flow into the vein, making it grow large and strong.

Most women have between 11 and 13 menstrual periods each year. You may be different: You may have more or fewer. Missed or irregular periods must be looked at in terms of what is normal for you. Menstrual periods are often irregular during the first few years after menstruation starts. It may take several years for the hormones that control menstruation to reach a balance. Menstrual periods also may be very irregular at the other end of the menstrual years. Many women realize that they are approaching perimenopause and menopause when their otherwise regular periods become irregular. Menopause occurs when it has been 12 months since you had a menstrual period. Pregnancy is the most common cause of a missed period. If you might be pregnant, treat yourself as if you are pregnant until you know for sure. Use a home pregnancy test as the first step to finding out whether you are pregnant.

Prostate cancer is the most common cancer among men (after skin cancer), but it can often be treated successfully. If you have prostate cancer or are close to someone who does, knowing what to expect can help you cope. Here you can find out all about prostate cancer, including risk factors, symptoms, how it is found, and how it is treated.

Gitelman syndrome is a kidney disorder that causes an imbalance of charged atoms (ions) in the body, including ions of potassium, magnesium, and calcium. The signs and symptoms of Gitelman syndrome usually appear in late childhood or adolescence. Common features of this condition include painful muscle spasms (tetany), muscle weakness or cramping, dizziness, and salt craving. Also common is a tingling or prickly sensation in the skin (paresthesias), most often affecting the face. Some individuals with Gitelman syndrome experience excessive tiredness (fatigue), low blood pressure, and a painful joint condition called chondrocalcinosis. Studies suggest that Gitelman syndrome may also increase the risk of a potentially dangerous abnormal heart rhythm called ventricular arrhythmia. The signs and symptoms of Gitelman syndrome vary widely, even among affected members of the same family. Most people with this condition have relatively mild symptoms, although affected individuals with severe muscle cramping, paralysis, and slow growth have been reported.

TAPP

Pain Management During Birth