Acquired immune deficiency syndrome or acquired immunodeficiency syndrome (AIDS or Aids) is a collection of symptoms and infections resulting from the specific damage to the immune system caused by the human immunodeficiency virus (HIV) in humans, and similar viruses in other species (SIV, FIV, etc.). The late stage of the condition leaves individuals susceptible to opportunistic infections and tumors. Although treatments for AIDS and HIV exist to decelerate the virus' progression, there is currently no known cure. HIV, et al., are transmitted through direct contact of a mucous membrane or the bloodstream with a bodily fluid containing HIV, such as blood, semen, vaginal fluid, preseminal fluid, and breast milk. This transmission can come in the form of anal, vaginal or oral sex, blood transfusion, contaminated hypodermic needles, exchange between mother and baby during pregnancy, childbirth, or breastfeeding, or other exposure to one of the above bodily fluids.
Infection by HIV
AIDS is the most severe acceleration of infection with HIV. HIV is a retrovirus that primarily infects vital organs of the human immune system such as CD4+ T cells (a subset of T cells), macrophages and dendritic cells. It directly and indirectly destroys CD4+ T cells. CD4+ T cells are required for the proper functioning of the immune system. When HIV kills CD4+ T cells so that there are fewer than 200 CD4+ T cells per microliter (µL) of blood, cellular immunity is lost, leading to the condition known as AIDS. Acute HIV infection progresses over time to clinical latent HIV infection and then to early symptomatic HIV infection and later to AIDS, which is identified on the basis of the amount of CD4+ T cells in the blood and the presence of certain infections.
In the absence of antiretroviral therapy, the median time of progression from HIV infection to AIDS is nine to ten years, and the median survival time after developing AIDS is only 9.2 months.[7] However, the rate of clinical disease progression varies widely between individuals, from two weeks up to 20 years. Many factors affect the rate of progression. These include factors that influence the body's ability to defend against HIV such as the infected person's general immune function.[8][9] Older people have weaker immune systems, and therefore have a greater risk of rapid disease progression than younger people. Poor access to health care and the existence of coexisting infections such as tuberculosis also may predispose people to faster disease progression. The infected person's genetic inheritance plays an important role and some people are resistant to certain strains of HIV. An example of this is people with the CCR5-Δ32 mutation are resistant to infection with certain strains of HIV. HIV is genetically variable and exists as different strains, which cause different rates of clinical disease progression. The use of highly active antiretroviral therapy prolongs both the median time of progression to AIDS and the median survival time.
Jumat, 26 Oktober 2007
Rabu, 24 Oktober 2007
CHICKEN POX
Chicken pox is a highly contagious viral infection caused by the varicella virus.
Chickenpox is a disease of childhood - 90% of cases occur in children aged 14 years and younger. Before widespread vaccination, the incidence of chicken pox in the United States approached the annual birth rate, averaging between 3.1 and 3.8 million cases per year. Chicken pox can occur at any time, but occurs most often in March, April, and May in temperate climates.
The varicella virus is an enveloped, double-stranded DNA virus. It attaches to the wall of the cell it invades, and then enters the cell. The virus uncoats and is transported to the nucleus where the viral DNA replicates creating new virions that are eventually released from the cell to infect other cells.
Chicken pox is acquired by direct contact with infected blister fluid or by inhalation of respiratory droplets. When a person with chicken pox coughs or sneezes, they expel tiny droplets that carry the varicella virus. A person who has never been exposed to chicken pox inhales these droplets and the virus enters the lungs, and then is carried through the bloodstream to the skin where it causes a rash. While the virus is in the bloodstream (before the rash begins) it causes typical viral symptoms like fever, fatigue, joint pains, headache, and swollen glands. These symptoms usually resolve by the time the rash develops. The incubation period of chicken pox averages 14 days with a range of 9 to 21 days.
The chicken pox rash begins on the trunk and spreads to the face and extremities. The chicken pox lesion starts as a 2-4 mm red papule which develops an irregular outline (rose petal). A thin-walled, clear vesicle (dew drop) develops on top of the area of redness. This "dew drop on a rose petal" lesion is very characteristic for chicken pox. After about 8-12 hours the fluid in the vesicle gets cloudy and the vesicle breaks leaving a crust. The fluid is Chickenpox is a disease of childhood - 90% of cases occur in children aged 14 years and younger. Before widespread vaccination, the incidence of chicken pox in the United States approached the annual birth rate, averaging between 3.1 and 3.8 million cases per year. Chicken pox can occur at any time, but occurs most often in March, April, and May in temperate climates. highly contagious, but once the lesion crusts over, it is not considered contagious. The crust usually falls off after 7 days sometimes leaving a craterlike scar. Although one lesion goes through this complete cycle in about 7 days, another hallmark of chicken pox is the fact that new lesions crop up every day for several days. Therefore, it may take about a week until new lesions stop appearing and existing lesions crust over. Children are not sent back to school until all lesions have crusted over.
The number of chicken pox lesions a person gets varies considerably. The usual range is 100 to 300 lesions. Usually, older children and adults develop more lesions than young children. Also cases of chicken pox acquired from contact with household members are typically more severe than those acquired from community contact. This is presumably because household contacts have closer contact. People who have previously traumatized skin, such as from a sunburn or eczema, may also develop a more extensive rash. In addition to affecting the skin, chicken pox can also cause lesions on the mucous membranes in the eyes, mouth, and vagina.
Chicken pox is typically diagnosed clinically based on the history of viral symptoms and the characteristic appearance of the rash. However, sometimes chicken pox can be confused with herpes simplex, impetigo, insect bites, or scabies. Sometimes a viral culture can be performed to confirm the diagnosis, but it takes from 1 to 14 days to get the results.
Chickenpox is a disease of childhood - 90% of cases occur in children aged 14 years and younger. Before widespread vaccination, the incidence of chicken pox in the United States approached the annual birth rate, averaging between 3.1 and 3.8 million cases per year. Chicken pox can occur at any time, but occurs most often in March, April, and May in temperate climates.
The varicella virus is an enveloped, double-stranded DNA virus. It attaches to the wall of the cell it invades, and then enters the cell. The virus uncoats and is transported to the nucleus where the viral DNA replicates creating new virions that are eventually released from the cell to infect other cells.
Chicken pox is acquired by direct contact with infected blister fluid or by inhalation of respiratory droplets. When a person with chicken pox coughs or sneezes, they expel tiny droplets that carry the varicella virus. A person who has never been exposed to chicken pox inhales these droplets and the virus enters the lungs, and then is carried through the bloodstream to the skin where it causes a rash. While the virus is in the bloodstream (before the rash begins) it causes typical viral symptoms like fever, fatigue, joint pains, headache, and swollen glands. These symptoms usually resolve by the time the rash develops. The incubation period of chicken pox averages 14 days with a range of 9 to 21 days.
The chicken pox rash begins on the trunk and spreads to the face and extremities. The chicken pox lesion starts as a 2-4 mm red papule which develops an irregular outline (rose petal). A thin-walled, clear vesicle (dew drop) develops on top of the area of redness. This "dew drop on a rose petal" lesion is very characteristic for chicken pox. After about 8-12 hours the fluid in the vesicle gets cloudy and the vesicle breaks leaving a crust. The fluid is Chickenpox is a disease of childhood - 90% of cases occur in children aged 14 years and younger. Before widespread vaccination, the incidence of chicken pox in the United States approached the annual birth rate, averaging between 3.1 and 3.8 million cases per year. Chicken pox can occur at any time, but occurs most often in March, April, and May in temperate climates. highly contagious, but once the lesion crusts over, it is not considered contagious. The crust usually falls off after 7 days sometimes leaving a craterlike scar. Although one lesion goes through this complete cycle in about 7 days, another hallmark of chicken pox is the fact that new lesions crop up every day for several days. Therefore, it may take about a week until new lesions stop appearing and existing lesions crust over. Children are not sent back to school until all lesions have crusted over.
The number of chicken pox lesions a person gets varies considerably. The usual range is 100 to 300 lesions. Usually, older children and adults develop more lesions than young children. Also cases of chicken pox acquired from contact with household members are typically more severe than those acquired from community contact. This is presumably because household contacts have closer contact. People who have previously traumatized skin, such as from a sunburn or eczema, may also develop a more extensive rash. In addition to affecting the skin, chicken pox can also cause lesions on the mucous membranes in the eyes, mouth, and vagina.
Chicken pox is typically diagnosed clinically based on the history of viral symptoms and the characteristic appearance of the rash. However, sometimes chicken pox can be confused with herpes simplex, impetigo, insect bites, or scabies. Sometimes a viral culture can be performed to confirm the diagnosis, but it takes from 1 to 14 days to get the results.
HEALTHY KID'S
Being fit is a way of saying a person eats well, gets a lot of physical activity (exercise), and has a healthy weight. If you're fit, your body works well, feels good, and can do all the things you want to do, like run around with your friends.
Here are five rules to live by, if you're a kid who wants to be fit. The trick is to follow these rules most of the time, knowing that some days (like your birthday) might call for cake and ice cream.
1. Eat a variety of foods, especially fruits and vegetables. You may have a favorite food, but the best choice is to eat a variety. If you eat different foods, you're more likely to get the nutrients your body needs.
2. Drink water and milk most often. When you're really thirsty, cold water is the No. 1 thirst-quencher. And there's a reason your school cafeteria offers cartons of milk. Kids need calcium to grow strong bones, and milk is a great source of this mineral. How much do kids need? Aim for 3 cups of milk per day, or its equivalent. You can mix it up by having milk and some other calcium-rich dairy foods.
3. Listen to your body. What does it feel like to be full? When you're eating, notice how your body feels and when your stomach feels comfortably full. Sometimes, people eat too much because they don't notice when they need to stop eating. Eating too much can make you feel uncomfortable and, over a period of time, can lead to unhealthy weight gain.
4. Limit screen time. Limit screen time. What's screen time? It's the amount of time you spend watching TV or DVDs, playing video games (console systems or handheld games), and using the computer. The more time you spend on these sitting-down activities, the less time available for active stuff, like basketball, bike riding, and swimming. Try to spend no more than 2 hours a day on screen time, not counting computer use related to school.
5. Be active. One job you have as a kid — and it's a fun one — is that you get to figure out which activities you like best. Not everyone loves baseball or soccer. Maybe your passion is karate, or kickball, or dancing. Ask your parents to help you do your favorite activities regularly. Find ways to be active every day. You might even write down a list of fun stuff to do, so you can refer to it when your mom or dad says it's time to stop watching TV or playing computer games!
Here are five rules to live by, if you're a kid who wants to be fit. The trick is to follow these rules most of the time, knowing that some days (like your birthday) might call for cake and ice cream.
1. Eat a variety of foods, especially fruits and vegetables. You may have a favorite food, but the best choice is to eat a variety. If you eat different foods, you're more likely to get the nutrients your body needs.
2. Drink water and milk most often. When you're really thirsty, cold water is the No. 1 thirst-quencher. And there's a reason your school cafeteria offers cartons of milk. Kids need calcium to grow strong bones, and milk is a great source of this mineral. How much do kids need? Aim for 3 cups of milk per day, or its equivalent. You can mix it up by having milk and some other calcium-rich dairy foods.
3. Listen to your body. What does it feel like to be full? When you're eating, notice how your body feels and when your stomach feels comfortably full. Sometimes, people eat too much because they don't notice when they need to stop eating. Eating too much can make you feel uncomfortable and, over a period of time, can lead to unhealthy weight gain.
4. Limit screen time. Limit screen time. What's screen time? It's the amount of time you spend watching TV or DVDs, playing video games (console systems or handheld games), and using the computer. The more time you spend on these sitting-down activities, the less time available for active stuff, like basketball, bike riding, and swimming. Try to spend no more than 2 hours a day on screen time, not counting computer use related to school.
5. Be active. One job you have as a kid — and it's a fun one — is that you get to figure out which activities you like best. Not everyone loves baseball or soccer. Maybe your passion is karate, or kickball, or dancing. Ask your parents to help you do your favorite activities regularly. Find ways to be active every day. You might even write down a list of fun stuff to do, so you can refer to it when your mom or dad says it's time to stop watching TV or playing computer games!
SARS (severe acute respiratory syndrome)
Severe acute respiratory syndrome or SARS is a respiratory disease in humans which is caused by the SARS coronavirus.
Initial symptoms are flu like and may include: fever, myalgia, lethargy, gastrointestinal symptoms, cough, sore throat and other non-specific symptoms. The only symptom that is common to all patients appears to be a fever above 38 °C (100.4 °F). Shortness of breath may occur later. Symptoms usually appear 2–10 days following exposure, but up to 13 days has been reported. In most cases symptoms appear within 2–3 days. About 10–20% of cases require mechanical ventilation.
The Chest X-ray (CXR) appearance of SARS is variable. There is no pathognomonic appearance of SARS but is commonly felt to be abnormal with patchy infiltrates in any part of the lungs. The initial CXR may be clear.
White blood cell and platelet counts are often low. Early reports indicated a tendency to relative neutrophilia and a relative lymphopenia — relative because the total number of white blood cells tends to be low. Other suggestive laboratory tests are raised lactate dehydrogenase and slightly raised creatine kinase and C-Reactive protein levels.
Diagnostic tests
With the identification and sequencing of the RNA of the coronavirus responsible for SARS on April 12, 2003, several diagnostic test kits have been produced and are now being tested for their suitability for use.
Three possible diagnostic tests have emerged, each with drawbacks. The first, an ELISA (enzyme-linked immunosorbent assay) test detects antibodies to SARS reliably but only 21 days after the onset of symptoms. The second, an immunofluorescence assay, can detect antibodies 10 days after the onset of the disease but is a labour and time intensive test, requiring an immunofluorescence microscope and an experienced operator. The last test is a PCR (polymerase chain reaction) test that can detect genetic material of the SARS virus in specimens ranging from blood, sputum, tissue samples and stools. The PCR tests so far have proven to be very specific but not very sensitive. This means that while a positive PCR test result is strongly indicative that the patient is infected with SARS, a negative test result does not mean that the patient does not have SARS.
SARS may be suspected in a patient who has:
1. Any of the symptoms including a fever of 38 °C (100.4 °F) or more AND
2.Either a history of :
1.Contact (sexual or casual) with someone with a diagnosis of SARS within the last 10 days OR Travel to any of the regions identified by the WHO as areas with recent local transmission of SARS (affected regions as of 10 May 2003[3] were parts of China, Hong Kong, Singapore and the province of Ontario, Canada
Treatment
Antibiotics are ineffective. Treatment of SARS so far has been largely supportive with antipyretics, supplemental oxygen and ventilatory support as needed. Suspected cases of SARS must be isolated, preferably in negative pressure rooms, with full barrier nursing precautions taken for any necessary contact with these patients. There was initially anecdotal support for steroids and the antiviral drug ribavirin, but no published evidence has supported this therapy. Many clinicians now suspect that ribavirin is detrimental. Researchers are currently testing all known antiviral treatments for other diseases including AIDS, hepatitis, influenza and others on the SARS-causing coronavirus. There is some evidence that some of the more serious damage in SARS is due to the body's own immune system overreacting to the virus. There may be some benefit from using steroids and other immune modulating agents in the treatment of the more acute SARS patients. Research is continuing in this area.
Initial symptoms are flu like and may include: fever, myalgia, lethargy, gastrointestinal symptoms, cough, sore throat and other non-specific symptoms. The only symptom that is common to all patients appears to be a fever above 38 °C (100.4 °F). Shortness of breath may occur later. Symptoms usually appear 2–10 days following exposure, but up to 13 days has been reported. In most cases symptoms appear within 2–3 days. About 10–20% of cases require mechanical ventilation.
The Chest X-ray (CXR) appearance of SARS is variable. There is no pathognomonic appearance of SARS but is commonly felt to be abnormal with patchy infiltrates in any part of the lungs. The initial CXR may be clear.
White blood cell and platelet counts are often low. Early reports indicated a tendency to relative neutrophilia and a relative lymphopenia — relative because the total number of white blood cells tends to be low. Other suggestive laboratory tests are raised lactate dehydrogenase and slightly raised creatine kinase and C-Reactive protein levels.
Diagnostic tests
With the identification and sequencing of the RNA of the coronavirus responsible for SARS on April 12, 2003, several diagnostic test kits have been produced and are now being tested for their suitability for use.
Three possible diagnostic tests have emerged, each with drawbacks. The first, an ELISA (enzyme-linked immunosorbent assay) test detects antibodies to SARS reliably but only 21 days after the onset of symptoms. The second, an immunofluorescence assay, can detect antibodies 10 days after the onset of the disease but is a labour and time intensive test, requiring an immunofluorescence microscope and an experienced operator. The last test is a PCR (polymerase chain reaction) test that can detect genetic material of the SARS virus in specimens ranging from blood, sputum, tissue samples and stools. The PCR tests so far have proven to be very specific but not very sensitive. This means that while a positive PCR test result is strongly indicative that the patient is infected with SARS, a negative test result does not mean that the patient does not have SARS.
SARS may be suspected in a patient who has:
1. Any of the symptoms including a fever of 38 °C (100.4 °F) or more AND
2.Either a history of :
1.Contact (sexual or casual) with someone with a diagnosis of SARS within the last 10 days OR Travel to any of the regions identified by the WHO as areas with recent local transmission of SARS (affected regions as of 10 May 2003[3] were parts of China, Hong Kong, Singapore and the province of Ontario, Canada
Treatment
Antibiotics are ineffective. Treatment of SARS so far has been largely supportive with antipyretics, supplemental oxygen and ventilatory support as needed. Suspected cases of SARS must be isolated, preferably in negative pressure rooms, with full barrier nursing precautions taken for any necessary contact with these patients. There was initially anecdotal support for steroids and the antiviral drug ribavirin, but no published evidence has supported this therapy. Many clinicians now suspect that ribavirin is detrimental. Researchers are currently testing all known antiviral treatments for other diseases including AIDS, hepatitis, influenza and others on the SARS-causing coronavirus. There is some evidence that some of the more serious damage in SARS is due to the body's own immune system overreacting to the virus. There may be some benefit from using steroids and other immune modulating agents in the treatment of the more acute SARS patients. Research is continuing in this area.
Blood Sugar
Blood sugar is a term used to refer to the amount of glucose in the blood. Glucose, transported via the bloodstream, is the primary source of energy for the body's cells. Blood sugar concentration, or glucose level, is tightly regulated in the human body. Normally, the blood glucose level is maintained between about 4 and 8 mmol/L (70 to 150 mg/dL). The total amount of glucose in the circulating blood is therefore about 3.3 to 7g (assuming an ordinary adult blood volume of 5 liters). Glucose levels rise after meals and are usually lowest in the morning, before the first meal of the day. Failure to maintain blood glucose in the normal range leads to conditions of persistently high (hyperglycemia) or low (hypoglycemia) blood sugar. Diabetes mellitus, characterized by persistent hyperglycemia of several causes, is the most prominent disease related to failure of blood sugar regulation. Though it is called "blood sugar" and sugars besides glucose are found in the blood, like fructose and galactose, only glucose levels are regulated via insulin and glucagon.
If blood sugar levels drop too low, a potentially fatal condition called hypoglycemia develops. Symptoms may include lethargy, impaired mental functioning, irritability, and loss of consciousness.
If levels remain too high, appetite is suppressed over the short term. Long-term hyperglycemia causes many of the long-term health problems associated with diabetes, including eye, kidney, and nerve damage.
SARS (Severe acute respiratory syndrome)
Severe acute respiratory syndrome or SARS is a respiratory disease in humans which is caused by the SARS coronavirus.
Initial symptoms are flu like and may include: fever, myalgia, lethargy, gastrointestinal symptoms, cough, sore throat and other non-specific symptoms. The only symptom that is common to all patients appears to be a fever above 38 °C (100.4 °F). Shortness of breath may occur later. Symptoms usually appear 2–10 days following exposure, but up to 13 days has been reported. In most cases symptoms appear within 2–3 days. About 10–20% of cases require mechanical ventilation.
The Chest X-ray (CXR) appearance of SARS is variable. There is no pathognomonic appearance of SARS but is commonly felt to be abnormal with patchy infiltrates in any part of the lungs. The initial CXR may be clear.
White blood cell and platelet counts are often low. Early reports indicated a tendency to relative neutrophilia and a relative lymphopenia — relative because the total number of white blood cells tends to be low. Other suggestive laboratory tests are raised lactate dehydrogenase and slightly raised creatine kinase and C-Reactive protein levels.
If blood sugar levels drop too low, a potentially fatal condition called hypoglycemia develops. Symptoms may include lethargy, impaired mental functioning, irritability, and loss of consciousness.
If levels remain too high, appetite is suppressed over the short term. Long-term hyperglycemia causes many of the long-term health problems associated with diabetes, including eye, kidney, and nerve damage.
SARS (Severe acute respiratory syndrome)
Severe acute respiratory syndrome or SARS is a respiratory disease in humans which is caused by the SARS coronavirus.
Initial symptoms are flu like and may include: fever, myalgia, lethargy, gastrointestinal symptoms, cough, sore throat and other non-specific symptoms. The only symptom that is common to all patients appears to be a fever above 38 °C (100.4 °F). Shortness of breath may occur later. Symptoms usually appear 2–10 days following exposure, but up to 13 days has been reported. In most cases symptoms appear within 2–3 days. About 10–20% of cases require mechanical ventilation.
The Chest X-ray (CXR) appearance of SARS is variable. There is no pathognomonic appearance of SARS but is commonly felt to be abnormal with patchy infiltrates in any part of the lungs. The initial CXR may be clear.
White blood cell and platelet counts are often low. Early reports indicated a tendency to relative neutrophilia and a relative lymphopenia — relative because the total number of white blood cells tends to be low. Other suggestive laboratory tests are raised lactate dehydrogenase and slightly raised creatine kinase and C-Reactive protein levels.
Jumat, 05 Oktober 2007
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