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256

Microbiology - Hepatitis C Virus

Hep C is a killer. 95% of cases lead to chronic liver problems. We are beginning to understand its mode of replication.. https://www.facebook.com/ArmandoHasu...  
YouTube
about 5 years ago
Static.www.bmj
1
27

Response from Hepatitis C Trust, BASL, BIA, BVHG, BSG, and BHIVA to article asking whether widespread screening for hepatitis C is justified

Koretz and colleagues argue that hepatitis C virus (HCV) screening should be delayed.1 We disagree. HCV transmission was common in the 1960s-80s, and because mortality occurs 30-40 years after infection deaths will rise exponentially over the next decade.2 Delaying effective intervention will have a massive impact. The authors argue that because a community study showed an increase in liver and non-liver mortality most infected people will not die from HCV. Infection can cause or exacerbate renal disease, diabetes, and dyslipidaemia and treatment reduces all cause mortality,3 indicating that both liver and non-liver related deaths are caused by …  
bmj.com
almost 5 years ago
8
0
102

Could these results indicate hepatitis?

Could these results indicate hepatitis? White cell count - 22 x 109/L (4-11) C-reactive protein (CRP)- 256 mg/L (<10) Serum alkaline phosphatase - 178U/L (45-105) Serum gamma glutamyl tranferase - 437 U/L (<50) Serum aspartate aminotransferase - 297 U/L (1-31) Serum total bilirubin - 10 µmol/L (1-22) Serum amylase - 2018 U/L (60-180) Serum urea - 6.7 mmol/L (2.5-7.5) Serum creatinine - 98 µmol/l (60-110) Raised white cell count and CRP indicate inflammation and liver-function tests are abnormal (except bilirubin). Would abnormal ALP, AST & GGT indicate hepatitis or does a normal bilirubin indicate normal breakdown of red cells & therefore normal liver function? Though my real problem here is I know that these are liver function tests, but not WHY they are liver function tests (and therefore how else abnormal results could occur...) Cheers.  
b d
about 7 years ago
2
0
30

What are liver ultrasounds NOT good at detecting?

Often when liver pathology is suggested, the imaging of choice seems to be ultrasound. What conditions would not be picked up on ultrasound that would be picked up on other imaging?  
Jess Pobbs
about 7 years ago
5
0
17

What are the causes of hepatic angiomyolipoma?

Simple question really. I know it's really rare, and kidney angiomyolipomas are more common (often related to tuberous sclerosis). But I have no idea about liver angiomyolipomas.... Really any information about it would be helpful, not just the aetiology!  
Rebecca Unwin
about 7 years ago
11
0
24

Why might this patient be feeling nauseous?

A patient feeling excessively nauseous having a history of cholecysectyomy is being administrated with gag's for the treatment of arthritis. The patient complains of vomiting and nausea constantly. Motilium is administrated for nausea but vomiting persist. When lft is done there is a slight increase of bilirubin i.e from 0.2 to 0.3. What is the possible cause of these excessive nauseous feelings? Administration of gag's and chondroiton sulphate or may be due to any problem with the liver function?  
komal zafar
about 7 years ago
4
1
34

Why do we use PT / INR instead of APTT to monitor the synthetic function of liver ?

I read that both PT and APTT are deranged in chronic liver disease as both come produced by the liver , but why do we use PT and INR to for monitoring instead of APTT.  
sukri nawi
almost 7 years ago
2
0
4

whats ur management in given scenario?

A patient with 8 cm x 8 cm abscess in right lobe of liver was treated with aspiration multiple times (3 times) and with system amebicide. Now cavity is remaning in right lobe of liver but there is nothing in the cavity. Seven days course of luminal amebicides is given. How will you follow up? A. Stool examination only B. USG weekly for 1 month followed by monthly USG till 1 year C. USG weekly for 3 months followed by CT scan at 3 months D. USG or CT scan monthly and stool examination weekly 94.  
sampath kumar
over 6 years ago
Foo20151013 2023 1n1xn42?1444773927
6
123

Successful liver transplantation using Facebook

In January 2012 I wrote about a girl who had created a Facebook page because she urgently needed a liver. In August 2004 I had a car accident in Germany, where damaged my limbs and some of my internal organs. That's why I need a liver URGENTLY! Over 26.000 people (family members, doctors, nurses, her friends and students from all parts of the country) followed and liked her page in 3 months. Finally she'd found a suitable liver, and she is fine now. I believe that our generation of health care professionals should be prepared for this and should provide meaningful help, because in the future we can not avoid patients who are interested in social media. E-patients will increasingly use web 2.0 tools as part of their health management and we must respond to that.  
Zoltán Cserháti
almost 7 years ago
Foo20151013 2023 2njk5o?1444774020
4
1327

LWW: Case Of The Month - April 2013

This month’s case is by David R Bell PhD, co-author of Medical Physiology: Principles for Clinical Medicine, 3e (ISBN: 9781451110395) For more information, or to purchase your copy, visit: http://tiny.cc/Rhoades4e, with 15% off using the discount code: MEDUCATION. The case below is followed by a quiz question, allowing you a choice of diagnoses. Select the one letter section that best describes the patient’s condition. The Case A 28-year old woman has an unremarkable pregnancy through her first 28 weeks of gestation, with normal weight gain and no serious complications. She has no previous history of diabetes, hypertension of other systemic disease before or during her current pregnancy. During her 30-week checkup, her blood pressure measures 128/85, and she complains about feeling slightly more “bloated” than usual with swelling in her legs that seems to get more uncomfortable as the day goes on. Her obsterician recommends that she get more bed rest, stay off her feet as much as possible and return for evaluation in one week. At the one-week follow-up, the patient presents with noticable”puffiness” in her face, and a blood pressure of 145/95. She complains she has been developing headaches, sporadic blurred vision, right-sided discomfort and some shortness of breath. She has gained more than 10 lb (4.5kg) in the past week. A urinalysis on the patient revelas no glucose but a 3+ reading for protein. Her obstetrician decides to admit her immediately to a local tertiary care hospital for further evaluation. Over the next 24 hours, the patient’s urine output is recorded as 500mL and contains 6.8 grams of protein. Her plasma albumin level is 3.1 g/dl, hemacrit 48%, indirect bilirubin 1.5mg/dl and blood platelets=77000/uL, respectively. Her blood pressure is now 190/100. It is decided to try to deliver the foetus. The expelled placenta is small and shows signs of widespread ischmic damage. Within a week of delivery, the mother’s blood pressure returns to normal, and her oedema subsides. One month later, the mother shows no ill effects of thos later-term syndrome. Question What is the clinical diagnosis of this patient’s condition and its underlying pathophysiology? A. Gestational Hypertension B. Preeclampsia C. Gestational Diabetes D. Compression of the Inferior Vena Cava Answer The correct answer is "B. Preeclampsia". The patient’s symptoms and laboratory findings are consistent with a diagnosis of Preeclampsia, which is a condition occurring in some pregnancies that causes life-threatening organ and whole body regulatory malfunctions. The patient’s negative urine glucose is inconsistent with gestational diabetes. Gestational hypertension or vena caval compression cannot explain all of the patient findings. The patient has three major abnormal findings- generalised oedema, hypertension and proteinuria which are all common in preeclampsia. Although sequalae of a normal pregnancy can include water and salt retention, bloating, modest hypertension and leg swelling (secondary to capillary fluid loss from increased lower limb capillary hydrostatic pressure due to compression of the inferior vena cava by the growing foetus/uterus), oedema in the head and upper extremities, a rapid 10 pound weight gain and shortness of breath suggests a generalized and serious oedematous state. The patient did not have hypertension before or within 20 weeks gestation (primary hypertension) and did not develop hypertension after the 20th week of pregnancy with no other abnormal findings (gestational hypertension). Hypertension with proteinuria occurring beyond the 20th week of pregnancy however is a hallmark of preeclampsia. In addition, the patient has hemolysis (elevated bilirubin and LDH levels), elevated liver enzyme levels and thrombocytopenia. This is called the HELLP syndrome (HELLP = Hemolysis, Elevated Liver enzymes and Low Platelets.), and is considered evidence of serious patient deterioration in preeclampsia. A urine output of 500 ml in 24 hours is 1/2 to 1/4 of normal output in a hydrated female and indicates renal insufficiency. Protein should never be found in the urine and indicates loss of capillaries integrity in glomeruli which normally are not permeable to proteins. The patient has substantial 24 urine protein loss and hypoalbuminemia. However, generally plasma albumin levels must drop below 2.5 gm/dl to decrease plasma oncotic pressure enough to cause general oedema. The patient’s total urinary protein loss was insufficient in this regard. Capillary hyperpermeability occurs with preeclampsia and, along with hypertension, could facilitate capillary water efflux and generalized oedema. However myogenic constriction of pre-capillary arterioles could reduce the effect of high blood pressure on capillary water efflux. An early increase in hematocrit in this patient suggests hemoconcentration which could be caused by capillary fluid loss but the patient’s value of 48 is unremarkable and of little diagnostic value because increased hematocrit occurs in both preeclampsia and normal pregnancy. PGI2, PGE2 and NO, produced during normal pregnancy, cause vasorelaxation and luminal expansion of uterine arteries, which supports placental blood flow and development. Current theory suggests that over production of endothelin, thromboxane and oxygen radicals in preeclampsia antagonize vasorelaxation while stimulating platelet aggregation, microthrombi formation and endothelial destruction. These could cause oedema, hypertension, renal/hepatic deterioration and placental ischemia with release of vasotoxic factors. The patient’s right-sided pain is consistent with liver pathology (secondary to hepatic DIC or oedematous distention). Severe hypertension in preeclampsia can lead to maternal end organ damage, stroke, and death. Oedematous distension of the liver can cause hepatic rupture and internal hemorrhagic shock. Having this patient carry the baby to term markedly risks the life of the mother and is not considered current acceptable clinical practice. Delivery of the foetus and termination of the pregnancy is the only certain way to end preeclampsia. Read more This case is by David R Bell PhD, co-author of Medical Physiology: Principles for Clinical Medicine, 3e (ISBN: 9781451110395) For more information, or to purchase your copy, visit: http://tiny.cc/Rhoades4e. Save 15% (and get free P&P) on this, and a whole host of other LWW titles at (lww.co.uk)[http://lww.co.uk] when you use the code MEDUCATION when you check out! About LWW/ Wolters Kluwer Health Lippincott Williams and Wilkins (LWW) is a leading publisher of high-quality content for students and practitioners in medical and related fields. Their text and review products, eBooks, mobile apps and online solutions support students, educators, and instiutions throughout the professional’s career. LWW are proud to partner with Meducation.  
Lippincott Williams & Wilkins
almost 7 years ago
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Quick pediatrics: Indications for Liver transplant in children

Prepare for USMLE,UK,CANADIAN,AUSTRALIAN, NURSING & OTHER MEDICAL BOARD examinations around the globe with us.Understand the basics, concepts and how to answ...  
youtube.com
almost 5 years ago
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0
1

Singapore identifies mutations that may enable earlier diagnosis of colorectal cancer recurrence

The findings will be used to develop diagnostic kits for individual patients with colorectal cancer to detect future liver metastasisA multi-disciplinary team of...  
medicalnewstoday.com
almost 5 years ago
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0
5

Adherence to drug regimen by liver transplant patients hindered by limited literacy, more meds

New research reports that liver transplant recipients with less understanding of treatment information and improper use of medications may be more likely to have trouble following the prescribed...  
medicalnewstoday.com
almost 5 years ago
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0
4

Study shows how melligen cell line derived from human liver cells can reverse diabetes

A recently published paper in the scientific journal Molecular Therapy - Methods & Clinical Development puts the spotlight on novel research that has been done by a team at the...  
medicalnewstoday.com
almost 5 years ago
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0
16

Erectile dysfunction drugs could protect liver from sepsis-induced damage, says Pitt team

Drugs that are on the market to treat erectile dysfunction (ED) could have another use--they might be able to protect the liver from damage caused by sepsis, a systemic inflammatory response to...  
medicalnewstoday.com
almost 5 years ago
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3

Using heart-lung support machine for donations after circulatory death boosted pool of available organs by 20 percent

Using heart-lung support technology, the University of Michigan's Transplant Center was able to increase the number of kidneys, livers and pancreases available for transplant by about 20 percent.  
medicalnewstoday.com
almost 5 years ago
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3

Standard nursing assessments improve ability to predict survival in cirrhosis patients

Patients hospitalized with advanced cirrhosis, a chronic and degenerative disease of the liver, are at increased risk of death.  
medicalnewstoday.com
almost 5 years ago
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0
9

Exercise at any level may benefit overweight patients with nonalcoholic fatty liver disease

For overweight or obese patients with nonalcoholic fatty liver disease, exercise - regardless of volume or intensity - may reduce both visceral and liver fat, a new study finds.  
medicalnewstoday.com
almost 5 years ago
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0
5

Computer model predicts how our livers will store fat

Computer model developed to predict how 'T09' causes the liver to store fat could be used to predict liver fat storage for other drugs and conditionsAs part of an...  
medicalnewstoday.com
almost 5 years ago
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4

Research team discovers backup system that helps sustain liver during crisis

Scientists from Montana State University and Sweden have discovered an antioxidant system that helps sustain the liver when other systems are missing or compromised.  
medicalnewstoday.com
almost 5 years ago