Hepatitis and HIV Co-Infection.


Acute viral hepatitis may be severe or fatal
Acute viral hepatitis may add to liver damage already present from other causes
e.g. Acute hepatitis A on other chronic viral hepatitides may be deadly

Hepatitis A & HIV, in Brief
Role seems significant
35 HIV+ with acute HAV
80% treatment interrupted X ~ 2 months
25% lost efficacy on resuming HAART
safe, effective VACCINE available for Hepatitis A and B – vaccinate!

Hepatitis C
Transmitted via IVDU/contaminated blood/perinatal > sex (receptive AS & STD)
In U.S., 4 million HCV+ → 85% chronic
If chronic → 20% cirrhotic @ 20 – 40 years
Once cirrhotic → 25% hepatocellular CA
(0.5% of total HCV+)
Alcohol & HIV worsen prognosis
Usually no symptoms but sometimes fatigue, RUQ ache, difficulty concentrating or isolated  ALT/AST

Compared to HCV mono-infection, co-infected patients have:
More rapid progression to
cirrhosis
decompensated liver disease
HCC
death

Diagnosing HCV in HIV
Do not rely on transaminases! There is no correlation between transaminase levels and disease severity.
HCV ELISA antibody screening
+ Antibody means “infected at some point”, need to determine if active or chronic infection
In advanced HIV, may be falsely negative
HCV RNA PCR confirms or excludes active disease
+ Viral load means “active hepatitis”
Quantitative HCV VL does not correlate with degree of liver damage and is not a surrogate marker for disease progression

Chronic Hepatitis C
STOP ALL ETHANOL
Consider opioid substitution therapy if active drug abuse
Assure immunity to Hepatitis A & B;  in not immune, offer vaccines
Obtain Genotype
Counsel on condoms and safer sex
Introduce risks vs. benefits of treatment
Assess if benefit of treatment outweighs risk

Hepatitis C Screening
Genotyping & Hep C VL are helpful in predicting response to therapy
1 ( & 4) is more refractory to treatment
If VL < 800,000 IU/mL, Geno 1 easier to treat
2 & 3 are very responsive
Attempt to get CD4>200 with ART
Pts with CD4% > 25% are more likely to have SVR
Preg. test unless hysterectomy or tubal ligation
CBC, Platelet, CMP/Lipid, PT with INR, PTT
TSH (autoimmune thyroiditis potential complication of therapy)

Erasing and restoring our memories.


In recent years, researchers studying the brain have implanted false memories, caused patients to hallucinate while sleeping, and even tricked the brain into hearing sounds that don’t exist.

Now, a team of neuroscientists has manipulated brain cells to both erase and then restore a memory, a finding that could help with treatment of brain diseases like Alzheimer’s or PTSD.

“Technologically, it’s a huge achievement,” says Steve Ramirez, a graduate student in the department of brain and cognitive sciences at the Massachusetts Institute of Technology who was not part of the study, but has published work on creating memories.

“It renders that possibility (of manipulating memory) is no longer science fiction, but something you can tackle experimentally in the lab.”

In a paper published in the journal Nature, a team at the University of California, San Diego created a memory in a rat and then erased it by stimulating the connections, or synapses, between nerve cells at different frequencies.

The first step was to create a memory. They did this by stimulating a group of nerves in the rat’s brain (which equated to the sound of a tone) that had been genetically modified to respond to light, while shocking the animal’s foot at the same time.

From the rat’s perspective, the sound of the tone (done by stimulating the nerve cells) was equated with the fear of getting a mild shock.

Then the team weakened the connection between the brain cells, which had the effect of erasing that memory.

Manipulating memory

But in a twist, they were also able to recover the fear-pain memory by strengthening the synaptic connection by stimulating the synapse with a different frequency.

“We can form a memory, and then turn it off and turn it on by selectively turning on synapses,” says Robert Malinow, professor of neurosciences and an author on the paper. “It puts together a number of things we have known and learned to produce this effect. It reinforces that synapses are important and can control memory.”

https://i1.wp.com/www.abc.net.au/reslib/201406/r1284424_17420046.jpg

Malinow says the finding could open the door to manipulating the creation of memories in humans as well. In PTSD, memories of certain traumatic events cause severe anxiety, depression and other problems in patients, while Alzheimer’s disease causes us to lose our memories.

A post-doctoral student in Malinow’s lab, Sadegh Nabavi, conducted the experiments and is the lead author on the Nature paper.

One expert, however, cautioned that it’s still too early to take these findings as a road map creating memories in an artificial brain, for example.

“We don’t understand enough about the brain to take those principals and make computers,” says Mark Mayford, a neuroscientist at the Scripps Research Institute in La Jolla, California. “Instead, people are trying to take a few principals and put them in standard computer software like learning algorithms.”

 

Shaken Baby Syndrome (SBS) often a false diagnosis really caused by vaccines .


A woman who had no prior history of violence was released from prison in April after serving nearly half of a 20-year sentence for the murder of an infant in her care.

baby

Jennifer Del Prete was a daycare worker who maintained her innocence throughout her entire ordeal. She was convicted of shaking four-month-old Isabella Zielinski after the child fell unconscious in her care. She never woke up from a coma and died in the hospital 10 months later.

During Del Prete’s trial, prosecutors insisted that it was a classic case of violent and intentional shaken baby syndrome (which is now officially known as “abusive head trauma”), and they had the medical experts to “prove it.”

‘Groundbreaking’ ruling

Now, however, U.S. District Judge Matthew Kennelly, who ordered Del Prete’s release, is not convinced of the shaken-baby verdict, or even that the typical symptoms that are used to diagnose it are sufficient to prove a person guilty of child abuse or murder.

As reported by the website Care2.com:

In a comprehensive 97-page opinion, Kennelly draws attention to the controversial science behind SBS, going so far as to suggest: “a claim of shaken baby syndrome is more an article of faith than a proposition of science.”

Kennelly’s ruling is being considered groundbreaking in some circles, because for the first time it condemns the shaken-baby diagnosis, which has been upheld in scores of courtrooms and has been used to convict hundreds of people on charges of child abuse and murder, as unreliable.

Since the 1990s, the website reports, more than 1,000 cases of shaken baby syndrome (SBS) have been heard in court. Between half and three-quarters of these cases have relied on an SBS-associated triad of symptoms as the only medical evidence “proving” the crime.

The triad — subdural hemorrhage (or bleeding surrounding the brain), retinal hemorrhage and swelling of the brain — has been used by prosecutors as irrefutable evidence that determines almost all important aspects of the case, such as how the child died (from being shaken violently), who did the shaking (the last person with the child) and what the state of mind was for the murder at the time (angry and intentional).

Vaccine reactions can mimic SBS symptoms

Additional physical symptoms like bruises and cuts that you might expect to see in cases of very extreme child abuse mostly did not need to be present to convict someone of SBS. It also was not necessary for any witnesses to have been present. So, the result was an overwhelming faith in the triad, in which it alone was powerful enough to determine a person’s guilt:

This is troubling for several reasons, not the least of which is that the science behind the triad is coming into question. Many doctors now acknowledge that the same symptoms that once were used to definitively conclude that SBS had taken place could actually be caused by other conditions, such as infections or bleeding disorders. There have also been findings that dispute that the assumption the shaking need necessarily be violent and intentional for these symptoms to take place.

And some experts believe that adverse reactions to vaccines, which can cause symptoms similar to SBS, are actually responsible for the deaths of some babies.

“Del Prete’s case can teach us about much more than the controversy surrounding SBS,” Care2.org says. “It shows us how crucial it is that evidence not be based on one idea alone. Theory is important, but over-reliance on it can be a bit like trusting a single witness when the rest of them have nothing incriminating to say. We need to be comprehensive in our trials, otherwise ‘innocent until proven guilty’ loses its meaning.”

For more information and breaking news regarding the dangers of vaccines, visit Vaccines.NaturalNews.com.

Sources:

http://www.care2.com

http://www.naturalnews.com

http://www.vaccineeducation.org

http://science.naturalnews.com

Microbes engineered for the direct conversion of biomass to ethanol fuel.


The promise of affordable transportation fuels from biomass—a sustainable, carbon neutral route to American energy independence—has been left perpetually on hold by the economics of the conversion process. New research from the University of Georgia has overcome this hurdle allowing the direct conversion of switchgrass to fuel.

The study, published in the Proceedings of the National Academy of Sciences, documents the direct conversion of to biofuel without pre-treatment, using the engineered bacterium Caldicellulosiruptor bescii.

Pre-treatment of the biomass feedstock—non-food crops such as switchgrass and miscanthus—is the step of breaking down before fermentation into . This pre-treatment step has long been the economic bottleneck hindering fuel production from lignocellulosic biomass feedstocks.

Janet Westpheling, a professor in the Franklin College of Arts and Sciences Department of Genetics, and her team of researchers—all members of U.S. Department of Energy-funded BioEnergy Science Center in which UGA is a key partner—succeeded in genetically engineering the organism C. bescii to deconstruct un-pretreated plant biomass.

“Given a choice between teaching an organism how to deconstruct biomass or teaching it how to make ethanol, the more difficult part is deconstructing biomass,” said Westpheling, who spent two and a half years developing genetic methods for manipulating the C. bescii bacterium to make the current work possible.

The UGA research group engineered a synthetic pathway into the organism, introducing genes from other anaerobic bacterium that produce ethanol, and constructed a pathway in the organism to produce ethanol directly.

“Now, without any pretreatment, we can simply take switchgrass, grind it up, add a low-cost, minimal salts medium and get ethanol out the other end,” Westpheling said. “This is the first step toward an industrial process that is economically feasible.”

The recalcitrance of plant biomass for the production of fuels, a resistance to microbial degradation evolved in plants over millions of years, results from their rigid cell walls that have been the key to their survival and the major impediment to biofuel production. Understanding the scientific basis of and ultimately eliminating recalcitrance as a barrier has been the core mission of the BioEnergy Science Center.

“To take a virtually unknown and uncharacterized organism and engineer it to produce a biofuel of choice within the space of a few years is a towering scientific achievement for Dr. Westpheling’s group and for BESC,” said Paul Gilna, director of the BioEnergy Science Center, headquartered at Oak Ridge National Laboratory. “It is a true reflection of the highly collaborative research we have built within BESC, which, in turn, has led to accelerated accomplishments such as this.”

Caldicellulosiruptor bacteria have been isolated around the world—from a hot spring in Russia to Yellowstone National Park. Westpheling explained that many microbes in nature demonstrate prized capabilities in chemistry and biology but that developing the genetic systems to use them is the most significant challenge.

“Systems biology allows for the engineering of artificial pathways into organisms that allow them to do things they cannot do otherwise,” she said.

Ethanol is but one of the products the bacterium can be taught to produce. Others include butanol and isobutanol (transportation fuels comparable to ethanol), as well as other fuels and chemicals—using biomass as an alternative to petroleum.

“This is really the beginning of a platform for manipulating organisms to make many products that are truly sustainable,” she said.

FDA Approves Generic Version of Painkiller Celebrex.


The U.S. Food and Drug Administration on Friday gave its approval to the first generic version of the powerful pain reliever Celebrex (celecoxib).

Celecoxib is a member of the cox-2 inhibitor family of painkillers, prescription medicines often used for arthritis and other conditions. The drugs emerged in the early 2000s and included once best-selling pain relievers such as Vioxx and Bextra.

However, Vioxx was pulled from the market in 2004 after studies revealed use of the drug raised heart risks, and the withdrawal of Bextra followed a year later. Celebrex has remained the only cox-2 inhibitor medication on drugstore shelves in the years since.

On Friday, Teva Pharmaceutical Industries got the nod from the FDA to market cheaper generic versions of celecoxib capsules in 50 milligram, 100 mg, 200 mg, and 400 mg strengths. Mylan Pharmaceuticals Inc. received permission to market 50 mg celecoxib capsules, the agency said.

“It is important for patients to have access to affordable treatment options for chronic conditions,” Dr. Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research, said in an agency statement. “Health care professionals and patients can be assured that these FDA-approved generic drugs have met our rigorous approval standards.”

Celecoxib also falls into the category known as a non-steroidal anti-inflammatory drug (NSAID). According to the FDA, like all NSAID medications, generic celecoxib will “have a Boxed Warning in their prescribing information (label) to alert health care professionals and patients about the risk of heart attack or stroke that can lead to death. This chance increases for people with heart disease or risk factors for it, such as high blood pressure, or taking NSAIDs for long periods of time.”

The FDA noted that potential side effects of celecoxib for people with arthritis include “abdominal pain, diarrhea, indigestion (dyspepsia), flatulence, swelling of the feet or legs (peripheral edema), accidental injury, dizziness, inflammation of the throat (pharyngitis), runny nose (rhinitis), swollen nasal passages, (sinusitis), upper respiratory tract infection, and rash.”

Super waterproof surfaces cause water to bounce like a ball.


The most hydrophobic surfaces in the world could help make energy generation more efficient.

PicMonkey_Collage11.jpg

Image: Brigham Young University

Scientists are studying the most extreme water proof surfaces in the world, with the aim of creating self-cleaning, ice-proof material that bounces water away.

To do this, they’re testing the way water bounces and rolls off of different hydrophobic surfaces – and capturing it all on ultra-high-speed camera.

http://pda.sciencealert.com.au/news/20140206-25601.html

Norovirus Infection: Get Facts About Symptoms and Treatments


http://www.medicinenet.com/script/main/mobileart.asp?articlekey=31128

From the desk of Zedie.

Is Wikipedia a reliable source for medical advice?


Although Wikipedia’s content can sometimes be questionable, its medical information often stands up to peer-reviewed literature

 

Wikipedia page

Lots of studies have looked at Wikipedia’s accuracy. Photograph: Alamy

It’s not uncommon for doctors to type unusual symptoms into Google and see what comes up – studies show between 47% and 70% of doctors and medical students use Wikipedia – and so far standards of medical care don’t seem to have plummeted. The public, of course, use it even more. Wikipedia’s medical content is guarded by the Wikiproject Medicine team, who take accuracy pretty seriously. So they were not pleased to see a study in the Journal of the American Osteopathic Association (a peer-reviewed publication) saying that nine out of 10 Wikipedia articles on common conditions have inaccuracies. These inaccuracies were identified by middle-grade doctors who reviewed statements of fact in each article against peer-reviewed medical publications. The paper does not give examples of what exactly these inaccuracies are. One media report quoted an inaccuracy in the number of times that blood pressure should be tested before starting treatment. Wikipedia seems, however, to be right (except when the blood pressure reading is very high), as it quotes National Institute for Health and Care Excellence (Nice) guidelines. So, should you stop using Wikipedia as your second opinion (or first if your GP is booked up), or is it good enough?

The solution

Lots of studies have looked at Wikipedia’s accuracy. It seems more reliable for kidney disease and mental health problems, less so for drug information (especially on how medicines interact with each other), digestive and liver diseases, and gastroenterology. One study found information on children’s ear, nose and throat problems had twice as many errors on Wikipedia as on eMedicine, a free online resource for medical professionals. This latest study found that, for each Wikipedia article, between 55% and 100% of the factual statements found were substantiated by the peer-reviewed literature. There is, however, often disagreement on what is “medical fact” within that literature and the study didn’t take this into account.

When searching online for medical advice, always look at a few sources (preferably ones with web addresses ending in .edu, .gov, or .org). Look at the date, who is providing it (an independent rather than commercial source is likely to be less biased) and whether evidence (such as references from journals) is given. NICE guidelines are a good source and they have patient versions of content, as does the Cochrane library. eMedicine is free but you may need a medical dictionary. Research in the BMJ and Plos Medicine is also freely available. Before acting on internet advice, it is advisable to talk to your doctor, bearing in mind that doctors, too, don’t always give the same medical advice as each other.

‘Robot sperm’ controlled by magnets.


sperm-inspired robot swimming
Sperm-inspired robots “swim” when they are made to wiggle by a moving magnetic field

Engineers have built a sperm-like robot that they can control with magnets.

The simple design has a metal-coated head and a flexible body about six times longer than a human sperm.

Using a magnetic field no stronger than a fridge magnet, the team made the robot “swim” forward and steered it towards a fixed point.

They hope the findings, published in the journal Applied Physics Letters, will be useful in medical and manufacturing applications.

“We have built a biologically inspired micro-robot that looks like a sperm cell but is completely fabricated in the lab,” said Dr Sarthak Misra, a robotics engineer at the University of Twente in the Netherlands.

Sperm, like some bacteria, use a whip-like “flagellum” to propel themselves through fluid.

Other studies of this process have included coupling a magnetic tail to a red blood cell, or controlling real sperm by steering them in metal microtubes.

The new gadget is made from a strong but flexible polymer, with a metal layer painted onto its head using a technique called electron beam evaporation.

That metal element is forced in different directions when the device is placed into a moving field, produced by the coils of an electromagnet.

Precise navigation

“The magnetic head is used to orient it in a certain direction and then, just by flapping its tail, it starts to move forward,” Dr Misra told the BBC. “The flapping happens because we change the current in the coils.”

MagnetoSperm
The simple robots consist of a flexible tail and a head with an added metallic layer

For its size, the robot can hardly compete with its biological inspiration for pace: it wiggles along at up to 0.5 body lengths per second, whereas a human sperm can cover several times its body length in that time.

Importantly, however, Dr Misra and his colleagues also showed that they could steer the robot with some precision. By adjusting the magnetic field changes with a computer, they navigated their creation towards a fixed point.

This means the little robots could be useful for positioning materials in nanomanufacturing, or for medical purposes. “It opens up a lot of applications, from targeted drug delivery to in vitro fertilisation – where you want to reach precise locations,” Dr Misra said.

For these ideas to work, the researchers need to test the technique in more complicated environments. They are moving on to those experiments, as well as working on making their “MagnetoSperm” smaller and faster.

human sperm
Human sperm are another six times smaller than the tiny robots that were modelled on them

Dr Matthew Baker, who studies molecular motors at the Victor Chang Cardiac Research Institute in Sydney, told BBC News the work was “very cool” but commented that the tiny contraptions are not robots in the sense that most of us would imagine.

“It’s just a piece of metal and it’s the field that’s doing the hard work,” Dr Baker explained. “The clever part is the oscillating, small, tunable magnetic field.”

This out-sourcing of power and navigation is what allows the gadget to be so small, according to the new study’s first author Dr Islam Khalil. “As technology progresses and many products get smaller, it becomes difficult to assemble objects on nano- and micro-scales,” he said in a press statement.

“MagnetoSperm can be used to manipulate and assemble objects at these scales, using an external source of magnetic field to control its motion.”

Scientists have 3D printed blood vessels.


Researchers are a step closer to creating artificial blood vessels that can be transplanted into humans.

PicMonkey_Collagebloodvessels.jpg

Over the past decade, scientists have become a lot better at growing artificial organs, but they’ve continuously struggled with creating blood vessels, which need to be flexible and capable of delivering essential nutrients when implanted into patients.

But now researchers from the Brighman and Women’s Hospital in the US have used a new technique to 3D bioprint blood vessels that could be integrated into the human body to help repair damage from accidents or disease.

The results have been published online in Lab on a Chip.

To make the blood vessels, the researchers first 3D printed an agarose fibre template that would create the “inside” channels of the blood vessels.

They then covered this with a gelatin-like substance called hydrogel, a press release explained.

“Our approach involves the printing of agarose fibres that become the blood vessel channels. But what is unique about our approach is that the fibre templates we printed are strong enough that we can physically remove them to make the channels,” said Khademhosseini. “This prevents having to dissolve these template layers, which may not be so good for the cells that are entrapped in the surrounding gel.”

Using this approach, the team was able to use the hydrogel to construct microchannel networks with necessary architectural features, as well as superior functionality, such as mass transport and cellular viability.

Most importantly, the researchers managed to successfully grow thin layers of endothelial cells, which line blood vessels in the human body, on the hydrogel.

“In the future, 3D printing technology may be used to develop transplantable tissues customised to each patient’s needs or be used outside the body to develop drugs that are safe and effective,” said Khademhosseini.