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Current treatment is a combination of pegylated interferon-alpha-2a or pegylated interferon-alpha-2b (brand names Pegasys or PEG-Intron) and the antiviral drug ribavirin for a period of 24 or 48 weeks, depending on hepatitis C virus genotype. In a large multicenter randomized control study among genotype 2 or 3 infected patients (NORDymanIC),[35] patients achieving HCV RNA below 1000 IU/mL by day 7 who were treated for 12 weeks demonstrated similar cure rates as those treated for 24 weeks.[36][37]
Pegylated interferon-alpha-2a plus ribavirin may increase sustained virological response among patients with chronic hepatitis C as compared to pegylated interferon-alpha-2b plus ribavirin according to a systematic review of randomized controlled trials .[38] The relative benefit increase was 14.6%. For patients at similar risk to those in this study (41.0% had sustained virological response when not treated with pegylated interferon alpha 2a plus ribavirin), this leads to an absolute benefit increase of 6%. About 16.7 patients must be treated for one to benefit (number needed to treat = 16.7; click here [39] to adjust these results for patients at higher or lower risk of sustained virological response). However, this study's results may be biased due to uncertain temporality of association, selective dose response.
Treatment is generally recommended for patients with proven hepatitis C virus infection and persistently abnormal liver function tests.
Treatment during the acute infection phase has much higher success rates (greater than 90%) with a shorter duration of treatment; however, this must be balanced against the 15-40% chance of spontaneous clearance without treatment (see Acute Hepatitis C section above).
Those with low initial viral loads respond much better to treatment than those with higher viral loads (greater than 400,000 IU/mL). Current combination therapy is usually supervised by physicians in the fields of gastroenterology, hepatology or infectious disease.
The treatment may be physically demanding, particularly for those with a prior history of drug or alcohol abuse. It can qualify for temporary disability in some cases. A substantial proportion of patients will experience a panoply of side effects ranging from a 'flu-like' syndrome (the most common, experienced for a few days after the weekly injection of interferon) to severe adverse events including anemia, cardiovascular events and psychiatric problems such as suicide or suicidal ideation. The latter are exacerbated by the general physiological stress experienced by the patient.
Psoriatic arthritis is a chronic arthritis. In some people, it is mild, with just occasional flare ups. In other people, it is continuous and can cause joint damage if it is not treated. Early diagnosis is important to avoid damage to joints. Psoriatic arthritis typically occurs in people with skin psoriasis, but it can occur in people without skin psoriasis, particularly in those who have relatives with psoriasis. Psoriatic arthritis typically affects the large joints, especially those of the lower extremities, distal joints of the fingers and toes, and also can affect the back and sacroiliac joints of the pelvis. For most people, appropriate treatments will relieve pain, protect the joints, and maintain mobility. Physical activity helps maintain joint movement. Psoriatic arthritis is sometimes misdiagnosed as gout, rheumatoid arthritis or osteoarthritis. - See more at: http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Psoriatic-Arthritis#sthash.VsBTUw76.dpuf
Many people have baggy and puffy lower eyelids. Lower Eyelid Surgery (Blepharoplasty) is the removal of excess fat and tightening of the skin, which can drastically minimize the appearance of baggy and puffy lower eyelids that makes everyone look tired and worn down. This procedure is just as popular with men as with women. A sense of well-being and alertness is the reason why most people elect to have this procedure. Lower lids surgery is a procedure that the best results are achieved when performed earlier than later. Dr. Lee has performed this surgery on patients who are 18 yrs old to 82 yrs old- all very happy with their results. The cause of baggy and puffy lower eyelid is due to a combination of herniating fat, excessive skin, and edema (water retention).
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Cytomegalovirus (CMV) continues to have a tremendous impact in solid organ transplantation despite remarkable advances in its diagnosis, prevention and treatment. It can affect allograft function and increase patient morbidity and mortality through a number of direct and indirect effects. Patients may develop asymptomatic viremia, CMV syndrome or tissue-invasive disease. Late-onset CMV disease continues to be a major problem in high-risk patients after completion of antiviral prophylaxis. Emerging data suggests that immunologic monitoring may be useful in predicting the risk of late onset CMV disease. There is now increasing interest in the development of an effective vaccine for prevention. Novel antiviral drugs with unique mechanisms of action and lesser toxicity are being developed. Viral load quantification is now undergoing standardization, and this will permit the generation of clinically relevant viral thresholds for the management of patients. This article provides a brief overview of the contemporary epidemiology, clinical presentation, diagnosis, prevention and treatment of CMV infection in solid organ transplant recipients.
Dialysis lecture 1. Dialysis Study: EXPERT NOTES for DHA, Bonent, CHT, B.Sc in Dialysis, Diploma in Dialysis https://amzn.eu/d/35Ui1kT
2. Dialysis Study : Q & A: MCQs, Fill in the blanks, True or False https://amzn.eu/d/gGn8u73
1. Dialysis Study :EXPERT NOTES for DHA, Bonent, CHT, B.Sc in Dialysis, Diploma in Dialysis, Naseha Helal.
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2. Dialysis Study: Q & A MCQ https://play.google.com/store/....books/details?id=T_3
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https://t.me/dialysislife PRINCIPLE OF dialysis
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Dialysis machine alarms
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DDS dialysis disequilibrium syndrome
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Peritoneal Dialysis
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Itching
https://youtu.be/T83Wm3HHU4M
What is CRRT
https://youtu.be/jPgFnoSEBMU
LVH
https://youtu.be/ZhFL3Z6LHeA
Sorbent dialysis
https://youtu.be/-rie5dC_FkY
RO Water
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Carbon filter RO water
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Hemoperfusion
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AV fistula or Dialysis fistula
https://youtu.be/uDbyfqCkCbo
Dialysis MCQ
https://youtu.be/zmOj0BL6jVY
AVF cannulation
https://youtu.be/PyqMcHA07zY
Complications of AV fistula
https://youtu.be/a_CXIvuOO_s
Blood clotting during Dialysis
https://youtu.be/9hYNepiO2o8
Muscle crapms
https://youtu.be/09s07Eiqr2k
Hepatitis C
https://youtu.be/qdNj_GhmnSE
Dialysis procedure
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Hypotension
https://youtu.be/4EVPmWTSyN8
Heparin free dialysis
https://youtu.be/rFqAn7HcWwM
Plasmapheresis
https://youtu.be/kbgsjjs9krg
Isolated ultrafiltration
https://youtu.be/xp5I5--uWb0
High flux dialyzer
https://youtu.be/gCNsErn1HHM
Urea and Creatinine
https://youtu.be/Id9AIySMQ6c
Practical RO water demo
https://youtu.be/2pXKGMDNS84
Sodium profiling
https://youtu.be/bE_DcBXNB5g
Peritoneal Dialysis
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Air embolism
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Dialysate
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How to stop Bleed from fistula
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Dialysis short form
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Dialyzer reprocessing
https://youtu.be/XelfkKsndlc
Dialysis catheter
https://youtu.be/V7y90m4xlv8
How to set KT/V
https://youtu.be/hWXjU8VTQdk
Mircera injection
https://youtu.be/STtd3I3EijA
Dialysis procedure
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Dialysis in snake bite poison
https://youtu.be/niA9RI38jyY
Uf profiling
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Heparin dose
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Hyperkalemia
https://youtu.be/1rWWNlcAuio
Change bandages of leaking fistula
https://youtu.be/_0cebWWdjM8
AvF needle
https://youtu.be/GvUxbXxftTk
Polycystic kidney disease
https://youtu.be/IhsMbHFXZG8
Nephrotic syndrome
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Diabetic nephropathy
https://youtu.be/v-FBIQ7MA4k
Hemodialysis permanent access
https://youtu.be/_YrwxwiR0f8
Sex and dialysis
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Albumin and dialysis
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Shamika Burrage survived a near-fatal car accident two years ago, but not without losing something pretty important: her left ear. Now, thanks to a novel procedure performed at an Army medical center in Texas, Burrage is getting that ear back in a most unusual way. Plastic surgeons harvested cartilage from Burrage's ribs to create a new ear and then grew it under the skin of her forearm. Then the doctors at William Beaumont Army Medical Center in El Paso successfully transplanted the ear from her arm to her head. The technique -- a first time in the Army -- is called prelaminated forearm free flap, said Lt. Col. Owen Johnson III, chief of plastic and reconstructive surgery at William Beaumont Army Medical Center. Some of the big advantages of it is that it reduced the chance of more scarring around Burrage's ear. Also, growing the ear under the skin of her forearm allows new blood vessels to form. "(The ear) will have fresh arteries, fresh veins and even a fresh nerve so she'll be able to feel it," Johnson said on the US Army's website. Burrage, a 21-year-old private, still has to endure two more surgeries, but she's feeling more optimistic about the future than ever in the years since her accident. "It's been a long process for everything, but I'm back," said Burrage.
Key facts
Hepatitis B is a viral infection that attacks the liver and can cause both acute and chronic disease.
The virus is transmitted through contact with the blood or other body fluids of an infected person - not through casual contact.
About 2 billion people worldwide have been infected with the virus and about 350 million live with chronic infection. An estimated 600 000 persons die each year due to the acute or chronic consequences of hepatitis B.
About 25% of adults who become chronically infected during childhood later die from liver cancer or cirrhosis (scarring of the liver) caused by the chronic infection.
The hepatitis B virus is 50 to 100 times more infectious than HIV.
Hepatitis B virus is an important occupational hazard for health workers.
Hepatitis B is preventable with a safe and effective vaccine.
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Hepatitis B is a potentially life-threatening liver infection caused by the hepatitis B virus. It is a major global health problem and the most serious type of viral hepatitis. It can cause chronic liver disease and puts people at high risk of death from cirrhosis of the liver and liver cancer.
Worldwide, an estimated two billion people have been infected with the hepatitis B virus (HBV), and more than 350 million have chronic (long-term) liver infections.
A vaccine against hepatitis B has been available since 1982. Hepatitis B vaccine is 95% effective in preventing HBV infection and its chronic consequences, and is the first vaccine against a major human cancer.
Histology of all the different types of cartilage. This video is a part of our Histology Video Course (https://youtube.com/playlist?l....ist=PLnr1l7WuQdDynxT
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Alcohol not broken down by the liver goes to the rest of the body, including the brain. Alcohol can affect parts of the brain that control movement, speech, judgment, and memory. These effects lead to the familiar signs of drunkenness: difficulty walking, slurred speech, memory lapses, and impulsive behavior.
Shut the front door: Scientists have finally found the perfect breasts. No, they weren't hiding in the Amazon or roving solo across the Sahara (although we have no doubt there are women in both the Amazon and the Sahara who have magnificent mammaries); it turns out these perfect breasts were hiding in a plastic surgeon's office this whole time! Now, before you get all worked up, the American Society of Plastic Surgeons (ASPS) would like you to know that the super-fake looking plastic breasts of yore are not actually what people think are most attractive now. According to a study published in the Journal of Plastic and Reconstructive Surgery—which involved asking over 1,300 people to look at pictures of naked boobies and rank them by hotness (stop laughing, this is serious research!)—people preferred a more "real" and "normal" look from their silicone, with the ideal breast shape having a 45:55 ratio. People said the best chests have 45 percent of the fullness above the nipple line and 55 percent of the fullness below, in a slightly teardrop shape. Researchers noted this preference remained consistent across gender, racial, and ethnic groups with the 45:55 ratio favored by 87 percent of women in their 30s, 90 percent of men, and 94 percent of plastic surgeons.
This animation demonstrates how a unilateral complete cleft lip repair is performed. This video is meant for educational purposes for patients and families. There are many ways to fix a complete cleft lip, but the technique shown here is the most common known as the Millard Rotation Advancement Repair.