Binding and Fusion: HIV begins its life cycle
when it binds to a CD4 receptor and one of two
co-receptors on the surface of a CD4+
Tlymphocyte. The virus then fuses with the host
cell. After fusion, the virus releases RNA, its
genetic material, into the host cell.

Reverse Transcription: An HIV enzyme
called reverse transcriptase converts the singlestranded HIV RNA to double-stranded HIV DNA.

Integration: The newly formed HIV DNA
enters the host cell's nucleus, where an HIV
enzyme called integrase "hides" the HIV DNA
within the host cell's own DNA. The integrated
HIV DNA is called provirus. The provirus may
remain inactive for several years, producing few or
no new copies of HIV

Transcription: When the host cell receives a
signal to become active, the provirus uses a host
enzyme called RNA polymerase to create copies of
the HIV genomic material, as well as shorter
strands of RNA called messenger RNA (mRNA).
The mRNA is used as a blueprint to make long
chains of HIV proteins.

Assembly: An HIV enzyme called protease cuts
the long chains of HIV proteins into smaller
individual proteins. As the smaller HIV proteins
come together with copies of HIV's RNA genetic
material, a new virus particle is assembled.

Budding: The newly assembled virus pushes out
("buds") from the host cell. During budding, the new
virus steals part of the cell's outer envelope. This
envelope, which acts as a covering, is studded with
protein/sugar combinations called HIV
glycoproteins. These HIV glycoproteins are
necessary for the virus to bind CD4 and coreceptors. The new copies of HIV can now move
on to infect other cells.

Lichen sclerosus is a skin condition that mainly affects the genital skin (vulva) in women and the penis in men. It most commonly occurs in middle-aged women. Symptoms may include itch, soreness, and changes in the appearance of affected skin.

Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition also can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity. The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well. While new types of medications have improved treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities.

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Because the continuous supply of glucose is stopped after birth, the neonate develops hypoglycemia because of insufficient substrate. Stimulation of fetal insulin release by maternal hyperglycemia during labor significantly increases the risk of early hypoglycemia in these infants.

Heart sounds are the noises generated by the beating heart and the resultant flow of blood through it. Specifically, the sounds reflect the turbulence created when the heart valves snap shut. In cardiac auscultation, an examiner may use a stethoscope to listen for these unique and distinct sounds that provide important auditory data regarding the condition of the heart. In healthy adults, there are two normal heart sounds often described as a lub and a dub (or dup), that occur in sequence with each heartbeat. These are the first heart sound (S1) and second heart sound (S2), produced by the closing of the atrioventricular valves and semilunar valves, respectively. In addition to these normal sounds, a variety of other sounds may be present including heart murmurs, adventitious sounds, and gallop rhythms S3 and S4.

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Primary sclerosing (skluh-ROHS-ing) cholangitis (koh-lan-JIE-tis) is a disease of the bile ducts, which carry the digestive liquid bile from your liver to your small intestine. In primary sclerosing cholangitis, inflammation causes scars within the bile ducts. These scars make the ducts hard and narrow and gradually cause serious liver damage. In most people with primary sclerosing cholangitis, the disease progresses slowly and can lead to liver failure, repeated infections, and tumors of the bile duct or liver. Liver transplant is the only known cure for primary sclerosing cholangitis. The search for other treatments to slow or stop primary sclerosing cholangitis is ongoing, and scientists have turned up many promising leads. Until better treatments are proved safe and effective, though, care for primary sclerosing cholangitis focuses on monitoring liver function, managing symptoms and, when possible, doing procedures that temporarily open blocked bile ducts.

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The goal of breast cancer surgery is to remove the entire tumor from the breast. Some of the lymph nodes in the underarm area (axillary nodes) may also be removed to see if cancer cells are present.

Posterior dislocations with associated fractures, also known as complex posterior dislocations, often require open reduction and fixation (ORIF). These dislocations are often associated with significant ligamentous injury. In some cases, complex posterior elbow dislocations may be managed with closed reduction. Posterior elbow dislocations that are neglected, as is not uncommon in developing countries, can often be effectively treated with open reduction. [9] Delayed vascular compromise is an important complication after reduction. All patients should be observed for a period of approximately 2-3 hours after reduction. If no evidence of vascular compromise arises, patients can be sent home with appropriate follow-up and instructions to watch for further problems.

Too much cholesterol in the blood can lead to cardiovascular disease. Heart disease is the No. 1 cause of death in the United States. Over 2,100 Americans die of cardiovascular disease each day, an average of one death every 40 seconds. The good news is, you can lower your cholesterol and reduce your risk of heart disease and stroke. Working with your doctor is key. It takes a team to develop and maintain a successful health program. You and your healthcare professionals each play an important role in maintaining and improving your heart health. Work with your doctor to determine your risk and the best approach to manage it. In all cases, lifestyle changes are important to reduce your risk for heart attack and stroke. In some cases, cholesterol-lowering statin medicines may also provide benefit. Learn how to make diet and lifestyle changes easy and lasting. Also make sure you understand instructions for taking medication because it won't work if you don't take it as directed. Lifestyle Changes Your diet, weight, physical activity and exposure to tobacco smoke all affect your cholesterol level. Know Your Fats Knowing which fats raise LDL cholesterol and which ones don't is the first step in lowering your risk of heart disease.

Vertigo is a sensation of spinning. If you have these dizzy spells, you might feel like you are spinning or that the world around you is spinning. Causes of Vertigo Vertigo is often caused by an inner ear problem. Some of the most common causes include: BPPV. These initials stand for benign paroxysmal positional vertigo. BPPV occurs when tiny calcium particles (canaliths) clump up in canals of the inner ear. The inner ear sends signals to the brain about head and body movements relative to gravity. It helps you keep your balance. BPPV can occur for no known reason and may be associated with age. Meniere's disease. This is an inner ear disorder thought to be caused by a buildup of fluid and changing pressure in the ear. It can cause episodes of vertigo along with ringing in the ears (tinnitus) and hearing loss. Vestibular neuritis or labyrinthitis. This is an inner ear problem usually related to infection (usually viral). The infection causes inflammation in the inner ear around nerves that are important for helping the body sense balance

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Electrical injuries can present with a variety of problems, including cardiac or respiratory arrest, coma, blunt trauma, and severe burns of several types. It is important to establish the type of exposure (high or low voltage), duration of contact, and concurrent trauma. Low-voltage AC injury without loss of consciousness and/or arrest These injuries are exposures of less than 1000V and usually occur in the home or office setting. Typically, children with electrical injuries present after biting or chewing on an electrical cord and suffer oral burns. Adults working on home appliances or electrical circuits can also experience these electrical injuries. Low-voltage AC may result in significant injury if there is prolonged, tetanic muscle contraction. Low-voltage AC injury with loss of consciousness and/or arrest In respiratory arrest or ventricular fibrillation that is not witnessed, an electrical exposure may be difficult to diagnose. All unwitnessed arrests should include this possibility in the differential diagnosis. Query EMS personnel, family, and coworkers about this possibility. Inquire if a scream was heard before the patient’s collapse; this may be due to involuntary contraction of chest wall muscles from electrical current. High-voltage AC injury without loss of consciousness and/or arrest Usually high-voltage injuries do not cause loss of consciousness but instead cause devastating thermal burns. In occupational exposures, details of voltage can be obtained from the local power company. High-voltage AC injury with loss of consciousness and/or arrest This is an unusual presentation of high-voltage AC injuries, which do not often cause loss of consciousness. History may need to come from bystanders or EMS personnel. Direct current (DC) injury These injuries typically cause a single muscle contraction that throws the victim away from the source. They are rarely associated with loss of consciousness unless there is severe head trauma, and victims can often provide their own history. Conducted electrical devices Conducted electrical weapons (CEWs) such as tasers are weapons used by law enforcement that deliver high-voltage current that is neither true AC or DC but is most like a series of low-amplitude DC shocks.[16] They can deliver 50,000 V in a 5-second pulse, with an average current of 2.1 mA.[17] Though they have been temporally associated with deaths in the law enforcement setting, conducted electrical devices (CEDs) in healthy volunteers have been shown to be safe without evidence of delayed arrhythmia or cardiac damage as measured by troponin I.[18, 17] One study of their use in 1201 law enforcement incidents showed mostly superficial puncture wounds from the device probes, and significant injuries only from trauma subsequent to shock, not from the device itself. Of 2 deaths in custody, neither was related to CEW exposure.[19]

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If you have placenta previa, it means that your placenta is lying unusually low in your uterus, next to or covering your cervix. The placenta is the pancake-shaped organ – normally located near the top of the uterus – that supplies your baby with nutrients through the umbilical cord.

A central venous catheter, also called a central line, is a long, thin, flexible tube used to give medicines, fluids, nutrients, or blood products over a long period of time, usually several weeks or more. A catheter is often inserted in the arm or chest through the skin into a large vein.

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