wellness

Globesity epidemic, insulin resistance, type II diabetes and syndrome X is frequently associated with fatty liver, alterations that can be benign and not progressive, or lead to cryptogenic cirrhosis, hepatoma and liver failure, because it is of chronic injury of this important body. Fatty infiltration of the liver is associated with a variety of conditions and diseases. Fatty liver or steatosis is a metabolic disease, which when associated with inflammation is called steatohepatitis, a condition which, as we said, can lead to cryptogenic cirrhosis.

We speak here of a non-alcoholic pathological changes (as the toxic of course produce steatohepatitis), which is very common and usually is diagnosed incidentally during abdominal ultrasound scans (liver hyperechoic) made to the assessment of patients. Fatty infiltration of the liver usually will not cause any clinical symptomatology. Normally the liver is 5% of fat, almost half made up of phospholipids, to a lesser extent triglycerides and cholesterol is unesterified. But it exceeds that liver fat content, mainly at the expense of triglyceride-spoken of fatty liver. It is associated with obesity, diabetes and hyperlipidemia, insulin resistance and syndrome X, with rapid weight loss diets, or the swing of it.

Although there may be signs of right upper quadrant dull pain, many patients turn to have an unexplained and persistent elevation of liver tests, AST, ALT and alkaline phosphatase (demonstration and of steatohepatitis, as in the simple steatosis, liver function tests are normal) , 70% are overweight and can detect some degree of hepatomegaly. Steatosis alone is a non-progressive disease, but it is when there is inflammation. The diagnosis is based on elevated transaminase levels, no significant alcohol consumption (<40 g / week), negative blood test for hepatitis B and C, and can be easily detected by liver ultrasound to get accuracy of ultrasonography in diagnosing fatty liver, but a definitive diagnosis is by biopsy liver.

Obesity is thought to be the most common cause of fatty infiltration of the liver. There are treatment strategies that can improve the picture, such as avoiding alcohol consumption and intake of hepatotoxic as acetaminophen, anti-inflammatory drugs, estrogen, and the gradual reduction in weight (low-fat diet versus low-carb) to avoid the rapid loss because the picture gets worse . We recommend the vaccination against hepatitis A and B, and drugs that prevent oxidative stress such as vitamin E, and (remember the hepatoprotective, In Barranquilla on famous Necroton), Silymarin, lecithin, betaine, or selenium; drugs that improve insulin sensitivity such as rosiglitazone or metformiu. In fatty infiltration of the liver, there is an increased amount of fat in the normal cells so you have to treat associated diseases such as diabetes or hyperlipidemia. It has also been used ursodeoxycholic acid and gemfibrozil. However, the use of many of these drugs do not have a good backup of evidence-based medicine.

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The small spots that many people are moving in your field of vision are called floaters in the eye. Usually it seen when looking at a plain background, like a wall or roof.

Floaters are small pieces of gelatin that forms in the vitreous, transparent, gelatinous fluid that fills the anterior chamber. Although they appear to be in front of the eye, actually float in the liquid contained within it, and are perceived by the retina (the layer inside the eye is sensitive to light) and shadows.

The appearance of floaters in the eye, whether in the form of small dots, circles, lines or cobwebs, may cause concern to those who have suffer, but it is usually minor and corresponds to the aging process.

Over time, the vitreous gel is shrinks; it separates from the retina and cause floaters in the eye. This is especially common in nearsighted people or after a cataract operation. When the vitreous gel is removed, the retina can tear and cause some minor bleeding in the eye. If the tear is not cure, it can become a retinal detachment.

Without an examination by an ophthalmologist, there is no way to tell if the Eye Floaters are serious. Any sudden appearance of many new floaters or flashes of light should be evaluated by your ophthalmologist.

What can be done to remove the floaters?

Floaters in the eye sometimes interfere with the view, often while reading, and can be quite annoying.

If one appears directly in your line of vision, it is best to move the eyes, causing the liquid inside to swirl and let the point goes beyond the road.

They are all more used to move the eyes from side to side, but looking up and down cause different currents inside the eye and may be more effective to divert the floaters.

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Definition

Blood clotting factors are twelve, all very important. When one of the twelve factors not adequately perform their work, others can not work together to form a clot and inhibit bleeding. It is true that hemophilia is a disorder of the clotting of blood, hereditary, by which their training takes longer to generate than normal and people who suffer lack the ability to stop bleeding. The peculiar name of “Hemophilia” means “Love of blood.” The romantic memory of the history of Russian monarchs Alexandra and Czar Nicholas II and the condition of his son, Alexis, contributed further to define hemophilia as a disease of kings ” but it is known that one inevitably affects of 10 thousand men , without distinction of race or social strata. It is passed from father to son, so it is a sex-linked inherited abnormality. There are several types of hemophilia, but the most common and best known include: Hemophilia A – factor VIII deficiency. Hemophilia B – factor IX deficiency. A hemophiliac who suffer from hemophilia A or B does not bleed faster than others, but they bleed longer than usual because the process of coagulation is not normal.

Causes

Hemophilia types A and B is an inherited disease that is transmitted by a gene located on chromosome X. Females have two X chromosomes, while males have one X chromosome and one Y chromosome A female carrier of hemophilia has the hemophilia gene on one of her X chromosomes, and there is a 50 percent chance that she may pass the defective gene to their male offspring. Men with hemophilia do not pass the gene to their sons. Generally, women are carriers of hemophilia A but do not suffer. Hemophilia B, also transmitted by sex-linked inheritance is less common than A. In approximately one third of hemophilia cases, there is no family history of the disease. These cases are due to a new or spontaneous development of the defective gene in women.

Symptoms

The most common symptoms of hemophilia is excessive, uncontrollable bleeding because of the missing clotting factor or is at low levels in the blood. The severity of symptoms depends on the degree of deficiency of clotting factor. Hemorrhages are characteristic of this disease and may occur without apparent cause. The most common symptoms of hemophilia are: Bruises can occur from blows little overwhelming, which can generate a large hematoma (a collection of blood under the skin, causing swelling). Spontaneous bleeding the tendency to bleed from the nose, mouth and gums with minor trauma or by regular brushing teeth, is often a sign of hemophilia. Bleeding into a joint Hemarthrosis (bleeding into a joint) can cause pain, immobility, and eventually deformity if not treated the right way. This is the most common complications due to hemophilia bleeding. These joint bleeds can lead to chronic arthritis pain, deformity and crippling with repeated occurrences. Bleeding into the muscles Bleeding into the muscles can cause swelling, pain and redness. Swelling from excessive blood in these areas can cause increased pressure on tissues and nerves in the area, causing damage and / or permanent deformation. Bleeding from injury or cerebral hemorrhage the injury or spontaneous bleeding in the brain is the most common cause of death in children with hemophilia and the most serious bleeding complication. Other sources of bleeding Blood in the urine or stool may also be a symptom of hemophilia. The wounds, dental extractions and surgeries cause prolonged bleeding.

Diagnosis

In addition to a complete medical history and physical examination is necessary to conduct a series of laboratory tests to evaluate the clotting process, including the clotting time, and also DNA testing. Also it determined in plasma levels of Factor VIII and IX to evaluate the severity of the deficiency.

Chromosomes are molecules biochemical DNA (Deoxyribonucleic acid) attached to proteins called histones. During cell division the chromatin (DNA dispersed in the cell nucleus) is concentrated and tightly wound around a frame protein (histones)     forming compact bodies called chromosomes.

It usually consisting of two arms called chromatids, which join via a lower density area and a center called the Centro mere. Separate components at the Centro mere are called arms (corresponding to half of a chromatic).

The chromosome size may range between 0.2 and 5 μm (micrometers) in length with a diameter of between 0.2 and 2 micrometers. The normal length of the chromosomes of mammals varies between 4-6 micrometers.

A micrometer equals one thousandth of a millimeter. (A millimeter divided into thousand parts)

In the metaphase chromosomes are duplicated chromatids (sister chromatids) and joined at the centromere. During anaphase has only one set of chromatids.

Normally there are 46 chromosomes in each human cell.

They are like a series of cookbooks. Each chromosome or cook-book contains thousands of recipes that are pieces of information or instructions.

These instructions or recipes are called “genes.” Therefore, the chromosomes are packages of genes, which direct the body’s development.

For example, there are genes that tell whether a person will have blue or brown eyes, brown hair or blond.

A gene also encodes and carries information of a specific product, such as a protein. This protein is involved in a specific process for determining a particular trait or characteristic.

All information that the body needs to work is of the chromosomes. The chromosomes contain the blueprint for growth and development.

Scattered among the 23 pairs of chromosomes are about 30,000 genes. Even a very small part of a chromosome can contain different genes.

The exact location or even the exact number of all genes is still unknown. (See: Genetic map of human genome). Studies   chromosomes do not include a detailed assessment of each gene.

Chromosomes come in pairs. One member of each pair comes from the father’s sperm cell and the other member of the pair, comes from the egg cell of the mother.

In other words, the baby receives half its genetic material of the mother and half from the father.

The sex chromosomes are usually placed next to other chromosomes. Children usually have one X and one Y chromosome, while girls have two X chromosomes this picture is called a “karyotype.”

Genetically transmitted diseases

Failures or anomalies in the genetic sequence are due to various disorders and diseases of genetic transmission, among others, are:

Glaucoma

It occurs in individuals who have a gene (particle chromosome) dominant feature. This eye disease is characterized by excessive intraocular pressure that causes progressive loss of visual field and   view.

Anemia facilgorme

Affects a large number of black people. In this disease the hemoglobin (oxygen carrier in the blood) of red blood cells are entirely replaced by abnormal hemoglobin called S. Therefore, red blood cells that contain adopt an S-shaped instead of disk, and with it are less able to     carry oxygen and they can block blood vessels of some     organs. As a result, individuals who suffer from anemia have     severe and usually fatal.

Hemophilia

It is transmitted by a recessive gene linked to chromosome X. Individuals     hemophilia tend to bleed abnormally, either spontaneously or as     minimum of wounds . The man can not transmit the hemophilia     disease to their sons, but all his daughters are healthy carriers. Each     son of a female carrier has a 50 % risk of being born with hemophilia.

Down Syndrome

They have 47 chromosomes (chromosome 21 is repeated); the individual has a set of defects, including severe mental retardation, muscle weakness and increased susceptibility to leukemia.

Turner Syndrome

It occurs when a woman has only 45 chromosomes (humans normally have 46 chromosomes), this determines that height is very low and does not develop secondary sexual characteristics typical of females. In addition, sexual organs never reach sexual maturity.

Klinefelder Syndrome

It occurs in one out of every thousand men, which are 47 chromosomes (they have an extra sex chromosome). Patients are sterile because the testes are unable to produce sperm. They also often suffer delay     mental.

Number of Chromosomes in different species

Dog

Each cell – dog or other animal, contains a kernel that is a “ribbon” called chromosomes. Their number is constant in each species, and dogs have 78, divided into 39 pairs.

Man

In man there are 23 pairs i.e. has 46 chromosomes

Cat

In the cat there are 19 pairs of chromosomes, therefore has 38 chromosomes.

Fruit Fly

It has four pairs, that is has 8 chromosomes

Frog

It has 13 pairs, 26 chromosomes

Horse

There are 33 pairs, or has 66 chromosomes

Dove

It has 40 pairs, has 80 chromosomes

Rooster

It has 39 pairs of chromosomes, or 78 chromosomes

Mouse

He has 20 pairs of chromosomes, 40 chromosomes in total

Rat

There are 21 pairs of chromosomes, 42 chromosomes

Hamster

There are 22 pairs of chromosomes, or has 44 chromosomes

Rabbit

There are 22 pairs or 44 chromosomes

Pig

It has 18 pairs, 36 chromosomes

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Common Forms of Inheritance
Each child has two copies of every gene in its body: one from the father and one from the mother. The genes that make each pair containing instructions for a dominant or recessive trait. Sometimes genes are altered for some reason and there is a medical condition.

Autosomal dominant
If a parent has the gene for an autosomal dominant condition, there is a probability of 50 percent (a probability of two) that the child has the same condition. Dominant disorders tend to be quite variable, with symptoms that can be null or severe.

Some conditions transmitted by autosomal dominant inheritance are:

• High cholesterol Family
• Huntington’s disease , a progressive nervous system disorder
• Some forms of glaucoma , which causes blindness if not treated
• Polydactyly: existence of extra fingers on the hands or feet
• Marfan syndrome , which affects the connective tissue (the connective tissue supports and connects the body’s structures , tendons , ligaments , cartilage and bone are examples of connective tissue)

Autosomal recessive
If both parents carry the same recessive gene that can cause a birth defect there is a likelihood of four of each of their children inherit the problem. If only one parent transmits the gene for the disorder, the normal gene received from the other parent will prevent the condition to manifest.

Autosomal recessive disorders are often severe and can lead to premature death. Some conditions transmitted by autosomal recessive inheritance are:

• sickle cell anemia , a blood disease that primarily affects African-Americans and Hispanic
• Tay -Sachs disease , which causes mental retardation and death , mainly in people of Eastern European Jewish or French Canadian
• Cystic fibrosis, a disorder of the lungs and digestive system that primarily affects Caucasian people of northern European descent
• Phenylketonuria (PKU ), a metabolic disorder that primarily affects Caucasian

Inheritance X -linked recessive
The X and Y chromosomes that determine sex. Normal women have two X chromosomes and males one X and one Y chromosome A disorder caused by an abnormal gene on one chromosome known as X -linked disorder X -linked or sex.

A seemingly normal mother with an abnormal gene on one of her X chromosomes has a probability of 50 percent (one out of two) to communicate it to his son. A woman who inherits an X chromosome with a gene for a sex -linked disorder usually has no symptoms of the disease since it has an X chromosome reserve with a normal copy of the same gene. However, men who inherit an X chromosome with a gene for a sex-linked disease have no second X chromosome reserves and, therefore, suffer from the disease.

Some conditions that are transmitted through inheritance X-linked recessive are:

• Hemophilia, in which the blood lacks a substance needed for blood clotting
• Colorblindness of the red and green
• Duchenne muscular dystrophy, which causes muscle weakness and death

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The role of physical therapy in hemophilia is still unknown to many health professionals. In this disease, where the protagonist has always been the hematologist, physical therapy also plays a role. Musculoskeletal problems that cause repeated spills can be alleviated from our field. A proper rehabilitation therapy can restore the patient greater independence and functional ability and, consequently, increase their quality of life.

Hemophilia is a bleeding disorder, hereditary, monogenic, recessive sex-linked. Its cause is deficiency of factor VII or blood clotting factor IX. This deficiency is the cause of cerebral hemorrhage that may be more severe, and / or musculoskeletal, with greater consequences. It is in these musculoskeletal injuries, rehabilitation treatment which can bring great solutions. Biggs and Mcfarlane already in 1962 published a series of works which proposed a new approach to treatment, emphasizing the value of the orthopedic field. Hemophilia, like all diseases, receives better treatment from a multidisciplinary perspective and the physiotherapist is essential in this team, always accompanied by appropriate hematological treatment.
The most common musculoskeletal injuries in hemophilia are the hemarthrosis, synovitis and muscle bruising. The patient ends up suffering a hemophilic arthropathy and consequently, all functional disorders and disability that entails. The hemarthrosis (blood intra-articular) are common in elbows, ankles and knees. The etiology may be trauma or spontaneous (unexplained), and severity is usually related to the intensity of the trauma. This deposit of blood causes an intra-articular synovial hypertrophy, which often lead to a new bleeding. This causes bleeding episode most of the time hemophilic synovitis. Recurrent intra-articular hemorrhage and hemosiderin iron deposits in the joint, which produces an inflammation of the synovium with the same physiological changes. As a result, an alteration in the nutrition of cartilage and the possibility are causing further bleeding. Another common injury is the muscle hematomas. The bleeding continues until suffering intramuscular pressure equals the pressure vessel intravascular injury. If the amount of blood exceeds the ability of phagocytes to absorb, is encapsulated and forms a cyst. This can evolve into a hemophilic pseudotumor, which can invade and damage nearby tissues or evolve and form an abscess.

The aims of hemophilia physical therapy in patients are broad. Relieve pain and sensory disturbances, helping the reabsorption hemorrhagic and inflammatory process, get a proper physical condition, improve their quality of life and prevent and treat injuries and after you might have. The techniques used are also diverse and range from exercise -sports for patients without lesions, all kinesitherapy techniques, thermotherapy, electrotherapy, magnetic therapy, laser therapy, hydrotherapy and ultrasound that we use every day in our professional activity. Each of these techniques pursues a specific objective, from the removal of the hematoma to improve mobility. It is noteworthy that each joint has its peculiarities when making a treatment, and the existence of orthoses, also specific to each joint.

Hemophilia is a common pathology in the rehabilitation services, but we must not forget that it exists. Like many other diseases go unnoticed in the broad spectrum of diseases that we usually deal with, but why not be left untreated. Hemophilia physical therapy are done by professional and ethical obligation to continue training for life. Investigate what you know, study what has been forgotten and never forget that there is always a treat, even if the treatment of consolation.

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The interferon therapy for multiple sclerosis is the main treatment are depend on what type of immune cell involved in the disease, according to a study by the School of Medicine, Stanford University (USA).

The results, published in the online edition of the journal Nature Medicine ‘, suggests that multiple sclerosis patients benefit from treatment with IFN -beta could be identified before starting therapy.

Interferon -beta (IFN -beta) is widely used against multiple sclerosis but is not always effective and do not know well the reasons why the treatment fails.

The scientists, led by Lawrence Steinman, studied experimental autoimmune encephalomyelitis, the mouse version of multiple sclerosis, and found that the IFN -beta treatment success was based on the type of immune cell that induced the disease.

If the symptoms were caused by so-called TH1 cells, a type of immune system helpers, IFN -beta worked, but if they participated TH17 cells, another type of immune system helpers, the disease worsened.

The researchers found that patients with multiple sclerosis who do not respond to IFN -beta had a worse disease and higher levels of IL- 17F, a molecule produced by TH17 cells, compared with those who responded.

These results raise the possibility of identifying which patients would be able to benefit from IFN -beta even before treatment begins, a prospect with significant clinical and financial implications.

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Initiated Days attendees learned the latest developments in the hands of the neurologist D. Pedro Guardado, who moved in recent months have come new drugs for patients who have developed an outbreak of multiple sclerosis, but for the time being in test phase. It also impacted some of the drugs that slow the development of disease by preventing one of causes resulting in a disability.

By the time stem cell treatment for multiple sclerosis to combat the outbreak and has costly consequences, form application requires for each patient to see a hospital daily, as are treatments that are delivered subcutaneously or intramuscularly. The immediate future is that there are drugs that are being tested for security, but in the words of neurologist “What we need is a more effective drug with fewer side effects and has a simpler method of administration.”

Attendees also learned that good sleep hygiene and tai chi or yoga practice help alleviate some of the consequences of MS. You recommended doing a search on the internet to find sites that offer a solution to aging, Parkinson’s, Alzheimer’s, multiple sclerosis, autism or macular degeneration. No matter the condition, or that the vast majority of stem cell treatment for multiple sclerosis have not yet had time to demonstrate its effectiveness.

Stem cells have become one of the promises of regenerative medicine and also a business opportunity for many schools that take advantage of the good image of stem cell research. Before these clinics were only in countries with very flexible health legislation, such as China, Singapore, Russia and the Seychelles. Now the “business” of stem cells has been transfer to the heart of Europe. Where the patients present with less suspicion.

The so-called “cell tourism“, booming and concern to health authorities. The European Medicines Agency has issued a warning note in which warns about the range of treatments based on unauthorized use of stem cells. A warning has been endorsed by the Spanish Ministry of Health through its agency of medicine: therapies, apart from being a proven effective, may pose safety problems for patients, “he warns.

The alert is not intended for patients who undergo these treatments in Spain, under the clinical trials in authorized hospitals. In the spotlight are clinics, outside our borders, which offer the promise of healing ailments for which science has yet to show the effectiveness of the cells.

Spanish Drug Agency recalled that treatments are “illegal.” no drug based on stem cells that has been approved for marketing in Spain or the European Union recalls its director. It can only be accessed under compassionate use or clinical trials authorized by special permit.

Outside this framework, the treatments are not safe. “In the best case, this is a fraud because the treatments in clinical research are free of cost. Nor do we know neither the number of cells that are introduced nor whether it is injected serum. In the worst cases, treatment may be dangerous, “he noted.

One of the clinics is now under the watchful eye of the European Medicines Agency in Germany. Regulatory agencies prefer not to point the finger at any center. But if there is one, specializes in cell therapy, which provides treatment for almost all kinds of problems that is XCell Center.

In this clinic stem cells from bone marrow of patients ‘cured’ from such complex diseases as amyotrophic lateral sclerosis and macular degeneration as common as erectile dysfunction. For these treatments charged an average of 7,000 euros, although the bill can reach 26,000 euros in the case of Parkinson’s, stroke or cerebral palsy. The process is almost all about the same, an extraction of the patient’s bone marrow and a subsequent injection of their own cells. No home follow-up after recovery.

“They play with the desperation of the sick”, says Augusto Silva, director of the Advanced Therapies Ministry of Health. “Many patients can not expect that the investigation take its course and travel anywhere with the promise of a cure. But Europe can not afford on their territory treatment centers that offer no guarantees and payment of a higher amount.”

No cell therapy has been stripped of its experimental nature. “There are still many questions to be resolved. We need to know how many cells should be used in each condition and patient, where to proceed . Are more concerned that these therapies work, but not scientific guarantees, “insists Smith.

Regulatory agencies have closed similar centers in the United States and in Europe, the Netherlands and Ireland following the inspection of drug agencies. In Germany, schools are investigated by XCell misleading advertising that make their treatment.

There are no reliable data on the number of Spanish patients who have come to be outside our borders. Though just a glimpse through the forums of patients with ALS, MS or ataxia to know that there are anecdotal cases. “It is difficult to quantify an activity that is out of control, recognizes Cristina Avendaño.

Advanced Therapy Unit of the Ministry of Health is also working on a guide for patients and doctors explaining the proper use of cell therapy. The document will be distributed in hospitals and nursing associations.

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While the infection caused by rotavirus is almost always mild and in children under 5 years in the most severe cases occur with a combination of constant vomiting and severe diarrhea leading to dehydration.

In the West, better nutrition and intravenous rehydration usually save the boys of this disease. Only in the United States, the virus causes the hospitalization of 55,000 children per year, of which about 20 die annually. Another reality is that in India, where 100 000 children die each year.

Dr. Paul Offit, chief of Infectious Diseases at Children’s Hospital of Philadelphia (United States ) and one of the developers of the Merck vaccine, said rotavirus symptoms are among the most common causes of hospital admission for winter.

Off it described the case of a young patient who had contracted the virus and fell into a state of semi – consciousness the next day while his mother was stuck in a traffic jam trying to get to hospital. The veins of the child, said the specialist, were so jammed that the surgeon had to have it channeled in the vein of the neck. “In Botswana, that child would have died, “he said.

Extreme care

In 1999, Wyeth withdrew from the U.S. market its vaccine against rotavirus ( Rotashield ) after it accused the company because of patients who had suffered inexplicably intussusception, i.e. the fold of a part of the intestine within another. This results in desperate pain, persistent vomiting and black stools.

A study by the National Institutes of Health in the United States concluded that the vaccine may not have been responsible for the intussusception, as it can be spontaneous and for unknown reasons. However, the final statistics showed that had affected one in 10,000 children.

Now, vaccines from GlaxoSmithKline ( Rotarix ) and Merck, Sharp & Dohme ( RotaTeq ) resulted in few cases of intussusception and no difference between children who had received the vaccine and those who received placebo. Both are oral administration and its composition includes weakened live virus, such as vaccination against polio.

While Glaxo tested its vaccine in children from poor families and average income in Latin America, the Merck study was conducted in rich countries like the United States and Finland, and in countries like Jamaica and Mexico. The first vaccine prevented 85% of severe cases of rotavirus and Merck, 98 percent. In its pilot phase, both vaccines were able to reduce hospitalization for diarrhea.

Dr. Roger I. Glass specialist vaccines the federal Centers for Disease Control and Prevention in Atlanta ( United States) said that the emergence of these two vaccines is “an amazing fact. Everyone is concerned about the severe acute respiratory syndrome ( SARS) or Ebola, but these diseases did not kill half a million people in a decade and rotavirus kills a million kids per year. “

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What is rotavirus?
Rotavirus is the leading cause of severe diarrhea and dehydration in children, in both developing and developed countries, with seasonal variation depending on latitude and climate. Specifically, rotavirus is responsible for nearly half of all cases of severe diarrhea requiring hospitalization.

What are the symptoms?
Signs and symptoms of rotavirus infection may include:
Fever
abdominal pain
Vomit
Watery diarrhea

Diarrhea can range from mild, moderate to severe and can last up to nine days.

Who gets rotavirus?
Rotavirus is highly infectious and contagious. It is Affects children around the world beyond their ethnicity, culture, social class or socioeconomic status. Mostly against rotavirus gastroenteritis among 4 to 36 months of age, this age group making up the risk group most exposed and vulnerable to disease.

How is rotavirus?
The primary mode of transmission is fecal -oral. Since the virus is stable in the environment, transmission can occur through ingestion of contaminated food or water, and contact with contaminated surfaces (such as a diaper, a toy or a pillow.) Infection can occur even in places where there are adequate levels of hygiene,

Where does the rotavirus?
The incidence is similar in developing countries and developed countries. Infection can occur even in places where there are adequate levels of hygiene, which suggests that differences in the environment (water, hygiene and sanitation) do not affect incidence.

When a child gets rotavirus?
Because it is so contagious and difficult to control over 95 % of children worldwide will become infected between 3 and 5 years of age. The highest rates of infection occur in children between 4 and 36 months of age who also have the highest risk of severe illness requiring hospitalization.

What is the severity of rotavirus infection?
The rotavirus can result in severe complications rapidly since those virus infections can cause significant loss of body fluids. If rotavirus disease is not immediately and properly managed it can lead to serious consequences such as dehydration, which can lead to hypovolemia (decrease of the normal amount of blood), circulatory collapse and even death. The risk of serious complications and death from rotavirus infection is higher in children than in adults.

What is the potential impact of rotavirus?
Each year, rotavirus causes approximately 440,000 deaths of children around the world. Most of these deaths occur in developing countries, while mortality from rotavirus infection is rare in developed countries. Rotavirus is the main cause of diarrhea requiring hospitalization and it is estimated that rotavirus causes one third of all diarrhea in children. In Latin America, it is estimated that rotavirus diarrhea is responsible for more than 15,000 deaths and 75,000 hospitalizations per year.

What to cope with a rotavirus infection?
Be alert to signs of dehydration: irritability, loss of appetite and dry mouth.
Managing the child infected fluids frequently to replace fluid loss from vomiting and diarrhea. When a child has severe diarrhea in phase is common for vomiting and diarrhea episodes occur with a frequency of up to 20 days. It is likely to be severe dehydration quickly hospitalized to receive intravenous fluids. Children with rotavirus usually receive supportive treatments that manage the symptoms and complications of the disease. Dehydration is usually treated through oral rehydration therapy.

Rotavirus treatment
What is rotavirus vaccine from MSD ?
This is a pentavalent oral vaccine to prevent rotavirus gastroenteritis in infants and children caused by serotypes G1, G2, G3, G4 and G serotypes that contain P1 ( as the G9 ).
As protection against natural rotavirus infection is largely specific to each serotype in Merck’s rotavirus vaccine have been selected human rotavirus serotypes G1, G2, G3, G4 and P1 because these strains caused about 90 % Of rotavirus disease in 1996-1999 in the United States and more than 88 % of them throughout the world between 1973 and 2003.

How is?
The vaccination schedule of Merck’s rotavirus vaccine consists of three oral liquid doses. The first dose should be administered at six to twelve weeks of age and subsequent doses should be administered at intervals of at least four weeks.

What studies were conducted with the vaccine?
The vaccine has been extensively evaluated in large study REST ( Rotavirus Efficacy and Safety Trial – Trial of the Efficacy and Safety Rotavirus), which included 70.301 children aged 6-12 weeks old, was released on January 5 2006 by the prestigious scientific journal New England Journal of Medicine. Study was a placebo-controlled, double-blind, randomized, conducted in 2001-2004 in 11 countries (Germany, Belgium, Costa Rica, United States [ including Puerto Rico ], Finland, Guatemala, Italy, Jamaica, Mexico, Sweden and Taiwan).

In REST the dose of Merck’s rotavirus vaccine consisted of three oral doses, delivered at intervals of four to ten weeks, the first dose administered at age six to twelve weeks.

What is the effectiveness of the vaccine?
In REST, which included 70.301 children, Merck’s rotavirus vaccine was shown to be very effective:

In a cohort of efficacy ( n = 5.673 )
74 % effective in preventing all cases of rotavirus gastroenteritis
98% effective in preventing severe cases of rotavirus gastroenteritis

In a cohort of health resource use (n = 57.134 )
96 % reduction in hospitalizations
94 % reduction in emergency visits
95 % reduction in hospitalizations / ER visits
87 % reduction in lost work days
86 % reduction in lost work days

What is the safety and tolerability profile of the vaccine?
In clinical studies has been generally well tolerated. The safety profile of this vaccine has been extensively tested in the large study REST ( Rotavirus Efficacy and Safety Trial – Trial of the Efficacy and Safety Rotavirus). REST is a comparative study with placebo and included 70.301 children.

The study was carried out active surveillance to identify potential cases of intussusception ( abnormal introduction of a portion of the intestine into another) of 7, 14 and 42 after each dose, and then every six weeks during the year following the first dose.
The Merck’s rotavirus vaccine did not increase the risk of intussusception compared to placebo. There were no confirmed cases of intussusception during the period of 42 days after the first dose and no accumulation of cases among vaccinated at any time after either dose. After follow up one year, reported four cases of intussusception in children who had received placebo during the study.

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