Among the neurotransmitter systems with enhanced functions are: GABA A , [23] 5-HT 3 receptor agonism [24] (responsible for GABAergic ( GABA A receptor PAM ), glycinergic , and cholinergic effects), nicotinic acetylcholine receptors . [25] Among those that are inhibited are: NMDA , [24] dihydropyridine-sensitive L-type Ca2+ channels [26] and G-protein-activated inwardly rectifying K+ channels . [27] Alcohol is also converted to a lipid metabolite phosphatidylethanol by phospholipase D2 and this metabolite is shown to bind directly to and regulate ion channels. [28] [29] The result of these direct effects is a wave of further indirect effects involving a variety of other neurotransmitter and neuropeptide systems, leading finally to the behavioural or symptomatic effects of alcohol intoxication. [22] The order in which different types of alcohol are consumed ("Grape or grain but never the twain" and "Beer before wine and you'll feel fine; wine before beer and you'll feel queer") does not have any effect. [30] GABA A receptors [ edit ] See also: GABAA § Ligands Ethanol binding to GABA A receptor Many of the effects of activating GABA A receptors have the same effects as that of ethanol consumption. ... Archived from the original on 2009-06-20 . Retrieved 2009-11-03 . , "Isaiah 28:1" . Net.bible.org. Archived from the original on 2009-06-20 .
The NFL responded to these results by claiming the study was incomplete. [21] On September 30, 2014, researchers with Boston University announced that in autopsies of 79 brains of former NFL players, 76 had tested positive for CTE. [22] As of January 2017, that number had grown to 90 out of 94. [23] A study published in The Journal of the American Medical Association in July 2017 showed that 110 of 111 former NFL players whose brains were examined were found to have suffered from CTE. [24] Prevention [ edit ] In October 2009, NFL Commissioner Roger Goodell and the NFL Concussion Committee were called before Congress to defend their policies against allegations of neglect. [25] [26] Goodell provided testimony, but was unable to answer many questions, as none of the primary authors of the league's research, Ira Casson , David Viano, or Elliot Pellman were present. [25] [26] As a result of this incident and pressure from the NFL Players Association, the NFL released a comprehensive overhaul of the league concussion policy in November and December 2009. [27] The policy expanded the list of symptoms that would prevent a player from returning to a game or practice on the same day their injury occurred. [27] [28] [29] With continued pressure to protect players, the NFL began preventing players knocked unconscious by a concussion from returning to a game or practice, a policy that applied to Detroit Lions running back Jahvid Best in 2009 . [30] Various players have filed lawsuits against the league for the concussions, accusing the league of hiding information that linked head trauma to permanent brain damage, Alzheimer's disease , and dementia . [31] [32] Some teams chose not to draft certain players in the NFL Draft due to their past concussion history.
Impairments can also be more intense if ECT is administered repetitively (sine wave simulation) as opposed to a single pulse (brief-pulse stimulation). [27] Electroconvulsive shock (ECS): The research in this field has been advanced by using animals as subjects. [28] Researchers induce RA in rats, for example, by giving daily ECS treatments. [29] This is done to further understand RA.
Hepatocellular carcinoma can be caused by hepatitis B virus , hepatitis C virus , [25] and by the helminth Schistosoma japonicum . [26] Lung cancer is associated with the bacterium Chlamydia pneumoniae , [27] with human papillomaviruses , and with Merkel cell polyomavirus . [28] Leukemia . Adult T-cell leukemia can be caused by human T-cell leukemia virus-1 . ... "Association between central nervous system infections during childhood and adult onset schizophrenia and other psychoses: a 28-year follow-up" . International Journal of Epidemiology . 26 (4): 837–43. doi : 10.1093/ije/26.4.837 .
Mumps vaccines use live attenuated viruses. [2] Most countries include mumps vaccination in their immunization programs, and the MMR vaccine , which also protects against measles and rubella , is the most commonly used mumps vaccine. [9] Mumps vaccination can also be done on its own [28] and as a part of the MMRV vaccine , which also provides protection against measles, rubella, chickenpox , and shingles . ... From 1968 to 1982, cases declined by 97% in the USA, in Finland cases were reduced to less than 1 per 100,000 people per year, [25] and a decline from 160 cases per 100,000 to 17 per 100,000 per year in England was observed from 1989 to 1995. [31] By 2001, there had been a 99.9% reduction in the number of cases in the USA and similar near-elimination in other vaccinating countries. [5] In Japan in 1993, concerns over the rates of aseptic meningitis following MMR vaccination with the Urabe strain prompted the removal of MMR vaccines from the national immunization program, resulting in a dramatic increase in the number of cases. [1] [5] Japan now provides voluntary mumps vaccination separately from measles and rubella. [28] Starting in the mid-1990s, controversies surrounding the MMR vaccine emerged.
Overview Mumps is an illness caused by a virus. It usually affects the glands on each side of the face. These glands, called parotid glands, make saliva. Swollen glands may be tender or painful. Salivary glands There are three pairs of major salivary glands — parotid, sublingual and submandibular. Each gland has its own tube (duct) leading from the gland to the mouth. Mumps are not common in the United States because of vaccines. But outbreaks do happen.
Pain triggered in this way can last throughout the menstrual cycle, not just during menstrual periods. [21] Also, endometriotic lesions can develop their own nerve supply, thereby creating a direct and two-way interaction between lesions and the central nervous system , potentially producing a variety of individual differences in pain that can, in some cases, become independent of the disease itself. [15] Nerve fibres and blood vessels are thought to grow into endometriosis lesions by a process known as neuroangiogenesis . [22] Infertility [ edit ] Main article: Endometriosis and infertility About a third of women with infertility have endometriosis. [1] Among those with endometriosis, about 40% are infertile. [1] The pathogenesis of infertility is dependent on the stage of disease: in early stage disease, it is hypothesised that this is secondary to an inflammatory response that impairs various aspects of conception, whereas in later stage disease distorted pelvic anatomy and adhesions contribute to impaired fertilisation. [23] Other [ edit ] Other symptoms include diarrhea or constipation , chronic fatigue, nausea and vomiting, migraines, low-grade fevers, heavy (44%) and/or irregular periods (60%), and hypoglycemia. [17] [24] [25] [18] There is an association between endometriosis and certain types of cancers, notably some types of ovarian cancer , [26] [27] non-Hodgkin's lymphoma and brain cancer . [28] Endometriosis is unrelated to endometrial cancer . [29] Rarely, endometriosis can cause endometrium-like tissue to be found in other parts of the body.
Rare endometriosis is a rare, non-malformative gynecologic disease characterized by the presence of functional endometrial glands and stroma in extrapelvic locations, such as lungs, pleura, kidneys, bladder, abdominal wall, umbilicus, and cesarean section scar among others. Clinical manifestations are menstrually-related and depend on the location of the ectopic tissue, but in general include pain, mass/nodule, swelling and/or bleeding in the involved area.
Overview Endometriosis (en-doe-me-tree-O-sis) is an often painful disorder in which tissue similar to the tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis. Rarely, endometrial-like tissue may be found beyond the area where pelvic organs are located. With endometriosis, the endometrial-like tissue acts as endometrial tissue would — it thickens, breaks down and bleeds with each menstrual cycle. But because this tissue has no way to exit your body, it becomes trapped.
Celiac disease , an autoimmune disorder caused by an immune response to the protein gluten, results in gluten intolerance and can lead to temporary lactose intolerance. [27] [28] The most widely distributed naturally occurring food chemical capable of provoking reactions is salicylate , [18] although tartrazine and benzoic acid are well recognised in susceptible individuals. [29] [30] [31] Benzoates and salicylates occur naturally in many foods, including fruits, juices, vegetables, spices, herbs, nuts, tea, wines, and coffee. ... "The diet factor in pediatric and adolescent migraine". Pediatr. Neurol . 28 (1): 9–15. doi : 10.1016/S0887-8994(02)00466-6 .
Oxygen supplementation, intravenous fluids, passive leg raising (not Trendelenburg position ) should be started and blood transfusions added if blood loss is severe. [7] It is important to keep the person warm to avoid hypothermia [27] as well as adequately manage pain and anxiety as these can increase oxygen consumption. [7] Negative impact by shock is reversible if it's recognized and treated early in time. [22] Fluids [ edit ] Aggressive intravenous fluids are recommended in most types of shock (e.g. 1–2 liter normal saline bolus over 10 minutes or 20 ml/kg in a child) which is usually instituted as the person is being further evaluated. [28] Colloids and crystalloids appear to be similar with respect to outcomes., [29] Balanced crystalloids and normal saline also appear to be similar in critically ill patients. [30] If the person remains in shock after initial resuscitation, packed red blood cells should be administered to keep the hemoglobin greater than 100 g/l. [7] For those with hemorrhagic shock, the current evidence supports limiting the use of fluids for penetrating thorax and abdominal injuries allowing mild hypotension to persist (known as permissive hypotension ). [31] Targets include a mean arterial pressure of 60 mmHg, a systolic blood pressure of 70–90 mmHg, [7] [32] or until their adequate mentation and peripheral pulses. [32] Hypertonic fluid may also be an option in this group. [33] Medications [ edit ] Epinephrine auto-injector Vasopressors may be used if blood pressure does not improve with fluids.
Such variants include DRB1 0401, DRB1 0402, DRB1 0405, DQA 0301, DQB1 0302 and DQB1 0201, which are common in North Americans of European ancestry and in Europeans. [25] Some variants also appear to be protective. [25] Environmental [ edit ] There is on the order of a 10-fold difference in occurrence among Caucasians living in different areas of Europe. [18] Environmental triggers and protective factors under research include dietary agents such as proteins in gluten , [26] time of weaning, gut microbiota, [27] viral infections, [28] [29] and bacterial infections like paratuberculosis . [30] Chemicals and drugs [ edit ] Some chemicals and drugs selectively destroy pancreatic cells. ... Diet [ edit ] Data suggest that gliadin (a protein present in gluten ) might play a role in the development of type 1 diabetes, but the mechanism is not fully understood. [26] [63] Increased intestinal permeability caused by gluten and the subsequent loss of intestinal barrier function, which allows the passage of pro-inflammatory substances into the blood, may induce the autoimmune response in genetically predisposed individuals to type 1 diabetes. [6] [63] There is evidence from experiments conducted in animal models that removal of gluten from the diet may prevent the onset of type 1 diabetes [26] [108] but there has been conflicting research in humans. [108] Virus [ edit ] One theory proposes that type 1 diabetes is a virus-triggered autoimmune response in which the immune system attacks virus-infected cells along with the beta cells in the pancreas. [28] [109] Several viruses have been implicated, including enteroviruses (especially coxsackievirus B ), cytomegalovirus , Epstein–Barr virus , mumps virus, rubella virus and rotavirus , but to date there is no stringent evidence to support this hypothesis in humans. [110] A 2011 systematic review and meta-analysis showed an association between enterovirus infections and type 1 diabetes, but other studies have shown that, rather than triggering an autoimmune process, enterovirus infections, as coxsackievirus B, could protect against onset and development of type 1 diabetes. [111] Some studies have found a decreased risk with oral rotavirus vaccine while others found no effect. [112] [113] Gene therapy [ edit ] Gene therapy has also been proposed as a possible cure for type 1 diabetes. [114] Stem cells [ edit ] Pluripotent stem cells can be used to generate beta cells but previously these cells did not function as well as normal beta cells. [115] In 2014 more mature beta cells were produced which released insulin in response to blood sugar when transplanted into mice. [116] [117] Before these techniques can be used in humans more evidence of safety and effectiveness is needed. [115] Vaccine [ edit ] Vaccines are being looked at to treat or prevent type 1 diabetes by inducing immune tolerance to insulin or pancreatic beta cells. [118] While Phase II clinical trials of a vaccine containing alum and recombinant GAD65 , an autoantigen involved in type 1 diabetes, were promising, as of 2014 Phase III had failed. [118] As of 2014, other approaches, such as a DNA vaccine encoding proinsulin and a peptide fragment of insulin, were in early clinical development. [118] The rotavirus vaccine and BCG vaccine are associated with a lower risk of type 1 diabetes. [119] [120] [121] Research continues to look at the BCG vaccine in type 1 diabetes as of 2019 [update] . [121] References [ edit ] ^ a b c d e f g h "Causes of Diabetes" . ... Annals of the New York Academy of Sciences . 1212 (1): 12–28. Bibcode : 2010NYASA1212...12T . doi : 10.1111/j.1749-6632.2010.05820.x .
To test for linkage between HLA and a locus for susceptibility to this disease, Clerget-Darpoux et al. (1980) studied 28 informative families with at least 1 child suffering from juvenile-onset IDDM. The 28 families were pooled with 21 from the literature and autosomal recessive inheritance was assumed.
Overview Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition. In this condition, the pancreas makes little or no insulin. Insulin is a hormone the body uses to allow sugar (glucose) to enter cells to produce energy. Different factors, such as genetics and some viruses, may cause type 1 diabetes. Although type 1 diabetes usually appears during childhood or adolescence, it can develop in adults. Even after a lot of research, type 1 diabetes has no cure. Treatment is directed toward managing the amount of sugar in the blood using insulin, diet and lifestyle to prevent complications.
The pivot-shift test involves flexing the knee while holding onto the ankle and slightly rotating the tibia inwards. [26] In the anterior drawer test, the examiner flexes the knees to 90 degrees, sits on the person's feet, and gently pulls the tibia towards him or herself. [27] The Lachman test is performed by placing one hand on the person's thigh and the other on the tibia and pulling the tibia forward. [28] These tests are meant to test whether the ACL is intact and therefore able to limit the forward motion of the tibia.
Overview An ACL injury is a tear or sprain of the anterior cruciate (KROO-she-ate) ligament (ACL) — one of the strong bands of tissue that help connect your thigh bone (femur) to your shinbone (tibia). ACL injuries most commonly occur during sports that involve sudden stops or changes in direction, jumping and landing — such as soccer, basketball, football and downhill skiing. Many people hear a pop or feel a "popping" sensation in the knee when an ACL injury occurs. Your knee may swell, feel unstable and become too painful to bear weight. Depending on the severity of your ACL injury, treatment may include rest and rehabilitation exercises to help you regain strength and stability, or surgery to replace the torn ligament followed by rehabilitation.
According to a study from Canada, the lack of knowledge about cannabis seems to be the main reason why adolescents start to smoke. [28] The authors observed a high correlation between adolescents that knew about the mental and physical harms of cannabis and their consumption. [29] It goes without saying that from the 1045 young participants, the ones who could name the less amount of negative effects about this drug were usually the ones who were consuming it. [30] They were not isolated cases either.
Overall survival was better than expected. [26] On the other hand, the Framingham Heart Study reported that PVCs in apparently healthy people were associated with a twofold increase in the risk of all-cause mortality , myocardial infarction and cardiac death . [20] In men with coronary heart disease and in women with or without coronary heart disease, complex or frequent arrhythmias were not associated with an increased risk. [27] The at-risk people might have subclinical coronary disease. [28] These Framingham results have been criticised for the lack of rigorous measures to exclude the potential confounder of underlying heart disease. [20] In the ARIC study of 14,783 people followed for 15 to 17 years those with detected PVC during 2 minute ECG, and without hypertension or diabetes on the beginning, had risk of stroke increased by 109%. [29] Hypertension or diabetes, both risk factors for stroke, did not change significantly risk of stroke for people with PVC. [29] It is possible that PVCs identified those at risk of stroke with blood pressure and impaired glucose tolerance on a continuum of risk below conventional diagnostic thresholds for hypertension and diabetes. [29] Those in ARIC study with any PVC had risk of heart failure increased by 63% [30] and were > twice as likely to die from coronary heart disease (CHD).
Resolving the inherent conflict between these perspectives strikes at the very heart of how biological mechanisms process memories after their initial encoding." [28] TEA is related to sleep in nearly three-quarters of cases, and persistent memory problems could be the result of nocturnal, subclinical attacks disrupting on-going consolidation processes.
In the public eye, Abel Coffin, the man who first brought them to the United States, continued to serve as a father figure to the twins. [28] The twins were soon involved in another conflict, during a performance in Alabama. ... This satirical work, with Twain's typical deadpan humor, jokes about, among other things, the twins' different attitudes and their romantic pursuit of the same woman. [107] The musical Chang & Eng , directed by Ekachai Uekrongtham , has themes of open-mindedness and interdependence, and it opened in Singapore in 1997. [79] Chang & Eng (2000), the debut novel of Darin Strauss , is a fictionalized account of the Bunker brothers' lives based on some historical context. [108] Chang is the narrator in God's Fool (2002), Mark Slouka 's first novel, and he has a hindsight letting him know the importance of future events. [109] The play I Dream of Chang and Eng by playwright Philip Kan Gotanda , a "reimagining" of the twins' lives which departs somewhat from truthfulness, was workshopped and performed at UC Berkeley in 2011. [110] Chang and Eng (played by Danial Son and Yusaku Komori) are featured in the musical biopic The Greatest Showman (2017) about the early years of the Barnum & Bailey Circus . [111] See also [ edit ] List of conjoined twins Notes and references [ edit ] Explanatory notes ^ Their parents named them In and Chun (or Jun ), which contrary to popular belief during their lifetime do not mean "left" and right", and they were known locally as the "Chinese twins". Huang 2018 , pp. 27–28. According to Huang, the twins themselves signed their names as 曾 and 因 .
Medical Dictionary . Archived from the original on 28 June 2013 . Retrieved 30 January 2013 . ^ Messenger AM, Barnes AN, Gray GC (2014). ... Centers for Disease Control and Prevention. 15 September 2011. Archived from the original on 28 June 2013 . Retrieved 5 June 2013 . ^ "Inhalation Anthrax" . cdc.gov . ... Retrieved 26 March 2017 . ^ "Avian flu: Poultry to be allowed outside under new rules" . BBC News . 28 February 2017. Archived from the original on 7 March 2017 . ... Archived (PDF) from the original on 17 December 2008 . Retrieved 28 December 2008 . ^ http://www.nasphv.org/ ^ Vidal, John (18 March 2020). " ' Tip of the iceberg': is our destruction of nature responsible for Covid-19?" ... Smithsonian.com. Archived from the original on 28 March 2017 . Retrieved 16 April 2017 . ^ Shute, Nancy.
Overview table [ edit ] Virus Percent of cancers [5] Associated cancer types Hepatitis B virus (HBV) Hepatocarcinoma [26] Hepatitis C virus (HCV) HCV is a known carcinogen, causing hepatocarcinoma [27] Human T-lymphotropic virus (HTLV) 0.03 Adult T-cell leukemia [28] Human papillomaviruses (HPV) 5.2 The types 16 and 18 are associated with cancers of cervix , [29] anus , [29] penis , [29] vulva/vagina , [5] and oropharyngeal cancer . [5] According to statistics in the United States, females are more impacted by HPV-associated cancers (83%) than males (74%). [30] Kaposi's sarcoma-associated herpesvirus (HHV-8) 0.9 Kaposi’s sarcoma , multicentric Castleman's disease and primary effusion lymphoma Merkel cell polyomavirus (MCV) NA Merkel cell carcinoma Epstein–Barr virus (EBV) NA Burkitt's lymphoma , Hodgkin’s lymphoma , post-transplant lymphoproliferative disease , nasopharyngeal carcinoma [31] and a subtype of stomach cancer . [32] Estimated percent of new cancers attributable to the virus worldwide in 2002. [5] NA indicates not available. ... PMID 22101257 . ^ Tang, CM; Yau, TO; Yu, J (28 May 2014). "Management of chronic hepatitis B infection: current treatment guidelines, challenges, and new developments" .
Psychological Voluntary withholding of the stool is a common cause of constipation. [15] The choice to withhold can be due to factors such as fear of pain, fear of public restrooms, or laziness. [15] When a child holds in the stool a combination of encouragement, fluids , fiber , and laxatives may be useful to overcome the problem. [28] Early intervention with withholding is important as this can lead to anal fissures . [29] Congenital A number of diseases present at birth can result in constipation in children . ... Alimentary Pharmacology & Therapeutics . 28 (7): 917–930. doi : 10.1111/j.1365-2036.2008.03806.x .
Overview Chronic constipation is infrequent bowel movements or difficult passage of stools that persists for several weeks or longer. Constipation is generally described as having fewer than three bowel movements a week. Though occasional constipation is very common, some people experience chronic constipation that can interfere with their ability to go about their daily tasks. Chronic constipation may also cause people to strain excessively in order to have a bowel movement. Treatment for chronic constipation depends in part on the underlying cause.
The autoantigens believed to cause the autoreactivity are the alpha and beta subunits of the H + /K + -ATPase. [27] [28] In a study, B12 deficiency caused by Helicobacter pylori was positively correlated with CagA positivity and gastric inflammatory activity, rather than gastric atrophy. [29] Less commonly, H. pylori and Zollinger-Ellison syndrome may also cause a form of nonautoimmune gastritis that can lead to pernicious anemia. [30] Impaired B 12 absorption can also occur following gastric removal ( gastrectomy ) or gastric bypass surgery. ... PMID 16916826 . ^ a b c Snow, CF (Jun 28, 1999). "Laboratory diagnosis of vitamin B12 and folate deficiency: a guide for the primary care physician".
In the relatives of 34 pernicious anemia probands, McIntyre et al. (1959) tested the ability to absorb orally given doses of cobalt-60 labeled vitamin B12 (Schilling test). The relatives of pernicious anemia patients showed a negative correlation with age; control subjects did not. The relatives showed a tendency to bimodality. Forty-eight percent of sibs and 32% of offspring had abnormal absorption. The authors suggested autosomal dominant inheritance. Wangel et al. (1968) suggested that the tendency to form autoantibodies against gastric parietal cells may be inherited as a dominant with incomplete penetrance. Later studies (McIntyre, 1968) yielded results that make a simple genetic hypothesis difficult to support.
Mortality caused by Wernicke's disease reaches 17% of diseases, which means 3.4/1000 or about 25 million contemporaries. [27] [28] The number of people with Wernicke's disease may be even higher, considering that early stages may have dysfunctions prior to the production of observable lesions at necropsy. ... Archived from the original on 2012-10-19. ^ a b HA Smith, p. 26-28 ^ a b Benedict, CA (2018-10-25). "Forgotten Disease: Illnesses Transformed in Chinese Medicine by Hilary A. ... Washington, D.C.: National Academy Press. ^ Polioencephalomalacia: Introduction Archived 2016-03-03 at the Wayback Machine , Merck Veterinary Manual ^ Polioencephalomacia: Introduction Archived 2010-05-28 at the Wayback Machine , "ACES Publications" ^ "Archived copy" .
Beriberi is a condition that occurs in people who are deficient in thiamine (vitamin B1). There are two major types of beriberi: wet beriberi which affects the cardiovascular system and dry beriberi which affects the nervous system. People with wet beriberi may experience increased heart rate, shortness of breath, and swelling of the lower legs. Signs and symptoms of dry beriberi include difficulty walking; loss of feeling in the hands and/or feet; paralysis of the lower legs; mental confusion; speech difficulty; pain; and/or vomiting. Beriberi is rare in the United States since many foods are now vitamin enriched; however, alcohol abuse, dialysis and taking high doses of diuretics increases the risk of developing the condition.
