Hepatitis

Usually Signs of Hepatitis A Symptoms

The Hepatitis A symptoms and signs usually appear from 15 to 50 days (2 to 7 weeks) after exposure to hepatitis A virus (HAV), and the average time HAV symptoms appears is 4 weeks. The hepatitis A symptoms and signs are usually mild and can not be observed in children under 6 years. Among older children and adults, early symptoms are similar to those of a stomach virus.

Possible hepatitis A symptoms and signs include:
- Extreme fatigue (tiredness).
- Fever.
- Sore muscles.
- Headaches.
- Pain in the right side of the abdomen below the ribs (when the liver is located).
- Nausea.
- Loss of appetite and weight loss.
- Yellowing of the skin and whites of the eyes (jaundice), sometimes accompanied by dark urine and clay-colored (whitish) stools. Jaundice is less common in children and young adults.

About 15% of people with signs of hepatitis A have symptoms of infection with HAV that performance or the last 6 to 9 months after the first infection occurred.1 The infection of hepatitis A is usually more severe than the first time, but the Arthritis can occur with it. After the infection goes away, the person usually returns to normal health. Rarely, cholestatic hepatitis occurs, which can cause itching and can last throughout the infection.

In general, when signs of hepatitis A symptoms occur, the amount of virus is shed in the feces is in decline. You can still spread the virus, but is less likely to do so after symptoms appear. The symptoms of hepatitis A signs usually last less than 2 months. In other countries, hepatitis A also called as l’hépatite A, la hepatitis A, epatite A, WZW typu A, hepatitt A.

Incoming Search Terms :

Hepatitis A Virus Infection Prevention Tips

Many ways to prevent Hepatitis A Virus Infection, such as :
1. Get vaccinated against hepatitis A, if your travel plans, work, health, or lifestyle puts you at risk for exposure to hepatitis A (HAV). For more information, see what increases the risk of this category.
2. Develop habits of hygiene.
- Make sure you and all family members wash their hands with soap and warm water after using the toilet and before preparing or eating food.
- wash dishes in hot soapy water or a dishwasher.
- discourage children from putting objects in their mouths, especially when they share toys with other children.
- Do not eat or drink anything that you think may have been prepared in filthy conditions.
3. Protect yourself before flying and when on his journey. If you are traveling to some of the world where sanitation is poor or if hepatitis A is a known problem, consult your doctor about vaccination against hepatitis A, immune globulin (Ig) or a combination vaccine against hepatitis A and B. Always drink bottled water or boil water before drinking. Avoid tap water or untreated well water or drinks with ice. And do not eat raw foods (such as unpeeled fruits or vegetables).
4. Crus not eat shellfish or cooked. If molluscs that live in water have been contaminated with feces containing the virus of hepatitis A infected molluscs May.

Child care workers should be educated about how often prevent the spread of hepatitis A prevention. Although children infected with hepatitis A may have little or no symptoms, can infect other people, including child care workers and other adults who may develop more severe symptoms. To prevent the spread of hepatitis A virus HAV, the child care workers must :
- Use plastic (not latex, because of the risk of allergic reaction), disposable gloves when changing diapers.
- Wash children’s hands, and then use a new pair of gloves when changing diapers for another child.
- Clean the diaper changing surface after each mutation.
- Talk to your doctor about getting vaccinated against HAV.

Incoming Search Terms :

Some Cirrhosis Treatment Complications Part 2

In Complications of Cirrhosis Treatment Part 1, you have learen more detail information about bleeding from varices, also edema and ascites. And now, in Some Cirrhosis Treatment Complications Part 2 I will give information more details about Hepatic encephalopathy, Hypersplenism, Spontaneous bacterial peritonitis (SBP)

Hepatic Encephalopathy

Patients with an abnormal sleep cycle, thought disorders, bizarre behavior, or other signs of hepatic encephalopathy usually be treated with a low protein diet and oral lactulose. The dietary protein is limited because it is a source of toxic compounds that cause hepatic encephalopathy. Lactulose, which is a liquid, the pitfalls of toxic compounds in the colon. Therefore, can be absorbed into the bloodstream and cause encephalopathy. To ensure that adequate lactulose present in the colon, at any time, patient dose should be used to produce semi-formed stools per day 2.3. (Lactulose is a laxative, and the adequacy of treatment may be tried by the looseness or increased stool frequency.) Encephalopathy If symptoms persist, oral antibiotics such as neomycin or metronidazole (Flagyl) can be added to the system. Antibiotics by blocking the production of toxic compounds by bacteria in the colon.

Hypersplenism

The filtration of blood by an enlarged spleen usually means that the cuts only mild symptoms of red blood cells (anemia), white blood cells (leukopenia) and platelets (thrombocytopenia), which do not require treatment. Severe anemia, however, may need blood transfusions or treatment with erythropoietin or epoetin alfa (Epogen, Procrit), hormones that stimulate red blood cell production. If the number of white blood cells are significantly reduced, another factor stimulating hormone called granulocyte colony is available to increase the number of white blood cells. An example of one of these factors is filgrastim (Neupogen).

There is no approved drug is still available to increase the number of platelets. As a precaution necessary, patients with low platelet count should not use aspirin or other antiinflammatory drugs (NSAIDs), because these drugs may affect platelet function. If a low number of platelets is associated with significant bleeding, platelet transfusions should be given normally. Surgical removal of the spleen (called splenectomy) should be avoided if possible because of the risk of excessive bleeding during surgery and the risk of anesthesia in advanced liver disease.

Spontaneous Bacterial Peritonitis (SBP)

Patients with suspected spontaneous bacterial peritonitis usually covered by paracentesis. The liquid that is extracted is examined for white blood cells and for bacteria. Culture is the inoculation of a sample of ascites in a bottle of fluid containing nutrients that promote growth of bacteria, facilitating the identification of even small amounts of bacteria. The blood and urine samples are often obtained for both culture, since many patients with spontaneous bacterial peritonitis has also infection in the blood and urine. In fact, many doctors believe the infection may have begun in the blood and urine and spread to cause ascites spontaneous bacterial peritonitis. Most patients with spontaneous bacterial peritonitis were hospitalized and treated with intravenous antibiotics such as ampicillin, gentamicin, and one of the most recent generations cephalosporins. In general, patients treated with antibiotics as follows:

• Patients with blood, urine and / or ascites fluid cultures containing bacteria.
• Patients without bacteria in the blood, urine and ascites, but who have a high number of white blood cells (neutrophils) in asciticfluid (> 250 neutrophils / cc). High number of neutrophils in the ascitic fluid usually means that there is a bacterial infection. Doctors believe that the absence of bacteria to grow in some patients with increased neutrophils is due either to a very small number of bacteria or inefficient farming techniques.

Spontaneous bacterial peritonitis is a serious infection. It often occurs in patients with advanced cirrhosis, whose immune system is weakened, but with modern antibiotics and early detection and treatment, the prognosis for recovery from an episode of spontaneous bacterial peritonitis is good.

In some patients, oral antibiotics (like Cipro or Septra) can be prescribed to prevent spontaneous bacterial peritonitis. All patients with cirrhosis and ascites should be treated with antibiotics to prevent spontaneous bacterial peritonitis, but some patients are at high risk for spontaneous bacterial peritonitis and justify preventive treatment :

• Patients with cirrhosis who were hospitalized for variceal bleeding are at high risk for spontaneous bacterial peritonitis and should be released in early antibiotics during hospitalization to prevent spontaneous bacterial peritonitis
• Patients with recurrent episodes of spontaneous bacterial peritonitis
• Patients with low protein content in ascites (accumulation of ascites with low protein is more susceptible to infection)

Incoming Search Terms :

Considerations For The Vaccine Against Hepatitis A

Adults who are considering a trip abroad where hepatitis A is common may in to test for antibodies to HAV (anti-HAV test) before starting a vaccination program against hepatitis A. If you already have HAV in the blood, which are protected against infection, and should not be vaccinated.

Please consider the following before you go through tests with anti-HAV before vaccination:

• The schedule can be less expensive than anti-HAV testing. The testing costs include the cost of a physician visit and laboratory tests. If tests show that you need to get vaccinated, you must pay to complete the vaccination series (two shots given at different times), including costs of additional consultations.
• You can receive the vaccine against hepatitis A, even if you have antibodies against hepatitis A in the blood, and no harm would result.
• The vaccine against hepatitis A is not fully effective until 4 weeks after injection. But the vaccine will provide some protection after 2 weeks.

If you will be tested for anti-HAV, make sure to do before your trip. People over 60 who want to receive the vaccine before 4 weeks before departure, because evidence suggests that the immune response develops more slowly in older people.

If you find that you need the vaccine, but which moves at less than 4 weeks, you should receive the first shot in the vaccination. One shot provides protection to 90% by the disease and may reduce the severity of the disease. If you want to be extra careful, you may receive the first shot in the vaccination and the injection of immune globulin (IG). This will ensure you’re protected against HAV. You can receive the second injection of the vaccine against hepatitis A 6 to 18 months (as recommended by the manufacturer of the vaccine) after the first shooting.

Other factors to consider regarding the vaccine against Hepatitis A :

• Two doses of vaccine are needed to protect themselves better, so try to get his first shot at least 6 months before going to a foreign country where hepatitis A is common.
• Routine vaccination of hospital personnel, food handlers and child care workers and attendees Center does not occur at this time, since their probability of infection is generally higher than the general community. However, some centers have child care workers get the shot because it works so well to prevent the disease. There are also very low likelihood of vaccine side effects. If outbreaks of HAV infection occur in these environments, people who have been exposed to the virus should receive an injection of immunoglobulin (IG).
• If you have had close personal contact with someone who has hepatitis A, you should get the vaccine against hepatitis A or an injection of IG as soon as possible. If you have received vaccine or IG within 2 weeks of exposure to hepatitis, you may not have symptoms of infection with HAV. For more information, see the section on drugs in this matter.
• The vaccine against hepatitis A also provides some protection against infection if exposed to the virus.

Incoming Search Terms :

Complications of Cirrhosis Treatment Part 1

The treatment complications of cirrhosis include Edema and Ascites, Bleeding from Varices, Hepatic encephalopathy, Hypersplenism, Spontaneous bacterial peritonitis (SBP). In Complications of Cirrhosis Treatment Part 1, I will give more detail information about edema and ascites, also bleeding from varices.

Edema and Ascites

The salt and water retention can lead to swollen ankles and legs (edema) or abdomen (ascites) in patients with cirrhosis. Doctors often advise patients with cirrhosis of limiting the intake of salt (sodium) and fluid to reduce edema and ascites. The amount of salt in the diet is generally limited to 2 grams per day and the liquid to 1.2 liters per day. In most patients with cirrhosis, however, salt and fluid restriction is not enough, and diuretics should be added.

Diuretics are drugs that act on the kidneys to promote excretion of salt and water in urine. A combination of the diuretic spironolactone (Aldactone) and furosemide can reduce or eliminate the edema and ascites in most patients. During treatment with diuretics, it is important to monitor kidney function by measuring blood levels of blood urea nitrogen (BUN) and creatinine to determine if a diuretic is used too. Too many diuretics can cause kidney dysfunction leading to elevated urea and creatinine in blood.

Sometimes when diuretics are not working (in this case, is known as refractory ascites), a long needle or catheter is used to make the ascitic fluid directly into the abdomen, a procedure called abdominal paracentesis. It is common to remove large quantities (liters) of fluid in the abdomen when ascites is abdominal distention causing pain and / or difficulty breathing, as it restricts the movement of the diaphragm.

Another treatment of refractory ascites is a procedure known as porto-systemic shunt transjugular intravenous TIPS.

Bleeding from Varices

If large varices develop in the stomach, esophagus or superior in patients with cirrhosis are at risk of serious bleeding due to rupture of these varices. Once varices have bled, they tend to bleed and the likelihood that patients die each episode of bleeding is high (30% -35%). Therefore, treatment is needed to prevent the episode (original) first bleeding and rebleeding. Treatments include medications and procedures to reduce the pressure in the portal vein and procedures to destroy varicose veins.

* Propranolol (Inderal), a beta blocker, is effective in reducing the pressure in the portal vein and is used to prevent the initial hemorrhage and rebleeding of varices in patients with cirrhosis. Another class of oral drugs that lower portal pressure is nitrates, eg isosorbide dinitrate (Isordil). Nitrates are often added to propranolol, while propranolol alone is not enough to reduce portal pressure and prevent bleeding.

* Octreotide (Sandostatin) also reduces the pressure of the portal vein and is used to treat variceal bleeding.

* During upper endoscopy (EGD) or sclerotherapy or ligation can be performed to remove varicose veins and stop the bleeding and prevent rebleeding. Sclerotherapy involves injecting small doses of sclerosing solution into varicose veins. Sclerosing solutions cause inflammation and scarring and varicose veins, erasing in the process. Band ligation is the use of rubber bands around the varices to erase. (Ligation of varicose veins is similar to rubber bands of hemorrhoids.) Complications of sclerotherapy: esophageal ulcers, bleeding ulcers of the esophagus perforation, esophagus, esophageal stricture (narrowing due to scarring that can cause) , dysphagia, mediastinitis (inflammation of the lungs that can cause chest pain), pericarditis (inflammation around the heart can cause chest pain), and peritonitis (infection of the abdominal cavity). Studies have shown that ligation may be slightly more effective with fewer complications than sclerotherapy.

* Transjugular intrahepatic portosystemic shunt (TIPS) is a surgical procedure to relieve pressure in the portal vein. TIPS is performed by a radiologist inserts a catheter (tube) into a vein in the neck to the inferior vena cava and hepatic vein in the liver. The stent then so that one end is in the high pressure portal vein and the other is in the low-pressure hepatic vein. This blood will not pass through the tube around the liver and therefore decreases the pressure in the portal vein and varicose veins and prevents bleeding varices. TIPS is particularly useful in patients unresponsive to beta-blockers, sclerotherapy of varicose veins or bands. (TIPS is also useful in the treatment of patients with ascites do not respond to salt and fluid restriction and diuretics.) TIPS can be used in patients with cirrhosis to prevent variceal bleeding while patients are awaiting transplant hepático. The most common side effect of TIPS is hepatic encephalopathy. Another major problem is the development advice of narrowing and occlusion of the stent, causing the recurrence of portal hypertension and variceal bleeding and ascites. The ranges of estimated frequency of stent occlusion in 30% -50% in 12 months. Fortunately, there are ways to open occluded stents. Other complications include bleeding boards due to accidental perforation of the capsule of the liver or bile duct, infection, heart failure and liver failure.

* A surgical operation to create a bypass (step) of the vein portal vein high pressure to low pressure can reduce blood flow and portal vein pressure and prevent variceal bleeding. The surgery is called distal splenorenal shunt (DSRS). To consider a bypass surgery in patients with portal hypertension who have early cirrhosis. (The risks of bypass surgery for these patients is lower in patients with advanced cirrhosis.) During DSRS, the surgeon separates the splenic vein, portal vein and attached to the renal vein. Blood is diverted from the spleen to the liver, lowering blood pressure in the portal vein and varices and prevention of variceal bleeding.

Incoming Search Terms :