Satellites – the viral kind
Satellites are subviral agents that differ from viroids because they depend on the presence of a helper virus for their propagation. Satellite viruses are particles that contain nucleic acid genomes encoding a structural protein that encapsidates the satellite genome. Satellite RNAs do not encode capsid protein, but are packaged by a protein encoded in the helper virus genome. Satellite genomes may be single-stranded RNA or DNA or circular RNA, and are replicated by enzymes provided by the helper virus. The origin of satellites remains obscure, but they are not derived from the helper virus.
Satellite viruses may infec...
Source: virology blog - January 22, 2015 Category: Virology Authors: Vincent Racaniello Tags: Basic virology Information helper virus hepatitis b virus hepatitis delta satellite virus mavirus mimivirus plant satellite RNA sputnik viral Source Type: blogs
Logical Fallacies in Defense of Aggresive Screening for and Treatment of Hepatitis C
And the hepatitis C follies continue... As we have frequently written, most recently last week, the hepatitis C screening and treatment bandwagon keeps rolling along. There is constant public argument about the prices of treatment regimens, which approach $100,000 per patient in the US. However, nearly all the public chatter, which seems mostly to come from corporate public relations people and marketers, investors and investment advisers, physicians with financial conflicts of interest, and pundits with little background in clinical epidemiology, seems never to question the assumption that the new drugs...
Source: Health Care Renewal - January 21, 2015 Category: Health Management Tags: anechoic effect evidence-based medicine hepatitis C logical fallacies Sovaldi Source Type: blogs
So Much Easier
I saw a patient the other day who was finally sober, again, after several relapses. She was working the program and doing very well indeed. She mentioned that she had gone to a yoga class, and then made the following comment:
It’s so much easier when I’m sober.
Which got us thinking about all kinds of other things that are easier when you’re sober:
Working: Much easier to get to work in the morning when you’re not hung over.
Laundry: Instead of getting so discouraged looking at the pile that you just have a drink.
Driving: without worrying about getting pulled over for DUI.
Yoga: and walking, swimm...
Source: Musings of a Dinosaur - January 20, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
The Fashion Challenges of the Emperor of Hepatitis C Treatment - Now in the BMJ, but Who Will Notice?
As we wrote, most recently last week, the hepatitis C screening and treatment bandwagon keeps rolling along. There is constant public argument whether about the prices of treatment regimens, which approach $100,000 per patient in the US. However, nearly all the public chatter, which seems mostly to come from corporate public relations people and marketers, investors and investment advisers, physicians with financial conflicts of interest, and pundits with little background in clinical epidemiology, seems never to question the assumption that the new drugs for hepatitis C are miraculous cures, which, of course, ...
Source: Health Care Renewal - January 15, 2015 Category: Health Management Tags: clinical trials evidence-based medicine health care prices hepatitis C Sovaldi Source Type: blogs
As the Hepatitis C Marketing Frenzy Continues, a Reminder Not to Ignore the Evidence
The Hepatitis C Spin Cycle Continues Since our last post in July, 2014, about sofosbuvir (Sovaldi, Gilead), the $1000 pill proclaimed to be a wonder drug for the treatment of hepatitis C, the marketing juggernaut for new antiviral drugs for this condition continues to roll along.For example, I just got a notice to look at a Gilead website which proclaims HCV can be curedIn October, Gilead got permission so sell Harvoni, a new combination drug that includes sofosbuvir and ledipasvir, hailed as a once daily pill that can cure hepatitis C, for a mere $94,500 for a typical treatment course. (See this article in the Wall ...
Source: Health Care Renewal - January 5, 2015 Category: Health Management Tags: AbbeVie clinical trials evidence-based medicine Gilead marketing Sovaldi Source Type: blogs
What is aldosterone escape?
Brief Review
Abstract: The term aldosterone escape in primary hyperaldosteronism is escape from the salt and water retaining effects of aldosterone. In the treatment of heart failure with angiotensin converting enzyme inhibitors, it is the breakthrough occurrence of aldosterone effect.
Different types of aldosterone escape
The term ‘aldosterone escape’ has been used in two different settings:
Aldosterone escape in primary hyperaldosteronism
Aldosterone escape in the treatment of heart failure with angiotensin converting enzyme inhibitors
Aldosterone escape in primary hyperaldosteronism
Aldosterone escape in ...
Source: Cardiophile MD - December 23, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs
MKSAP: 50-year-old man with cirrhosis
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 50-year-old man is evaluated in follow-up for a recent diagnosis of cirrhosis secondary to nonalcoholic steatohepatitis. He has a history of asthma, type 2 diabetes mellitus, hyperlipidemia, and obesity. His current medications are inhaled fluticasone, montelukast, insulin glargine, insulin lispro, simvastatin, and lisinopril.
On physical examination, temperature is 37.5 °C (99.5 °F), blood pressure is 120/70 mm Hg, pulse rate is 80/min, and respiration rate is 16/min; BMI is 31. Abdominal examination reveal...
Source: Kevin, M.D. - Medical Weblog - December 13, 2014 Category: Journals (General) Authors: mksap Tags: Conditions GI Source Type: blogs
The Wire
Nursing home staff became concerned about a patient because he was “floppy.” He was a 59-year-old man with stage 3 chronic kidney disease, right ventricular heart failure, hypertension, cirrhosis, and insulin-dependent type 2 diabetes mellitus. He had been sleeping all day, according to his nurse, but he was not responding when she checked on him in the evening, and she could “drop his arm and it would just hit his face.”
He was hypotensive (90/50 mm Hg) and bradycardic (about 30 beats/min) in the ED. Respirations were slow and shallow. He was protecting his airway, but was hypoxic (SpO2 82%). IV access was esta...
Source: Spontaneous Circulation - December 9, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
The Wire
Nursing home staff became concerned about a patient because he was “floppy.” He was a 59-year-old man with stage 3 chronic kidney disease, right ventricular heart failure, hypertension, cirrhosis, and insulin-dependent type 2 diabetes mellitus. He had been sleeping all day, according to his nurse, but he was not responding when she checked on him in the evening, and she could “drop his arm and it would just hit his face.”
He was hypotensive (90/50 mm Hg) and bradycardic (about 30 beats/min) in the ED. Respirations were slow and shallow. He was protecting his airway, but was hypoxic (SpO2 82%). IV access was es...
Source: Spontaneous Circulation - December 9, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
How and when to call palliative care
Did I tell you that I was a big fan of palliative care? Palliative care started around 15 years ago at the VA where I worked. We saw the service evolve. We saw how the palliative care approach improved the quality of both life and death.
Many physicians have not yet accepted or at least understood palliative care. Many physicians use some palliative care principles and believe palliative care is superfluous. My experience is quite different. In the two hospitals where I have worked with palliative care, our patients receive a team approach to quality of life. The palliative care team designs a program for the patie...
Source: DB's Medical Rants - December 6, 2014 Category: Internal Medicine Authors: rcentor Tags: Attending Rounds Source Type: blogs
Suppressing the Origins of Fibrosis
Fibrosis is a type of scarring in which excessive connective tissue is created in response to damage. It plays an important role in the pathology of a range of age-related conditions, but does this process have its origins in a sufficiently narrow set of mechanisms that it could be selectively suppressed or disabled entirely in the near future?
[Researchers] have identified what they believe to be the cells responsible for fibrosis, the buildup of scar tissue. Fibrotic diseases, such as chronic kidney disease and failure, lung disease, heart failure and cirrhosis of the liver, are estimated to be responsible for up to 45 ...
Source: Fight Aging! - December 3, 2014 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Cardiology MCQ: Platypnea-orthodeoxia
Platypnea-orthodeoxia has been described in:
a) Pulmonary arteriovenous malformation
b) Cirrhosis liver
c) Aortic aneurysm
d) All of the above
Correct answer: d) All of the above
Platypnea-orthodeoxia is characterized by dyspnoea and systemic oxygen desaturation on assuming the sitting or standing position. It was originally described by Burchell et al in 1949 [Burchell HB et al. Reflex orthostatic dyspnea associated with pulmonary hypertension. Am J Physiol. 1949; 159: 563–564]. The basic requirement for the condition is an interatrial communication in the form of a patent foramen ovale, atrial septal defect or an atria...
Source: Cardiophile MD - November 26, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Top stories in health and medicine, November 11, 2014
From MedPage Today:
Estrogen May Protect Heart by Inhibiting Mineralocorticoid. Estrogen inhibition of a key receptor that helps regulate blood pressure may be a new mechanism by which premenopausal women are protected from cardiovascular disease.
Colorectal Ca Rates on the Rise in Younger People. The incidence of colon and rectal cancer increased significantly in people younger than 50, but decreased overall and among older people.
HCV Combo Effective After Liver Transplant. A two-drug combination for hepatitis C (HCV) appeared to be curative in more than 90% of liver transplant recipients.
Transferring Liver Patients M...
Source: Kevin, M.D. - Medical Weblog - November 11, 2014 Category: Journals (General) Authors: MedPage Today Tags: News Cancer GI Heart Source Type: blogs
Cardiology MCQ 336: Platypnea-orthodeoxia
Platypnea-orthodeoxia has been described in:
a) Pulmonary arteriovenous malformation
b) Cirrhosis liver
c) Aortic aneurysm
d) All of the above
["Click here for the answer with explanation", "Correct Answer:"]
d) All of the above
Platypnea-orthodeoxia is characterized by dyspnoea and systemic oxygen desaturation on assuming the sitting or standing position. Read more…
The post Cardiology MCQ 336: Platypnea-orthodeoxia appeared first on Cardiophile MD. (Source: Cardiophile MD)
Source: Cardiophile MD - October 8, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Debate Around the Hepatitis C Drug Must Take Into Account the Benefits to Patients and the Long-Term Savings
This report projected that without new treatments and cures for hepatitis C, "annual medical costs for patients with this disease would more than double from $30 billion to over $85 billion over the next 20 years - an unsustainable trend."
Previous therapies for hepatitis C carried numerous side effects, such as anemia and depression, while only helping about half of patients. Cure rates for Sovaldi, however, were nearly 90% in clinical trials before the drug was approved for sale in December, and there were far fewer complications. The Millman report points out that complications associated with the disease are ver...
Source: Policy and Medicine - August 1, 2014 Category: American Health Authors: Thomas Sullivan Source Type: blogs
