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Tuesday 7 October 2014

什么是肝炎?

什么是肝炎?

http://en.kllproject.lv/wp-content/uploads/2012/11/Plant-to-Preat-Hepatitis-B.jpg
在线问答
2014年6月
问:什么是肝炎?
答:肝炎为肝脏炎症。病情可自行消退,也可发展成肝纤维化(“结痂”)、肝硬化或肝癌。肝炎病毒是全球肝炎的最常见病因,但其它感染、有毒物质(如酒精和某些药物等)以及自身免疫性疾病也能引起肝炎。
主要有五种肝炎病毒,分别为甲、乙、丙、丁和戊型。由于该病的疾病负担和所导致的死亡情况,及其形成暴发和流行性传播的可能性,这五类肝炎最为受人关注。特别是乙型和丙型肝炎,它们导致数亿人罹患慢性疾病,同时二者还是肝硬化和癌症的最常见病因。
甲型和戊型肝炎的典型病因是食用受污染的食物或水。乙型、丙型和丁型肝炎感染则通常是与受污染体液的非肠道接触的结果。这些病毒的常 见传播途径包括摄入受污染血液或血液制品、使用受污染设备进行侵入性医疗操作程序。乙型肝炎还通过母亲在分娩时传播给婴儿,由家庭成员传播给儿童,同时它 还能够通过性接触传播。
急性感染的出现可能会伴有有限症状或无症状,也可能出现诸如黄疸(皮肤和眼睛发黄)、尿黄、极度疲乏、恶心、呕吐和腹痛等症状。
问:都有哪些不同的肝炎病毒?
答:科学家们已经识别出五种截然不同的肝炎病毒并以甲、乙、丙、丁、戊型作为辨识。虽然它们都会引起肝病,但在重要方面又有所不同。
甲肝病毒存在于感染者的粪便中,最经常通过食用受污染的水或食物传播。某些性行为也能够传播甲型肝炎病毒。大多数感染 病例仅有轻微症状,大部分人会完全康复并在未来保持对甲型肝炎病毒的免疫力。然而,甲型肝炎病毒感染也可能很严重,甚至会威胁生命。在世界上环境卫生较差 地区生活的大多数人都感染过这种病毒。已有可预防甲肝病毒的安全有效疫苗。
乙肝病毒通过接触受感染的血液、精子及其他体液传播。乙肝病毒能够在分娩时通过受感染母亲传播给婴儿,或通过家庭成员 传染给处于儿童早期的婴儿。病毒也可以通过使用乙肝病毒污染过的血液和血液制品,在医疗操作中采用污染性注射和注射毒品传播。卫生保健工作者在为乙肝病毒 感染者提供保健时,可能出现意外针刺伤,因此乙肝病毒也对他们构成威胁。已有可预防乙肝病毒的安全有效疫苗。
丙肝病毒同样也最经常通过接触受感染血液传播。使用丙肝病毒污染过的血液和血液制品,在医疗操作中采用带有污染的注射以及注射毒品均可能造成病毒传播。它还有可能通过性途径传播,但较不常见。还没有丙肝病毒疫苗。
丁肝病毒感染仅发生在乙肝病毒感染者中。丁肝病毒和乙肝病毒双重感染可能会造成更加严重的疾病和更差的后果。安全有效的乙肝疫苗能够为抵御丁肝病毒感染带来保护。
戊肝病毒同甲肝病毒一样,也大多通过食用受污染的水或食物感染。在发展中世界,戊肝病毒是肝炎疫情的常见病因,越来越多的发达国家也认识到它是一项重要病因。安全有效预防戊肝病毒感染的疫苗已经被开发出来,但尚不能做到普遍可得。

Qué es la hepatitis?

¿Qué es la hepatitis?

http://en.kllproject.lv/wp-content/uploads/2012/11/Plant-to-Preat-Hepatitis-B.jpgPreguntas y respuestas en línea
24 de junio de 2014
P: ¿Qué es la hepatitis?
R: La hepatitis es una inflamación del hígado. La afección puede remitir espontáneamente o evolucionar hacia una fibrosis (cicatrización), una cirrosis o un cáncer de hígado. Los virus de la hepatitis son la causa más frecuente de las hepatitis, que también pueden deberse a otras infecciones, sustancias tóxicas (por ejemplo, el alcohol o determinadas drogas) o enfermedades autoinmunitarias.
La hepatitis A y la E son causadas generalmente por la ingestión de agua o alimentos contaminados. Las hepatitis B, C y D se producen de ordinario por el contacto con humores corporales infectados. Son formas comunes de transmisión de estos últimos la transfusión de sangre o productos sanguíneos contaminados, los procedimientos médicos invasores en que se usa equipo contaminado y, en el caso de la hepatitis B, la transmisión de la madre a la criatura en el parto o de un miembro de la familia al niño, y también el contacto sexual.
La infección aguda puede acompañarse de pocos síntomas o de ninguno; también puede producir manifestaciones como la ictericia (coloración amarillenta de la piel y los ojos), orina oscura, fatiga intensa, náuseas, vómitos y dolor abdominal.
P: ¿Cuáles son los distintos virus de la hepatitis?
R: Los científicos han identificado cinco virus de la hepatitis designados por las letras, A, B, C, D y E. Todos causan enfermedades hepáticas, pero se distinguen por varios rasgos importantes.
El virus de la hepatitis A (VHA) está presente en las heces de las personas infectadas y casi siempre se transmite por el consumo de agua o alimentos contaminados. Se puede propagar también por ciertas prácticas sexuales. En muchos casos la infección es leve, y la mayoría de las personas se recuperan por completo y adquieren inmunidad contra infecciones futuras por este virus. Sin embargo, las infecciones por el VHA también pueden ser graves y potencialmente mortales. La mayoría de los habitantes de zonas del mundo en desarrollo con saneamiento deficiente se han infectado con este virus. Se cuenta con vacunas seguras y eficaces para prevenir la infección por el VHA.
El virus de la hepatitis B (VHB) se transmite por la exposición a sangre, semen y otros líquidos corporales infecciosos. También puede transmitirse de la madre infectada a la criatura en el momento del parto o de un miembro de la familia infectado a un bebé. Otra posibilidad es la transmisión mediante transfusiones de sangre y productos sanguíneos contaminados, inyecciones con instrumentos contaminados durante intervenciones médicas y el consumo de drogas inyectables. El VHB también plantea un riesgo para el personal sanitario cuando este sufre pinchazos accidentales de aguja mientras asiste a personas infectadas por el virus. Existe una vacuna segura y eficaz para prevenir esta infección.
El virus de la hepatitis C (VHC) se transmite casi siempre por exposición a sangre contaminada, lo cual puede suceder mediante transfusiones de sangre y derivados contaminados, inyecciones con instrumentos contaminados durante intervenciones médicas y el consumo de drogas inyectables. La transmisión sexual también es posible, pero mucho menos común. No hay vacuna contra la infección por el VHC.
Las infecciones por el virus de la hepatitis D (VHD) solo ocurren en las personas infectadas con el VHB; la infección simultánea por ambos virus puede causar una afección más grave y tener un desenlace peor. Hay vacunas seguras y eficaces contra la hepatitis B que brindan protección contra la infección por el VHD.
El virus de la hepatitis E (VHE), como el VHA, se transmite por el consumo de agua o alimentos contaminados. El VHE es una causa común de brotes epidémicos de hepatitis en las zonas en desarrollo y cada vez se lo reconoce más como una causa importante de enfermedad en los países desarrollados. Se han obtenido vacunas seguras y eficaces para prevenir la infección por el VHE, pero no tienen una distribución amplia.

Hepatitis types

Q: What are the different hepatitis viruses?
A: Scientists have identified 5 unique hepatitis viruses, identified by the letters A, B, C, D, and E. While all cause liver disease, they vary in important ways.
http://img.emedtvdt.com/i1/emedtv_102755.jpghttp://yourstdhelp.com/images/jaundicehepa.jpgHepatitis A virus (HAV) is present in the faeces of infected persons and is most often transmitted through consumption of contaminated water or food. Certain sex practices can also spread HAV. Infections are in many cases mild, with most people making a full recovery and remaining immune from further HAV infections. However, HAV infections can also be severe and life threatening. Most people in areas of the world with poor sanitation have been infected with this virus. Safe and effective vaccines are available to prevent HAV.
Hepatitis B virus (HBV) is transmitted through exposure to infective blood, semen, and other body fluids. HBV can be transmitted from infected mothers to infants at the time of birth or from family member to infant in early childhood. Transmission may also occur through transfusions of HBV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. HBV also poses a risk to healthcare workers who sustain accidental needle stick injuries while caring for infected-HBV patients. Safe and effective vaccines are available to prevent HBV.
Hepatitis C virus (HCV) is mostly transmitted through exposure to infective blood. This may happen through transfusions of HCV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. Sexual transmission is also possible, but is much less common. There is no vaccine for HCV.
Hepatitis D virus (HDV) infections occur only in those who are infected with HBV. The dual infection of HDV and HBV can result in a more serious disease and worse outcome. Hepatitis B vaccines provide protection from HDV infection.
Hepatitis E virus (HEV) is mostly transmitted through consumption of contaminated water or food. HEV is a common cause of hepatitis outbreaks in developing parts of the world and is increasingly recognized as an important cause of disease in developed countries. Safe and effective vaccines to prevent HEV infection have been developed but are not widely available.

What is Hepatitis?

 hepatitis
a disease characterized by inflammation of the liver. http://www.onelifehealth.net/wp-content/uploads/2014/06/What-is-Hepatitis-A.jpg
Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer. Hepatitis viruses are the most common cause of hepatitis in the world but other infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases can also cause hepatitis. There are 5 main hepatitis viruses, referred to as types A, B, C, D and E. These 5 types are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer.
Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids. Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment and for hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact.
Acute infection may occur with limited or no symptoms, or may include symptoms such as jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.

Monday 6 October 2014

What is HIV?

What is HIV?

HIV stands for Human Immunodeficiency Virus.

It is a virus that attacks the human immune system. Someone infected with the virus can live with HIV or be HIV positive for many years without becoming ill or showing symptoms. During this time however, HIV remains in the body damaging the immune system and the person remains infectious; able to spread the virus to others if a few simple precautions are not follwed. HIV Virus

Over time, HIV can damage the immune system to such a degree that infections may begin to occur as a result of a weakened immune system. Eventually, one may acquire various illnesses due to the damage done by the virus.

When this happens this is called AIDS or Acquired Immune Deficiency Syndrome. That is, a collection of illnesses.

What is the difference between HIV and AIDS?

In simple terms - you can't 'catch' AIDS. You can, however, catch HIV. Being infected with HIV does not mean that one has AIDS, but if left undiagnosed and/or untreated, HIV infection damages the immune system and can progress to AIDS. 
AIDS results from the desruction of the immune system by HIV. The immune system's function is to fight off infections and other diseases. If your immune system is damaged or not working well, you are at risk of life-threatening infections and cancers. HIV attacks and destroys the disease fighting cells of the immune system. The body is left with a weakened defense against disease.

How is HIV transmitted?transmission risks

HIV is found in the following body fluids;  semen, blood, vaginal fluids and breast milk. Infection can only occur when body fluids from an infected person enter the blood stream of another person. 
Worldwide, unprotected sex between men and women is the main route of HIV transmission. In Australia, HIV has mainly been transmitted through unprotected sex between men. However, transmission rates between men and women are increasing.

 HIV can be transmitted by:

  • Unprotected sex (sex without a condom)
  • Sharing needles and syringes
  • Unsterile body piercing or tattooing
  • Mother to child
  • Blood transfusion and/or blood products pre 1990

HIV cannot be transmitted by:

  • Coughing
  • Hugging
  • Kissing
  • Sneezing
  • Spitting
  • Crying
  • Sharing Cutlery and crockery
  • Bed Linen
  • Toilets or Showers
  • Mosquitoes
  • Or through any form of casual contact

Sunday 5 October 2014

What are the symptoms of flu?

What are the symptoms of flu?

It is common to confuse flu with a bad cold. Flu and cold symptoms may include a runny/blocked nose, sore throat, and cough. Here are some symptoms which a person with flu will have. These are not common heavy cold symptoms:
  • high temperature
  • cold sweats, shivers
  • headache
  • aching joints, aching limbs
  • fatigue, feeling utterly exhausted
  • gastro-intestinal symptoms, such as nausea, vomiting, and diarrhea, are much more common among children than adults
These symptoms may linger for about a week. The feeling of tiredness and gloom can continue for several weeks.

How serious is flu?

In the majority of cases flu is not serious - it is just unpleasant. For some people, however, there can be severe complications. This is more likely if you are elderly or have some other longstanding illness that can undermine your immune system. Your risk of experiencing severe flu complications is higher if:
  • you are over 65
  • you are a baby or a very young child
  • you are pregnant
  • you have some kind of heart or cardiovascular disease
  • you have a chest problem, such as asthma or bronchitis
  • you have a kidney disease
  • you suffer from diabetes
  • you are taking steroids
  • you are undergoing treatment for cancer
  • you have any longstanding disease that can significantly lower your immune system

What is influenza?

Influenza, or flu, is a respiratory illness that is caused by a virus. Flu is highly contagious and is usually spread by the coughs and sneezes of a person who is infected.

You can also catch flu from an infected person if you touch them (e.g. shaking hands). Adults are contagious one day before getting symptoms and up to 7 days after becoming ill. This means that you can spread the influenza virus before you even know you are infected. A flu epidemic, when a large number of people in one country are infected with flu, can last several weeks.

According to the National Institutes of Health, between 5% and 20% of Americans get the flu each year. More than 200,000 people are hospitalized and 36,000 die annually because of flu in the United States.

What is flu?

Influenza, or flu, is a respiratory illness that is caused by a virus. Flu is highly contagious and is usually spread by the coughs and sneezes of a person who is infected.

You can also catch flu from an infected person if you touch them (e.g. shaking hands). Adults are contagious one day before getting symptoms and up to 7 days after becoming ill. This means that you can spread the influenza virus before you even know you are infected. A flu epidemic, when a large number of people in one country are infected with flu, can last several weeks.

According to the National Institutes of Health, between 5% and 20% of Americans get the flu each year. More than 200,000 people are hospitalized and 36,000 die annually because of flu in the United States.

What is swine flu?

Swine flu (swine influenza) is a disease of pigs. It is a highly contagious respiratory disease caused by one of many Influenza A viruses. Approximately 1% to 4% of pigs that get swine flu die from it. It is spread among pigs by direct and indirect contact, aerosols, and from pigs that are infected but do not have symptoms. In many parts of the world pigs are vaccinated against swine flu.

Most commonly, swine flu is of the H1N1 influenza subtype. However, they can sometimes come from the other types, such as H1N2, H3N1, and H3N2.

The current outbreak of swine flu that has infected humans is of the H1N1 type - this type is not as dangerous as some others.

Avian Influenza (Bird Flu) can also infect pigs

Avian flu and human seasonal flu viruses can infect pigs, as well as swine influenza. The H3N2 influenza virus subtype, a virulent one, is thought to have come from pigs - it went on to infect humans.

It is possible for pigs to be infected with more than one flu virus subtype simultaneously. When this happens the genes of the viruses have the opportunity to mingle. When different flu subtypes mix they can create a new virus which contains the genes from several sources - a reassortant virus.

Cervical Cancer symptoms and risk

Risk factors

When you get a diagnosis of cervical cancer, it's natural to wonder what may have caused the disease. Doctors usually can't explain why one woman develops cervical cancer and another doesn't.
However, we do know that a woman with certain risk factors may be more likely than other women to develop cervical cancer. A risk factor is something that may increase the chance of developing a disease.
Studies have found that infection with the virus called HPV is the cause of almost all cervical cancers. More than half of women by the age of 50 have been exposed to HPV, but most HPV infections clear up on their own. An HPV infection with a high risk type of HPV that doesn't go away can cause cervical cancer in some women.
Other risk factors, such as smoking, can act to increase the risk of cervical cancer among women infected with HPV even more.
A woman's risk of cervical cancer can be reduced by getting regular cervical cancer screening tests. If abnormal cervical cell changes are found early, cancer can be prevented by removing or killing the changed cells before they become cancer cells.
Another way a woman can reduce her risk of cervical cancer is by getting an HPV vaccine before becoming sexually active (between the ages of 9 and 26). Even women who get an HPV vaccine need regular cervical cancer screening tests. Vaccines reduce a person's  risk of getting an infection, but do not prevent such infections in every vaccinated person.

Symptoms

Early cervical cancers usually don't cause symptoms. When the cancer grows larger, women may notice abnormal vaginal bleeding:
  • Bleeding that occurs between regular menstrual periods
  • Bleeding after sexual intercourse, douching, or a pelvic exam
  • Menstrual periods that last longer and are heavier than before
  • Bleeding after going through menopause
Women may also notice...
Cervical cancer, infections, or other health problems may cause these symptoms. A woman with any of these symptoms should tell her doctor so that problems can be diagnosed and treated as early as possible

What is cancer?

What is cancer?

Cancer begins in cells, the building blocks that make up tissues. Tissues make up the cervix and other organs of the body.
Normal cervical cells grow and divide to form new cells as the body needs them. When normal cells grow old or get damaged, they die, and new cells take their place.
Sometimes, this process goes wrong. New cells form when the body does not need them, and old or damaged cells do not die as they should. The buildup of extra cells often forms a mass of tissue called a growth or tumor.
Growths on the cervix can be benign (not cancer) or malignant (cancer):
  • Benign growths (polyps, cysts, or genital warts):
    • are rarely a threat to life
    • don't invade the tissues around them
  • Malignant growths (cervical cancer):
    • may become a threat to life if not found soon enough
    • can invade nearby tissues and organs
    • can spread to other parts of the body
Cervical cancer begins in cells on the surface of the cervix. Over time, the cervical cancer can invade more deeply into the cervix and nearby tissues.
Cervical cancer cells can spread by breaking away from the cervical tumor. They can travel through lymph vessels to nearby lymph nodes. Also, cancer cells can spread through the blood vessels to the lungs, liver, or bones. The process of spreading of cancer cells from the tissue in which they arise to other tissues elsewhere is called metastasis.
After spreading, cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues. See the Staging section for information about cervical cancer that has spread.

What is the cervix?

What is the cervix?

http://www.indusladies.com/wp/wp-content/uploads/2013/11/cervical_cancer.jpg The cervix is part of a woman's reproductive system. It's in the pelvis. The cervix is the lower, narrow part of the uterus (womb).

The cervix is a passageway:
  • The cervix connects the uterus to the vagina. During a menstrual period, blood flows from the uterus through the cervix into the vagina. The vagina leads to the outside of the body.
  • The cervix makes mucus. During sex, mucus helps sperm move from the vagina through the cervix into the uterus.
  • During pregnancy, the cervix is tightly closed to help keep the baby inside the uterus. During childbirth, the cervix opens to allow the baby to pass through the vagina.

Saturday 4 October 2014

Cervical Cancer facts

Cervical Cancer
(Cancer of the Cervix)

Cervical cancer facts*

*Cervical cancer facts medical author:
    Female Illustration - Cervical Cancer
  • Causes and risk factors for cervical cancer have been identified and include human papillomavirus (HPV) infection, having many sexual partners, smoking, taking birth control pills, and engaging in early sexual contact.
  • HPV infection may cause cervical dysplasia, or abnormal growth of cervical cells.
  • Regular pelvic exams and Pap testing can detect precancerous changes in the cervix.
  • Precancerous changes in the cervix may be treated with cryosurgery, cauterization, or laser surgery.
  • The most common symptoms and signs of cervical cancer are abnormal vaginal bleeding, increased vaginal discharge, bleeding after going through menopause, pain during sex, and pelvic pain.
  • Cervical cancer can be diagnosed using a Pap smear or other procedures that sample the cervix tissue.
  • Chest X-rays, CT scan, MRI, and a PET scan may be used to determine the stage of cervical cancer.
  • Cancer of the cervix requires different treatment than cancer that begins in other parts of the uterus.
  • Treatment options for cervical cancer include radiation therapy, surgery, and chemotherapy.
  • Two vaccines, Gardasil and Cervarix, are available to prevent HPV infection.
  • The prognosis of cervical cancer depends upon the stage and type of cervical cancer and the tumor size.

 


Aloe vera extrection process step by step

http://www.absolutaloe.com/imgns/subproductos.jpg

Swine flu 6

Swine flu treatment
The best treatment for influenza infections in humans is prevention by vaccination. Work by several laboratories has recently produced vaccines. The first vaccine released in early October 2009 was a nasal spray vaccine that was approved for use in healthy individuals ages 2 through 49. The injectable vaccine, made from killed H1N1, became available in the second week of October 2009. This vaccine was approved for use in ages 6 months to the elderly, including pregnant females. Both of these vaccines were approved by the CDC only after they had conducted clinical trials to prove that the vaccines were safe and effective.
Almost all vaccines have some side effects. Common side effects of H1N1 vaccines (alone or in combination with other flu viral strains) are typical of flu vaccines used over many years and are as follows:
  • Flu shot: Soreness, redness, minor swelling at the shot site, muscle aches, low-grade fever, and nausea do not usually last more than about 24 hours.
  • Nasal spray: runny nose, low-grade fever, vomiting, headache, wheezing, cough, and sore throat
The flu shot (vaccine) is made from killed virus particles so a person cannot get the flu from a flu shot. However, the nasal spray vaccine contains live virus that have been altered to hinder its ability to replicate in human tissue. People with a suppressed immune system should not get vaccinated with the nasal spray. Also, most vaccines that contain flu viral particles are cultivated in eggs, so individuals with an allergy to eggs should not get the vaccine unless tested and advised by their doctor that they are cleared to obtain it. Like all vaccines, rare events may occur in some rare cases (for example, swelling, weakness, or shortness of breath). If any symptoms like these develop, the person should see a physician immediately.
Two antiviral agents have been reported to help prevent or reduce the effects of swine flu. They are zanamivir (Relenza) and oseltamivir (Tamiflu), both of which are also used to prevent or reduce influenza A and B symptoms. These drugs should not be used indiscriminately, because viral resistance to them can and has occurred. Also, they are not recommended if the flu symptoms already have been present for 48 hours or more, although hospitalized patients may still be treated past the 48-hour guideline. Severe infections in some patients may require additional supportive measures such as ventilation support and treatment of other infections like pneumonia that can occur in patients with a severe flu infection. The CDC has suggested in their interim guidelines that pregnant females can be treated with the two antiviral agents.

Swine flu 5

How is swine flu diagnosed?

Swine flu is presumptively diagnosed clinically by the patient's history of association with people known to have the disease and their symptoms listed above. Usually, a quick test (for example, nasopharyngeal swab sample) is done to see if the patient is infected with influenza A or B virus. Most of the tests can distinguish between A and B types. The test can be negative (no flu infection) or positive for type A and B. If the test is positive for type B, the flu is not likely to be swine flu. If it is positive for type A, the person could have a conventional flu strain or swine flu. However, the accuracy of these tests has been challenged, and the U.S. Centers for Disease Control and Prevention (CDC) has not completed their comparative studies of these tests. However, a new test developed by the CDC and a commercial company reportedly can detect H1N1 reliably in about one hour; the test was formerly only available to the military. In 2010, the FDA approved a commercially available test that could detect H1N1 within four hours. Most of these rapid tests are based on PCR technology.
Swine flu is definitively diagnosed by identifying the particular antigens associated with the virus type. In general, this test is done in a specialized laboratory and is not done by many doctors' offices or hospital laboratories. However, doctors' offices are able to send specimens to specialized laboratories if necessary. Because of the large number of novel H1N1 swine flu cases that occurred in the 2009-2010 flu season (the vast majority of flu cases [about 95%-99%] were due to novel H1N1 flu viruses), the CDC recommended only hospitalized patients' flu virus strains be sent to reference labs to be identified. H3N2v flu strains and other flu virus strains are diagnosed by similar methods.

Friday 3 October 2014

Ebola treatment centre sets a new pace

Liberia: Ebola treatment centre sets a new pace

October 2014
At the Island Clinic in Monrovia, Liberia the discharge of a patient who has recovered from Ebola virus disease inspires joy among all the health workers at the facility. Every life saved is another boost to morale.
WHO/C. Black
“As we see fewer people dying, the health workers are becoming more confident about their work,” says Dr Atai Omoruto, a Ugandan doctor deployed to Liberia by WHO and is serving as officer in charge at the clinic. “Understandably, at the beginning the health workers were anxious, but with more people surviving they feel empowered and motivated to continue. They are also getting more comfortable working with protective equipment”.
“As we see fewer people dying, the health workers are becoming more confident about their work.”
Dr Atai Omoruto, Ugandan doctor and officer in charge at the Island Clinic
Dr Omoruto is part of a WHO-deployed team of Ugandan doctors and health workers. The group has vast experience in managing Ebola outbreaks, having faced many cases of this disease since 2000. The Ugandans work alongside nearly 600 Liberian colleagues treating patients and helping to maintain the strict infection control measures that are necessary at the centre.

Addressing risks for health workers

Health workers caring for people with Ebola virus disease are at high risk of becoming ill and dying from the disease. Since the beginning of the outbreak in Liberia, nearly 200 health workers across the country have been infected, and more than half of them have died from the disease. Continuous training and monitoring of infection control is crucial in protecting more health workers from being infected.
Jackie Sudue, a Liberian nurse, became infected with Ebola virus early in September while handling the corpse of an individual who was believed incorrectly not to have died of Ebola. After spending two weeks in a treatment centre she recovered and tested negative for Ebola virus on 24 September.
“I will start working tomorrow at the Island Clinic,” Ms Sudue says. “I wish I could work on psychosocial support, but working on a ward would be fine too. Being an Ebola survivor helps me to better understand patients.”

Discharges increasing

After being refurbished by the Liberian Ministry of Health and Social Welfare with support from WHO and other partners, the Island Clinic opened its doors as an Ebola treatment centre on 21 September. The centre filled to capacity within 24 hours.
“The first days were very intense. Many people were coming in and we did not know if they had Ebola virus disease or not. Others were already in a late stage of infection and were dying upon arrival,” Dr Omoruto says. On average 15-20 patients are currently being admitted to the clinic every day.
WHO/C. Black
The Island Clinic was originally intended to have 120 beds but sometimes stretches its capacity to care for up to 210 patients.
Now as laboratory testing is starting to keep pace with admissions and potential discharges, more people are able to leave the clinic. On 26 September, 26 people were discharged, leaving some 160 patients inside the clinic. Early in October, the United States Centers for Disease Control and Prevention will begin operating a laboratory inside the clinic, which is expected to accelerate clinical decision-making.
For one patient, Mr Nyenati Kaffia, leaving was bittersweet. “I lost my son but my daughter recovered; we are going home now.”

Swine flu 4

What are the symptoms of swine flu?

https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_N1CH9Bs9ISsasKuIXt215ocgyHqoZZZpbvfzIBGWHGFuUD_l-oXKfQ3-5BTuaB1wQ3Z5vpDqNypo_bguC9GWiJyPtPLrYebzKIdPcFdX7zygA5LKZ_hkU6SxoadABkbFctFIGBfTBFQ/s400/swine+flu+symptoms.jpg Symptoms of swine flu are similar to most influenza infections: fever (100 F or greater), cough, nasal secretions, fatigue, and headache, with fatigue being reported in most infected individuals. Some patients also get nausea, vomiting, and diarrhea. In Mexico, many of the initial patients infected with H1N1 influenza were young adults, which made some investigators speculate that a strong immune response, as seen in young people, may cause some collateral tissue damage.
Some patients develop severe respiratory symptoms and need respiratory support (such as a ventilator to breathe for the patient). Patients can get pneumonia (bacterial secondary infection) if the viral infection persists, and some can develop seizures. Death often occurs from secondary bacterial infection of the lungs; appropriate antibiotics need to be used in these patients. The usual mortality (death) rate for typical influenza A is about 0.1%, while the 1918 "Spanish flu" epidemic had an estimated mortality rate ranging from 2%-20%. Swine (H1N1) flu in Mexico had about 160 deaths and about 2,500 confirmed cases, which would correspond to a mortality rate of about 6%, but these initial data were revised and the mortality rate worldwide was estimated to be much lower. Fortunately, the mortality rate as of H1N1 remained low and similar to that of the conventional flu (average conventional flu mortality rate is about 36,000 per year; projected H1N1 flu mortality rate was 90,000 per year in the U.S. as determined by the president's advisory committee, but it never approached that high number).http://www.aegisasia.com/wp-content/uploads/swine-flu-symptoms.jpg
Fortunately, although H1N1 developed into a pandemic (worldwide) flu strain, the mortality rate in the U.S. and many other countries only approximated the usual numbers of flu deaths worldwide. Speculation about why the mortality rate remained much lower than predicted includes increased public awareness and action that produced an increase in hygiene (especially hand washing), a fairly rapid development of a new vaccine, and patient self-isolation if symptoms developed. Research is ongoing to develop data-based answers to such questions.

Swine flu 3

What causes swine flu?

The cause of the 2009 swine flu was an influenza A virus type designated as H1N1. In 2011, a new swine flu virus was detected. The new strain was named influenza A (H3N2)v. Only a few people (mainly children) were first infected, but CDC officials reported increased numbers of people infected in the 2012-13 flu season. Currently (fall 2013), there are not large numbers of people infected with H3N2v. Unfortunately, another virus termed H3N2 (note no "v" in its name) has been detected and caused flu, but this strain is different from H3N2v. In general, all of the influenza A viruses have a structure similar to the H1N1 virus; each type has a somewhat different H and/or N structure.
Picture of antigenic shift and antigenic drift in swine flu (H1N1).

Why is swine flu now infecting humans?

Many researchers now consider that two main series of events can lead to swine flu (and also avian or bird flu) becoming a major cause for influenza illness in humans.
First, the influenza viruses (types A, B, C) are enveloped RNA viruses with a segmented genome; this means the viral RNA genetic code is not a single strand of RNA but exists as eight different RNA segments in the influenza viruses. A human (or bird) influenza virus can infect a pig respiratory cell at the same time as a swine influenza virus; some of the replicating RNA strands from the human virus can get mistakenly enclosed inside the enveloped swine influenza virus. For example, one cell could contain eight swine flu and eight human flu RNA segments. The total number of RNA types in one cell would be 16; four swine and four human flu RNA segments could be incorporated into one particle, making a viable eight RNA-segmented flu virus from the 16 available segment types. Various combinations of RNA segments can result in a new subtype of virus (this process is known as antigenic shift) that may have the ability to preferentially infect humans but still show characteristics unique to the swine influenza virus (see Figure 1). It is even possible to include RNA strands from birds, swine, and human influenza viruses into one virus if a single cell becomes infected with all three types of influenza (for example, two bird flu, three swine flu, and three human flu RNA segments to produce a viable eight-segment new type of flu viral genome). Formation of a new viral type is considered to be antigenic shift; small changes within an individual RNA segment in flu viruses are termed antigenic drift and result in minor changes in the virus. However, these can accumulate over time to produce enough minor changes that cumulatively change the virus' antigenic makeup over time (usually years).
Second, pigs can play a unique role as an intermediary host to new flu types because pig respiratory cells can be infected directly with bird, human, and other mammalian flu viruses. Consequently, pig respiratory cells are able to be infected with many types of flu and can function as a "mixing pot" for flu RNA segments (see Figure 1). Bird flu viruses, which usually infect the gastrointestinal cells of many bird species, are shed in bird feces. Pigs can pick these viruses up from the environment, and this seems to be the major way that bird flu virus RNA segments enter the mammalian flu virus population. Figure 1 shows this process in H1N1, but the figure represents the genetic process for all flu viruses, including human, swine, and avian strains.

Swine flu 2

What to Do if You Think You Have H1N1 Swine Flu Virus

If you've got fever, cough, or one of the other symptoms of the flu, you may be wondering if you have contracted the H1N1 swine flu virus. The reality is that it isn't possible to know unless specialized testing is ordered, and for uncomplicated cases of the flu in non-hospitalized patients, routine testing for the H1N1 virus is not being carried out.
http://www.drchetan.com/wp-content/uploads/2013/03/Swine-Flu-Prevention.jpg

Swine Flu

(Swine Influenza A [H1N1 and H3N2v] Virus)
symptoms, precautionary measures and after diagnosing how to cure.
 

Swine flu (H1N1 and H3N2v influenza virus) facts

  • Swine flu is a respiratory disease caused by influenza viruses that infect the respiratory tract of pigs and result in a barking cough, decreased appetite, nasal secretions, and listless behavior.
  • Swine flu viruses may mutate (change) so that they are easily transmissible among humans.
  • The 2009 swine flu outbreak was due to infection with the so-called H1N1 virus and was first observed in Mexico.
  • Symptoms of swine flu in humans are similar to most influenza infections: fever (100 F or greater), cough, nasal secretions, fatigue, and headache.
  • Two antiviral agents, zanamivir (Relenza) and oseltamivir (Tamiflu), have been reported to help prevent or reduce the effects of swine flu if taken within 48 hours of the onset of symptoms.

What is the swine flu?

Swine flu (swine influenza) is a respiratory disease caused by viruses (influenza viruses) that infect the respiratory tract of pigs, resulting in nasal secretions, a barking cough, decreased appetite, and listless behavior. Swine flu produces most of the same symptoms in pigs as human flu produces in people. Swine flu can last about one to two weeks in pigs that survive. Swine influenza virus was first isolated from pigs in 1930 in the U.S. and has been recognized by pork producers and veterinarians to cause infections in pigs worldwide. In a number of instances, people have developed the swine flu infection when they are closely associated with pigs (for example, farmers, pork processors), and likewise, pig populations have occasionally been infected with the human flu infection. In most instances, the cross-species infections (swine virus to man; human flu virus to pigs) have remained in local areas and have not caused national or worldwide infections in either pigs or humans. Unfortunately, this cross-species situation with influenza viruses has had the potential to change. Investigators decided the 2009 swine flu strain, first seen in Mexico, should be termed novel H1N1 flu since it was mainly found infecting people and exhibits two main surface antigens, H1 (hemagglutinin type 1) and N1 (neuraminidase type1). The eight RNA strands from novel H1N1 flu have one strand derived from human flu strains, two from avian (bird) strains, and five from swine strains. Swine flu is transmitted from person to person by inhalation or ingestion of droplets containing virus from people sneezing or coughing; it is not transmitted by eating cooked pork products. The newest swine flu virus that has caused swine flu is influenza A H3N2v (commonly termed H3N2v) that began as an outbreak in 2011. The "v" in the name means the virus is a variant that normally infects only pigs but has begun to infect humans.
 

Aloe vera for joints pain

http://www.nanohealthtechnology.com/wp-content/uploads/2010/09/NanoHealthTechnology.com-Agel-FLX-for-all-of-your-joint-pain-the-solution-to-the-end-of-joint-pain.jpg JOINT PAIN USE ALOE VERA
Joint pain occurs because of many causes , some of the most common include lupus -- and inflammatory joint condition, gout -- pain caused by build-up of uric acid, bursitis -- inflammation around the joint, arthritis - inflammation of the joint itself, fibromyalgia - a little understood disease that causes pain and fatigue, and osteoporosis -- a bone disorder.  Any how if you are the patient of anyone of the disease describing up than use aloe vera regularly.  Doesn't matter use aloe vera juice, aloe vera gel etc.  And most of you can also use it externally.  So bring aloe vera use it regularly and feel the power of this miracle plant.
http://dyfcnd1bn49xi.cloudfront.net/wp-content/uploads/2013/02/anatomy-of-the-knee.jpg

Thursday 2 October 2014

蘆薈典型應用該類超支

  1. 增強免疫力
  2. 增強皮膚健康
  3. 調節重量和能量水平
  4. 治愈牙齦疾病
  5. 便秘
  6. 死機炎症

Алоэ вера Преимущества

  1. Иммунная Повышение
  2. Усиливает здоровья кожи
  3.   Регулирует вес и уровень энергии
  4. Лечит заболевания десен
  5. Конец Запор
  6. Остановки Воспаление  

الألوة فيرا للوجه

ترطيب
علاج حب الشباب
مكافحة شيخوخة الجلد
علاج حروق الشمس  

مزايا نباتات

تقوية المناعة
يعزز صحة الجلد
ينظم الوزن والطاقة المستوى
تشفي من أمراض اللثة
ينتهي الإمساك
يوقف التهاب   

알로에 베라의 장점

  1. 면역 부스터
  2.    피부 건강 향상 
  3. 무게 에너지 레벨을 조절
  4. 잇몸 질환 치료합니다
  5.  변비를 종료 
  6. 중단합니다 염증

aloe vera FOR ACIDITY AND CONSTIPATION

If anyone of you are the patient of ACIDITY OR CONSTIPATION and try all kind of chemical oriented medicines.  Don's worry and feel relax i think you all have heard about aloe vera and the new herbal remedy according to my point of view which you don't know about is Psyllium seed husks or isbagol husks. 
These herbs are very very effective in couple of diseases.  Not only acidity, constipation but also blood pressure, hear attack, intestinal ulcer, stomach ulcer as well.  Really if you don't believe me than consult your physician who have good knowledge about herbs and herbal medicines.  A lot of doctors have help me in my research.  They also admired my research. so the bottom line is 


ALOE VERA AND PSYLLIUM SEED HUSKS
Vs
acidity, constipation but also blood pressure, hear attack, intestinal ulcer, stomach ulcer 

and believe me the winner is aloe vera and psyllium seed husks

glow Face with aloe vera

Many people use aloe vera clear gel inside the leaves to help soothe burns and heal wounds. Health care practitioners, Indian and PAKISTANI herbal medical practitioners also  use aloe vera to treat skin disorders, wounds, sunburn, radiation burns.  Regularly applying aloe vera gel to your face can help make your complexion clearer and smoother and reduce inflammation. Alot of medical and general stores and pharmacies sell aloe vera gel.

1st step

Cut aloe vera leaf from an aloe plant with a pair of scissors or a kitchen knife. Clean off any dirt from the leaf by gently scrubbing it with a wet toothbrush or nailbrush. Rinse the leaf under running water.

2nd step

Slice the spines off the sides of the leaf with a sharp kitchen knife. Cut the leaf in half vertically and extract the gel inside with a spoon.

3rd step

Apply a thin layer of aloe vera gel over your face and allow it to dry for at least one hour. Remove the gel with warm water and a clean washcloth.

Beautiful look of the miracle plant


Wednesday 1 October 2014

Aloe vera for face


Aloe vera cactus like full of jell and truly is a miracle plant.  Grown in drier climates such as Pakistan, Africa and India, this herbal remedy can provide natural relief including dry skin and severe acne. The beneficial part of the aloe vera plant can be found  hidden within in its long, thick leaves. 

Benefits of Aloe Vera for Face

Moisturize
The moisturizing effect works for both men and women. It is excellent for facial use, especially for women who use makeup frequently, as it effectively cleans and softens the skin.
Treat Acne
The antimicrobial properties of aloe vera is also one of the besgt option for acne treatment. Not only will aloe vera help to prevent acne.  Aloe vera also has anti-inflammatory properties as well as it reduce the skin inflammation caused by acne.
Fight Skin Aging
Applying aloe vera gel to your face regularly can decrease the lines and wrinkles associated with aging.  It also complexes the skin.  Aloe vera contains both vitamin C and E, both of which are known to be vital for healthy skin and also help to improve natural firmness, leaving your skin soft, supple and hydrated.
Treat Sunburn
The healing properties of aloe vera gel can reduce the pain and inflammation associated with sunburn. It can restore your skin's natural moisture and also acts as a protective barrier against further damage.

Aloe vera for hepatitis



https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhssKwgCRA7CryoGUaUcMHcydLnWGhZ2nekn6RDHDLUUhEwhb-tYbnz6BW5ScwYdG6FvrcP4CIaDdIqzQtJJdk6bL2gRqc9kyr0TPbZPYIjn_mV7UElO7bJ4vXVyrlpfCq2ZCjc7t83hi4/s200/hepatitis-s2-person-with-jaundice.jpgI you are hepatitis patient using all kind of medicines and living frustrated life.  Don't worry use the best ever and magical remedy.  The remedy for vital power and happiness (Aloe Vera) GOD gifted plant with alot of minerals, vitamins, proteins and much more for the health of human. 

Acute hepatitis due to aloe vera extract.
[Modified from:  Rabe C, Musch A, Schirmacher P, Kruis W, Hoffmann R. Acute hepatitis induced by an aloe vera preparation: A case report. World J Gastroenterol 2005; 11: 303-4. PubMed Citation]

 

A 57 year old German woman developed jaundice, itching and right upper quadrant pain 3 to 4 weeks after starting aloe vera tablets (500 mg daily), which she was taking for aging.  She also was taking vitamin C and zinc, but no other prescription medications.  She denied a history of liver disease, alcohol use or risk factors for viral hepatitis.  On examination, she was jaundiced and had right upper quadrant tenderness, but no rash, fever or signs of chronic liver disease.  Laboratory testing showed increased bilirubin values (8.9 mg/dL) and marked elevations in serum aminotransferase levels (ALT 1480 U/L, AST 711 U/L), with minimal increase in alkaline phosphatase (265 U/L) (Table).  Tests for acute hepatitis A, B, C and E were negative.  Serum antinuclear antibody was borderline positive (titer 1:40).  Abdominal ultrasound showed no evidence of biliary obstruction.  A liver biopsy showed an acute hepatitis, with portal and parenchymal infiltrates including plasma cells and eosinophils and bridging necrosis with cholestasis.  The aloe vera was stopped and her symptoms rapidly resolved.  The biochemical abnormalities resolved more slowly; serum enzymes were still elevated 5 months later but were near normal at one year.

 

Key Points

Medication: Aloe vera (500 mg daily)
Pattern: Hepatocellular (R=39)
Severity: 3+ (jaundice, hospitalization)
Latency: 4 weeks
Recovery: 6 months
Other medications:Vitamin C, zinc

Laboratory Values

Time After Starting Time After Stopping ALT (U/L) Alk P (U/L) Bilirubin (mg/dL) Other


Aloe vera tablets 500 mg daily for 4 weeks
4 weeks 0 1480 265 8.9 Admission, liver biopsy
6 weeks 2 weeks 226

Discharge
6 months 5 months 180
Normal Asymptomatic
1 year 12 months 40
Normal
Normal Values <22 <160 <1.2

Comment

This was the first published report of hepatitis from aloe vera.  An elderly woman with no exposures to viral hepatitis or other reasons to have liver disease developed an acute hepatitis-like syndrome after taking an oral aloe vera extract for a month.  Most other causes of acute hepatitis were adequately excluded.  A liver biopsy showed an acute hepatitis with cholestasis and eosinophils suggestive of a drug induced liver injury.  Biochemical recovery was somewhat prolonged.  While there did not appear to be other possible causes for liver injury in this case, the issue of possible contamination is always present and the aloe vera product being used had been purchased outside of Germany.


Case 2.  Recurrent acute hepatitis due to aloe vera.
[Modified from Case 2 in:  Yang HN, Kim DJ, Kim YM, Kim BH, Sohn KM, Choi MJ, Choi YH. Aloe-induced toxic hepatitis. J Korean Med Sci 2010; 25: 492-5. PubMed Citation]

 

A 62 year old Korean woman developed fatigue followed by jaundice 3 months after starting an aloe vera powder (420 mg daily).  There was no history of liver disease or alcoholism.  Laboratory test results showed a serum total bilirubin of 14.6 mg/dL with marked elevations in serum aminotransferase levels (ALT 1564 U/L, AST 1477 U/L), but minimal increases in alkaline phosphatase (211 U/L) (Table).  Tests for hepatitis A, B, C and E were negative.  Abdominal ultrasound showed no evidence of biliary obstruction.  A liver biopsy showed changes of acute hepatitis with lobular and portal infiltrates and cholestasis.  The aloe vera was stopped and after a week she began to improve.  Six weeks after stopping the herbal, liver tests were close to normal.  During subsequent follow up, however, she restarted an aloe vera extract and a month later serum ALT values were again elevated (785 U/L), although bilirubin was normal.  Six months later she returned with jaundice (bilirubin 15.8 mg/dL, ALT 1135 U/L, alkaline phosphatase 243 U/L), but refused admission or further evaluation.

 

Key Points

Medication:Aloe vera (420 mg daily)
Pattern: Hepatocellular (R=32)
Severity: 3+ (jaundice, hospitalization)
Latency: 3 months initially, 1 month on reexposure
Recovery: Approximately 6 weeks; relapse on reexposure
Other medications:None mentioned

Laboratory Values

Time After Starting Time After Stopping ALT (U/L) Alk P (U/L) Bilirubin (mg/dL) Other


Aloe vera 420 mg daily for ~3 months
12 weeks 0 1564 211 14.6 Admission
13 weeks 1 week 1504 202 21.2 Liver biopsy
14 weeks 2 weeks 754 176 5.8
15 weeks 3 weeks 425 163 4.5
16 weeks 4 weeks 135 110 3.4
18 weeks 6 weeks 21 110 2.1


Aloe vera 420 mg daily, restarted for 1 month
4 weeks 0 785 165 1.5
Normal Values <33 <160 <1.2

Comment

This is one of the better documented cases of acute liver injury due to an aloe vera product in the literature.  The latency to onset was 3 months initially and the patient developed fairly severe jaundice.  Serum aminotransferase levels were quite high and the pattern of injury was clearly hepatocellular.  A week after the aloe vera was stopped, liver tests began to improve and they were almost normal 6 weeks later.  This patient was an herbal salesperson and restarted the aloe vera on her own, despite having been told that it probably caused the liver injury.  The latency on reexposure was only one month, although the injury was somewhat less severe, with enzyme elevations without jaundice.  However, six months later she returned with jaundice and a similar pattern of serum enzyme elevations, but refused further evaluation.  While recurrent toxic hepatitis due to reexposure was the most likely diagnosis, the other possibility was a relapsing, acute onset of autoimmune hepatitis.


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REPRESENTATIVE TRADE NAMES
Aloe Vera – Generic


DRUG CLASS
Herbals and Dietary Supplements


SUMMARY INFORMATION

 

Fact Sheet at National Center for Complementary and Alternative Medicine, NIH

 

Fact Sheet at MedlinePlus/Natural Medicines Comprehensive Database

 

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DRUG CAS REGISTRY NUMBER MOLECULAR FORMULA STRUCTURE
Aloe Vera 8001-97-6 Herbal Not Applicable

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REFERENCES
Aloe Vera
 

References Last Updated: 30 May 2014


  1. Zimmerman HJ. Unconventional drugs. Miscellaneous drugs and diagnostic chemicals. In, Zimmerman, HJ. Hepatotoxicity: the adverse effects of drugs and other chemicals on the liver. 2nd ed. Philadelphia: Lippincott,1999: pp. 731-4.  (Expert review of hepatotoxicity published in 1999; several herbal medications are discussed, but not aloe vera).

  2. Liu LU, Schiano TD. Hepatotoxicity of herbal medicines, vitamins and natural hepatotoxins. In, Kaplowitz N, DeLeve LD, eds. Drug-induced liver disease. 2nd ed. New York: Informa Healthcare USA, 2007, pp. 733-54.  (Review of hepatotoxicity of herbal and dietary supplements [HDS] published in 2007; mentions that aloe vera is generally nonhepatotoxic).

  3. Aloe. In, PDR for Herbal Medicines. 4th ed. Montvale, New Jersey: Thomson Healthcare Inc. 2007: pp. 19-26.  (Compilation of short monographs on herbal medications and dietary supplements).

  4. Vogler BK, Ernst E. Aloe vera: a systematic review of its clinical effectiveness. Br J Gen Pract 1999; 49: 823-8. PubMed Citation  (Systematic review of the literature on aloe vera identified 3 controlled trials of oral therapy for short periods in hyperlipidemia and diabetes found only mild and reversible adverse events and no mention of hepatotoxicity).

  5. Stedman C. Herbal hepatotoxicity. Semin Liver Dis 2002; 22: 195-206. PubMed Citation (Review and description of patterns of liver injury due to herbals, including discussion of potential risk factors, and herb-drug interactions).

  6. Luyckx VA, Ballantine R, Claeys M, Cuyckens F, Van den Heuvel H, Cimanga RK, Vlietinck AJ, et al. Herbal remedy-associated acute renal failure secondary to Cape aloes. Am J Kidney Dis 2002; 39: E13. PubMed Citation  (47 year old man presented with acute renal failure and serum enzyme elevations [ALT 713 U/L, AST 2034 U/L, Alk P 74 U/L, bilirubin 0.6 mg/dL], having taken herbal medications for digestive complaints; mass spectrometry of herbal revealed it to be an extract of Aloe capensis).

  7. Schiano TD. Hepatotoxicity and complementary and alternative medicines. Clin Liver Dis 2003; 7: 453-73. PubMed Citation  (Comprehensive review of herbal associated hepatotoxicity, including common patterns of presentation).

  8. Pittler MH, Ernest E. Systematic review: hepatotoxic events associated with herbal medicinal products. Aliment Pharmacol Ther 2003; 18: 451-71. PubMed Citation  (Systematic review of published cases of hepatotoxicity due to herbal medications listing 52 case reports or case series, most common agents being celandine [3], chaparral [3], germander [8], Jin Bu Huan [3], kava [1], Ma huang [3], pennyroyal [1], skullcap [2], Chinese herbs [9], valerian [1]).

  9. Estes JD, Stolpman D, Olyaei A, Corless CL, Ham JM, Schwartz JM, Orloff SL. High prevalence of potentially hepatotoxic herbal supplement use in patients with fulminant hepatic failure. Arch Surg 2003; 138: 852-8. PubMed Citation  (Among 20 patients undergoing liver transplantation for acute liver failure during 2001-2, 10 were potentially caused by herbals, but none attributed to aloe vera).

  10. Langmead L, Feakins RM, Goldthorpe S, Holt H, Tsironi E, De Silva A, Jewell DP, et al. Randomized, double-blind, placebo-controlled trial of oral aloe vera gel for active ulcerative colitis. Aliment Pharmacol Ther 2004; 19: 739-47. PubMed Citation  (Randomized controlled trial of 4 week course of aloe vera vs placebo in 44 patients with ulcerative colitis found improvements in clinical scores with aloe vera; adverse side effects were minor and similar in the two groups, and “no patient developed abnormal blood tests attributable to aloe vera”).

  11. Can A, Akev N, Ozsoy N, Bolkent S, Arda BP, Yanardag R, Okyar A. Effect of aloe vera leaf gel and pulp extracts on the liver in type-II diabetic rat models. Biol Pharm Bull 2004; 27: 694-8. PubMed Citation  (In animal models exposed to stress, aloe vera appeared to attenuate liver injury attributable to diabetes).

  12. Rabe C, Musch A, Schirmacher P, Kruis W, Hoffmann R. Acute hepatitis induced by an aloe vera preparation: A case report. World J Gastroenterol 2005; 11: 303-4. PubMed Citation  (57 year old German woman developed jaundice and itching 1 month after starting aloe vera [500 mg/day] [bilirubin 8.9 mg/dL, ALT 1480 U/L, Alk P 265 U/L], resolving slowly: Case 1).

  13. Kanat O, Ozet A, Ataergin S. Aloe vera-induced acute toxic hepatitis in a healthy young man. Eur J Intern Med 2006; 17: 589. PubMed Citation  (24 year old man developed jaundice 3 weeks after starting aloe vera [500 mg by mouth daily] [bilirubin 9 mg/dL, ALT 2400 U/L, Alk P 400 U/L], resolving within 6 weeks of stopping).

  14. Bottenberg MM, Wall GC, Harvey RL, Habib S. Oral aloe vera-induced hepatitis. Ann Pharmacother 2007; 41: 1740-3. PubMed Citation  (73 year old woman developed jaundice having taking aloe vera capsules for constipation for five years [bilirubin 10.7 rising to 22.8 mg/dL, ALT 1451 U/L, Alk P 328 U/L, SMA 1:160], with normal ERCP and liver biopsy showing acute hepatitis, resolving within 4 months of stopping).

  15. Seeff LB. Herbal hepatotoxicity. Clin Liver Dis 2007; 11: 577-96. PubMed Citation  (Review of herbal induced hepatotoxicity, with details on specific herbal compounds).

  16. Chalasani N, Fontana RJ, Bonkovsky HL, Watkins PB, Davern T, Serrano J, Yang H, Rochon J; Drug Induced Liver Injury Network (DILIN). Causes, clinical features, and outcomes from a prospective study of drug-induced liver injury in the United States. Gastroenterology 2008; 135: 1924-34. PubMed Citation  (Among 300 cases of drug induced liver disease in the US collected between 2004 and 2008, 9% of cases were attributed to herbal medications, but no case was attributed to aloe vera alone or in combination with other agents).

  17. Belfrage B, Malmstrom R. [Several cases of liver affected by aloe vera]. Lakartidningen 2008; 105: 45. Swedish. PubMed Citation  (Reports of liver injury due to aloe vera include 4 in the Swedish database [2 hepatitis, 1 jaundice and 1 enzyme elevations only, arising within 3 months after starting and resolving on stopping] and 5 in the international database [2 hepatitis and 3 with enzyme elevations only]).

  18. Curciarello J, De Ortuzar S, Borzi S, Bosia D. [Severe acute hepatitis associated with intake of aloe vera tea]. Gastroenterol Hepatol 2008; 31: 436-8. Spanish. PubMed Citation  (26 year old man developed abdominal pain followed by jaundice 4 weeks after starting homemade aloe vera tea [bilirubin 8.4 rising to 13.8 mg/dL, ALT 935 U/L, Alk P normal], with subsequent worsening of protime and appearance of ascites, resolving 4 months after tea was stopped).

  19. Surjushe A, Vasani R, Saple DG. Aloe vera: a short review. Indian J Dermatol 2008; 53:163-6. PubMed Citation.  (Overview of the known contents and purported activities of aloe vera; clinical use is supported mostly by anecdotal data and results of clinical trials have been “mixed”; hepatitis listed as a side effect).

  20. García-Cortés M, Borraz Y, Lucena MI, Peláez G, Salmerón J, Diago M, Martínez-Sierra MC, et al. [Liver injury induced by "natural remedies": an analysis of cases submitted to the Spanish Liver Toxicity Registry]. Rev Esp Enferm Dig 2008; 100: 688-95. Spanish. PubMed Citation  (Among 521 cases of drug induced liver injury submitted to Spanish registry, 13 [2%] were due to herbals, none due to aloe vera).

  21. Navarro VJ. Herbal and dietary supplement hepatotoxicity. Semin Liver Dis 2009; 29: 373-382. PubMed Citation  (Overview of the regulatory environment, clinical patterns, and future directions in research with HDS; aloe vera is listed as a potential hepatotoxin but not specifically discussed).

  22. Jacobsson I, Jönsson AK, Gerdén B, Hägg S. Spontaneously reported adverse reactions in association with complementary and alternative medicine substances
    in Sweden. Pharmacoepidemiol Drug Saf 2009; 18: 1039-47. PubMed Citation   (Review of 778 spontaneous reports of adverse reactions to herbals to Swedish Registry found 15 to Aloe vera, including two cases of hepatitis; no details given).

  23. Yang HN, Kim DJ, Kim YM, Kim BH, Sohn KM, Choi MJ, Choi YH. Aloe-induced toxic hepatitis. J Korean Med Sci 2010; 25: 492-5. PubMed Citation  (Three women, ages 55 to 62 years, developed symptomatic liver injury 3 to 6 months after starting aloe vera extract [bilirubin 1.6, 14.6 and 0.8 mg/dL, ALT 565, 1564 and 666 U/L, Alk P 309, 211 and 298 U/L], resolving rapidly with stopping, one patient having recurrence upon reexposure: Case 2).    

  24. Reuben A, Koch DG, Lee WM; Acute Liver Failure Study Group. Drug-induced acute
    liver failure: results of a U.S. multicenter, prospective study. Hepatology 2010;
    52: 2065-76. PubMed Citation  (Among 1198 patients with acute liver failure enrolled in a US prospective study between 1998 and 2007, 133 [11%] were attributed to drug induced liver injury of which 12 [9%] were due to herbals, including several herbal mixtures, usnic acid, Ma Huang, black cohosh, and Hydroxycut, but not aloe vera).

  25. Stickel F, Kessebohm K, Weimann R, Seitz HK. Review of liver injury associated with dietary supplements. Liver Int 2011; 31: 595-605. PubMed Citation  (Review of current understanding of liver injury from herbals and dietary supplements focusing upon Herbalife and Hydroxycut products, green tea, usnic acid, noni juice, Chinese herbs, vitamin A and anabolic steroids; aloe vera is not discussed).

  26. Jiménez-Encarnación E, Ríos G, Muñoz-Mirabal A, Vilá LM. Euforia-induced acute
    hepatitis in a patient with scleroderma. BMJ Case Rep 2012; 2012. PubMed Citation (45 year old woman with systemic sclerosis developed jaundice 1 month after starting Euphoria, a combination herbal product whose ingredients included aloe vera, resveratrol, green tea, noni and several berries [bilirubin 17.7 mg/dL, ALT 837 U/L, Alk P 134 U/L], with slow recovery over the 18 months after stopping).

  27. Teschke R, Wolff A, Frenzel C, Schulze J, Eickhoff A. Herbal hepatotoxicity: a
    tabular compilation of reported cases. Liver Int 2012; 32: 1543-56. PubMed Citation  (A systematic compilation of all publications on the hepatotoxicity of specific herbals identified 185 publications on 60 different herbs, herbal drugs and supplements including four publications on aloe vera).

  28. Bunchorntavakul C, Reddy KR. Review article: herbal and dietary supplement
    hepatotoxicity. Aliment Pharmacol Ther 2013; 37: 3-17. PubMed Citation  (Systematic review of literature on HDS associated liver injury mentions that aloe vera has been associated with clinically apparent hepatotoxicity). 

  29. Teschke R, Genthner A, Wolff A, Frenzel C, Schulze J, Eickhoff A. Herbal hepatotoxicity: analysis of cases with initially reported positive re-exposure tests. Dig Liver Dis 2014; 46: 264-9. PubMed Citation(Reanalysis of published cases of herbal hepatotoxicity found criteria for a positive re-challenge by the RUCAM system was met in only 21 of 34 cases reporting a positive re-challenge; one case of rechallenge with aloe vera was considered "highly probable" [Yang 2010]).

  30. Vázquez-Fernández P, Garayoa-Roca A, Añón-Rodríguez R, Cabezas-Macián M, Serra-Desfilis MÁ, Mora-Miguel F. Aloe vera: Not always so beneficial in patients with chronic liver disease. Rev Esp Enferm Dig 2013; 105: 434-5. PubMed Citation(49 year old man with chronic hepatitis C and cirrhosis developed jaundice after starting aloe vera drinks for 10 days [bilirubin 21 mg/dL, ALT 93 U/L, Alk P 421 U/L], no mention of previous laboratory results or response to withdrawal of the herbal).