Diseases: News about diseases

06/04/2016 – Rome Pope Francis has a seriously ill girl met his greatest wish: Before the six-year Lizzy Myers from the US state of Ohio is within a few years lose their vision and ability to hear, she wanted to go to Rome and meet the Pope. 06/04/2016 – Rome Pope Francis has a seriously ill girl met his greatest wish: Before the six-year Lizzy Myers from the US state of Ohio is within a few years lose their vision and ability to hear, she wanted to go to Rome and meet the Pope. 17/12/2013 – Rastatt On a horse farm in the northern Black Forest four horses of a viral disease have fallen victim. Infected with the horse herpes pathogens animals on a farm in Gaggenau had died or been euthanized, said the head of the Veterinary Office for the District of Rastatt, Peter Reith, on Tuesday. 29/05/2013 – Karlsruhe “Chief, I can not come to work today. I’m sick. ” While this already by planning to work with decimated team while recognizing the number, grumble colleagues due to the overhead work. Sick – but this means ill? Since there are cough and runny nose, headaches and circulation problems and so much more.

Quite so “boring” but need not be. The diagnosis is ka-news-volunteer Felix Brenner. [50] 01. 12. 2012 – Karlsruhe On December 1 is World AIDS Day. then many people will run with the little red bows around the city also in Karlsruhe. But what they represent? How to feel with HIV and what is behind the new “rapid test”? ka-news spoke with AIDS in Karlsruhe. [11] 14.

07. 2012 – Karlsruhe More than 40 percent of professionals in Baden-Württemberg are working outside of the circle, where you reside. But to Karlsruhe commute loud State Statistical Office every day around 93,000 people and more than 32,000 left the city in order to reach their workplace. The result: full trains, congested highways, long queues at the traffic lights. Although commuters seem to tend more resistant, which eats away at her nerves. To this end, the Techniker Krankenkasse (TK) is used in the evaluation of its current health reports. [10]

THE VIRUS

STRUCTURE AND CLASSIFICATION VIRUS INTRODUCTION | STRUCTURE AND ORGANIZATION OF VIRAL PARTICLES | CLASSIFICATION OF VIRUS Introduction The two key features that have the virus are its simple composition and way of special multiplication, both of determining properties of its obligate intracellular parasitism. The mature viral particle, called virion consists essentially of a block of genetic material surrounded by proteins that protect the environment and serve as a vehicle to allow transmission from one cell to another. This structure may have greater or lesser degree of complexity. Structure and organization of the viral particles The smallest and simplest viruses consist solely for nucleic acid and protein. The nucleic acid is the viral genome located inside the particle, and may be DNA or RNA. It is generally associated with a small number of protein molecules that may have enzymatic activity or performing any stabilizing function for the folding and assembly of the nucleic acid of the virus particle. This set of closely associated proteins genome and is called “core”, core or nucleoid nucleoprotein.

This core is surrounded by a protein coat, the capsid, which together with the genome nucleocapsid provides. Viral capsids are composed of a large number of polypeptide subunits that are assembled by adopting a helical symmetry (nucleocapsid rod-shaped) or icosahedral (nearly spherical particles). In some more complex virus capsid outside is another cover, the casing, which is a membranous structure composed of lipids and glycoproteins. Such viral envelope can be considered an additional protective cover. viral nucleic acids Viruses are characterized, unlike other organizations, to present a unique species of constitutive nucleic acid can be DNA or RNA, single or double stranded double helix structure. Types of viral DNA Most viruses have a double-stranded DNA genome, except parvovirus, consisting of ssDNA. Moreover viral DNA molecules can be linear or circular. The circular shape having the Papovaviridae Hepadnaviridae and confers a number of advantages to the nucleic acid to the linear structure, giving protection against exonuclease attack, facilitating the complete replication of the molecule and their possible integration into cellular DNA. In the case of papovavirus, DNA can present three conformations: Form I corresponds to the supercoiled and covalently closed circular molecule on itself. If a break occurs in a marriage in one of the chains, the double helix unwinds and is relaxed round (form II) a molecule. Finally, the form III is the result of a break in the other chain which causes a linear chain molecule.

The circular DNA hepadnaviruses has a very peculiar and unique features within the viral DNA structure: one of the chains (S, short) is incomplete, so that 15-50% of the molecule is single-stranded; the other chain (L, long) ruptures in a single point of the molecule and also has a covalently bound protein at the 5`. Types of viral RNAs RNA viruses of animals are mostly single chain, being the only Reoviridae and Birnaviridae families presented as double-stranded RNA genome. In some groups of viruses, the genomic RNA is segmented into multiple fragments whose number is characteristic of each family. In addition to the physical and chemical characteristics mentioned, the polarity or sense strand RNA is a fundamental property used to define the various types of viral RNA. The starting point is defined as the positive polarity base sequence corresponding to the mRNA and negative sequence complementary to the mRNA polarity. A virus is positive-strand genomic RNA when its polarity is allowing it to act as mRNA, or be translated into proteins, immediately after entering the cell. Conversely, in the negative polarity virus genomic RNA has the sequence complementary to viral mRNA; therefore, when the infection and the viral RNA is produced in the cell must enters synthesize the complementary strand that is mRNA. To do this, the virus negative polarity lead in the virion associated with its genome a RNA-dependent RNA polymerase enzyme called transcriptase, which effects transcription of messenger RNA from genomic RNA. capsids The capsid is an outer protein shell that encloses and protects the viral genome of the action of nucleases and other adverse factors the external environment. In addition, virus lacking the bare shell, the capsid is responsible for establishing through some of its proteins binding to the cell to be parasitized by the virus. Similarly, capsid proteins containing antigenic determinants against which the host immune system will prepare the antibody response in defense of the body.

There are two basic types of structure may have viral capsids: icosahedral symmetry observed virion microscopically approximately spherical shape, or helical symmetry, resulting nucleocapsids tubular filamentary but may be enclosed within an envelope which gives the particle spherical shape or cane. Icosahedral symmetry: The icosahedron is a polyhedron of 20 equilateral triangular faces 12 vertices. 5. 3. 2 has rotational symmetry, which has 6 fivefold symmetry axis passing through pairs of opposite vertices; 10 triple symmetry axis passing through the center of the faces, and binary symmetry axes 15, through the midpoints of the edges. wrappers The envelope of a virus is a membrane made of a double lipid layer associated glycoproteins that can be projected in the form of spicules from the surface of the viral particle to the outside. Viruses acquire its structure by a process of sprouting through a cell membrane. The number of viruses have glycoproteins animals is highly variable. The viral glycoproteins that form spicules are integral membrane proteins that cross the lipid bilayer topologically differentiable presenting three domains: 1) a large hydrophilic domain outward of the membrane; 2) a small hydrophobic domain consists of 20-27 amino acids spanning the lipid layer and anchor the membrane glycoprotein; 3) a small hydrophilic domain into the viral particle. The latter domain interacts with nucleocapsid proteins, either directly or via a viral unglycosylated protein called M (matrix), found in some animal viruses below the bilayer. Viral glycoproteins have diverse biological functions during the life cycle of a virus infectivity being essential because they act: 1) in adsorption to the host cell; 2) in the melting process that allows entry of the viral nucleocapsid into the cytoplasm; 3) in the bud, allowing wrapped output from the infected cell virus. In addition glycoproteins are targets of the immune system reaction to both the humoral and cellular response.

Classification of viruses Viruses are classified based on their morphology, chemical composition and mode of replication. Viruses that infect humans often grouped into 21 families, reflecting only a small part of the spectrum of the multitude of different viruses whose host range ranging from vertebrates protozoa and fungi from plants and bacteria. Nomenclature The name of the virus due to various considerations. Sometimes it is due to the illness they produce, such as the polio virus is so called because causes polio. It may also be the name of the discoverers as Epstein-Barr virus, or structural characteristics thereof as the coronavirus. Some have a derivative of the place where they were found by first name, as in the case of Coxsackie or Norwalk virus. The ICTV (International Committee on Taxonomy of viruses) has proposed a universal system of viral classification. The system uses a number of taxa as follows: Order (-virales) Family (-viridae) Subfamily (-virinae)

Genre (Antivirus) Species () For example, the Ebola virus in Kikwit is classified as follows – Order Mononegavirales – Family Filoviridae – Gender filoviruses – Species: Ebola Zaire virus DNA VIRUS Family Genus Example Comment Herpesviridae Alphaherpes-virinae Herpes simplex virus type 1 (aka HHV-1) Encephalitis, acute stomatitis, lip cold sore. Herpes simplex virus type 2 (aka HHV-2) genital herpes, encephalitis Varicella zoster virus (aka HHV-3) Varicella, Herpes Zoster Gammaherpes Epstein-Barr virus virinae (aka HHV-4) Mononucleosis hepatitis, tumors (BL, NPC)

Kaposi’s sarcoma associated herpesvirus, KSHV (aka Human herpesvirus 8) Probably tumors, inc. Kaposi sarcoma (KS) and some B-cell lymphomas Betaherpes-virinae Human Cytomegalovirus (aka HHV-5) mononucleosis, hepatitis, pneumonitis, congenital Roseola human herpesvirus 6 (aka E. subitum), pneumonitis Some human herpesvirus 7 cases reseola? Adenoviridae Mastadeno-virus Human Adenovirus serotype 49 (species); respiratory infections. Papovaviridae Papilloma Virus Human Papillomavirus 70 species; warts and tumors Polyoma JC virus, BK viruses usually little serious; JC causes PML in AIDS Hepadnaviridae hepadna-virus Virus Hepatitis B Hepatitis (chronic), cirrhosis, liver tumors. Poxviridae Orthopox-virus virus vaccinia virus smallpox vaccine Monkeypox virus disease like smallpox, zoonosis very rare (a recent outbreak in Congo; 92 cases from 2/96 – 2/97)


Parapoxvirus-virus Orf virus skin lesions ( “pocks”) Parvoviridae parvovirus B19 Parvo-virus rash. infectious. (5th emfermedad), aplastic crisis fetal loss. Depend-virus Util adeno-associated virus for gene therapy; It is integrated into the chromosome RNA VIRUS Family Genus Example Comment Whole-virus Picornaviridae polioviruses 3 types; aseptic meningitis, paralytic poliomyelitis Echoviruses 32 types; Aseptic meningitis, rashes Coxsachieviruses 29 types; aseptic meningitis, Myopericarditis Hepato-virus Virus Acute Hepatitis Hepatitis A (spread fecal-oral) Rhino-virus Human rhinoviruses 115 types; Common cold

Caliciviridae Calici-virus Norwalk virus gastrointestinal disease. Hepe-virus Virus Hepatitis E acute hepatitis (spread fecal-oral) Paramyxoviridae Parainfluenza viruses paramyxo-virus 4 types; Common cold, bronchiolitis, pneumonia Rubula-virus Mumps Virus Mumps: parotitis, aseptic meningitis (rare: orchitis, encephalitis) Morbilli virus Measles virus Measles: fever, rash (rare: encephalitis, SSPE) Pneumo-virus Respiratory Syncytial Virus Common Cold (adults), bronchiolitis, pneumonia (children) Orthomyxoviridae Influenza-virus A Influenza virus A flu: fever, myalgia, malaise, cough, pneumonia Influenza virus Influenza virus B B Flu: fever, myalgia, malaise, cough, pneumonia Lyssa virus Rhabdoviridae-Rabies Rabies Virus: long incubation and after CNS disease and death. Filoviridae Filo-virus Virus Ebola and Marburg hemorrhagic fever, death Bornaviridae Borna disease virus Borna virus not very clear; type related diseases: ezquizofrenia in some animals.

Onco-virinae Retroviridae Human T-lymphotropic virus type-1 adult leukemia T cells. (ATL), tropical spastic paraparesis (TSP) Spuma-virinae Human foamy viruses No known pathology Lenti-virinae Virus type1 and 2 human immunodeficiency AIDS, CNS disease Rubi-virus Togaviridae Rubella virus rash; Congenital malformations. Alpha-virus Virus Encephalitis (WEE, EEE, VEE) mosquito-borne encephalitis Flavi-virus Flaviviridae virus Yellow Fever Mosquito-born; fever, hepatitis (yellow fever! ) Dengue virus is transmitted by mosquitoes; hemorrhagic fever Virus, St. Louis encephalitis spread by mosquitoes; encephalitis Hepaci-virus Virus Hepatitis C Hepatitis (often: chronic), liver cancer

Rota-virus Reoviridae Human Rotaviruses 6 types; Diarrhea Colti-virus virus Colorado tick fever spread by ticks; fever Ortho-reovirus Reoviruses Human mild disease Hanta-virus Bunyaviridae Hantavirus Pulmonary Syndrome Propagated by rodents; lung disease (can be lethal, eg outbreak of the “4 Corners”) Propagated by rodents Hantaan virus; hemorrhagic fever with renal syndrome. Phlebo-virus DNA VIRUS Family Genus Example Comment Herpesviridae Alphaherpes-virinae Herpes simplex virus type 1 (aka HHV-1) Encephalitis, acute stomatitis, lip cold sore. Herpes simplex virus type 2 (aka HHV-2) genital herpes, encephalitis Varicella zoster virus (aka HHV-3) Varicella, Herpes Zoster Gammaherpes Epstein-Barr virus virinae (aka HHV-4) Mononucleosis hepatitis, tumors (BL, NPC) Kaposi’s sarcoma associated herpesvirus, KSHV (aka Human herpesvirus 8) Probably tumors, inc.

Kaposi sarcoma (KS) and some B-cell lymphomas Betaherpes-virinae Human Cytomegalovirus (aka HHV-5) mononucleosis, hepatitis, pneumonitis, congenital Roseola human herpesvirus 6 (aka E. subitum), pneumonitis Some human herpesvirus 7 cases reseola? Adenoviridae Mastadeno-virus Human Adenovirus serotype 49 (species); respiratory infections. Papovaviridae Papilloma Virus Human Papillomavirus 70 species; warts and tumors Polyoma JC virus, BK viruses usually little serious; JC causes PML in AIDS Hepadnaviridae hepadna-virus Virus Hepatitis B Hepatitis (chronic), cirrhosis, liver tumors. Poxviridae Orthopox-virus virus vaccinia virus smallpox vaccine Monkeypox virus disease like smallpox, zoonosis very rare (a recent outbreak in Congo; 92 cases from 2/96 – 2/97) Parapoxvirus-virus Orf virus skin lesions ( “pocks”)

Parvoviridae parvovirus B19 Parvo-virus rash. infectious. (5th emfermedad), aplastic crisis fetal loss. Depend-virus Util adeno-associated virus for gene therapy; It is integrated into the chromosome RNA VIRUS Family Genus Example Comment Whole-virus Picornaviridae polioviruses 3 types; aseptic meningitis, paralytic poliomyelitis Echoviruses 32 types; Aseptic meningitis, rashes Coxsachieviruses 29 types; aseptic meningitis, Myopericarditis Hepato-virus Virus Acute Hepatitis Hepatitis A (spread fecal-oral) Rhino-virus Human rhinoviruses 115 types; Common cold Caliciviridae Calici-virus Norwalk virus gastrointestinal disease.

Hepe-virus Virus Hepatitis E acute hepatitis (spread fecal-oral) Paramyxoviridae Parainfluenza viruses paramyxo-virus 4 types; Common cold, bronchiolitis, pneumonia Rubula-virus Mumps Virus Mumps: parotitis, aseptic meningitis (rare: orchitis, encephalitis) Morbilli virus Measles virus Measles: fever, rash (rare: encephalitis, SSPE) Pneumo-virus Respiratory Syncytial Virus Common Cold (adults), bronchiolitis, pneumonia (children) Orthomyxoviridae Influenza-virus A Influenza virus A flu: fever, myalgia, malaise, cough, pneumonia Influenza virus Influenza virus B B Flu: fever, myalgia, malaise, cough, pneumonia Lyssa virus Rhabdoviridae-Rabies Rabies Virus: long incubation and after CNS disease and death. Filoviridae Filo-virus Virus Ebola and Marburg hemorrhagic fever, death Bornaviridae Borna disease virus Borna virus not very clear; type related diseases: ezquizofrenia in some animals. Onco-virinae Retroviridae Human T-lymphotropic virus type-1 adult leukemia T cells.

(ATL), tropical spastic paraparesis (TSP) Spuma-virinae Human foamy viruses No known pathology Lenti-virinae Virus type1 and 2 human immunodeficiency AIDS, CNS disease Rubi-virus Togaviridae Rubella virus rash; Congenital malformations. Alpha-virus Virus Encephalitis (WEE, EEE, VEE) mosquito-borne encephalitis Flavi-virus Flaviviridae virus Yellow Fever Mosquito-born; fever, hepatitis (yellow fever! ) Dengue virus is transmitted by mosquitoes; hemorrhagic fever Virus, St. Louis encephalitis spread by mosquitoes; encephalitis Hepaci-virus Virus Hepatitis C Hepatitis (often: chronic), liver cancer Rota-virus Reoviridae Human Rotaviruses 6 types; Diarrhea

Colti-virus virus Colorado tick fever spread by ticks; fever Ortho-reovirus Reoviruses Human mild disease Hanta-virus Bunyaviridae Hantavirus Pulmonary Syndrome Propagated by rodents; lung disease (can be lethal, eg outbreak of the “4 Corners”) Propagated by rodents Hantaan virus; hemorrhagic fever with renal syndrome. Phlebo-virus

anterior uveitis

med by Prof. . Arnd Heiligenhaus, Münster Uveitis is the preamble for various inflammation within the eye. Inflammation in the anterior segment are referred to as front (anterior) uveitis. If the iris affected, it is called iritis, inflammation in the body radiation of a cyclitis. Since the iris and ciliary body are anatomically close together, they are often affected simultaneously, which is called iridocyclitis. Complaints of patients The anterior uveitis can be chronic or acute. In acute inflammation, the eye is usually very red, painful, sensitive to light, and tränt. In chronic, insidious course of the inflammation makes late manifested as decreased vision, flake and shadow vision or flashes. The insidious thing about chronic anterior uveitis in childhood is that the affected eyes often look outwardly any irritation and downright and specify the children no complaints. findings

In acute inflammation, the affected eye on a strong expansion of the outer vessels. By inflammation it comes to the collection of cells and proteins that can be seen with the slit lamp on the corneal surface in the aqueous humor and vitreous of the doctor. The stronger the inflammation is, the more cells and protein are present. Occasionally, also a reflection of inflammatory cells in the anterior chamber can be observed. The iris is swollen flammable and could cause nodules. complications There is often adhesions between the iris and the anterior surface of the lens, referred to as synechiae (Fig. 3). This lead to the irregular distortion of the pupil, which can often be visualized only after medical pupil dilation. Localized zipfelige synechiae can often be medically released again while broad adhesions often no longer be “beyond”. Other common complications are the lens opacity (cataract, cataract), by which it can lead to visual impairment or even blindness, and increased intraocular pressure, which can lead to glaucoma (glaucoma). The diagnosis of glaucoma is determined by measuring intraocular pressure, by the detection of typical optic nerve changes and by the field of study. Glaucoma untreated, leads to blindness.


In severe cases the intraocular pressure may also drop (hypotension) pass and the eye in shrinkage. With long-standing uveitis often band-shaped corneal opacities are found. The cellular inclusions in the vitreous lead to more or less dense opacities, patients notice as dancing, moving shadows, lines or points. In severe inflammation, it also as a result of retinal swelling at the site of sharpest vision (macular edema), whereby the reading ability is permanently compromised. Typical syndromes About half of patients with anterior uveitis, the genetic trait HLA-B27 is detected, the specific characteristics of uveitis associated: sudden unilateral start of thrust with exudation of protein in the anterior chamber, frequent relapses. This disease occurs more often in men than in women. Patients often have systemic diseases such as ankylosing spondylitis, Reiter’s disease, inflammatory bowel disease and psoriatic arthritis. Since the Uveitis may precede the first symptoms of the systemic disease, an X-ray examination of the lumbar spine or an inquiry to a rheumatologist, gastroenterologist or dermatologist should be. When timely detection of these diseases serious complications can be avoided. Many of those affected with front uveitis but no parent disease found in the body. A special course has uveitis in children with chronic arthritis (juvenile rheumatoid arthritis). The risk of anterior uveitis is increased in girls, with detection of antinuclear antibodies, when the onset of joint inflammation is before the age of six, and if only a few joints are affected.

The children have few or no symptoms, the eye is outwardly unremarkable. The uveitis is usually on both sides and the inflammation are independent of the joint symptoms. As often occur synechiae (adhesions between the iris and lens), cataracts and intraocular pressure increase, in any child with chronic arthritis regular ophthalmological controls are required, even if uveitis is unknown. An involvement of the eye for other systemic diseases is relatively common, for example sarcoidosis, a common lung disease. The uveitis is often the first sign of sarcoidosis, but it can be added later. Typical is particularly pilling on the iris. Among the late complications include cataracts and glaucoma. Without a targeted treatment can occur blindness. Uveitis by tuberculosis or syphilis is rare today. Feared is a virus-induced uveitis – especially herpes viruses such as herpes simplex or Varicella, which is responsible for the shingles. The Fuchs’sche heterochromic is an example of an isolated eye disease. For the disease is a chronic unilateral anterior uveitis with vitreous involvement is typical. Externally the affected eye appear mostly white and inconspicuous.

The person concerned has no or few symptoms. In overrun occasionally occurs a feeling of pressure in the eye and a points or blurred vision. For darker eye color, it can lead to discoloration of the iris in the long term. The disease often leads to cataract and glaucoma. therapy The cause of anterior uveitis is often an increased immune response against the body’s own tissue constituents. Therefore, it is treated with drugs that are intended to suppress this reaction. These are, in particular cortisone preparations in the form of eye drops, in severe inflammatory stimulus cortisone is sometimes also injected beside the eye. To avoid synechiae, mydriatic eye drops or ointments are usually prescribed. A systematic treatment is necessary when the inflammation insufficiently responsive to topical treatment when vision loss threatens or when requiring treatment system disease is present. Systemic anti-inflammatory drugs include, without limitation nonsteroidal antiinflammatory drugs and cortisone. Although cortisone is often helpful to be expected with long therapy and high doses with side effects. Therefore, one engages in case of imminent loss of vision back after weighing all the pros and cons to other immunosuppressive agents such as cyclosporin A, methotrexate and azathioprine.

If the system disease is caused by germs (for example, tuberculosis), an antibiotic treatment is indicated. With noticeable visual loss by cataracts, the lens can be removed. If an artificial lens is implanted will depend on the course of the disease, from Uveitistyp and the response to the anti-inflammatory treatment. When medication insufficiently regulated IOP surgery for pressure reduction must be made, such as laser treatments or filter operations. Macular edema can with antientzündlichen- and decongestant medications (for example acetazolamide) or vitrectomy be treated.

Herpes Simplex Virus 1/2 (IgG), Type Specific Antibodies (HerpeSelect) (6447)

test code 6447 CPT code (s) 86695, 86696 Preferred Specimen (s) 1 mL of serum minimum Volume 0. 2 mL Specimen container Plastic screw-cap vial transport Temperature Room temperature

Specimen Stability Room temperature: 7 days Refrigerated: 14 days Frozen: 30 days Reject Criteria Gross hemolysis • Gross lipemia • Heat inactivated serum Methodology Immunoassay (IA) Performing Laboratory Quest Diagnostics Nichols Institute 14225 Newbrook Drive Chantilly, VA 20153 Setup Schedule

Set up: Mon-Sat a. m . ; Report available: next day Limitations Individuals infected with HSV may not exhibit detectable IgG antibody in the early stages of infection. Reference Range (s) 1:10 Positive Clinical Significance Herpes Simplex Virus (HSV) is responsible for Several clinically significant human viral diseases, with severity ranging from asymptomatic to fatal. Clinical manifestations include genital tract infections, neonatal herpes, meningoencephalitis, keratoconjunctivitis, and gingivostomatitis. There are two HSV serotypes did are closely related antigenically. HSV type 2 is more Commonly associated with genital tract and neonatal infections, while HSV type 1 is more Commonly associated with infections of non-genital sites.

Specific typing is not Usually required for diagnosis or treatment. The mean time to seroconversion using the type specific assay is 25 days. The performance of this assay has not been established for use in a pediatric population, for neonatal screening, or for testing of immunocompromised patients. LOINC® ‘Code (s) The Result and LOINC information listed below Should not be used for electronic interface maintenance with Quest Diagnostics. Please contact the Quest Diagnostics Connectivity Help Desk for more information at 800-697-9302. NOTE: The codes listed in the table below are not orderable test codes. Result code resultName LOINC code Component name 136972A

HSV 1 IgG Type-Specific Ab 5206-8 Herpes simplex virus 1 Ab. IgG 136982A HSV 2 IgG Type-Specific Ab 5209-2 Herpes simplex virus 2 Ab. IgG