...Hepatic Encephalopathy Name________ Directions: Gender: Male Age: 47 Setting: Hospital Ethnicity: African American Preexisting Conditions: Cirrhosis secondary to alcohol hepatitis, hypertension, esophageal varices Coexisting Conditions: Disability: Unemployed (on disability) for past four years Socioeconomic: Married, father of two boys (ages 19 and 17 years old), history of drinking one quart of hard liquor each day for three years prior to diagnosis of cirrhosis Pharmacologic: Lactulose (Cephulac), neomycin sulfate (mycifradin sulfate) Client Profile: Mr. Escobar is a 47-year old male with a history of cirrhosis. He lives with his wife and teenage sons. His wife brought him to the emergency department today because she noticed that her husband had increasing confusion and lethargy and was having difficulty walking. His wife states, “ He is probably acting a little fun because he is sleep deprived. He hasn’t slept very much in the past few days.” Case Study: Mr. Escobar is afebrile. His blood pressure is 136/68, pulse 88, and respiratory rate 18. His oxygen saturation is 98% on room air. He is awake, alert, and oriented to person only. His speech is slow and he appears tired. The nurse notices a foul odor to his breath. Upon physical examination, he is found to have a slightly distended abdomen. The health care provider (HCP) does not note any asterixis. The HCP requests an abdominal ultrasound, which reveals fatty infiltration of the...
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...and gambling. Binge drinking is another form of alcohol abuse. As frequent binger or drinking or getting severely drunk more than twice is classed as alcohol misuse. Alcohol can harm a person’s health, interpersonal relationship, and even your ability to function in every day functions like work, going to school and other daily activities. If a person driven while drunk or regularly binge drinks (more than 5 standard drinks in one drinking sessions), they are considered to have been involved in alcohol abuse. Binge drinking is associated with individual reporting poor health. They can be plague with illness like cirrhosis liver failure and the endocrine system lead to gynecomastia they have the inability to process toxins leads to hepatic encephalopathy....
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...by small branches originating from the left main portal vein, or from segmental branches from adjacent segments. It is drained by small hepatic veins joining directly to the anterior wall of the inferior vena cava Seg 2 displayed in yellow. * This segment is the superior part of the left lateral segment. Segment 2 is usually drained by this superior hepatic vein coursing laterally, and joining the left hepatic vein before the junction to the inferior vena cava. * Its portal supply is provided by a branch originating from the left main portal branch. In most cases, you can easily follow this branch from its origin. Segment 2 is separated from Segment 4A by a vertical scissura containing the left hepatic vein. * Segment 2 is separated from Segment 3 by a trans-axial scissura or transverse scissura containing the left main portal branch and from segment 1 by the ligamentum venosum. From the external surface of the liver, Segment 2 is separated from Segment 4A by the falciform ligament. Segment 3 is displayed in light blue. * This segment is the inferior part of the left lateral segment. * Its portal supply is provided by a branch originating from the left main portal branch. * It is usually drained by the left hepatic vein. Segment 3 is separated from Segment 4B by a vertical scissura containing the left hepatic vein, and from Segment 2 by the tranverse scissura. Segment 3 is separated from Segment 1 by the ligamentum venosum. * From the external...
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...1. The splenic and portal veins can be demonstrated by the injection of radio-opaque dye into the spleen. This has been done in dogs with exteriorised or subcutaneous spleens, and in humans with enlarged spleens by direct injection. 2. The injected dye leaves the spleen quickly and in large amounts, and demonstrates the sizes of the splenic and portal veins. 3. In the absence of portal obstruction a filling defect is present where the superior mesenteric flow meets the splenic. 4. In the presence of portal obstruction the site of obstruction is indicated. In addition, collateral veins are filled with dye, the portal vein is dilated and a reflux of dye may occur into the superior mesenteric vein. Changes in the direction of blood flow in the portal tributaries may be shown. Any patient who has splenomegaly of unknown origin is a candidate for diagnostic splenic puncture, and theoretically any candidate for diagnostic splenic puncture is a candidate for splenography. The term splenography, used by the authors for convenience, is by no means widely accepted, commonly used synonyms being splenic portography, splenoportography, transabdominal splenic portal venography, and intrasplenic portal venography. A special equipment tray assembled specifically for this procedure contains sterile drapes, sponges, appropriate needles for local anesthesia and splenic puncture, syringes, and a flexible rubber connector. With the patient in place on the radiographic apparatus, a field...
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...When Monsanto decided to introduce its genetically modified soybeans to Europe, they were faced with numerous uncontrollable forces in which they had to contend. Monsanto had little opposition to the product in the US. Consumers were indifferent to the technology and for the most part, embraced it. With this success, they assumed that the sentiment would be shared internationally. After all, Monsanto had good intentions. They had aspirations to reduce pesticide use and subside world hunger. Despite these intentions, they failed to realize that foreign environments have differing values and can be difficult to assess especially regarding political, legal and cross-cultural differences. Ultimately the product was not accepted in Europe mostly out of concern for food safety. It is important to analyze and understand the forces they were faced with to have a sense of why Monsanto failed. Monsanto failed in Europe for two main reasons. The first (outside of Monsanto’s control) was the recent outbreak of Mad Cow disease linked to British Beef, yet downplayed by the government. This event just so happened to coincide with the introduction of the genetically modified soybeans. There had been a loss of trust in government and food safety. We can refer to uncertainty avoidance in Hofstede’s four dimensions model to understand this further. Many European countries rank high in uncertainty avoidance and are risk averse. Members of this type of society have high anxiety...
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...What are Prions and their role? Prions are the proteins that cause Mad Cow Disease also known as BSE. Prions are an infectious protein. Prions are defined as an proteinaceous infectious particle, the protein is capable of changing the conformation of proteins to match its own and becomes infectious without the use of genetic materials. They can cross between species such as cattle, and sheep. Extreme heats chemical agents can inactivate the proteins. Prions are naturally occurring in the body and are not considered foreign nor do they stimulate the immune system and will not hurt your body, however the disease causing prions contact the normal prions by physical contact and alter the normal prions therefore causing the disease. With Mad Cow Disease The Prions target the specific protein in the cell that is normal called PrPC The role of protein Misfolding in BSE Diseased proteins result from improper folding and therefore the misfolded proteins induces copies of the same protein to also again misfold and increases the disease progress when it is misfolded. The scrapie prion PrPsc contacts and bumps into the normal cellular form PrPc intermediate and shifts the folding process converting them to the misfolded prion (the sheep version of mad cow disease called the PrPsc prion). The process continues over and over again. The body continues producing the normal cell PrPc and the scrapie prion PrPsc continues creating more replications of itself without needing any nucleic...
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...Creutzfeldt-Jakob disease (CJD), better know as Mad Cow Disease (MCD) when it affects cattle, has been around since the 1970’s. The disease affects the brain, making it deteriorate quickly. The person will experience memory and behavior changes, vision problems, and poor muscle coordination (Creutzfeldt-Jakob Disease 2017, October 3.) Being the rare disease it is, Creutzfeldt-Jakob disease has managed to take the life of more than a thousand people. Deemed incurable, it is important to be informed of the deadly disease. There are certain things that cause this disease, ways the disease affects your body, and some treatment and prevention plans. Some people believe that the only way to get Creutzfeldt-Jakob’s disease is by eating undercooked or infected meat. However, there are numerous ways to contract the disease. Thankfully, Creutzfeldt-Jakob is not common in today's times anymore. For every one million people in the world, only one will be affected every year (Creutzfeldt-Jakob Disease Fact Sheet, 2003.) Scientists have discovered that you can get CJD genetically, acquired, or sporadically (Creutzfeldt-Jakob Disease, 2017.) When people get CJD from their genetics, it means that their chromosome 20 gene is changing. The chromosome 20 gene is also known as the gene responsible for prion protein (Creutzfeldt-Jakob Disease, 2017.) The way that this gene changes in a person is because the mishap was passed down from their parent. This type of CJD usually occurs when the person...
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...Colby Trost Mrs. Watson English Comp. I 9 December 2015 Mad Cow Disease There are many deadly diseases in the world. Aids, Small Pox, and Ebola are just a few of these diseases. However, only a handful of diseases have a 100% fatality rate (“Contagious Diseases”). Bovine spongiform encephalopathy, better known as mad cow disease, is one of the most deadly diseases in the world with a 100% fatality rate (“Basics 1”). Mad Cow disease was first discovered in the United Kingdom during the late 1980’s. Even though it wasn’t discovered until the 1980’s, research suggests that the disease first infected cattle during the 1970’s. The disease then exploded in the United Kingdom. The numbers of cases grew until 1993 when the number peaked near 1000...
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...Report on: BSE Crisis Misconception of Risks & Flaws within the system Abstract The BSE or the mad cow epidemic was a major crisis in British history. The BSE disease was first identified in cattle in 1986. Though the cause of the disease is not known till now, but how the disease spread was known at initial stage. Contamination of BSE into cattle happens due to consumption of BSE contaminated MBM. There was a scientific assumption that BSE might not be transmitted to human, but there was a risk of contamination to human also. But policy-makers’ perception of risk was wrong and they were consistently assuring people that beef is safe to eat, and BSE is not transmissible to human. There existed a great divergence about the perception of risks between the scientists, policy-makers and the public. Message of risk was not communicated to public in fear of irrational over reaction or risks to the industry. Scientific risk assessment was understated and misinterpreted by the policy-makers’ risks assessment on economic views, and the public was kept unaware about the risks. The flaws and shortcomings that existed in the then system aggravated the crisis. It had become necessary to separate scientific risks assessment from the political risk assessments. The outbreak of the epidemic in 1996 after 10 years of denial brought disaster to the British beef industry and created sense of betrayal and mistrust among the public. To re-establish the confidence a wide range of reforms...
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...nucleus, it is not a virus or bacteria; it is only a protein (Hinz, A., Doremus, C., 1997). Prions cause a wide range of neurologic diseases in sheep, cows, and humans and were identified by Stanley Prusiner at UCSF in 1981 (Immunity and Disease, 2001). Prions are responsible for transmissible spongiform encephalopathies or TSE’s. Spongiform encephalopathies can develop three different ways, either by a normal prion changing into an abnormal one, or the PRNP gene that targets the creation of a protein which mutates into an abnormal protein, or consumption of contaminated items (Hinz, A., Doremus, C., 1997). TSE’s are very rare and affect around one person in every million each year over the world. TSE’s include bovine spongiform encephalopathy, or mad cow disease in cattle, scrapie in sheep, chronic wasting disease in deer, and Creutzfeldt-Jakob disease in people. The most well know TSE is mad cow disease. From 1984 through 2000, two hundred thousand cattle with bovine spongiform encephalopathy died, with another four million slaughtered that potentially had the infection. All the infections have been in Eastern Europe, with the majority in England. Bovine spongiform encephalopathy...
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..."R" groups helps to stabilize protein structure by holding the protein in the shape made by the hydrophobic interactions. Due to protein folding, ionic bonding can occur between the positively and negatively charged "R" groups that come in contact with one another. Folding can also result in covalent bonding between the "R" groups of cysteine amino acids, also known as a disulfide bridge (strongest bond). Van der Waals forces interactions help in the stabilization of protein structure. These interactions refer to to the attractive and repulsive forces that occur between molecules that become polarized. These forces contribute to the bonding that occurs between molecules. (Borges,2014) Bovine Spongiform Encephalopathy Mad cow disease or bovine spongiform encephalopathy is a deadly neurological disease that affects adult cattle. It is transmitted from animal to animal through contaminated food that contain infected central nervous system and spinal cord remnants. The contaminated food contain prions, a type of misfolded protein. A healthy brain prion protein (PrP) Is converted into a diseased PrPSc. “All known prions induce the formation of an amyloid fold, in which the protein polymerises into an aggregate consisting of tightly packed beta sheets. Amyloid aggregates are fibrils, growing at their ends, and...
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...by water (Wolfe, 2000). These hydrophobic molecules are water fearing. Ionic bonding occurs when the R group is charged and there is an attraction between positive and negative charges (Wolfe, 2000). Disulfide bridges occur between 2 cysteine molecules and only occurs between these 2 molecules (Wolfe, 2000). These types of bonds have very strong covalent bonds (Wolfe, 2000). Hydrogen bonds occur between R groups that are polar or charged (Borges, 2014). What happens is, a hydrogen atom is shared with another amino acid between a nitrogen atom or an oxygen atom, creating the hydrogen bond (Borges, 2014). These are the weakest of the bonds (Borges, 2014). F. Prions play a significant role in the development of bovine spongiform encephalopathy or Mad Cow Disease. Prions are proteins which cause disease (Wolfe, 2000). They are formed by the protein itself, it is a misfolded version of the protein and this misfolded version is harmful (Concepts in biochemistry, n.d). Two forms have been identified by Stanley Prusiner, who discovered prions in 1997, the two forms are PrPc and PrPSc, the latter being the harmful form (Concepts in biochemistry, n.d). These harmful prions affect the nonharmful...
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...Scrapie is a specific type of prion which could cause a central nervous system disease among sheep and goats. Prion is a kind of abnormally folded protein which has “extreme resistance to ionizing and ultraviolet.” (Prusiner, 2) According to current researches, scrapie prions are converted from normal cellular PrP by changing some α-helices into β-sheets. This converting process would change the solubility of the protein and also prevent the protein from digested by proteases. Since researcher has invented techniques to transfer scrapie prions from sheep into mice, scrapie has become the prion people studied the most. As Prusiner mentions in his book, transgenetic studies in prion discovered that “PrPSC acts as a template upon which PrPC is...
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...data-analyzing technologies to understand and use them. In 2006, 252 million acres of transgenic crops were planted in 22 countries by 10.3 million farmers. The majority of these crops were herbicide- and insect-resistant soybeans, corn, cotton, canola, and alfalfa. Other crops grown commercially or field-tested are a sweet potato resistant to a virus that could decimate most of the African harvest, rice with increased iron and vitamins that may alleviate chronic malnutrition in Asian countries, and a variety of plants able to survive weather extremes. On the horizon are bananas that produce human vaccines against infectious diseases such as hepatitis B; fish that mature more quickly; cows that are resistant to bovine spongiform encephalopathy (mad cow disease); fruit and nut trees that yield years earlier, and plants that produce new plastics with unique properties. In 2006, countries that grew 97% of the global transgenic crops...
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...1.1 Introduction The UK beef industry is generally defined as an industry which is consist of a complex and in other situations they have an extremely fragmented supply chain, with other correlated sectors and sub-sectors. The British beef industry includes large number of seperated producers and a combined retail and processing sector. Therefore, as the British beef industry consists of many suppliers the industry has an elastic supply. This is because the existance of large number of suppliers enable the industry to react or bring changes to the supply in accordance with the fluctuating demand. The British beef industry is worth £6.4 billion of the British economy, playing an important role in protecting the economy’s rural way of life and providing employment opportunities to more than 130,000 workers. The UK beef sector concentrates on cross breeding dairy cows with beef and as well as concentrating on the international market. Inconsistent or contradiction in composing of finished animals is the biggest challenge the UK beef industry is facing. Having a nature of large number of fragmented foundation of 63,000 supplies, this inconsistency leads to unnecessary costs that should be passed onto the consumers. This creates a negative impact on the quality of beef produced and the value of the customers towards consumption of beef compared to other alternative meats. The industry that is mainly affected due to the demand and supply fluctuations in the...
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