“Hepatitis D, also known as “delta hepatitis,” is a liver infection caused by the Hepatitis D virus (HDV). Hepatitis D is uncommon in the United States. Hepatitis D only occurs among people who are infected with the Hepatitis B virus (BHV) because HDV is an incomplete virus that requires the helper function of HBV to replicate. HDV can be an acute, short-term, infection or a long-term, chronic infection.  Hepatitis E is a liver infection caused by the Hepatitis E virus (HEV). Hepatitis E is a self-limited disease that does not result in chronic infection. While rare in the United States, Hepatitis E is common in many parts of the world. It is transmitted from ingestion of fecal matter, even in microscopic amounts, and is usually associated with contaminated water supply in countries with poor sanitation. There is currently no FDA-approved vaccine for Hepatitis E.  Both these types of hepatitis have no vaccine.”

Missouri Department of Health and Senior Services

“Hepatitis A-Estimated 24,900 new infections in 2018; Hepatitis B-Estimated 21,600 new infections in 2018• Estimated 862,000 people living with chronic HBV infection in 2016;&Hepatitis C-Estimated 50,300 new infections in 2018• Estimated 2.4 million people living with HCV infection in 2016.”.

CDC.gov

Viral hepatitis, including hepatitis A, hepatitis B, and hepatitis C, are distinct diseases that affect the liver and have different hepatitis symptoms and treatments. Other causes of hepatitis include recreational drugs and prescription medications. Hepatitis type is determined by laboratory tests.

HEPATITIS A:

If you have this infection, you have inflammation in your liver that’s caused by a virus. You don’t always get symptoms, but when you do, you might have: Jaundice (yellowing of the skin), Pain in your belly, Loss of appetite, Nausea, Fever, Diarrhea, Fatigue, Loss of weight, fever, sore muscles, **Pain on the right side of the belly, under the rib cage-where your liver is located** (if not a combination of these symptoms).

Children often have the disease with few symptoms.

You can spread the Hepatitis A virus about 2 weeks before your symptoms appear and during the first week they show up, or even if you don’t have any.

How it’s transmitted:

You can catch the disease if you drink water or food that’s been contaminated with the stool of someone with the virus.  You can also get infected if you:

-Eat fruits, vegetables, or other foods that were contaminated during handling.

-Eat raw shellfish harvested from water that’s got the virus in it.

-Swallow contaminated food.

Examples: Sometimes a group of people who eat at the same restaurant can get hepatitis A. This can happen when an employee with hepatitis A doesn’t wash his or her hands well after using the bathroom and then prepares food. It can also happen when a food item is contaminated by raw sewage or by an infected garden worker.

-The disease can also spread in day care centers. Children, especially those in diapers, may get stool on their hands and then touch objects that other children put into their mouths. And workers can spread the virus if they don’t wash their hands well after changing a diaper.

How Is It Diagnosed?

Blood tests allow doctors to diagnose it. **It is important to identify the type of hepatitis virus causing the infection to prevent it from spreading and to start the proper treatment. Since this Hepatitis A virus infection is spread through food or water that has been contaminated by the feces (stool) of an infected person.

Are There Any Long-Term Effects?

Usually the virus doesn’t cause any long-term problems or complications. But according to the CDC, 10% to 15% of people with hepatitis A will have symptoms that last a long time or come back over a 6- to 9-month period. In rare situations, some people may have liver failure or need a transplant.

What’s the Treatment?

No treatments can cure the disease. Your doctor may take tests that check your liver function to be sure your body is healing.

Who is at highest risk for this?

-Live with or have sex with someone who’s infected.*

-Travel to countries where hepatitis A is common.*

Remember the people who are also at risk:

-Men who have sex with men*

-People who inject illegal drugs*

-Kids in child care and their teachers*

HEPATITIS B

Hepatitis is a serious disease caused by the hepatitis B virus (HBV). Infection with this virus can cause scarring of the liver, liver failure, liver cancer, and even death. What happens to most cases of Hepatitis patients is the adult cases (up to 95%), hepatitis B causes limited infection. Usually people manage to fight off the infection successfully within a few months, developing an immunity that lasts a lifetime. (This means you won’t get the infection again).  Blood tests show evidence of this immunity, but no signs of active infection. Unfortunately, this is not true in infants and young children in which 90% of infants and 30% to 50% of children will develop a chronic infection.

Symptoms of acute infection (when a person is first infected with hepatitis) include:

-Jaundice (yellowing of the skin or whites of the eyes and/or a brownish or orange tint to the urine)/Unusually light colored stool/Unexplained fatigue that persists for weeks or months/Flu-like symptoms such as fever, loss of appetite, nausea, and vomiting/Abdominal Pain

Often, symptoms occur one to six months after exposure, with an average of three month. An estimated 30% of those infected do not have any symptoms at all.

How it’s transmitted:

Hepatitis B is spread in infected blood and other bodily fluids such as semen and vaginal secretions. It is spread in the same way that the virus that causes AIDS (HIV) is spread but hepatitis B is 50 to 100 times more infectious. Most people who are infected with hepatitis B in the U.S. do not know they have it. If you’re pregnant and you’ve got hepatitis B, you could give the disease to your unborn child. If you deliver a baby who’s got it, he needs to get treatment in the first 12 hours after birth.

How it’s diagnosed:                                                                                                              

If your doctor suspects that you may have hepatitis B, he or she will perform a complete physical exam and order blood tests to look at the function of your liver. Hepatitis B is confirmed with blood tests that detect the virus.

If your disease becomes chronic, liver biopsies (tissue samples) may be obtained to detect the severity of the disease.

Are There Any Long-Term Effects?

Liver damage if the virus is not taken care will happen with multiple organ crash from putting affect on other organs from doing their jobs.

WHAT’S THE TREATMENT:

Treatment depends on whether you:

-Have been recently infected with the virus (treating acute hepatitis B).*

-Have the symptoms of an acute infection. *

-Have chronic infection (Have had the hepatitis B for a chronic period of time).

-Acute vs Chronic=different RX.*

Acute Hep B. you should get a shot of hepatitis B immunoglobulin (HBIG) and the first of three shots of the hepatitis B Vaccine (What is a PDF document?). It is important to receive this treatment within 7 days after a needle stick and within 2 weeks after sexual contact that may have exposed you to the virus. The sooner you receive treatment after exposure, the better the treatment works.

Regarding Chronic Hep B treatment depends on how active the virus is in your body and your chance of liver damage. The goal of treatment is to stop liver damage by keeping the virus from multiplying.

Antiviral medicine is used if the virus is active and you are at risk for liver damage. Medicine slows the ability of the virus to multiply.

Antiviral treatment isn’t given to everyone who has chronic hepatitis B.

Follow-up visits

Whether or not you take medicine, you will need to visit your doctor regularly. He or she will do blood tests to check your liver and the activity of the hepatitis B virus in your body.

Some of the tests can find out whether the virus is multiplying in your liver, which would increase your risk of liver damage.

Liver transplant

If you develop advanced liver damage and your condition becomes life-threatening, you may need a liver transplant. But not everyone is a good candidate for a liver transplant.

If you have not gotten a hepatitis B vaccine and think you may have been exposed to the virus, you should get a shot of hepatitis B immunoglobulin (HBIG) and the first of three shots of the hepatitis B vaccine. It is important to receive this treatment within 7 days after a needle stick and within 2 weeks after sexual contact that may have exposed you to the virus. The sooner you receive treatment after exposure, the better the treatment works.

THOSE AT HIGHEST RISK FOR HEPATITIS B:

-Being born in, or spending more than 6 months in, parts of the world where hepatitis B is common or where a large number of people have been infected for a long time. Such areas include Southeast and Central Asia, the islands of the South Pacific, the Amazon River basin, the Middle East, Africa, Eastern Europe, and China.

-Being a man who has sex with men.

-Being sexually active. This includes having unprotected sex with someone who is infected with the virus or whose sexual history is unknown to you.

-Having more than one yex partner. (Your risk is higher if you have another sexually transmitted infection such as chlamydia.)

-Living with someone who has a chronic hepatitis B infection.

-Getting  or body piercing and tattoos from someone who doesn’t sterilize his or her equipment.

-Sharing needles or other equipment (such as cotton, spoons, and water) to inject illegal drugs.

” High blood pressure (hypertension) is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease. Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries.”

MAYO CLINIC

High Blood Pressure – what is it?

The most common cause of heart disease is narrowing or blockage of the coronary arteries, the blood vessels that supply blood to the heart itself. This is called coronary artery disease and happens slowly over time.  In HIGH Blood Pressure the arteries & veins narrow!  Think of a balloons that make animals that mom and dad buy us when at the circus or a fair.  Take one of those long thin balloons and if inflated what happens to the balloon if we step on it?  Right, due to increase pressure and it will POP!  Same concept with HTN; the pressure increases in the vessels due to vessels to narrow or contrict in size (like stepping on the balloon) causing increased pressure in the vessels causing the diagnosis hypertension (HTN).  If the high pressure does not get controlled a vessel can pop causing a hemmoragic stroke if it occurs in the brain or the pop of a vessel will cause hemmorage elsewhere if not in the brain.  Remember vessels in the brain for the most part are small.

High Blood Pressure or HTN affects 80 million Americans and nearly half of the people in the UK between the ages of 65 and 74, and a large percentage of those between the ages of 35 and 65. One of the problems associated with high blood pressure is that you will probably not even know you have it until you happen to have your blood pressure taken during a routine physical examination.

Upon diagnosis, you may wonder why you never saw it coming. Most people don’t. Only those with severe high blood pressure experience any warning signs at all.

These signs can include headaches, impaired vision, and black-outs.

What B/P actually tells us regarding the numbers!

It is the measurement of the force that blood applies to the walls of the arteries as it flows through them carrying oxygen and nutrients to the body’s vital organs and systems. Naturally, our blood is under pressure as it rushes through our arteries. Even those with blood pressure in the normal range will experience an increase in their blood pressure during rigorous physical activity or during times of stress. It only becomes a problem when the blood continues to run high. This condition of blood pressure is known as hypertension or high blood pressure and in 95% of the cases, the cause of it is never known. However, we do know the factors that set a person up to develop hypertension.

Blood Pressure Readings:

Factors influencing High Blood Pressure

They are as follows:

NON-MODAFIABLE RISK FACTORS ARE 4: HEREDITY-HIGH B/P RUNNING IN THE FAMILY

AGE-THE OLDER, THE HIGHER PROBABILITY YOU WILL END UP WITH B/P DEPENDING ON YOUR HEALTH AND HOW GOOD YOU TAKE CARE OF YOURSELF.

SEX-MALES VS FEMALES

RACE-HIGHIER IN AFROAMERICAN AS OPPOSED TO WHITE.

MODAFIABLE RISK FACTORS=FACTORS YOU CAN CONTROL IN YOUR LIFESPAN:

1-Obesity=Those with a body mass index of 30 or greater.

2-Drinking more than 2 to 4 alcoholic drinks a day.

3-Smoking

4-High cholesterol

5-Diabetes

6-Ongoing Stress/Anxiety

7-Continuous use of excessive salt consumption

Possible causes of High Blood Pressure

Sometimes the cause of a person’s high blood pressure is determined, but this happens in only 5% of the cases. When a cause is found, the person is diagnosed with secondary high blood pressure [hypertension]. In most of these cases, the cause can be linked to an underlying illness such as kidney disease, adrenal gland disease, or narrowing of the aorta. Contraceptive pills, steroids, and some medications can also cause secondary high blood pressure [hypertension], though instances of this are not all that common.

High Blood Pressure and the important numbers:

We hear the numbers, but do we really know what they mean? Since your blood pressure numbers can help you to understand your overall health status, it is important that you keep track of it. By knowing where your numbers are right now, you can head off such serious high blood pressure complications as angina, heart attacks, stroke, kidney damage, and many others that might surprise you – like eye problems and gangrene.

Medical professionals generally provide your blood pressure to you in terms of two numbers – a top one and a bottom one. For example, if your blood pressure is 120/80, they may say that you have a blood pressure of 120 over 80. Here is a definition for these numbers:

The top number– this is your systolic blood pressure. It measures the force of blood in the arteries as your heart beats. The top number means the pressure is reading your heart at work.  That is why this number is always highier.

The bottom number – this is your diastolic blood pressure. It is the pressure of your blood when the heart is relaxed in between the times when it is pumping. Means the pressure is reading your heart at rest.  That is why the number is always lowest.

Your blood pressure requires monitoring when you have a systolic blood pressure of 140 or over and/or a diastolic blood pressure of 90 or over. Those with diabetes must maintain a lower blood pressure that those who don’t have the condition. Diabetics should maintain a blood pressure of less than 130/80.

Monitors for measuring High Blood Pressure

It is wise to monitor your blood pressure at home in addition to having it taken at your doctor’s office. This will allow you to provide your doctor with readings that have been taken over time, providing a more in depth look at your personal health condition. This will help your doctor to prescribe the right hypertensive medication and treatment for your specific condition.  Taking your B/P everyday will help you notice, probably before your visit to the MD,  changes in your B/P and especially high blood pressure started which will allow you to get it under control sooner and before it’s a challenge in life changes or before it does worse give you a result that is not reversible (like a stroke  or a aortic aneurysm rupture, for example).

The best blood pressure monitors are those that take your measurement from the upper arm. Those that provide readings from the wrist or finger are not as reliable. You’ll also want to make sure that the blood pressure monitor you are considering has been proven in clinical trials. Trusted name brands include those made by Omron, LifeSource, Mark of Fitness, Micro Life, and A and D Instruments. There are other brands available – the important thing is to do your research.

Revised 2/16/2021 by Elizabeth Lynch RNBSN 35 yrs/Cardiac RN

“At least seven disorders are part of or closely related to Autism. Each disorder has symptoms commonly seen with autism, as well as its own specific symptoms.  Medical comorbidities are also commonly seen in autism spectrum disorder including PANS/PANDAS, ADD/ADHD, seizures, dental issues, sleep disturbances and gastrointestinal symptoms. ”

Autism Research Institute

“Risk factors of prostate enlargement are aging, family history, heart disease and diabetes, and lifestyle.”

MAYO CLINIC

Normal Prostate vs. Benign Prostatic Hyperplasia

The prostate is a walnut-shaped gland that is part of the male reproductive system. The main function of the prostate is to make a fluid that goes into semen. Prostate fluid is essential for a man’s fertility. The gland surrounds the urethra at the neck of the bladder. The bladder neck is the area where the urethra joins the bladder. The bladder and urethra are parts of the lower urinary tract. The prostate has two or more lobes, or sections, enclosed by an outer layer of tissue, and it is in front of the rectum, just below the bladder. The urethra is the tube that carries urine from the bladder to the outside of the body. In men, the urethra also carries semen out through the penis.

What is benign prostatic hyperplasia?

Benign prostatic hyperplasia––also called BPH––is a condition in men in which the prostate gland is enlarged and not cancerous. Benign prostatic hyperplasia is also called benign prostatic hypertrophy or benign prostatic obstruction.

The prostate goes through two main growth periods as a man ages. The first occurs early in puberty, when the prostate doubles in size. The second phase of growth begins around age 25 and continues during most of a man’s life. Benign prostatic hyperplasia often occurs with the second growth phase.

As the prostate enlarges, the gland presses against and pinches the urethra. The bladder wall becomes thicker. Eventually, the bladder may weaken and lose the ability to empty completely, leaving some urine in the bladder. The narrowing of the urethra and urinary retention––the inability to empty the bladder completely––cause many of the problems associated with benign prostatic hyperplasia.

Ending line the prostate enlarges pushes up to the superior both front and back aspects of the penis (just below the urinary bladder) narrowing the urethra in the penis shaft (on both sides of the urethra) causing urination difficulty and frequently urinating.  (See figure below  the picture shows in the top part the urinary bladder and the prostate below it Left normal Right BPH).

What causes benign prostatic hyperplasia?

The cause of benign prostatic hyperplasia is not well understood; however, it occurs mainly in older men. Benign prostatic hyperplasia does not develop in men whose testicles were removed before puberty. For this reason, some researchers believe factors related to aging and the testicles may cause benign prostatic hyperplasia.

Throughout their lives, men produce testosterone, a male hormone, and small amounts of estrogen, a female hormone. As men age, the amount of active testosterone in their blood decreases, which leaves a higher proportion of estrogen. Scientific studies have suggested that benign prostatic hyperplasia may occur because the higher proportion of estrogen within the prostate increases the activity of substances that promote prostate cell growth.

Another theory focuses on dihydrotestosterone (DHT), a male hormone that plays a role in prostate development and growth. Some research has indicated that even with a drop in blood testosterone levels, older men continue to produce and accumulate high levels of DHT in the prostate. This accumulation of DHT may encourage prostate cells to continue to grow. Scientists have noted that men who do not produce DHT do not develop benign prostatic hyperplasia.

How common is BPH?

Benign prostatic hyperplasia is the most common prostate problem for men older than age 50. In 2010, as many as 14 million men in the United States had lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Although benign prostatic hyperplasia rarely causes symptoms before age 40, the occurrence and symptoms increase with age. Benign prostatic hyperplasia affects about 50 percent of men between the ages of 51 and 60 and up to 90 percent of men older than 80.

Signs and Symptoms

BPH, the prostate gland grows in size. It may compress the urethra which courses through the center of the prostate. This can impede the flow of urine from the bladder through the urethra to the outside. It can cause urine to back up in the bladder (retention) leading to the need to urinate frequently during the day and night. Other common symptoms include a slow flow of urine, the need to urinate urgently and difficulty starting the urinary stream. More serious problems include urinary tract infections=pain in pelvic region and complete blockage of the urethra, which would be a medical emergency and can lead injury to the kidneys.

Treatment:

Is BPH always treated?

No. Treatment of BPH is usually reserved for men with significant symptoms. Watchful waiting with medical monitoring once a year is appropriate for most men with BPH.

How is BPH treated?

There are several different ways to treat BPH:

Men should carefully weigh the risks and benefits of each of these options. Prostate surgery has traditionally been seen as offering the most benefits for BPH but unfortunately carries the most risks.

• Watchful waiting is often chosen by men who are not bothered by symptoms of BPH. They have no treatment but get regular checkups and wait to see whether or not the condition gets worse.

Medical Treatment through drugs is used by some men rangaing from alpha blockers relax the smooth muscles of the prostate, and the bladder neck.  An example of these meds are tamsulosin (Flomax), alfuzosin (Uroxatral), and older medications such as terazosin (Hytrin), slidosin (Rapaflo) or doxazosin (Cardura).  

Also 5-alpha reductase inhibitors block the conversion of the male hormone testosterone into its active form in the prostate.  Examples of 5-alpha reductase inhibitors include Finasteride (Proscar) and dutasteride (Avodart). Side effects of finasteride may include declining interest in sex, problems getting an erection, and problems with ejaculation.

Surgery or office procedures may also be used to treat BPH, most commonly in men who have not responded satisfactorily to medication or those who have more severe problems, such as a complete inability to urinate.

• Transurethral resection of the prostate (TURP) has been used for the longest period of time. After the patient is given anesthesia, the doctor inserts a special instrument into the urethra through the penis. With the instrument, the doctor then shaves away part of the inner prostate to relieve the outflow of urine from the bladder.
• Laser procedures: A number of laser procedures are available, some of which can be performed in the doctor’s office with minimal anesthesia. These procedures also involve the removal of obstructing prostate tissue. They are generally associated with less bleeding and quicker recovery than TURP.
• Microwave therapy: This procedure is generally performed in the office and involves the use of microwave energy delivered to the prostate to kill some of the cells leading eventually to shrinkage of the prostate.

“Overweight and obesity can cause changes in the body that help lead to cancer. These changes can include long-lasting inflammation and higher than normal levels of insulin, insulin-like growth factor, and sex hormones. The risk of cancer increases with the more excess weight a person gains and the longer a person is overweight”

Center for Disease Control and Prevention CDC