Cytomegalovirus Retinitis
Cytomegalovirus
Retinitis
Foscarnet
Cytomegalovirus Infections
Retinitis Pigmentosa
Ganciclovir
AIDS-Related Opportunistic Infections
Eye Infections, Viral
Antiviral Agents
Muromegalovirus
Acquired Immunodeficiency Syndrome
Interleukin-10 Receptor alpha Subunit
Organophosphorus Compounds
Organophosphonates
Drug Implants
Phosphonoacetic Acid
CD4 Lymphocyte Count
Visual Acuity
Antiretroviral Therapy, Highly Active
Vitreous Body
Cytomegalovirus Vaccines
Intravitreal Injections
Viral Load
Prospective Studies
Drug Therapy, Combination
Immediate-Early Proteins
Eye Proteins
CD4-Positive T-Lymphocytes
Anti-HIV Agents
Idiopathic CD4+ T lymphocytopenia disclosed by the onset of empyema thoracis. (1/177)
A 56-year-old man was admitted to our hospital in December 1996 due to empyema thoracis. A laboratory examination revealed lymphocytopenia and CD4+ T lymphocytopenia (<300 cells/ microl). No evidence for a human immunodeficiency virus (HIV) infection was found. No malignant, hematological or autoimmune disease was detected. We thus diagnosed this case as being idiopathic CD4+ T lymphocytopenia (ICL). During his hospital treatment, he was affected with cytomegaloviral retinitis and cured by therapy. His subsequent treatment went well without a recurrence of severe infection although a low CD4+ T lymphocyte count continued after the recovery from empyema thoracis. (+info)Cytomegalovirus (CMV) retinitis activity is accurately reflected by the presence and level of CMV DNA in aqueous humor and vitreous. (2/177)
To evaluate the potential of ocular and systemic specimens to provide markers of active cytomegalovirus (CMV) retinitis, we examined the relationship between virologic and clinical aspects of CMV infections in AIDS patients with CMV retinitis. CMV polymerase chain reaction (PCR) analysis of 74 aqueous humor and vitreous specimens indicated that ocular specimens can provide accurate markers to differentiate active and inactive CMV retinitis (aqueous or vitreous PCR, P<.001). Moreover, these markers were superior to extraocular measures, including plasma PCR (P=.08) and blood and urine CMV cultures (P=.05). A direct correlation was identified between the quantity of CMV DNA in aqueous humor or vitreous specimens and the corresponding surface area of active CMV retinitis (r2=.69 and.44, respectively). Thus, qualitative and quantitative PCR-based analyses of aqueous humor can provide valuable markers of CMV retinitis activity. Such assays could provide rapid and reliable tools to assist in management of patients with CMV retinitis in whom the view of the retina is obscured. (+info)Phase I study of combination therapy with intravenous cidofovir and oral ganciclovir for cytomegalovirus retinitis in patients with AIDS. (3/177)
Ganciclovir and cidofovir, two antiviral agents used in the treatment of cytomegalovirus (CMV) retinitis, have a synergistic effect inhibiting CMV replication in vitro. In a phase I study, seven patients with AIDS-related CMV retinitis were treated with cidofovir (5 mg/kg intravenously every 2 weeks) combined with ganciclovir (1 g orally three times a day). During a median of 5.5 months (range, 1-12 months) of combined therapy, only one patient had retinitis progression, and only two of 28 blood cultures (specimens of which were obtained on a monthly basis) yielded CMV. Dose-limiting adverse ocular effects (anterior uveitis [two patients] and hypotony [two patients]) occurred in three of seven patients. The results suggest that combination therapy with intravenous cidofovir and oral ganciclovir (a regimen that does not require indwelling central venous catheter access) might enhance clinical efficacy. Less frequent administration of cidofovir in combination with oral ganciclovir should be prospectively studied to determine if the incidence of treatment-associated toxicity might be reduced. (+info)Oral ganciclovir for patients with cytomegalovirus retinitis treated with a ganciclovir implant. Roche Ganciclovir Study Group. (4/177)
BACKGROUND: The intraocular ganciclovir implant is effective for local treatment of cytomegalovirus retinitis in patients with the acquired immunodeficiency syndrome (AIDS), but it does not treat or prevent other systemic manifestations of cytomegalovirus infection. METHODS: Three hundred seventy-seven patients with AIDS and unilateral cytomegalovirus retinitis were randomly assigned to one of three treatments: a ganciclovir implant plus oral ganciclovir (4.5 g daily), a ganciclovir implant plus oral placebo, or intravenous ganciclovir alone. The primary outcome measure was the development of new cytomegalovirus disease, either contralateral retinitis or biopsy-proved extraocular disease. RESULTS: The incidence of new cytomegalovirus disease at six months was 44.3 percent in the group assigned to the ganciclovir implant plus placebo, as compared with 24.3 percent in the group assigned to the ganciclovir implant plus oral ganciclovir (P=0.002) and 19.6 percent in the group assigned to intravenous ganciclovir alone (P<0.001). As compared with placebo, oral ganciclovir reduced the overall risk of new cytomegalovirus disease by 37.6 percent over the one-year period of the study (P=0.02). However, in the subgroup of 103 patients who took protease inhibitors, the rates of new cytomegalovirus disease were low and of similar magnitude, regardless of treatment assignment. Progression of retinitis in the eye that initially received an implant was delayed by the addition of oral ganciclovir, as compared with placebo (P=0.03). Treatment with oral or intravenous ganciclovir reduced the risk of Kaposi's sarcoma by 75 percent (P=0.008) and 93 percent (P<0.001), respectively, as compared with placebo. CONCLUSIONS: In patients with AIDS and cytomegalovirus retinitis, oral ganciclovir in conjunction with a ganciclovir implant reduces the incidence of new cytomegalovirus disease and delays progression of the retinitis. Treatment with oral or intravenous ganciclovir also reduces the risk of Kaposi's sarcoma. (+info)Cystoid macular oedema and cytomegalovirus retinitis in patients with HIV disease treated with highly active antiretroviral therapy. (5/177)
BACKGROUND: Although cystoid macular oedema (CMO) is a rare cause of visual loss in AIDS related cytomegalovirus (CMV) retinitis, nine cases are reported of CMO occurring in HIV infected patients with a prior diagnosis of CMV who were receiving highly active antiretroviral therapy (HAART). METHODS: Medical and ophthalmological records of nine AIDS patients with inactive CMV retinitis were retrospectively analysed. Ophthalmic examination data, laboratory findings, and the systemic antiviral treatment were studied. Ophthalmic examination included visual acuity, anterior chamber flare measured with the laser flare cell meter (LCFM), vitreous haze quantification according to the Nussenblatt grading system, and fluorescein angiography. RESULTS: Nine HIV infected patients, eight men and one woman, mean age 39 years (range 29-53 years) presented with inactive CMV retinitis and CMO. On fluorescein angiography, CMO was present only in eyes (14 eyes) with signs of previous CMV retinitis. CMV retinitis was inactive in all of them. Visual acuity ranged from 20/200 to 20/30. In 10 eyes with CMV retinitis, anterior chamber flare measured with the LCFM ranged from 18.5 to 82 photons/ms (mean 35.42 ph/ms). A significant vitreous inflammation (1.5+) was observed in eight eyes. All patients had been treated with anti-CMV drugs for a mean period of 18 months (range 12-36 months). All nine patients received HAART with a combination of two nucleotide analogue reverse transcriptase inhibitors and one protease inhibitor for a mean period of 14 months (range 9-18 months). The HIV viral load was below detectable levels (< 200 copies/ml) in eight patients and low (3215 copies/ml) in one. At the time of CMO, the median CD4+ lymphocyte count was 232 cells x 10(6)/l (range 99-639). CONCLUSION: In AIDS patients, the usual absence of intraocular inflammation in eyes affected by CMV retinitis has been tentatively explained by the profound cellular immunodeficiency. In these patients, treated with HAART, CD4+ counts were increased for several months (mean 14 months). In their eyes, CMV retinitis was associated with significant ocular inflammation and CMO. These findings could be related to the restoration of immune competence after HAART as recently shown. (+info)IL-10 in HIV infection: increasing serum IL-10 levels with disease progression--down-regulatory effect of potent anti-retroviral therapy. (6/177)
To examine the potential pathogenic role of IL-10 in HIV infection, we measured serum IL-10 levels in 51 HIV-infected patients and 23 healthy controls both on cross-sectional and longitudinal testing. All clinical groups (Centers for Disease Control (CDC) categories) of HIV-infected patients had significantly higher circulating IL-10 levels than controls, with the highest levels among the AIDS patients, particularly in patients with ongoing Mycobacterium avium complex (MAC) infection. Among 32 HIV-infected patients followed with longitudinal testing (median observation time 39 months), patients with disease progression had increasing IL-10 levels in serum, in contrast to non-progressing patients where levels were stable. While both IL-10 and tumour necrosis factor-alpha (TNF-alpha) increased in patients with disease progression, the IL-10/TNF-alpha ratio decreased in these patients, suggesting imbalance between these two cytokines. Finally, we found that highly active anti-retroviral therapy (HAART) induced a significant, gradual decrease in IL-10 levels but without normalization. These findings suggest a pathogenic role for IL-10 in HIV infection, and may suggest a possible role for immunomodulating therapy which down-regulates IL-10 activity in addition to concomitant potent anti-retroviral therapy in HIV-infected patients. (+info)Treatment of immune recovery vitritis with local steroids. (7/177)
AIMS: To report a series of patients requiring treatment for falling visual acuity associated with immune recovery vitritis, a recently described syndrome of a predominantly vitreous inflammatory reaction in patients with AIDS and cytomegalovirus (CMV) retinitis. METHODS: The medical records of all patients requiring treatment for falling visual acuity associated with immune recovery vitritis were reviewed between March 1996 and March 1998. RESULTS: Nine eyes in seven patients required treatment for falling visual acuity. All patients had inactive CMV retinitis and had received highly active antiretroviral treatment including a protease inhibitor. Vitreous inflammation developed at a mean of 5.5 months (range 1-14) after starting a protease inhibitor. The onset of inflammation correlated with a mean rise in CD4(+) lymphocyte levels of 83 x 10(6)/l (range 30-128). The visual acuity fell by a mean of 2.8 Snellen lines (range 1-4) before treatment, and rose by a mean of 1.9 Snellen lines (range 0-4) after treatment with orbital floor steroids. The mean time interval between treatment with orbital floor steroids and improvement in visual acuity was 3.5 weeks (range 1-8). Following treatment the visual acuity improved or remained stable in all nine eyes, eight eyes returning to within one line of their preinflammation Snellen visual acuity. No eyes developed reactivation or progression of CMV retinitis after treatment, and none developed any other pathology. CONCLUSIONS: Orbital floor steroids appear to be have a useful role in the treatment of persistent immune recovery vitritis where the visual acuity is compromised. (+info)Cytomegalovirus (CMV) resistance in patients with CMV retinitis and AIDS treated with oral or intravenous ganciclovir. (8/177)
Treatment of cytomegalovirus (CMV) retinitis with oral ganciclovir results in relatively low plasma concentrations of drug, which theoretically could cause more frequent viral resistance compared with intravenous (iv) ganciclovir. By use of a plaque-reduction assay to quantify phenotypic sensitivity to ganciclovir, virus isolates were studied from patients with CMV retinitis participating in four clinical trials of oral ganciclovir. Before treatment, 69% of patients were culture-positive but just 1.1% of patients yielded a resistant CMV, defined as a median inhibitory concentration (IC50) >6 microM. On treatment, the first resistant isolate was recovered at 50 days. Overall, 3.1% of patients receiving iv ganciclovir and 6. 5% of those taking oral ganciclovir shed resistant CMV (median ganciclovir exposures of 75 and 165 days, respectively). Since IC50s for clinical isolates increased proportionately with treatment duration, it is likely that viral resistance would be more frequent with longer treatment. (+info)Cytomegalovirus retinitis is a sight-threatening eye infection that affects the retina, which is the light-sensitive tissue at the back of the eye. It is caused by cytomegalovirus (CMV), a type of herpesvirus that can remain inactive in the body for years after initial infection.
In people with weakened immune systems, such as those with HIV/AIDS or those who have undergone organ transplantation, CMV can reactivate and cause serious complications. When it infects the retina, it can cause inflammation, hemorrhage, and necrosis (cell death), leading to vision loss.
Symptoms of CMV retinitis may include floaters, blurred vision, blind spots, or loss of peripheral vision. If left untreated, the infection can spread to other parts of the eye and cause further damage. Treatment typically involves antiviral medications that are given intravenously or in the form of eye drops. In some cases, laser surgery may be necessary to prevent the spread of the infection.
Cytomegalovirus (CMV) is a type of herpesvirus that can cause infection in humans. It is characterized by the enlargement of infected cells (cytomegaly) and is typically transmitted through close contact with an infected person, such as through saliva, urine, breast milk, or sexual contact.
CMV infection can also be acquired through organ transplantation, blood transfusions, or during pregnancy from mother to fetus. While many people infected with CMV experience no symptoms, it can cause serious complications in individuals with weakened immune systems, such as those undergoing cancer treatment or those who have HIV/AIDS.
In newborns, congenital CMV infection can lead to hearing loss, vision problems, and developmental delays. Pregnant women who become infected with CMV for the first time during pregnancy are at higher risk of transmitting the virus to their unborn child. There is no cure for CMV, but antiviral medications can help manage symptoms and reduce the risk of complications in severe cases.
Retinitis is a medical term that refers to the inflammation of the retina, which is the light-sensitive tissue located at the back of the eye. The retina is responsible for converting light into electrical signals that are then sent to the brain and interpreted as visual images. Retinitis can be caused by various factors, including infections, autoimmune diseases, or genetic conditions.
The inflammation associated with retinitis can affect any part of the retina, but it typically involves the retinal pigment epithelium (RPE) and the photoreceptor cells (rods and cones). Depending on the severity and location of the inflammation, retinitis can cause a range of visual symptoms, such as blurry vision, floaters, loss of peripheral vision, or night blindness.
Retinitis is often distinguished from another condition called retinopathy, which refers to damage to the retina caused by diabetes or other systemic diseases. While both conditions can affect the retina and cause visual symptoms, retinitis is characterized by inflammation, while retinopathy is characterized by damage due to circulatory problems.
It's important to note that retinitis is a serious condition that requires prompt medical attention. If left untreated, it can lead to permanent vision loss or blindness. Treatment options for retinitis depend on the underlying cause and may include antibiotics, corticosteroids, or other immunosuppressive medications.
Foscarnet is an antiviral medication used to treat infections caused by viruses, particularly herpes simplex virus (HSV) and varicella-zoster virus (VZV). It is a pyrophosphate analog that inhibits viral DNA polymerase, preventing the replication of viral DNA.
Foscarnet is indicated for the treatment of severe HSV infections, such as mucocutaneous HSV in immunocompromised patients, and acyclovir-resistant HSV infections. It is also used to treat VZV infections, including shingles and varicella zoster virus (VZV) infection in immunocompromised patients.
Foscarnet is administered intravenously and its use requires careful monitoring of renal function and electrolyte levels due to the potential for nephrotoxicity and electrolyte imbalances. Common side effects include nausea, vomiting, diarrhea, and headache.
Cytomegalovirus (CMV) infections are caused by the human herpesvirus 5 (HHV-5), a type of herpesvirus. The infection can affect people of all ages, but it is more common in individuals with weakened immune systems, such as those with HIV/AIDS or who have undergone organ transplantation.
CMV can be spread through close contact with an infected person's saliva, urine, blood, tears, semen, or breast milk. It can also be spread through sexual contact or by sharing contaminated objects, such as toys, eating utensils, or drinking glasses. Once a person is infected with CMV, the virus remains in their body for life and can reactivate later, causing symptoms to recur.
Most people who are infected with CMV do not experience any symptoms, but some may develop a mononucleosis-like illness, characterized by fever, fatigue, swollen glands, and sore throat. In people with weakened immune systems, CMV infections can cause more severe symptoms, including pneumonia, gastrointestinal disease, retinitis, and encephalitis.
Congenital CMV infection occurs when a pregnant woman passes the virus to her fetus through the placenta. This can lead to serious complications, such as hearing loss, vision loss, developmental delays, and mental disability.
Diagnosis of CMV infections is typically made through blood tests or by detecting the virus in bodily fluids, such as urine or saliva. Treatment depends on the severity of the infection and the patient's overall health. Antiviral medications may be prescribed to help manage symptoms and prevent complications.
Retinitis pigmentosa (RP) is a group of rare, genetic disorders that involve a breakdown and loss of cells in the retina - a light-sensitive tissue located at the back of the eye. The retina converts light into electrical signals which are then sent to the brain and interpreted as visual images.
In RP, the cells that detect light (rods and cones) degenerate more slowly than other cells in the retina, leading to a progressive loss of vision. Symptoms typically begin in childhood with night blindness (difficulty seeing in low light), followed by a gradual narrowing of the visual field (tunnel vision). Over time, this can lead to significant vision loss and even blindness.
The condition is usually inherited and there are several different genes that have been associated with RP. The diagnosis is typically made based on a combination of genetic testing, family history, and clinical examination. Currently, there is no cure for RP, but researchers are actively working to develop new treatments that may help slow or stop the progression of the disease.
Ganciclovir is an antiviral medication used to prevent and treat cytomegalovirus (CMV) infections, particularly in individuals who have undergone organ transplants or have weakened immune systems due to conditions like HIV/AIDS. It works by inhibiting the replication of the virus, thereby reducing its ability to cause damage to the body's cells and tissues.
The medical definition of Ganciclovir is:
A synthetic nucleoside analogue with antiviral activity against herpesviruses, including cytomegalovirus (CMV). Ganciclovir is converted intracellularly to its active form, ganciclovir triphosphate, which inhibits viral DNA polymerase and subsequently prevents viral replication. It is primarily used for the prevention and treatment of CMV infections in immunocompromised patients, such as those who have undergone organ transplants or have HIV/AIDS. Ganciclovir is available in various formulations, including oral capsules, intravenous solution, and ocular implants.
AIDS-related opportunistic infections (AROIs) are infections that occur more frequently or are more severe in people with weakened immune systems, such as those with advanced HIV infection or AIDS. These infections take advantage of a weakened immune system and can affect various organs and systems in the body.
Common examples of AROIs include:
1. Pneumocystis pneumonia (PCP), caused by the fungus Pneumocystis jirovecii
2. Mycobacterium avium complex (MAC) infection, caused by a type of bacteria called mycobacteria
3. Candidiasis, a fungal infection that can affect various parts of the body, including the mouth, esophagus, and genitals
4. Toxoplasmosis, caused by the parasite Toxoplasma gondii
5. Cryptococcosis, a fungal infection that affects the lungs and central nervous system
6. Cytomegalovirus (CMV) infection, caused by a type of herpes virus
7. Tuberculosis (TB), caused by the bacterium Mycobacterium tuberculosis
8. Cryptosporidiosis, a parasitic infection that affects the intestines
9. Progressive multifocal leukoencephalopathy (PML), a viral infection that affects the brain
Preventing and treating AROIs is an important part of managing HIV/AIDS, as they can cause significant illness and even death in people with weakened immune systems. Antiretroviral therapy (ART) is used to treat HIV infection and prevent the progression of HIV to AIDS, which can help reduce the risk of opportunistic infections. In addition, medications to prevent specific opportunistic infections may be prescribed for people with advanced HIV or AIDS.
Viral eye infections are caused by viruses that invade different parts of the eye, leading to inflammation and irritation. Some common types of viral eye infections include conjunctivitis (pink eye), keratitis, and dendritic ulcers. These infections can cause symptoms such as redness, watering, soreness, sensitivity to light, and discharge. In some cases, viral eye infections can also lead to complications like corneal scarring and vision loss if left untreated. They are often highly contagious and can spread through contact with contaminated surfaces or respiratory droplets. Antiviral medications may be used to treat certain types of viral eye infections, but in many cases, the infection will resolve on its own over time. Preventive measures such as good hygiene and avoiding touching the eyes can help reduce the risk of viral eye infections.
Antiviral agents are a class of medications that are designed to treat infections caused by viruses. Unlike antibiotics, which target bacteria, antiviral agents interfere with the replication and infection mechanisms of viruses, either by inhibiting their ability to replicate or by modulating the host's immune response to the virus.
Antiviral agents are used to treat a variety of viral infections, including influenza, herpes simplex virus (HSV) infections, human immunodeficiency virus (HIV) infection, hepatitis B and C, and respiratory syncytial virus (RSV) infections.
These medications can be administered orally, intravenously, or topically, depending on the type of viral infection being treated. Some antiviral agents are also used for prophylaxis, or prevention, of certain viral infections.
It is important to note that antiviral agents are not effective against all types of viruses and may have significant side effects. Therefore, it is essential to consult with a healthcare professional before starting any antiviral therapy.
I'm sorry for any confusion, but "Muromegalovirus" is not a recognized term in medical literature or in virology. It's possible there may be a misunderstanding or typo in your query. Murine gammaherpesvirus 68 (MHV-68) is a virus that infects rodents and is studied in laboratory settings to understand gammaherpesvirus biology and pathogenesis, including Kaposi's sarcoma-associated herpesvirus (KSHV) and Epstein-Barr virus (EBV), which are human pathogens. If you meant to ask about Murine cytomegalovirus (MCMV), that is a different virus and is a member of the betaherpesvirinae subfamily, which can cause serious disease in mice.
If you could provide more context or clarify your question, I would be happy to help further.
Acquired Immunodeficiency Syndrome (AIDS) is a chronic, life-threatening condition caused by the Human Immunodeficiency Virus (HIV). AIDS is the most advanced stage of HIV infection, characterized by the significant weakening of the immune system, making the person more susceptible to various opportunistic infections and cancers.
The medical definition of AIDS includes specific criteria based on CD4+ T-cell count or the presence of certain opportunistic infections and diseases. According to the Centers for Disease Control and Prevention (CDC), a person with HIV is diagnosed with AIDS when:
1. The CD4+ T-cell count falls below 200 cells per cubic millimeter of blood (mm3) - a normal range is typically between 500 and 1,600 cells/mm3.
2. They develop one or more opportunistic infections or cancers that are indicative of advanced HIV disease, regardless of their CD4+ T-cell count.
Some examples of these opportunistic infections and cancers include:
* Pneumocystis pneumonia (PCP)
* Candidiasis (thrush) affecting the esophagus, trachea, or lungs
* Cryptococcal meningitis
* Toxoplasmosis of the brain
* Cytomegalovirus disease
* Kaposi's sarcoma
* Non-Hodgkin's lymphoma
* Invasive cervical cancer
It is important to note that with appropriate antiretroviral therapy (ART), people living with HIV can maintain their CD4+ T-cell counts, suppress viral replication, and prevent the progression to AIDS. Early diagnosis and consistent treatment are crucial for managing HIV and improving life expectancy and quality of life.
Interleukin-10 receptor alpha subunit (IL-10RĪ±) is a protein that plays a crucial role in the immune system. It is a component of the interleukin-10 receptor, which is a heterodimer composed of IL-10RĪ± and IL-10RĪ² subunits.
IL-10 is an anti-inflammatory cytokine that binds to this receptor complex, leading to the activation of various signaling pathways that downregulate immune responses. The activation of the IL-10RĪ±/IL-10RĪ² heterodimer results in the recruitment and phosphorylation of Janus kinases (JAK1 and Tyk2), which then phosphorylate and activate signal transducer and activator of transcription proteins (STAT1, STAT3, and STAT5). These activated STATs subsequently translocate to the nucleus and regulate the transcription of various genes involved in immune response regulation.
IL-10RĪ± is widely expressed on hematopoietic cells, including T cells, B cells, monocytes, macrophages, and dendritic cells. Mutations in the IL-10RĪ± gene have been associated with severe early-onset inflammatory bowel disease, highlighting its essential role in maintaining immune homeostasis.
Organophosphorus compounds are a class of chemical substances that contain phosphorus bonded to organic compounds. They are used in various applications, including as plasticizers, flame retardants, pesticides (insecticides, herbicides, and nerve gases), and solvents. In medicine, they are also used in the treatment of certain conditions such as glaucoma. However, organophosphorus compounds can be toxic to humans and animals, particularly those that affect the nervous system by inhibiting acetylcholinesterase, an enzyme that breaks down the neurotransmitter acetylcholine. Exposure to these compounds can cause symptoms such as nausea, vomiting, muscle weakness, and in severe cases, respiratory failure and death.
Organophosphonates are a class of organic compounds characterized by the presence of a carbon-phosphorus bond. They contain a phosphonic acid group, which consists of a phosphorus atom bonded to four oxygen or nitrogen atoms, with one of those bonds being replaced by a carbon atom.
In a medical context, organophosphonates are commonly used as radiopharmaceuticals in diagnostic nuclear medicine procedures, such as bone scans. These compounds have the ability to bind to hydroxyapatite, the mineral component of bones, and can be labeled with radioactive isotopes for imaging purposes. They may also be used in therapeutic settings, including as treatments for conditions such as tumor-induced hypercalcemia and Paget's disease of bone.
It is important to note that organophosphonates are distinct from organophosphates, another class of compounds that contain a phosphorus atom bonded to three oxygen or sulfur atoms and one carbon atom. Organophosphates have been widely used as pesticides and chemical warfare agents, and can pose significant health risks due to their toxicity.
Cytosine is one of the four nucleobases in the nucleic acid molecules DNA and RNA, along with adenine, guanine, and thymine (in DNA) or uracil (in RNA). The single-letter abbreviation for cytosine is "C."
Cytosine base pairs specifically with guanine through hydrogen bonding, forming a base pair. In DNA, the double helix consists of two complementary strands of nucleotides held together by these base pairs, such that the sequence of one strand determines the sequence of the other. This property is critical for DNA replication and transcription, processes that are essential for life.
Cytosine residues in DNA can undergo spontaneous deamination to form uracil, which can lead to mutations if not corrected by repair mechanisms. In RNA, cytosine can be methylated at the 5-carbon position to form 5-methylcytosine, a modification that plays a role in regulating gene expression and other cellular processes.
A drug implant is a medical device that is specially designed to provide controlled release of a medication into the body over an extended period of time. Drug implants can be placed under the skin or in various body cavities, depending on the specific medical condition being treated. They are often used when other methods of administering medication, such as oral pills or injections, are not effective or practical.
Drug implants come in various forms, including rods, pellets, and small capsules. The medication is contained within the device and is released slowly over time, either through diffusion or erosion of the implant material. This allows for a steady concentration of the drug to be maintained in the body, which can help to improve treatment outcomes and reduce side effects.
Some common examples of drug implants include:
1. Hormonal implants: These are small rods that are inserted under the skin of the upper arm and release hormones such as progestin or estrogen over a period of several years. They are often used for birth control or to treat conditions such as endometriosis or uterine fibroids.
2. Intraocular implants: These are small devices that are placed in the eye during surgery to release medication directly into the eye. They are often used to treat conditions such as age-related macular degeneration or diabetic retinopathy.
3. Bone cement implants: These are specially formulated cements that contain antibiotics and are used to fill bone defects or joint spaces during surgery. The antibiotics are released slowly over time, helping to prevent infection.
4. Implantable pumps: These are small devices that are placed under the skin and deliver medication directly into a specific body cavity, such as the spinal cord or the peritoneal cavity. They are often used to treat chronic pain or cancer.
Overall, drug implants offer several advantages over other methods of administering medication, including improved compliance, reduced side effects, and more consistent drug levels in the body. However, they may also have some disadvantages, such as the need for surgical placement and the potential for infection or other complications. As with any medical treatment, it is important to discuss the risks and benefits of drug implants with a healthcare provider.
Phosphonoacetic acid (PAA) is not a naturally occurring substance, but rather a synthetic compound that is used in medical and scientific research. It is a colorless, crystalline solid that is soluble in water.
In a medical context, PAA is an inhibitor of certain enzymes that are involved in the replication of viruses, including HIV. It works by binding to the active site of these enzymes and preventing them from carrying out their normal functions. As a result, PAA has been studied as a potential antiviral agent, although it is not currently used as a medication.
It's important to note that while PAA has shown promise in laboratory studies, its safety and efficacy have not been established in clinical trials, and it is not approved for use as a drug by regulatory agencies such as the U.S. Food and Drug Administration (FDA).
A CD4 lymphocyte count is a laboratory test that measures the number of CD4 T-cells (also known as CD4+ T-cells or helper T-cells) in a sample of blood. CD4 cells are a type of white blood cell that plays a crucial role in the body's immune response, particularly in fighting off infections caused by viruses and other pathogens.
CD4 cells express a protein on their surface called the CD4 receptor, which is used by human immunodeficiency virus (HIV) to infect and destroy these cells. As a result, people with HIV infection or AIDS often have low CD4 lymphocyte counts, which can make them more susceptible to opportunistic infections and other complications.
A normal CD4 lymphocyte count ranges from 500 to 1,200 cells per cubic millimeter of blood (cells/mm3) in healthy adults. A lower than normal CD4 count is often used as a marker for the progression of HIV infection and the development of AIDS. CD4 counts are typically monitored over time to assess the effectiveness of antiretroviral therapy (ART) and to guide clinical decision-making regarding the need for additional interventions, such as prophylaxis against opportunistic infections.
Visual acuity is a measure of the sharpness or clarity of vision. It is usually tested by reading an eye chart from a specific distance, such as 20 feet (6 meters). The standard eye chart used for this purpose is called the Snellen chart, which contains rows of letters that decrease in size as you read down the chart.
Visual acuity is typically expressed as a fraction, with the numerator representing the testing distance and the denominator indicating the smallest line of type that can be read clearly. For example, if a person can read the line on the eye chart that corresponds to a visual acuity of 20/20, it means they have normal vision at 20 feet. If their visual acuity is 20/40, it means they must be as close as 20 feet to see what someone with normal vision can see at 40 feet.
It's important to note that visual acuity is just one aspect of overall vision and does not necessarily reflect other important factors such as peripheral vision, depth perception, color vision, or contrast sensitivity.
Antiretroviral Therapy, Highly Active (HAART) is a medical treatment regimen used to manage HIV infection. It involves the combination of three or more antiretroviral drugs from at least two different classes, aiming to maximally suppress viral replication and prevent the development of drug resistance. The goal of HAART is to reduce the amount of HIV in the body to undetectable levels, preserve immune function, and improve quality of life for people living with HIV. Commonly used antiretroviral classes include nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), integrase strand transfer inhibitors (INSTIs), and fusion inhibitors.
The vitreous body, also known simply as the vitreous, is the clear, gel-like substance that fills the space between the lens and the retina in the eye. It is composed mainly of water, but also contains collagen fibers, hyaluronic acid, and other proteins. The vitreous helps to maintain the shape of the eye and provides a transparent medium for light to pass through to reach the retina. With age, the vitreous can become more liquefied and may eventually separate from the retina, leading to symptoms such as floaters or flashes of light.
Herpesviridae infections refer to diseases caused by the Herpesviridae family of double-stranded DNA viruses, which include herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2), varicella-zoster virus (VZV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), human herpesvirus 7 (HHV-7), and human herpesvirus 8 (HHV-8). These viruses can cause a variety of clinical manifestations, ranging from mild skin lesions to severe systemic diseases.
After the initial infection, these viruses typically become latent in various tissues and may reactivate later in life, causing recurrent symptoms. The clinical presentation of Herpesviridae infections depends on the specific virus and the immune status of the host. Common manifestations include oral or genital ulcers (HSV-1 and HSV-2), chickenpox and shingles (VZV), mononucleosis (CMV), roseola (HHV-6), and Kaposi's sarcoma (HHV-8).
Preventive measures include avoiding close contact with infected individuals during the active phase of the infection, practicing safe sex, and avoiding sharing personal items that may come into contact with infectious lesions. Antiviral medications are available to treat Herpesviridae infections and reduce the severity and duration of symptoms.
Cytomegalovirus (CMV) vaccines are medical products being developed to prevent or ameliorate infection and disease caused by the human cytomegalovirus. CMV is a type of herpesvirus that can cause serious health problems in people with weakened immune systems, such as those undergoing organ transplantation, people living with HIV/AIDS, and newborns infected with the virus before birth (congenital CMV infection).
There are currently no approved vaccines for CMV. However, several vaccine candidates are being investigated in clinical trials to evaluate their safety, immunogenicity, and efficacy. These vaccine candidates use various approaches, such as:
1. Live-attenuated viruses: These vaccines contain weakened forms of the virus that can stimulate an immune response without causing disease. An example is the Towne vaccine, which has been studied in clinical trials for several decades.
2. Recombinant proteins: These vaccines use specific viral proteins to induce an immune response. For instance, a glycoprotein B (gB) subunit vaccine has shown promising results in phase II clinical trials.
3. Virus-like particles (VLPs): VLPs mimic the structure of the virus but do not contain any viral genetic material. They can be used to induce an immune response without causing infection.
4. DNA vaccines: These vaccines use plasmids containing CMV genes to stimulate an immune response. A DNA vaccine encoding the CMV phosphoprotein 65 (pp65) has been tested in clinical trials.
5. mRNA vaccines: Similar to DNA vaccines, mRNA vaccines use genetic material to induce an immune response. Moderna Therapeutics is developing an mRNA vaccine candidate for CMV.
The development of a safe and effective CMV vaccine remains a significant public health priority, as CMV infection can lead to severe complications in vulnerable populations.
An intravitreal injection is a medical procedure in which medication is delivered directly into the vitreous cavity of the eye, which is the clear, gel-like substance that fills the space between the lens and the retina. This type of injection is typically used to treat various eye conditions such as age-related macular degeneration, diabetic retinopathy, retinal vein occlusion, and uveitis. The medication administered in intravitreal injections can help to reduce inflammation, inhibit the growth of new blood vessels, or prevent the formation of abnormal blood vessels in the eye.
Intravitreal injections are usually performed in an outpatient setting, and the procedure typically takes only a few minutes. Before the injection, the eye is numbed with anesthetic drops to minimize discomfort. The medication is then injected into the vitreous cavity using a small needle. After the injection, patients may experience some mild discomfort or a scratchy sensation in the eye, but this usually resolves within a few hours.
While intravitreal injections are generally safe, there are some potential risks and complications associated with the procedure, including infection, bleeding, retinal detachment, and increased intraocular pressure. Patients who undergo intravitreal injections should be closely monitored by their eye care provider to ensure that any complications are promptly identified and treated.
Intravenous injections are a type of medical procedure where medication or fluids are administered directly into a vein using a needle and syringe. This route of administration is also known as an IV injection. The solution injected enters the patient's bloodstream immediately, allowing for rapid absorption and onset of action. Intravenous injections are commonly used to provide quick relief from symptoms, deliver medications that are not easily absorbed by other routes, or administer fluids and electrolytes in cases of dehydration or severe illness. It is important that intravenous injections are performed using aseptic technique to minimize the risk of infection.
An injection is a medical procedure in which a medication, vaccine, or other substance is introduced into the body using a needle and syringe. The substance can be delivered into various parts of the body, including into a vein (intravenous), muscle (intramuscular), under the skin (subcutaneous), or into the spinal canal (intrathecal or spinal).
Injections are commonly used to administer medications that cannot be taken orally, have poor oral bioavailability, need to reach the site of action quickly, or require direct delivery to a specific organ or tissue. They can also be used for diagnostic purposes, such as drawing blood samples (venipuncture) or injecting contrast agents for imaging studies.
Proper technique and sterile conditions are essential when administering injections to prevent infection, pain, and other complications. The choice of injection site depends on the type and volume of the substance being administered, as well as the patient's age, health status, and personal preferences.
Electroretinography (ERG) is a medical test used to evaluate the functioning of the retina, which is the light-sensitive tissue located at the back of the eye. The test measures the electrical responses of the retina to light stimulation.
During the procedure, a special contact lens or electrode is placed on the surface of the eye to record the electrical activity generated by the retina's light-sensitive cells (rods and cones) and other cells in the retina. The test typically involves presenting different levels of flashes of light to the eye while the electrical responses are recorded.
The resulting ERG waveform provides information about the overall health and function of the retina, including the condition of the photoreceptors, the integrity of the inner retinal layers, and the health of the retinal ganglion cells. This test is often used to diagnose and monitor various retinal disorders, such as retinitis pigmentosa, macular degeneration, and diabetic retinopathy.
Viral load refers to the amount or quantity of virus (like HIV, Hepatitis C, SARS-CoV-2) present in an individual's blood or bodily fluids. It is often expressed as the number of virus copies per milliliter of blood or fluid. Monitoring viral load is important in managing and treating certain viral infections, as a higher viral load may indicate increased infectivity, disease progression, or response to treatment.
Prospective studies, also known as longitudinal studies, are a type of cohort study in which data is collected forward in time, following a group of individuals who share a common characteristic or exposure over a period of time. The researchers clearly define the study population and exposure of interest at the beginning of the study and follow up with the participants to determine the outcomes that develop over time. This type of study design allows for the investigation of causal relationships between exposures and outcomes, as well as the identification of risk factors and the estimation of disease incidence rates. Prospective studies are particularly useful in epidemiology and medical research when studying diseases with long latency periods or rare outcomes.
Combination drug therapy is a treatment approach that involves the use of multiple medications with different mechanisms of action to achieve better therapeutic outcomes. This approach is often used in the management of complex medical conditions such as cancer, HIV/AIDS, and cardiovascular diseases. The goal of combination drug therapy is to improve efficacy, reduce the risk of drug resistance, decrease the likelihood of adverse effects, and enhance the overall quality of life for patients.
In combining drugs, healthcare providers aim to target various pathways involved in the disease process, which may help to:
1. Increase the effectiveness of treatment by attacking the disease from multiple angles.
2. Decrease the dosage of individual medications, reducing the risk and severity of side effects.
3. Slow down or prevent the development of drug resistance, a common problem in chronic diseases like HIV/AIDS and cancer.
4. Improve patient compliance by simplifying dosing schedules and reducing pill burden.
Examples of combination drug therapy include:
1. Antiretroviral therapy (ART) for HIV treatment, which typically involves three or more drugs from different classes to suppress viral replication and prevent the development of drug resistance.
2. Chemotherapy regimens for cancer treatment, where multiple cytotoxic agents are used to target various stages of the cell cycle and reduce the likelihood of tumor cells developing resistance.
3. Cardiovascular disease management, which may involve combining medications such as angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, diuretics, and statins to control blood pressure, heart rate, fluid balance, and cholesterol levels.
4. Treatment of tuberculosis, which often involves a combination of several antibiotics to target different aspects of the bacterial life cycle and prevent the development of drug-resistant strains.
When prescribing combination drug therapy, healthcare providers must carefully consider factors such as potential drug interactions, dosing schedules, adverse effects, and contraindications to ensure safe and effective treatment. Regular monitoring of patients is essential to assess treatment response, manage side effects, and adjust the treatment plan as needed.
Immediate-early proteins (IEPs) are a class of regulatory proteins that play a crucial role in the early stages of gene expression in viral infection and cellular stress responses. These proteins are synthesized rapidly, without the need for new protein synthesis, after the induction of immediate-early genes (IEGs).
In the context of viral infection, IEPs are often the first proteins produced by the virus upon entry into the host cell. They function as transcription factors that bind to specific DNA sequences and regulate the expression of early and late viral genes required for replication and packaging of the viral genome.
IEPs can also be involved in modulating host cell signaling pathways, altering cell cycle progression, and inducing apoptosis (programmed cell death). Dysregulation of IEPs has been implicated in various diseases, including cancer and neurological disorders.
It is important to note that the term "immediate-early proteins" is primarily used in the context of viral infection, while in other contexts such as cellular stress responses or oncogene activation, these proteins may be referred to by different names, such as "early response genes" or "transcription factors."
Viral DNA refers to the genetic material present in viruses that consist of DNA as their core component. Deoxyribonucleic acid (DNA) is one of the two types of nucleic acids that are responsible for storing and transmitting genetic information in living organisms. Viruses are infectious agents much smaller than bacteria that can only replicate inside the cells of other organisms, called hosts.
Viral DNA can be double-stranded (dsDNA) or single-stranded (ssDNA), depending on the type of virus. Double-stranded DNA viruses have a genome made up of two complementary strands of DNA, while single-stranded DNA viruses contain only one strand of DNA.
Examples of dsDNA viruses include Adenoviruses, Herpesviruses, and Poxviruses, while ssDNA viruses include Parvoviruses and Circoviruses. Viral DNA plays a crucial role in the replication cycle of the virus, encoding for various proteins necessary for its multiplication and survival within the host cell.
Eye proteins, also known as ocular proteins, are specific proteins that are found within the eye and play crucial roles in maintaining proper eye function and health. These proteins can be found in various parts of the eye, including the cornea, iris, lens, retina, and other structures. They perform a wide range of functions, such as:
1. Structural support: Proteins like collagen and elastin provide strength and flexibility to the eye's tissues, enabling them to maintain their shape and withstand mechanical stress.
2. Light absorption and transmission: Proteins like opsins and crystallins are involved in capturing and transmitting light signals within the eye, which is essential for vision.
3. Protection against damage: Some eye proteins, such as antioxidant enzymes and heat shock proteins, help protect the eye from oxidative stress, UV radiation, and other environmental factors that can cause damage.
4. Regulation of eye growth and development: Various growth factors and signaling molecules, which are protein-based, contribute to the proper growth, differentiation, and maintenance of eye tissues during embryonic development and throughout adulthood.
5. Immune defense: Proteins involved in the immune response, such as complement components and immunoglobulins, help protect the eye from infection and inflammation.
6. Maintenance of transparency: Crystallin proteins in the lens maintain its transparency, allowing light to pass through unobstructed for clear vision.
7. Neuroprotection: Certain eye proteins, like brain-derived neurotrophic factor (BDNF), support the survival and function of neurons within the retina, helping to preserve vision.
Dysfunction or damage to these eye proteins can contribute to various eye disorders and diseases, such as cataracts, age-related macular degeneration, glaucoma, diabetic retinopathy, and others.
CD4-positive T-lymphocytes, also known as CD4+ T cells or helper T cells, are a type of white blood cell that plays a crucial role in the immune response. They express the CD4 receptor on their surface and help coordinate the immune system's response to infectious agents such as viruses and bacteria.
CD4+ T cells recognize and bind to specific antigens presented by antigen-presenting cells, such as dendritic cells or macrophages. Once activated, they can differentiate into various subsets of effector cells, including Th1, Th2, Th17, and Treg cells, each with distinct functions in the immune response.
CD4+ T cells are particularly important in the immune response to HIV (human immunodeficiency virus), which targets and destroys these cells, leading to a weakened immune system and increased susceptibility to opportunistic infections. The number of CD4+ T cells is often used as a marker of disease progression in HIV infection, with lower counts indicating more advanced disease.
Anti-HIV agents are a class of medications specifically designed to treat HIV (Human Immunodeficiency Virus) infection. These drugs work by interfering with various stages of the HIV replication cycle, preventing the virus from infecting and killing CD4+ T cells, which are crucial for maintaining a healthy immune system.
There are several classes of anti-HIV agents, including:
1. Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs): These drugs act as faulty building blocks that the virus incorporates into its genetic material, causing the replication process to halt. Examples include zidovudine (AZT), lamivudine (3TC), and tenofovir.
2. Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs): These medications bind directly to the reverse transcriptase enzyme, altering its shape and preventing it from functioning properly. Examples include efavirenz, nevirapine, and rilpivirine.
3. Protease Inhibitors (PIs): These drugs target the protease enzyme, which is responsible for cleaving viral polyproteins into functional components. By inhibiting this enzyme, PIs prevent the formation of mature, infectious virus particles. Examples include atazanavir, darunavir, and lopinavir.
4. Integrase Strand Transfer Inhibitors (INSTIs): These medications block the integrase enzyme, which is responsible for inserting the viral genetic material into the host cell's DNA. By inhibiting this step, INSTIs prevent the virus from establishing a permanent infection within the host cell. Examples include raltegravir, dolutegravir, and bictegravir.
5. Fusion/Entry Inhibitors: These drugs target different steps of the viral entry process, preventing HIV from infecting CD4+ T cells. Examples include enfuvirtide (T-20), maraviroc, and ibalizumab.
6. Post-Attachment Inhibitors: This class of medications prevents the virus from attaching to the host cell's receptors, thereby inhibiting infection. Currently, there is only one approved post-attachment inhibitor, fostemsavir.
Combination therapy using multiple classes of antiretroviral drugs has been shown to effectively suppress viral replication and improve clinical outcomes in people living with HIV. Regular adherence to the prescribed treatment regimen is crucial for maintaining an undetectable viral load and reducing the risk of transmission.
Viral proteins are the proteins that are encoded by the viral genome and are essential for the viral life cycle. These proteins can be structural or non-structural and play various roles in the virus's replication, infection, and assembly process. Structural proteins make up the physical structure of the virus, including the capsid (the protein shell that surrounds the viral genome) and any envelope proteins (that may be present on enveloped viruses). Non-structural proteins are involved in the replication of the viral genome and modulation of the host cell environment to favor viral replication. Overall, a thorough understanding of viral proteins is crucial for developing antiviral therapies and vaccines.
An encyclopedia is a comprehensive reference work containing articles on various topics, usually arranged in alphabetical order. In the context of medicine, a medical encyclopedia is a collection of articles that provide information about a wide range of medical topics, including diseases and conditions, treatments, tests, procedures, and anatomy and physiology. Medical encyclopedias may be published in print or electronic formats and are often used as a starting point for researching medical topics. They can provide reliable and accurate information on medical subjects, making them useful resources for healthcare professionals, students, and patients alike. Some well-known examples of medical encyclopedias include the Merck Manual and the Stedman's Medical Dictionary.