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maid abuse essay Local host defenses local host defenses of both the upper and lower respiratory tract along with the anatomy of the airways are important in preventing infection. Upper respiratory defenses include the mucociliary apparatus of the nasopharynx, nasal hair, normal bacterial flora, iga, and complement. Local host defenses of the lower respiratory tract include cough, mucociliary apparatus of the trachea and bronchi, antibodies (iga, igm, and igg), complement, and alveolar macrophages. Mucous lines the cells of the respiratory tract, forming a protective barrier for the cells. This minimizes the ability of organisms to attach to the cells and initiate the infectious process. The squamous epithelial cells of the upper respiratory tract are not ciliated, but those of the columnar epithelial cells of the lower tract are. The cilia beat in a uniform fashion upward, moving particles up and out of the lower respiratory tract. Particles greater than 10 microns (μm) are efficiently trapped by mechanisms of the upper airway and are removed from the nasopharynx either by swallowing or by expulsion. The mucociliary apparatus of the trachea and bronchi along with the sharp angles of the bronchi often are effective at trapping and eliminating particles that are 2 to 10 μm in size. Particles in the range of 0. 5 to 1 μm may consistently reach the alveolar sacs of the lung. Microorganisms fall within this size range, and if they reach the alveolar sacs, then infection may result if alveolar macrophages and other defenses cannot contain the organisms. Aspiration varicella-zoster virus, herpes simplex virus, and others. In children, viral pneumonia is more commonly caused by respiratory syncytial virus, influenza a, and parainfluenza, and less commonly those listed previously for adults.

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http://projects.csail.mit.edu/courseware/?term=anti-abortion-essay anti abortion essay If there is no record of vaccination, or immunization history is unknown, hiv-infected patients and adults with high-risk sexual behavior or occupational exposure to hbv should be vaccinated. »» hepatitis c coinfection all hiv-infected patients should be screened for hepatitis c infection. Patients coinfected with hepatitis c virus (hcv) and hiv have an increased rate of progression to cirrhosis, decompensated liver disease, hepatocellular carcinoma, and death compared with monoinfected hcv alone. 15 all hcv/hiv coinfected patients should be considered for therapy, taking into consideration the hcv genotype, stage of liver disease, as well as patient specific factors that may contraindicate therapy (eg, nonadherence, depression, substance abuse). The goal of hcv treatment is to achieve sustained virologic response (absence of detectable viremia greater than or equal to 3 months after discontinuation of treatment) and to decrease the progression of liver injury and likelihood of end-stage liver disease. Comprehensive treatment guidelines for hiv/hcv-coinfected patients are available and have recently been updated to reflect the rapidly evolving treatment options for hcv. 16 recommended treatment regimens for hcv consist of pegylated interferon-α 2a or 2b, ribavirin, sofosbuvir, and simeprevir, with the combinations and duration of treatment determined by hcv genotype. Sofosbuvir and simeprevir are novel direct acting antivirals that exhibit potent antiviral activity and minimal toxicity. However, simeprevir, an hcv protease inhibitor, is metabolized primarily by cyp3a4 and is a substrate for the drug transporter p-glycoprotein (p-gp) and organic anion transporting polypeptide 1b1. Due to the potential for significant drug interactions, simeprevir is not recommended for use with hiv protease inhibitors, cobicistat, or the nonnucleoside reverse transcriptase inhibitors efavirenz, nevirapine, and etravirine.

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