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Q: I was wondering where you get your drinking water in Yakutsk, and if you have any pollution. Dwellers of Yakutsk complain mainly about the absence of good filtering equipments used in the city water supply system.
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You can drink water as much as you want because our body contains 70% of water and is always in a need of new amounts of it. That means if you have 72 kg (160 lbs) you should drink 2,3 liters ( 80 oz) of water per day. An integral part of the carbon dioxide is hydrate carbonate, which balances acids and bases in the organism. In case you have a sensitive stomach, drink regular water because carbon dioxide can increase the acidity in your stomach and you may have stomach problems afterwards.
We use cookies to personalise content and ads, to provide social media features and to analyse our traffic. A tremendous number of flea eggs are laid in an infested home or lawn, as will be discussed in the section “adult fleas.”  Many people worry about the exact “cycle” of fleas when trying to exterminate fleas in their home.  Locations of immature insects and their capabilities are more important information than the life cycle of one single pest! It is important to use a flea insect growth regulator (IGR) inside the home.  Insect growth regulators do not directly kill adult insects and do not kill adult fleas.
Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. When I was “raw,” I positively glowed,  so points 1 and 2 were readily apparent to most anyone who saw me.
The Great Complete Protein Myth has been recanted over and over and over again, but people insist on continuing to believe it.
While all animal foods contain all of those 8 amino acids, not all plant foods do (or, rather, some plant foods contain one in only trace amounts). In her 1971 classic, Diet for a Small Planet, Frances Moore Lappe suggested that plant proteins were incomplete, and so vegetarians had to pay special attention to food combining to ensure they got complete protein (e.g.
In 1971 I stressed protein complementarity because I assumed that the only way to get enough protein … was to create a protein as usable by the body as animal protein. With three important exceptions, there is little danger of protein deficiency in a plant food diet. Our bodies store amino acids, so even if you don’t get all eight essential amino acids in one meal, it’s ok!! The way we obsess about protein in this country, you’d think protein deficiency would be an epidemic.
The fact that you eat food does not make you a nutrition expert any more than driving a car makes you a mechanic.
I learned as a vegan that 100% rabbit food is challenging to digest, I gained weight, created epic farts and craved weed all the time. Pregnant women are advised to consume 60grams of protein a day, that would be challenging to do with rabbit food and without epic farts. There enough wonderfully delicious and nutritious sources of complete proteins in the plant world. Tanya McRawa sorry but as much as I LOVE your latest posts on Easter bunny and Kuchinich – one HUGE dislike to this one! Furthermore, eating a conscious diet that includes healthy and cruelty-free meat is actually significantly more ecologically responsible than eating only vegetables. Both industrial agriculture to produce vegetables AND industrial meat production destroy the integrity, stability and beauty of the biotic community, thus, both are wrong, per this ethic.
Eating bison from the Great Plains, for example (whose mere presence in that area is a key to ecosystem restoration), is vastly superior to eating vegetables, even if grown organically, in that same region, because the latter degrades those ecosystems. I do have a nutrition education and background, and I will say that in my studies from back in the 70's, complete proteins made up the vegetarian diet. Try to grow a baby on a raw vegan diet and then breastfeed it and then raise the child on the same diet.
For those for whom this is primarily an ethical issue, I'd suggest that foregoing animal products can actually be unethical, depending on the situation.
I can answer each of those and more about the bison I consciously choose to eat, and I can also attest that this choice aligns with Leopold's land ethic. Point being: there are a whole lot more relevant questions we need to start asking if we truly want to feel honestly good about the food we ingest. I recommend anyone who truly wants to understand proper nutrition read Loren Cordain’s book about the paleo diet. You understand a whole lot its almost tough to argue with you (not that I really will need to…HaHa).
While we may joke by saying that a "domestic cat" is an oxymoron -- can you really "own" a cat? Purring is generally associated with positive experiences, like being fed or petted, so it's assumed by most people to be a sign of a happy cat. A purr happens when the cat's brain sends messages to its laryngeal muscles -- the muscles around its vocal chords -- allowing them to twitch 25 to 150 times per second, or 25 to 150 hertz. But since cats are also known to knead pillows and other surfaces, another explanation is that the behavior stems from a time when wild cats would pat down foliage to make a bed.
Dogs come in all shapes and sizes -- from Irish wolfhound to Chihuahua -- while cats, aside from having different colored fur, all look pretty similar to the untrained eye. But dogs' genetics are better at mutating, which is how we get so many different types of dogs. According to the study, all cats alive today last shared a common ancestor 11 million years ago. You'd think that a notorious neat-freak of an animal would like being cleaned off in a bath, but that's not the case with cats.
One is that a waterlogged coat doesn't dry quickly and makes cats exceedingly uncomfortable.
Humans began to see cats as partners once our ancestors switched to agriculture-based livelihoods, because they were good at catching mice and other vermin. Correction: An earlier version of this article suggested that tigers avoid the water due to the threat of predators there when, in fact, they love to swim.
Anatomy and Physiology is the single most important topic to master if you want to succeed in nursing school. Tympanic Cavity: This is the name of the physical space that contains the all the structures of the middle ear. Round Window (not labeled in diagram): This nifty little hole is covered by a thin membrane that is similar to the ear drum, but it has a very different function. Cranial Nerve VIII (aka the Vestibular and Cochlear Nerves, aka Vestibulocochlear Nerve, aka Acoustic Nerve): Do you remember your mnemonic for the 12 cranial nerves? Bony Labrynth: A special name for the area within the temporal bone that is carved out specifically for the cochlea and semi-circular ducts to fit into.
Auditory Tube (aka Eustachian Tube): This canal connects the ear to the nose and throat cavity.
Apply Cold Water To Burned Area is a catchphrase and reaction image used to emphasize that someone has been disrespected or made fun of.
The earliest known use of an image depicting the emergency burn treatment as a metaphor for “you got burned” can be found in a FunnyJunk[3] post submitted on May 12th, 2012 in response to a class disciplinary report describing a hostile exchange between two students.
The reaction image was posted by oodlesandoodles[4] was paired with the text “Hope they remembered to pour some cool water on that burn” and received 76 upvotes from FunnyJunk members. On May 14th, We Know Memes[5] posted an image macro pairing the burn image with a screenshot of an iPhone message where a person declines another’s romantic advances by calling them ugly.
Researching Now Running Man 37,534 views Kabaneri of the Iron Fortress 5,385 views Views from the 6 Cover Parodies 9,519 views I AM A MAN! If you consume sugar in moderation, you are not at risk, but people consume plenty of sugar without even knowing it. Sugar is part of some foods, such as honey, pure fruit juice, raisins, mangos, and bananas, which are simple carbohydrates. When your body has a sugar overdose, many symptoms occur, like hyperactivity, consequent fatigue, yeast infections, depression, headaches, colds or sinus problems, mental disorientation and sleepiness. Another problems sugar can trigger are higher diabetes risk, heart disease, cancer development, especially breast cancer. When we consume too much sugar, the body uses as much as it needs to boost energy, while the rest that is not needed is stored as fat.
Sugar cravings occur after a meal is digested and your body sends signals to the brain that it is hungry again.
At first you will feel bad and experience cravings, but you will feel better and improve your health after some period.
Lunch: Chicken breast with cooked butternut squash, carrots, beets, parsnips, turnips, beans and almonds. Dinner: Broiled fish with a bowl of green beans or salmon with fried broccoli and mushrooms.
Medical Disclaimer Statements on Get Holistic Health about health issues aren't meant to identify, treat, cure, or protect against illness. Previous Story Previous post: Feeding Your Body Before and After LipoNext Story Next post: 9 Essential Oils You Need In Your Life! A couple of centuries ago, one merchant, Fyodor Shergin, tried to dig the well and get to ground water, but eventually his well became the world’s deepest ice vertical tunnel. It’s a pretty short info, as I am not a scientist and unable to provide more profound facts for your writing work.
Look at the map and you will see that there are a lot of rivers in the Republic of Sakha (Yakutia) and there are many private companies that are ready to supply waters from them. If you feel exhausted, tired or under stress, mineral water will act on you as an energy drink.
An IGR overloads flea eggs and flea larvae with a juvenile hormone mimic – in other words, immature fleas exposed to an IGR will not grow up or develop into fully developed adult fleas.  Insect growth regulators can be used alone (for flea prevention) or combined with an insecticide that is approved for indoor flea control. I’d smile and explain that there’s plenty of protein in a vegan diet (even one without grains or beans!), that humans don’t really need as much protein as the meat and dairy and “fitness” industries would have us believe, and that, in fact, too much protein (especially animal protein) has been overwhelmingly correlated with cancer (both in the lab and epidemiologically). People would pause, rummaging through their What To Say To A Vegan file, and triumphantly display the “complete protein” clause: “Yes, but plant protein is incomplete protein, and so you need to be really careful to combine foods properly so you’re not deficient!!!” Then they’d look at me with a strange mixture of smugness, concern, and confusion. Of the 22 standard amino acids, there are eight that the human body cannot synthesize from other compounds: we must get these directly from our diet, so they’re called essential. In combating the myth that meat is the only way to get high-quality protein, I reinforced another myth. The exceptions are diets very heavily dependent on [1] fruit or on [2] some tubers, such as sweet potatoes or cassava, or on [3] junk food (refined flours, sugars, and fat).
In fact, it’s recently been suggested that meat (especially cooked) helped us evolve bigger brains. My wife and I have a mostly vegetable, grain and legume diet with animal protein from our own harvest of free-range wild venison, which has practically no fat or cholesterol and is totally free of the dubious chemical and genetic alterations of market meats.
I tend to side with Michael Pollan, mostly: eat what your grandparents would recognize as food — eat REAL food! I feel a bit like Woody Allen in Sleeper in which it is discovered that all our conventional wisdom about diet is completely backwards (in a sort of absurd way in the movie, but not in your article). Actually we have an epidemic of missing long chain fats with the obsession over low cholesterol. I do love cheese, though, and buy it from a store that sells Amish-made cheese; their cows are milked by hand, and treated more humanely than conventional dairy farms.
All plants and animals manufacture their own b12 we get it from animal protein only because the animal has consumed somethings rich in bacteria and its body manufactured it. At first I thought it was going to be wacky anti-carnivore stuff, but it really makes sense. Perhaps it is a myth that complete proteins are a necessary component of diet, but it is an equally persistent and discredited myth in some circles that eating meat is per se unhealthy.
Being healthy is about how much fat your are carrying around, and how much fat you have is all about energy in vs energy out. She is not a doctor nor a nutritionis is someone who tells her expierence, that is only that a single expierence far away from knowledge. It's in fact harder for me to find ethical veggies than ethical meats, at least during the winter. Cats are instinctively drawn toward boxes because they're protected on three sides and can watch what's going on around them through the opening. So when they're hiding out in a box and see something interesting go by, they can spring out and take that thing by surprise. Kittens learn to purr a few days after birth, researchers suggest, as a way to tell Mom "I'm okay." But cats also purr when they're frightened or injured, so it's not always a way to communicate contentment.
Some research has suggested that sound frequencies in this range can be therapeutic, strengthening bones and providing pain relief.
And their behaviors toward humans are driven mostly by instinct, including kneading, which kittens do to their mother's stomachs to stimulate milk flow.
Or, since they have scent glands in their paws, kneading may be a way for cats to mark territory.


After smelling the plant, which is related to mint, they'll roll around euphorically, chase invisible prey and keep coming back for another hit.
The compound binds to the cat's olfactory receptors -- which is why eating catnip doesn't do much -- to mimic a feline pheromone that makes them go nuts. Researchers suggest they have what's called a "slippery genome," meaning that their genetic makeup will adapt to mutations (that might otherwise have fatal consequences) relatively quickly. You'd think they would have diverged quite a bit genetically in the ensuing years, but comparing the genome of a Siberian tiger to domestic cats showed few big differences, suggesting cats are all "very well adapted, successful evolutionary machines,” one of the researchers said. Some love going for a swim, but most others will try their best to claw everything within reach at bath time.
But it's also possible that humans have simply always sheltered domesticated cats from the elements, so as a species they aren't used to getting drenched. Unlike dogs, who may wait patiently by the door for their owners to get home, cats tend to show much greater indifference to their human overlords.
But they were almost never bred for any specific purpose other than hunting or looking pretty. But remember, they haven't been bred to obey human orders like dogs have, so it can be a bit more exasperating. I created Your Nursing Tutor in 2010 based on a desire to help you (yes, you!) get through nursing school without losing your mind.
Though this specific image is the one most often used, other depictions including drawings can also be found. Sugar is added in many foods and drinks, such as sodas, breakfast cereals, pouch juices, salad dressings, yogurts and candy. It gets to the intestines and the body reacts to it as intestinal bacteria and increases the levels of blood sugar.
If you do so, you will go through classic withdrawal symptoms of any addiction, such as sadness, headaches, queasiness, fatigue and cravings. We order two big bottles of drinking water (each 25 litres) and that’s enough for 5 days only.
Some uses DIY-filtered waters for cooking and drinking, a few would prefer to take waters right from faucets. Some businessmen start even thinking over exporting still water to China, but it is more like an idea to exercise on. HSV-1 can also cause genital herpes. Herpes simplex virus 2 (HSV-2) is the most common cause of genital herpes, but it can also cause oral herpes.
Look, I’m not here to tell you never to eat meat or dairy — that’s your business, and if it works for you (and you’re sourcing it in as ethical a way as possible), great. The infamous eight are: isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine. I gave the impression that in order to get enough protein without meat, considerable care was needed in choosing foods.
Fortunately, relatively few people in the world try to survive on diets in which these foods are virtually the sole source of calories. It’s quite possible that including some animal products in your diet might be best for you.
I know, not everyone has or even supports that option, but it works for us both ethically and nutritionally. I'm mostly wary of people selling me protein shakes and powders and such, as if we need more protein.
Now I have some ammo because I recently became vegetarian and am dealing with questions and opinions from friends and family. A nutrition professor recently lost a lot of weight and lowered his cholesterol and blood pressure by eating nothing but Twinkies. And, come to think of it, most of their other choices in life – spiritual, physical, emotional, psychological. I have been eating paleo for years and doing crossfit style exercise and have never been healthier, not just anecdotally but by actual measurement of my before and after cholesterol, resting heart rate, etc. It's often thought that adult cats associate the motion with maternal comfort (and food), so they repeat it in adulthood. We've got Siamese, British shorthair, Maine coon, Manx, Persian, Scottish fold and lots more.
Cats (along with humans and the vast majority of other animals), on the other hand, don't have this ability.
A 2013 study in Nature Communications revealed that big cats -- lions, tigers, and leopards -- share 95.6 percent of their DNA with our fuzzy domestic felines.
Big cats did, however, show several genetic mutations not present in other animals that help them run faster and digest meat better. It could be that cats associate water with predators -- even big cats will sometimes stay on land to avoid river-dwelling crocodiles. Combine that with the fact that they frequently reproduce with their feral counterparts and you've got a domesticated species that is still, essentially, wild. Jinx in "Meet The Parents." There's even a kitty toilet training seat, dubbed the Litter Kwitter, that helps a cat learn how to do its business with a series of plastic rings covering the toilet bowl. ASPCA suggests the secret is motivation -- find a treat your cat goes absolutely nuts for every time -- and refraining from any punishment over a misunderstood command. I believe in breaking through all the confusing technical jargon to get right to the point of what’s most important to remember. We need more great nurses out there, so I want you to achieve your dream of becoming one, too.
Material shown by Get Holistic Health is for educational purposes only and isn't meant to substitute for the recommendation of a doctor and other medical professional. Trends in HSV Types and Genital Herpes Genital herpes can be caused by either HSV-2 or HSV-1.
In all other diets, if people are getting enough calories, they are virtually certain of getting enough protein.
Whether you eat a reasonable portion of foie gras or refuse to touch the stuff is largely insignificant healthwise. Then, through my educational background, I understood more about what food combinations worked and what didn't. Grass fed beef, free range hormone free poultry, vegetables and nuts are indeed a healthy diet. Not that your cat sees you as its mother, necessarily -- more like a roommate who's super tall for reasons it doesn't understand. So in some ways, Fluffy is actually just a harmless -- depending on her mood -- version of a fearsome predator.
Or, since cats are also predators themselves, they may have a strong natural aversion to getting wet because the smell they give off (like a wet dog) after a bath is a dead giveaway to prey. The idea is that over time, the owner will remove each smaller ring in succession, enlarging the opening over the bowl until there's nothing but a regular toilet seat. She completed an editorial internship at Elephant Journal and still writes for them when Waylon reminds her.
One way people become deficient is through not enough friendly bacteria, with pesticides, sterilization, not enough fermenting, or from a poor diet and lifestyle breeding paracites and bacteria that interfere with our friendly bacteria wiping them out. In recent years, HSV-1 has become a significant cause in developed countries, including the United States. She landed a job at the company of her dreams, Integral Life, and is currently putting her third-person writing skills to work in her own online writing business, Conscious Copywriting.
In traditional cultures they make allot of fermented foods, soils were rich and they thrived being vegetarian even vegan.
Veganism probably results in reduced calorie intake, which is where all the benefit comes from. The more athletic I was, the more my body needed some protein to sustain the exercise levels. The risk of infection is highest during outbreak periods when there are visible sores and lesions. If we can look at the root of our lack we will realize there is more than enough to nourish us if we take the time and care in the growing and preperation of our foods we have all that we could ever need and more. Symptoms When genital herpes symptoms do appear, they are usually worse during the first outbreak than during recurring attacks.
Herpes, Pregnancy, and Newborn Infants Herpes can pose serious risks for a pregnant woman and her baby. The risk is greatest for mothers with a first-time infection, because the virus can be transmitted to the infant during childbirth. Guidelines from the American Academy of Pediatrics recommend using specific diagnostic tests for women in labor to determine the risk of transmission.
Babies born to mothers infected with genital herpes are treated with the antiviral drug acyclovir, which can help suppress the virus. They include human herpes virus 8 (the cause of Kaposi sarcoma) and varicella-zoster virus (also known as herpes zoster, the virus responsible for shingles and chickenpox). The word "herpes" comes from the Greek word "herpein," meaning "to creep." This refers to the unique characteristic pattern of all herpes viruses to creep along local nerve pathways to the nerve clusters at the end, where they remain in an inactive (dormant) state for variable periods of time. HSV-1 can also cause genital herpes, which is a sexually transmitted disease (STD). Herpes simplex virus 2 (HSV-2) is the usual cause of genital herpes, but it can also cause oral herpes.
Until recently, the general rule was to assume that HSV-1 caused oral herpes and HSV-2 caused genital herpes. It is now clear, however, that either type of herpes virus can be found in the genital or oral areas (or other sites).
In fact, HSV-1 is now responsible for more than half of all new cases of genital herpes in developed countries. The Disease ProcessHerpes is transmitted through close skin-to-skin contact. To infect people, the herpes simplex viruses (both HSV-1 and HSV-2) must get into the body through tiny injuries in the skin or through a mucous membrane, such as inside the mouth or on the genital or anal areas. The risk for infection is highest with direct contact of blisters or sores during an outbreak. But the infection can also develop from contact with an infected partner who does not have visible sores or other symptoms. Once the virus has contact with the mucous membranes or skin wounds, it enters the nuclei of skin tissue cells and begins to replicate. The virus is then transported from the nerve endings of the skin to clusters of nerve cells (ganglia) where it remains inactive (latent) for some period of time.
However, at some point, the virus wakes up and travels along nerve pathways to the surface the skin where it begins to multiply again.
During this time, the virus can infect other people if it is passed along in body fluids or secretions. Viral shedding may be accompanied by noticeable symptoms (outbreak) but it can also occur without causing symptoms (asymptomatic shedding).
In either case, a person is infectious during periods of viral shedding. Symptoms may appear as multiple small red bumps or patches that develop blisters. Certain triggers can wake up the virus from its dormant state and cause it to become active again. In general, recurrent episodes of herpes cause less severe symptoms than the primary outbreak. HSV-1 is the most prevalent form of herpes simplex virus, and infection is most likely to occur during preschool years. People can get HSV-2 through genital contact or HSV-1 through mouth-to-genital contact with an infected partner. People with active symptoms of genital herpes are at very high risk for transmitting the infection. Unfortunately, most cases of genital herpes infections occur when the virus is shedding but producing no symptoms.
Most people either have no symptoms or do not recognize them when they appear. In the past, genital herpes was mostly caused by HSV-2, but HSV-1 genital infection is increasing. There is also evidence that children today are less likely to get cold sores and become exposed to HSV-1 during childhood. Centers for Disease Control and Prevention (CDC), about 1 in 6 Americans ages 14 to 49 years have genital herpes.
While HSV-2 remains the main cause of genital herpes, HSV-1 has significantly increased as a cause, most likely because of oral-genital sex. African-American women are at particularly high risk. People with compromised immune systems, such as those who have HIV, are at very high risk for genital herpes. Drugs that suppress the immune system, and organ transplantation, can also weaken the immune system and increase the risk for contracting genital herpes. It is almost impossible to defend against the transmission of oral herpes, because it can be transmitted by very casual contact, including kissing.
Still, you can help reduce the risk of transmitting oral herpes by not sharing objects that touch the mouth, such as eating and drinking utensils, toothbrushes, and towels. It is best to refrain from any type of sex (vaginal, anal, or oral) during periods of active outbreak.
However, herpes can also be transmitted when symptoms are not present (asymptomatic shedding).
Only water-based lubricants (K-Y Jelly, Astroglide, AquaLube, and glycerin) should be used.


It is very unlikely to transmit or contract genital herpes from a toilet seat or bath towel. Studies suggest that male circumcision may help reduce the risk of HSV-2, as well as human papillomavirus (HPV) and HIV infections. However, herpes can cause significant and widespread complications in people who don't have a fully functioning immune system.
The CDC recommends that all people diagnosed with herpes simplex virus 2 (HSV-2) get tested for HIV. Most people with HIV are co-infected with HSV-2 and are particularly vulnerable to its complications. HSV-2 infection increases HIV levels in the genital tract, which makes it easier for the HIV virus to be spread to sexual partners. Herpes and PregnancyPregnant women who have genital herpes due to either HSV-2 or HSV-1 have an increased risk for miscarriage, premature labor, inhibited fetal growth, or transmission of the herpes infection to the infant in the uterus or at the time of delivery. Herpes in newborn babies (herpes neonatalis) can be a very serious condition. Fortunately, neonatal herpes is rare.
Although about 25 to 30% of pregnant women have genital herpes, less than 0.1% of babies are born with neonatal herpes. The baby is at greatest risk during a vaginal delivery, especially if the mother has an asymptomatic infection that was first introduced late in the pregnancy.
The risk for transmission also increases if infants with infected mothers are born prematurely, there is invasive monitoring, or instruments are used during vaginal delivery. Transmission can occur if the amniotic membrane of an infected woman ruptures prematurely, or as the infant passes through an infected birth canal.
This risk is increased if the woman is having or has recently had an active herpes outbreak in the genital area. Very rarely, the virus is transmitted across the placenta, a form of the infection known as congenital herpes. Also rarely, newborns may contract herpes during the first weeks of life from being kissed by someone with a herpes cold sore. Infants may get congenital herpes from a mother with an active herpes infection at the time of birth. Aggressive treatment with antiviral medication is required. Most infected pregnant women do not have a history of symptoms, so herpes infection is often not suspected or detected at the time of delivery. Fortunately, if a woman does have genital lesions, rapid diagnostic blood tests can quickly determine her chances of transmitting the virus to her baby during delivery. Some women with new or recurrent herpes may also be prescribed antiviral medication during pregnancy. A woman with herpes can usually safely breastfeed her baby, as long as she does not have a lesion on her breast or nipple.
Neonatal herpes can spread to the brain and central nervous system, causing encephalitis and meningitis. Herpes can also spread to internal organs, such as the liver and lungs. Infants infected with herpes are treated with acyclovir, an antiviral drug. They usually receive several weeks of intravenous acyclovir treatment, followed by several months of oral acyclovir. It is important to treat babies quickly, before the infection spreads to the brain and other organs. Fortunately, rapid diagnostic tests and treatment with acyclovir have significantly improved survival rates and reduced complication rates.
Nearly all who recover have some impairment, ranging from very mild neurological changes to paralysis. Like encephalitis, meningitis symptoms include headache, fever, stiff neck, vomiting, and sensitivity to light. Fortunately, herpes meningitis usually resolves after about a week without complications, although symptoms can recur. Herpes Eye ComplicationsOcular herpes is a recurrent infection that affects the eyes. Herpes Skin ComplicationsEczema Herpeticum: A rare form of herpes infection called eczema herpeticum, also known as Kaposi varicelliform eruption, can affect people with skin disorders and those with a weakened immune system. In children, this is often caused by thumb sucking or finger sucking while they have a cold sore. It can also occur in adult health care workers, such as dentists, because of increased exposure to the herpes virus. The use of latex or polyurethane gloves prevents herpes whitlow in health care workers. SymptomsHerpes symptoms vary depending on whether the outbreak is initial or recurrent.
The primary outbreak is usually worse than recurrent outbreaks, with more severe and prolonged symptoms. In fact, studies indicate that 10 to 25% of people infected with HSV-2 are unaware that they have genital herpes.
The first signs are a tingling sensation in the affected areas (genitalia, buttocks, and thighs) and groups of small red bumps that develop into blisters.
The sores may sometimes itch, but itching decreases as they heal. About 40% of men and 70% of women develop other symptoms during initial outbreaks of genital herpes, such as flu-like discomfort, headache, muscle aches, and fever. Some women may have difficulty urinating and may, occasionally, require a urinary catheter. The virus sheds for a much shorter period of time (about 3 days) compared to an initial outbreak of 3 weeks. Women may have only minor itching, and the symptoms may be even milder in men. On average, people have about four recurrences during the first year, although this varies widely. There are some differences in frequency of recurrence depending on whether HSV-2 or HSV-1 caused genital herpes. HSV-2 genital infection is more likely to cause recurrences than HSV-1. Symptoms of Oral Herpes Oral herpes (herpes labialis) is most often caused by HSV-1, but it can also be caused by HSV-2. It usually affects the lips and, in some primary attacks, the mucus membranes in the mouth. The sores last 10 to 14 days and can be very uncomfortable. Blisters that may be preceded or accompanied by sore throat, fever, swollen glands, and painful swallowing. Recurrent Oral Herpes Infection: A recurrent oral herpes infection is much milder than the primary outbreak. It usually manifests as a single sore, commonly called a cold sore or fever blister (because it may arise during a bout of cold or flu).
The sore usually shows up on the outer edge of the lips and rarely affects the gums or throat.
Recurrences of genital herpes are more likely with HSV-2 infection than with HSV-1 infection. Occasionally, the symptoms may not resemble those of the primary episode, but appear as fissures and scrapes in the skin or as general inflammation around the affected area. They include sunlight, wind, fever, physical injury, surgery, menstruation, suppression of the immune system, and emotional stress. For most people, outbreaks recur with more frequency during the first year after an initial attack. The good news is that in most healthy people, recurring infections tend to become progressively less frequent, and less severe, over time. However, other conditions can resemble herpes, and doctors cannot base a herpes diagnosis on visual inspection alone.
These tests include: Virologic tests (viral culture of the lesion) Serologic tests (blood tests that detect antibodies) The CDC recommends that both virologic and serologic tests be used for diagnosing genital herpes.
People diagnosed with genital herpes should also be tested for other sexually transmitted diseases. At this time, experts do not recommend screening for HSV-1 or HSV-2 in the general population. Genital herpes can be caused by either HSV-1 or HSV-2. It is important to determine which virus is involved, as the type of herpes infection influences prognosis and treatment recommendations. Recurrences of genital herpes, and viral shedding without overt symptoms, are much less frequent with HSV-1 infection than with HSV-2. False-negative (testing negative when herpes infection is actually present) or false-positive (testing positive when herpes infection is not actually present) results can occur. Your health care provider may recommend that you have a test repeated. Virologic TestsViral culture tests are made by taking a fluid sample, or culture, from the lesions as early as possible, ideally within the first 48 hours of the outbreak.
PCR tests are much faster and more accurate than viral cultures, and the CDC recommends PCR for detecting herpes in spinal fluid when diagnosing herpes encephalitis.
PCR can make many copies of the virus' DNA, so that even small amounts of DNA in the sample can be detected. However, many labs now use PCR for herpes testing because it is highly accurate. An older type of virologic testing, the Tzanck smear test, uses scrapings from herpes lesions. The scrapings are stained and examined under a microscope for the presence of giant cells with many nuclei or distinctive particles that carry the virus (called inclusion bodies). The Tzanck test is not reliable for providing a conclusive diagnosis of herpes infection and is not recommended by the CDC. Serologic TestsSerologic (blood) tests can identify antibodies that are specific for either HSV-1 or HSV-2.
When the herpes virus infects you, your body's immune system produces specific antibodies to fight off the infection. If a blood test detects antibodies to herpes, it is evidence that you have been infected with the virus, even if the virus is in a non-active (dormant) state. The presence of antibodies to herpes also indicates that you are a carrier of the virus and might transmit it to others. Serologic tests can be especially useful for people who do not have active symptoms, but who have other risk factors for herpes (such as other STDs, multiple sex partners, or a monogamous partner who has genital herpes). Although glycoprotein (gG) type-specific tests have been available for many years, many of the older nontype-specific tests that cannot distinguish HSV-1 from HSV-2 are still on the market. Canker sores frequently crop up singly or in groups on the inside of the mouth, or on or underneath the tongue. They usually heal within 2 weeks without treatment. Canker sores (Aphthous ulcers) are very common. The drugs are used initially to treat a first attack of herpes, and then afterward to either treat recurrent outbreaks (episodic therapy) or reduce frequency of recurrences (suppressive therapy).
Drugs can, however, reduce the severity of symptoms, improve healing times, and prevent recurrences. If people experience very severe disease or complications, they need to be hospitalized and receive an antiviral drug intravenously. Your health care provider will prescribe one of the three antiviral medications, which you will take for 7 to 10 days.
You should begin the medication as soon as you notice any signs or symptoms of herpes, preferably during the prodrome stage that precedes the outbreak of lesions. If taken during prodrome, episodic therapy may help prevent an outbreak from occurring or reduce its severity.
Valacyclovir is taken once a day. Suppressive treatment can reduce the frequency of outbreak recurrences by 70 to 80%. It is generally recommended for people who have frequent recurrences (6 or more outbreaks per year).
Because herpes recurrences often diminish over time, you should discuss annually with your health care provider whether you should stay with drug therapy or discontinue it. While taking any suppressive therapy for genital herpes, it is still important to regularly use latex condoms and to avoid any sexual activity during recurrences.
A new form of acyclovir (Sitavig) is administered orally as an adhesive tablet; it is applied to the gum region of the mouth, where it dissolves during the course of the day.
In addition, acyclovir is available in topical form, as is the related drug penciclovir (Denavir). Topical TreatmentsThese ointments or creams can help shorten healing time and duration of symptoms. However, none are truly effective at eliminating outbreaks. Penciclovir (Denavir) heals HSV-1 sores on average about half a day faster than without treatment, stops viral shedding, and reduces the duration of pain.
Ideally, you should apply the cream within the first hour of symptoms, although the medication can still help if applied later. Apply the cream 5 times a day, beginning at the first sign of tingling or pain. Over-the-counter topical ointments may provide modest relief. They include Anbesol gel, Blistex lip ointment, Camphophenique, Herpecin-L, Viractin, and Zilactin. Some contain a topical anesthetic such as benzocaine, tetracaine, or phenol. Lip balm that contains sunblock, or sunscreen applied around the lips may help prevent sun-triggered outbreaks.
Herbs and SupplementsGenerally, manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products. Just like a drug, herbs and supplements can affect the body's chemistry, and therefore have the potential to produce side effects that may be harmful. There have been several reported cases of serious and even lethal side effects from herbal products.
Always check with your provider before using any herbal remedies or dietary supplements. Many herbal and dietary supplement products claim to help fight herpes infection by boosting the immune system. There has been little research on these products, and little evidence to show that they really work. Epidemiology, clinical presentation, and antibody response to primary infection with herpes simplex virus type 1 and type 2 in young women. Seroprevalence of herpes simplex virus type 2 among persons aged 14 - 49 years -- United States, 2005-2008.
Guidance on management of asymptomatic neonates born to women with active genital herpes lesions. Epub 2013 Jan 28. Martin ET, Krantz E, Gottlieb SL, Magaret AS, Langenberg A, Stanberry L, et al. Genital shedding of herpes simplex virus among symptomatic and asymptomatic persons with HSV-2 infection.



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