If the condition is detected early and treated appropriately, people with Wilson disease can usually enjoy normal health and a normal lifespan. Unfortunately, untreated Wilson disease is associated with severe brain damage, liver failure, and death.[6]

Trientine HCl (Brand name: Syprine )

Zinc acetate (Brand name: Galzin)

FDA-Approved Treatments The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition.

Although estimates vary, it is believed that Wilson’s disease occurs in approximately one in 30,000 to 40,000 people worldwide.

Most affected individuals with psychiatric symptoms also have neurologic symptoms concurrently or will develop them within about three years and Kayser-Fleischer rings in the corneas of their eyes.

Common neurological symptoms of Wilson disease that may appear and progress with time include tremor, involuntary movements, difficulty swallowing (dysphagia), difficulty speaking and poor articulation (dysarthria), lack of coordination, spasticity, dystonic postures, and muscle rigidity. Almost all affected individuals with the neurological symptoms of Wilson’s disease have Kayser-Fleischer rings in their eyes that can be identified by an ophthalmologist.

This happens most frequently in people with Wilson’s disease during adolescence and more commonly in women.

Research indicates that a normal variation in the PRNP gene may modify the course of Wilson disease. The PRNP gene provides instructions for making prion protein, which is active in the brain and other tissues and appears to be involved in transporting copper.

Patients in the pediatric age bracket who present a clinical picture of autoimmune hepatitis should be investigated for WD (Class I, Level B). 11 Adult patients with atypical autoimmune hepatitis or who respond poorly to standard corticosteroid therapy should also be investigated for WD (Class I, Level C). 12 WD should be considered in the differential diagnosis of patients presenting with nonalcoholic fatty liver disease or have pathologic findings of nonalcoholic steatohepatitis (Class IIb, Level C). 13 WD should be suspected in any patient presenting with acute hepatic failure with Coombs‐negative intravascular hemolysis, modest elevations in serum aminotransferases, or low serum alkaline phosphatase and ratio of alkaline phosphatase to bilirubin of <2 (Class I, Level B).

Recommendations: 1 WD should be considered in any individual between the ages of 3 and 55 years with liver abnormalities of uncertain cause. Age alone should not be the basis for eliminating a diagnosis of WD (Class I, Level B). 2 WD must be excluded in any patient with unexplained liver disease along with neurological or neuropsychiatric disorder (Class I, Level B). 3 In a patient in whom WD is suspected, Kayser‐Fleischer rings should be sought by slit‐lamp examination by a skilled examiner. The absence of Kayser‐Fleischer rings does not exclude the diagnosis of WD, even in patients with predominantly neurological disease (Class I, Level B).

More recently, molecular diagnostic studies have made it feasible either to define patterns of haplotypes or polymorphisms of DNA surrounding ATP7B which are useful for identification of first‐degree relatives of newly diagnosed patients or to examine directly for disease‐specific ATP7B mutations on both alleles of chromosome

Vegan diets are usually higher in dietary fiber, magnesium, folic acid, vitamins C and E, iron, and phytochemicals, and they tend to be lower in calories, saturated fat and cholesterol, long-chain n–3 (omega-3) fatty acids, vitamin D, calcium, zinc, and vitamin B-12

However, vegan diets provide insufficient amounts of B12 (Craig & Mangels, 2009).

To explain the supplement finding, it is possible that individuals choosing a vegan diet for health reasons are more focused on obtaining required nutrients from foods, and therefore did not feel the need to use supplements.

ethical vegans reported a greater intake of sweets than did health vegans

Reviews of research have shown that they provide a wide variety of vitamins, minerals, phytochemicals and fibers (Liu, 2003), and that increased consumption is associated with health benefits, namely, reduced incidence of coronary heart disease, type 2 diabetes, and obesity

involved in forming highly processed soy, excessive consumption of these forms may have harmful effects.

This raises the question of whether the health advantages of a vegan diet result from just avoiding animal products, or from an overall concern for health that includes choosing nutritious foods and engaging in other health-promoting behaviors

overall death rate for vegans was reduced 15%, which approached statistical significance

Similarly, vegans are found to have lower cholesterol (Bradbury et al., 2013) and blood pressure (Pettersen, Anousheh, Fan, Jaceldo-Siegl, & Fraser, 2012), as well as reduced risk of cardiovascular disease (Spencer, Appleby, Davey, & Key, 2003) and diabetes (

a vegan diet has increased substantially in the past 15 years from approximately 300,000 to 500,000 people in 1997 to between 2.5 and 6 million

Findings thus do not necessarily signify that vegans are healthier than omnivores, but rather confirm that they do not experience greater eating-related pathology than their omnivorous counterparts.

Vegans in the present study did not differ significantly from omnivores in scores on any other measure of eating behaviors and attitudes administered, including the Drive for Thinness Scale, the Drive for Muscularity Scale, and discrepancy between self-reported current weight and ideal weight.

They also were more likely to consider themselves “healthy” (p < 0.001) and to prepare food at home (p < 0.001). Vegans more frequently consumed fruits, vegetables, nuts, beans and grains (all p < 0.001), and less frequently consumed caffeinated soft drinks (p < 0.001).

North Korea’s constitution sets forth a number of rights protections, but in reality the government quashes all forms of disfavored expression and opinion and prohibits any organized political opposition, independent media, free trade unions, and civil society organizations. Religious freedom is systematically repressed.

The United Nations Commission of Inquiry on Human Rights in the Democratic People’s Republic of Korea (COI), set up by the Human Rights Council (HRC), issued a report in 2014 documenting extermination, murder, enslavement, torture, imprisonment, rape, forced abortion, and other sexual violence in North Korea. It concluded that the “gravity, scale and nature of these violations reveal a State that does not have any parallel in the contemporary world.”

November 2016 states that Pyongyang uses earnings from overseas labor for its nuclear and ballistic missile programs, which would be a violation of previous Security Council resolutions.

The number of North Korean overseas workers could be as high as 120,000.

The United States waited two years to pass the North Korea Sanctions and Policy Enhancement Act of 2016, which mandated sanctions against Pyongyang’s atrocities. That summer, the Obama administration issued against North Korea its first human rights-related sanctions, including the designation of its leader Kim Jong Un. A second set of sanctions in December sanctioned North Korean companies involved in the exportation of workers, and in January this year targeted those responsible for internal repression and prison camps.

In September, the misconfiguration of a server in North Korea revealed to the world that the network contained only 28 websites, all controlled by official bodies or state-owned enterprises.

The existing computer network remained available to a very limited number of people, providing access to domestic websites and email services only.

Almost everyone was denied internet and international mobile phone services.

briefly detained incommunicado, interrogated and expelled from the country because the government found the stories they produced highlighting aspects of everyday life in Pyongyang to be ‘disrespectful’.

The government persisted in restricting access to outside sources of information; there were no national independent newspapers, media or civil society organizations.

the government had increased its surveillance efforts to prevent people from leaving via the Chinese-Korean border.

On their arrival in South Korea, the North Korean authorities claimed that the 12 women in the group were abducted from China and taken to South Korea. According to a media interview with their former colleagues arranged in Pyongyang by the North Korean government, the workers had their passports taken away from them while in China, which would have restricted their ability to travel freely.1

A total of 1,414 people left North Korea and arrived in South Korea.

parotid glands

encephalitis (2). If the virus is able to infect the cerebrospinal fluid, it travels within the ventricles where the CSF is produced (2). The virus then replicates within these areas and can penetrate into the brain and destroy some of the epithelial integrity, causing it to disintegrate into the CSF (2).

Introduction

Immunocompromised people are at risk of getting keratitis or encephalitis

The normal postmenarchal and premenopausal vaginal pH is 3.8-4.2. At this pH, growth of pathogenic organisms usually is inhibited.

bacterial vaginosis (40-45%), vaginal candidiasis (20-25%), and trichomoniasis (15-20%); yet 7-72% of women with vaginitis may remain undiagnosed.

Many Serratia spp. isolates (39-73%) are resistant to gentamicin Footnote 7. They are all resistant to penicillins and cephalosporin.

Serratia spp. are usually susceptible to aminoglycosides, fluoroquinolones, and co-trimazole

The latter bacteria produce biofilms, which only consist of microcolonies of undifferentiated cells. Serratia spp. also produces β-lactamases

SERRATIA SPP.

Most S. marcescens strains are resistant to several antibiotics because of the presence of R-factors, which are a type of plasmid that carry one or more genes that encode resistance; all are considered intrinsically resistant to ampicillin, macrolides, and first-generation cephalosporins (such as cephalexin)

S. marcescens is a motile organism and can grow in temperatures ranging from 5–40 °C and in pH levels ranging from 5 to 9. It is differentiated from other Gram-negative bacteria by its ability to perform casein hydrolysis, which allows it to produce extracellular metalloproteinases which are believed to function in cell-to-extracellular matrix interactions. S. marcescens also exhibits tryptophan and citrate degradation.

Viridans streptococci are usually organisms of low virulence

Although little is known about the transmission of viridans streptococci, studies of S. mutans passage within families indicates that intra-family transmission is common

Viridans streptococci are the predominant species of the human oral flora and commonly inhabit other areas of the upper respiratory, gastrointestinal, and female genital tracts. Viridans streptococci are occasionally found in the skin flora.

Streptococci are Gram-positive spherical or ovoid bacteria

oral mucosa is the most common portal of entry

The VGS are a group of catalase-negative, Gram-positive cocci with a chaining morphology on microscopic examination.

commensal flora

VGS can cause invasive disease, such as endocarditis, intra-abdominal infection, and shock.

Brucella can gain entry into the human body through breaks in the skin, mucous membranes, conjunctivae, and respiratory and gastrointestinal (GI) tracts.

Mediterranean fever, Malta fever, gastric remittent fever, and undulant fever.

undulant fever is often used to describe this disease because the fever rises and falls in waves.