This article will examine all the most common symptoms in-depth and offer advice to those who are hesitant to seek out treatment.

What exactly is LCS and how do I know if I’ve got it?

The million-dollar question. With so many varying symptoms, ranging from leg pain and breathing difficulty to brain fog and depression, healthcare is still trying to get a proper feel for the after-effects of Covid in certain individuals. Here are a few key facts you should keep in mind.

• Long Haul Covid, PASC, LCS, or CCS is a very real thing. It is now a recognized and documented medical consequence of coronavirus infection in some people. The exact percentage of people who will suffer from LCS is still unknown. This report from the CDC offers a new perspective and actual figures, but it’s too early yet to call these figures definitive and the CDC’s goal in publishing these is to draw your doctor’s attention to the incidence of LCS as becoming more commonplace.
• A study published in December of 2020, entitled Characterizing Long COVID in an International Cohort: 7 Months of Symptoms and Their Impact (links to a PDF file ) is based on survey results from more than 3,700 self-described COVID “Long Haulers” in 56 countries. They show nearly half couldn’t work full time six months after unexpectedly developing prolonged symptoms of COVID-19. A small percentage of respondents, thankfully, seemed to have bounced back from brief bouts of Long COVID, though time will tell whether they have fully recovered.
• There is no clear age group or demographic more likely to suffer from LCS. Some evidence exists to suggest that if you have pre-existing lung/heart/other conditions, these may increase your risk for developing LCS but the jury is still out on this. What is clear is that no age group is exempt from developing LCS.
• Good news. You aren’t losing your mind. This is an important point to grasp for most who start experiencing symptoms. Brain fog, depression, cognitive impairment and even waking dream states can all be caused by LCS and can have a profound impact on your mental health and thought patterns. Not seeking out help will increase your levels of stress and simply contribute to the worsening of symptoms.
• Not all medical practitioners will recognize your symptoms as LCS. Ensure your care provider is up to speed on the signs and symptoms of the condition, but don’t step into the public trap of self-diagnosis. Keep an open mind and discuss ALL your symptoms openly with your health care provider.
• What makes this condition so difficult to diagnose with certainty is that you may tick a number of boxes and not actually have LCS. Your doctor is the only person properly qualified to properly assess your condition and we’d recommend examining LCS extensively as a potential cause of any new mental health symptoms you may be experiencing, particularly if you’ve recently had a brush with the coronavirus.
• You may even have had a mild Covid infection and not been aware of it or simply passed it off as mild flu or sniffles. To play it safe, if you’re exhibiting some of the symptoms below, go in and have yourself checked out properly. A test that looks for coronavirus antibodies can help identify an earlier infection if you’re uncertain you’ve had Covid or haven’t recently had a PCR test.

So, about those symptoms. Pull up a chair, it’s a long and growing list and you can expect additional symptoms to be added to this list over the coming months and some to fall away as our understanding of the condition improves.

LCS Symptoms

In the 2020 study referenced above, the following was found among 3,762 respondents from 56 countries. We’ve used this report as the basis for this article as it encompasses the broadest set of symptoms we’ve seen described and contains more detail than other reports.

Prevalence of 205 symptoms in 10 organ systems was estimated in this cohort, with 66 symptoms traced over seven months. Respondents experienced symptoms in an average of 9.08 (95% confidence interval 9.04 to 9.13) organ systems. The most frequent symptoms reported after month 6 were: fatigue (77.7%, 74.9% to 80.3%), post-exertional malaise (72.2%, 69.3% to 75.0%), and cognitive dysfunction (55.4%, 52.4% to 58.8%). These three symptoms were also the three most commonly reported overall

To best describe the findings in this cohort we’ve dissected the graphs published in the report and reproduced them below, as per the reports license Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). We’ll start with the neuropsychiatric symptoms (brain and mood-related). Bars represent the percentage of respondents who experienced each symptom at any point in their illness and are divided into nine sub-categories. When all rows in a given panel use the same denominator, the first row, labeled “All,” indicates the percentage of respondents who experienced any symptoms in that category. Error bars are 95% confidence intervals. Base scale is prevalence (in percentage)

Nest, we’ll move on to the non-neuropsychiatric symptoms. In other words, everything to do with the rest of the body, but excluding the brain. Bars represent the percentage of respondents who experienced each symptom at any point in their illness. Symptoms are categorized by the affected organ systems. When all rows in a given panel use the same denominator, the first row, labeled “All,” indicates the percentage of respondents who experienced any symptoms in that category. Error bars are 95% confidence intervals.

As the lists of possible symptoms are lengthy, we’ve summarized them below and you can view prevalence for each in the linked report. To simplify finding your symptoms, we have again separated these as per the report and graphics above, neuropsychiatric symptoms are shown first followed by non-neuropsychiatric.

List of neuropsychiatric symptoms for LCS

Brain fog/Cognitive dysfunction and memory impairment symptoms

• poor attention or concentration (74.8%)
• difficulty thinking (64.9%)
• difficulty with executive functioning (planning, organizing, figuring out the sequence of actions, abstracting) (57.6%)
• difficulty problem-solving or decision-making (54.1%)
• slowed thoughts (49.1%)
• short-term memory loss (64.8%)
• long-term memory loss (36.12%)
• forgetting how to do routine tasks (12.0%)
• unable to make new long-term memories (7.3%)

Memory symptoms, cognitive dysfunction, and the impact of these on daily life were experienced at the same frequency across all age groups. Of those who experienced memory and/or cognitive dysfunction symptoms and had a brain MRI, 87% of the brain MRIs (n=345, of 397 who were tested) came back without abnormalities.

Speech and language symptoms

• problems with word retrieval (46.3%)
• difficulty communicating verbally (29.2%)
• difficulty reading/processing written text (24.8%)
• difficulty processing/understanding others. (23.8%)

Those who spoke two or more languages had changes to their non-primary language. Speech and language symptoms occurred in 13.0% of respondents in the first week, increasing to 40.1% experiencing these issues in month 4. 38.0%of respondents with symptoms for over 6 months reported speech and language symptoms in month 7.

Sensorimotor symptoms

• numbness
• coldness in a body part
• tingling/pins and needles
• electric zap
• facial paralysis
• facial pressure/numbness, and weakness

Tingling, prickling, and/or pins and needles were the most common at 49% of respondents. Refer to Supplemental Table S3 (shown below) for the most commonly affected anatomical locations.

Sleep-related symptoms

78.6% of respondents experienced difficulty with sleep. The table below lists each type of sleep symptom, as well as the percentage of respondents with that symptom who also listed it as pre-existing (before COVID-19 infection).

Headaches

Headaches were reported by 77.0% of participants, with the most common manifestations being ocular 40.9%, diffuse 35.0%, and temporal 34.0%. 24.0% of respondents reported headaches after thinking/mental exertion and 23.0% experienced migraines. Of those experiencing migraines, 56.4% did not list migraines as a pre-existing condition. 46% of all respondents reported headaches during week 1, 54% of respondents experiencing symptoms in month 4 reported headaches in month 4, and 50% of respondents experiencing symptoms in month 7/reported headaches in month 7.

Emotion and mood

• Anxiety (the most common psychological symptom reported at 57.9%)
• Irritability (51.0%)
• Depression (47.3%)
• Apathy (39.2%)
• Mood lability, assessed by “mood swings” and “difficulty controlling emotions (46%)
• Suicidality (11.6%)
• Mania and hypomania (2,6 AND 3.4% respectively)

Of those who reported anxiety, 61.4% had no anxiety disorder prior to COVID. Of those who reported depression, 55.0% had no depressive disorder prior to COVID.

Taste and smell

• Loss of smell ((35.9%)
• Loss of taste (33.7%)
• Altered sense of taste (25.1%)
• Phantom smells (i.e. olfactory hallucinations or phantosmia) (23.2%)
• Altered sense of smell (19.8%)

Phantom smells were accompanied by a write-in question asking for a description of the smells, in which the most common words were “smoke,” “burning,” “cigarette,” and “meat.” Changes to smell and taste were more likely to occur earlier in the illness course, with 33.2% occurring in week 1. 25.2% of respondents with symptoms for over 6 months experienced changes to taste and smell in month 7.

Hallucinations

The most common hallucination reported was olfactory hallucinations 23.2%, mentioned above. Visual hallucinations were reported by 10.4% of respondents, auditory hallucinations by 6.5%, and tactile hallucinations by 3.1%.

List of non-neuropsychiatric symptoms for LCS

Systemic

• Fatigue (98.3%)
• Weakness (44.5%
• Elevated temperature below 100.4F (58.2%)
• Fever above 100.4F (30.8%)

3.0% (113 respondents) experienced a continuous fever (>100.4F) for 3 or more months, and 15.0% (563 respondents) experienced an elevated temperature, continuously, for 3 or more months. Skin sensations of burning, itching, or tingling without a rash were reported by 47.8% of respondents.

Reproductive/Genitourinary/Endocrine

• Menstrual/period issues (36.1% of respondents with active menstrual cycle)
• Abnormally irregular periods (26.1%,)
• Abnormally heavy periods/clotting (19.7%)
• Post-menopausal bleeding/spotting among cis females over 49 (4.5%)
• Early menopause among cis females in their 40s (3.0%)
• Extreme thirst (35.8%)
• Bladder control (14.1%)

Sexual dysfunction occurred across genders, experienced by 14.6% of male respondents, 8.0% of female respondents, and 15.9% of nonbinary respondents. 10.9% of cis male participants and 3.2% of nonbinary participants reported pain in testicles.

Cardiovascular (heart and circulation)

• Heart palpitations (67.4%)
• Tachycardia (61.4%)
• Pain/burning in the chest (53.1%)
• Fainting (12.9%)

Cardiovascular symptoms were more common over the first 2 months than in later months. Even so, 40.1% of respondents with symptoms for over 6 months experienced heart palpitations, 33.7% experienced tachycardia, and 23.7% experienced pain/burning in the chest in month 7.

Postural Orthostatic Tachycardia Syndrome (POTS)

To screen for POTS, participants were asked whether they had the ability to measure their heart rate, if their heart rate changed based upon posture, and if standing resulted in an increase of over 30 BPM. Of the 2,308 patients who reported tachycardia, 72.8% (1680) reported being able to measure their heart rate. Of those, 52.4% (570) reported an increase in heart rate of at least 30 BPM on standing.

Musculoskeletal

• Chest tightness (74.8%)
• Muscle aches (69.1%)
• Joint pain (52.2%)

Musculoskeletal symptoms were common in this cohort, seen in 93.9%. In month 7, chest tightness affected 32.9% of month 7 respondents and muscle aches affected 43.7% of month 7 respondents

Immunologic and Autoimmune

• Heightened reaction to old allergies (12.1%)
• New allergies (9.3%)
• New or unexpected anaphylaxis reactions were notable at 4.1%

20.3% of respondents (n=765) reported experiencing changes in sensitivity to medications,

Reactivation and test results for latent disease

Since being infected with SARS-CoV-2, 2.8% of respondents reported experiencing shingles (varicella-zoster reactivation), 6.9% reported current/recent EBV infection, 1.7% reported current/recent Lyme infection, and 1.4% reported current/recent CMV infection. Detailed results are shown in the table below.

HEENT (Head, ears, eyes, nose, throat)

28 symptoms were defined as symptoms of the head, ears, eyes, nose, and throat (graphic above). All respondents experienced at least one HEENT symptom. A sore throat was the most prevalent symptom (59.5%) which was reported almost twice as often as the next most prevalent symptom, blurred vision (35.7%). Within this category, symptoms involving vision were as common as other organs. Notably, 1.0% of participants reported a total loss of vision (no data on the extension and duration of vision loss were collected).

Ear and hearing issues (including hearing loss), other eye issues, and tinnitus (ringing in the ears) became more common over the duration studied. Tinnitus, for example, increased from 11.5% of all respondents reporting it in week 1 to 26.2% of respondents with symptoms for over 6 months reporting it in month 7.

Pulmonary and Respiratory (lungs)

• Shortness of breath (77.4%)
• Dry cough at (66.2%)
• Breathing difficulty with normal oxygen levels (60.4%)
• Rattling of breath (17.0%)

Dry cough was reported by half of the respondents in week 1 (50.6%) and week 2 (50.0%) and decreased to 20.1% of respondents with symptoms for over 6 months in month 7. Shortness of breath and breathing difficulties with normal oxygen increased from week 1 to week 2 and had a relatively slow decline after month 2. Shortness of breath remained prevalent in 37.9% of respondents with symptoms in month 7.

Gastrointestinal (stomach)

• Diarrhea (59.7%)
• Loss of appetite (51.6%)
• Nausea (47.8%,)

Of respondents experiencing symptoms after month 6, 20.5% reported diarrhea and 13.7% reported a loss of appetite in month 7.

Dermatologic (skin)

• Itchy skin (31.2%)
• Skin rashes (27.8%)
• Petechiae (17.8%
• COVID toe (13.0%)

COVID toe, petechiae, and skin rashes were most likely to be reported in months 2 through 4 and decreased thereafter.

Post-exertional malaise

The survey asked participants whether they have experienced “worsening or relapse of symptoms after physical or mental activity during COVID-19 recovery”. Borrowing from Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) terminology, this is referred to as postexertional malaise (PEM). 89.1% of participants reported experiencing either physical or mental PEM.

• Of the respondents who experience PEM triggered by physical exertion, 49.6% experience it the following day, 42.5% experience it the same day, and 28.7% experience PEM immediately after.
• Of the respondents who experience PEM triggered by mental exertion, 42.2% experience it the same day, and 31.4% experience it immediately after.

For some respondents the time PEM started varied. A high number of the respondents with PEM (68.3%) indicated that the PEM lasted for a few days. For physical exertion, the mean severity rating was 7.71, and for mental exertion, the mean severity rating was 5.47.

Recovery and long term prognosis for LCS

Now you know the possible effects of LCS the next question on everyone’s mind is an obvious one. Is this permanent or do people recover, and if they do, what sort of time frames are we looking at.

These are both difficult questions, particularly as we are still only getting to grips with the condition and we don’t have a long enough frame of reference yet to answer the question definitively. Obviously, the degree to which your organs have been affected, pre-existing conditions, and the type of symptoms you exhibit all play a role. Let’s look again at the cohort from the report above.

Relapses: triggers & experience

Patients with Long COVID can experience relapsing-remitting symptoms. A minimum of 85.9% of respondents reported experiencing relapses. Respondents characterized their relapses as occurring in an irregular pattern (52.8%) and in response to a specific trigger (52.4%). The most common triggers of relapses, or of general worsening of symptoms, that respondents reported were

• Physical activity (70.7%)
• Stress (58.9%)
• Exercise (54.39%)
• Mental activity (46.2%
• More than a third of menstruating participants experienced relapses during (34.3%) or before menstruation (35.2%).

Heat and alcohol were other triggers of relapse. Triggers that were written in by respondents included food with sugar and high histamines (reported by 70 respondents); lack of sleep or rest (64 respondents); cold air (39 respondents); overworking or schoolwork (28 respondents); smoke, pollution, and chemical odors (24 respondents).

Approximately half (51.7%) of respondents indicated that their symptoms have slowly improved over time, while 8.9% indicated that their symptoms have gradually worsened and 10.8% have had symptoms rapidly worsen over time.

Remaining symptoms after 6 months

Only 164 out of 3762 participants (4.4%) experienced a temporary break in symptoms. The remaining participants reported symptoms continuously, until symptom resolution or up to taking the survey. A total of 2454 (65.2%) respondents were experiencing symptoms for at least 6 months. For this population, the top remaining symptoms after 6 months were primarily a combination of systemic and neurological symptoms. Over 50% experienced the following symptoms:

• Fatigue (80.0%)
• Post-exertional malaise (73.3%)
• Cognitive dysfunction (58.4%)
• Sensorimotor symptoms (55.7%)
• Headaches (53.6%)
• Memory issues (51.0%)

In addition, between 30%-50% of respondents were experiencing the following symptoms after 6 months of symptoms:

• insomnia
• heart palpitations
• muscle aches
• shortness of breath
• dizziness and balance issues
• sleep and language issues
• joint pain
• tachycardia
• other sleep issues.

How is LCS affected by pre-existing conditions?

Again, let’s examine the data from the cohort. Most patients (83%) reported at least one pre-existing condition. The most commonly reported pre-existing conditions were;

• Seasonal allergies (36.3%)
• Environmental allergies (24.1%)
• Migraines (18.7%)
• Asthma (17.1%)

Other conditions of note include acid reflux (12.2%), irritable bowel syndrome (12.9%), vitamin D deficiency (11.8%), obesity (10.7%), hypertension (9.1%), hyperlipidemia (7.4%), and myalgic encephalomyelitis / chronic fatigue syndrome (2.5%).

In the United States, the prevalence of asthma in the general population is 7.7%. While this cohort is not representative of the U.S. population, the prevalence of asthma (17.07%) should be noted.

Making it personal, the voices of respondents

We’ve added these, not to concern you, but to allow you a deeper understanding of the extent to which LCS can affect your life and if you’re experiencing these symptoms, to assure you, you not losing your mind. We strongly urge you to seek help from a trusted medical practitioner who is knowledgeable in the field of LCS.

On Cognitive Dysfunction and Memory Loss

“mother has started to help me take the medications I’m on because I can’t remember if I’ve taken them immediately after having the bottle in my hand”

“was trying to fill out a mortgage application form and couldn’t remember our rent. I put £3750 a month. My partner said, no it’s £1375. So I put £13750. My partner said no, so I tried several more times — I was just guessing numbers”

“sitting on the toilet to pee and had to stop for a second to think if I was really there and not about to pee myself or the bed”

“don’t remember what I did in March or April up until the last week of April. I had almost nothing on my schedule. I don’t know what I did”

“put food on the gas stove and walked away for over an hour, only noticing when they were smoking/burning”

“forget how to do normal routines like running a meeting at work”

“felt lost driving and had to stop and find my position in a GPS to be able to drive back home. It’s a route I have done hundreds of times”

“have trouble comprehending new ideas”

“can’t hold multiple trains of thought […] If I tell myself I have to water my plants, I must do it before another thought comes into my mind because otherwise, I will forget”

“can’t follow plots in movies or tv shows, have to write everything down, have to remember to look at notes”

“had to terminate many phone calls because I could no longer comprehend the speakers nor communicate clearly with them”

“used to do the New York Times crossword puzzle every single day and I can’t even manage the mini ones now”

“can’t focus on reading complex texts, and it makes me feel very tired to do that”

“Found that I had become dyslexic — and knew it was happening at the time, could not remember how to spell words — also found I was missing words from sentences and sometimes writing things that did not make sense”

Should I see a psychiatrist or psychologist first?

Medika’s advice on this is no. Your first port of call should be a doctor qualified to recognize the symptoms of LCS. The right provider can assist you with an appropriate treatment strategy without necessarily resorting to psychotropic drugs and antidepressants which can have serious long-term implications for your mental health.

First, explore the probable diagnosis of LCS with a qualified medical practitioner, particularly if you’re experiencing a number of the symptoms listed above.

If you would like to share your personal experiences of LCS, we encourage you to use the form below and we’ll add your voice to the conversation.

The post The Complete A to Z of Long Haul Covid Symptoms. What you Need to Know appeared first on Medika Life.

• FBN
• FBN1_HUMAN
• fibrillin 1 (Marfan syndrome)
• MFS1
• SGS

The FBN1 gene provides instructions for making a large protein called fibrillin-1. This protein is transported out of cells into the extracellular matrix, which is an intricate lattice of proteins and other molecules that forms in the spaces between cells. In this matrix, molecules of fibrillin-1 attach (bind) to each other and to other proteins to form threadlike filaments called microfibrils.

Microfibrils form elastic fibers, which enable the skin, ligaments, and blood vessels to stretch. Microfibrils also provide support to more rigid tissues such as bones and the tissues that support the nerves, muscles, and lenses of the eyes. Microfibrils store a protein called transforming growth factor beta (TGF-β), a critical growth factor.

TGF-β affects development by helping to control the growth and division (proliferation) of cells, the process by which cells mature to carry out specific functions (differentiation), cell movement (motility), and the self-destruction of cells (apoptosis). Microfibrils help regulate the availability of TGF-β, which is turned off (inactivated) when stored in microfibrils and turned on (activated) when released.

Health Conditions related to genetic changes of FBN1

Acromicric Dysplasia

At least nine FBN1 gene mutations have been identified in people with acromicric dysplasia. This condition is characterized by severely short stature, short limbs, stiff joints, and distinctive facial features.

FBN1 gene mutations that cause acromicric dysplasia are located in an area of the gene called exons 41 and 42, and change single protein building blocks (amino acids) in a region of the fibrillin-1 protein called TGF-β binding-protein-like domain 5. The mutations result in a reduction and disorganization of the microfibrils. Without enough normal microfibrils to store TGF-β, the growth factor is abnormally active. These effects likely contribute to the physical abnormalities that occur in acromicric dysplasia, but the mechanisms are unclear.

It is unknown why the FBN1 gene mutations that cause acromicric dysplasia lead to short stature, while certain other FBN1 gene mutations that also increase TGF-β activity cause a disorder called Marfan syndrome (see below), which is characterized by tall stature.

Isolated Ectopia Lentis

More than 30 mutations in the FBN1 gene have been found to cause isolated ectopia lentis. In this condition, the lens in one or both eyes is off-center (displaced), which leads to vision problems. Most of the FBN1 gene mutations that cause this condition change single amino acids in the fibrillin-1 protein. As a result, the production of normal fibrillin-1 protein is reduced, leading to a decrease in microfibril formation or the formation of impaired microfibrils.

Without enough functional microfibrils to anchor the lens in its central position at the front of the eye, the lens becomes displaced, resulting in isolated ectopia lentis and related vision problems. Ectopia lentis is classified as isolated when it occurs alone, without signs and symptoms affecting other body systems.

However, some people initially diagnosed with isolated ectopia lentis caused by FBN1 gene mutations later develop additional features typical of a condition called Marfan syndrome (described below), such as abnormalities of the large blood vessel that distributes blood from the heart to the rest of the body (the aorta). In these cases, the diagnosis often changes from isolated ectopia lentis to Marfan syndrome.

Marfan Syndrome

Researchers have identified more than 1,300 FBN1 gene mutations that cause Marfan syndrome, a disorder that affects the connective tissue supporting the body’s joints and organs. Abnormalities in the connective tissue lead to heart and eye problems in people with this disorder. In addition, affected individuals are usually tall and slender with elongated fingers and toes and other skeletal abnormalities.

Most of the mutations that cause Marfan syndrome change a single amino acid in the fibrillin-1 protein. The remaining FBN1 gene mutations result in an abnormal fibrillin-1 protein that cannot function properly. FBN1 gene mutations that cause Marfan syndrome reduce the amount of fibrillin-1 produced by the cell, alter the structure or stability of fibrillin-1, or impair the transport of fibrillin-1 out of the cell.

These mutations lead to a severe reduction in the amount of fibrillin-1 available to form microfibrils. Without enough microfibrils, excess TGF-β growth factors are activated and elasticity in many tissues is decreased, leading to overgrowth and instability of tissues and the signs and symptoms of Marfan syndrome.

Weill-Marchesani syndrome

Mutations in the FBN1 gene have also been identified in Weill-Marchesani syndrome. One of the identified mutations deletes part of the gene, leading to the production of an unstable version of the fibrillin-1 protein. The unstable protein likely interferes with the assembly of microfibrils. Abnormal microfibrils weaken connective tissue, which causes the eye, heart, and skeletal abnormalities associated with Weill-Marchesani syndrome.

Other Disorders

Mutations in the FBN1 gene can cause a condition called stiff skin syndrome. This condition is characterized by very hard, thick skin covering most of the body. The abnormal skin limits movement and can lead to joint deformities called contractures that restrict the movement of certain joints. The signs and symptoms of stiff skin syndrome usually become apparent in infancy to mid-childhood.

Mutations in the FBN1 gene can cause another condition called MASS syndrome. This condition involves abnormalities in several parts of the body, including the mitral valve (one of the valves that controls blood flow through the heart), the aorta (a large blood vessel that distributes blood from the heart to the rest of the body), the skeleton, and the skin.

It is unknown why different mutations in the FBN1 gene cause such a variety of disorders.

Chromosomal Location

Cytogenetic Location: 15q21.1, which is the long (q) arm of chromosome 15 at position 21.1

Molecular Location: base pairs 48,408,313 to 48,645,709 on chromosome 15 (Homo sapiens Updated Annotation Release 109.20200522, GRCh38.p13) (NCBI)

The post FBN1 gene, fibrillin 1 appeared first on Medika Life.

Alpha-1 antitrypsin prevents the digestive enzyme trypsin from breaking down proteins until trypsin reaches the intestines. Alpha-1 antitrypsin also inhibits other enzymes, including a powerful enzyme called neutrophil elastase that is released from white blood cells to fight infection.

Alpha-1 antitrypsin protects the lungs from neutrophil elastase, which can damage lung tissue if not properly controlled. Alpha-1 antitrypsin is produced in the liver and then transported to the lungs via the blood.

Alpha-1 antitrypsin Deficiency

More than 120 mutations in the SERPINA1 gene have been identified. Some of these mutations do not affect the production of alpha-1 antitrypsin, while others cause a shortage (deficiency) of the protein. Without enough functional alpha-1 antitrypsin, neutrophil elastase destroys the small air sacs in the lungs (alveoli) and causes lung disease. Excessive damage to the alveoli leads to emphysema, an irreversible lung disease that causes extreme shortness of breath.

Many SERPINA1 gene mutations change single protein building blocks (amino acids) in alpha-1 antitrypsin, which alters the protein’s structure. The most common mutation that causes alpha-1 antitrypsin deficiency replaces the amino acid glutamic acid with the amino acid lysine at protein position 342 (written as Glu342Lys or E342K). This mutation results in a version of the SERPINA1 gene called the Z allele that produces very little alpha-1 antitrypsin.

Abnormal alpha-1 antitrypsin proteins may bind together to form a large molecule, or polymer, that cannot leave the liver. The accumulation of these polymers results in liver damage. In addition, lung tissue is destroyed because not enough alpha-1 antitrypsin is available to protect against neutrophil elastase. Polymers of alpha-1 antitrypsin may also contribute to excessive inflammation, which may explain some of the other features of alpha-1 antitrypsin deficiency, such as a skin condition called panniculitis.

Other SERPINA1 gene mutations lead to the production of an abnormally small form of alpha-1 antitrypsin that is quickly broken down in the liver. As a result, little or no alpha-1 antitrypsin is available in the lungs. While the liver remains healthy in individuals with these mutations, the lungs are left unprotected from neutrophil elastase.

Chromosomal Location

Cytogenetic Location: 14q32.13, which is the long (q) arm of chromosome 14 at position 32.13

Molecular Location: base pairs 94,376,747 to 94,390,654 on chromosome 14 (Homo sapiens Updated Annotation Release 109.20200522, GRCh38.p13) (NCBI)

This gene is also referred to as

• A1A
• A1AT
• A1AT_HUMAN
• AAT
• alpha-1 antiproteinase
• alpha-1 antitrypsin
• alpha-1 proteinase inhibitor
• alpha1AT
• PI
• PI1
• protease inhibitor 1 (anti-elastase)
• serine (or cysteine) proteinase inhibitor, clade A (alpha-1 antiproteinase, antitrypsin), member 1
• serpin peptidase inhibitor, clade A (alpha-1 antiproteinase, antitrypsin), member 1

The post The SERPINA1 Gene, serpin family A member 1 appeared first on Medika Life.

Psychiatrist

A psychiatrist is a medical doctor (M.D) who specializes in mental health, including substance use and disorders.

Psychiatrists are multi-faceted. They’re able to diagnose underlying medical and complex psychiatric conditions, to prescribe medications, and administer somatic therapies (e.g., electroconvulsive therapy or ECT). There is a common misconception that psychiatrists only prescribe meds. The falsehood is mainly due to the current set up of the health care system.

Psychiatry.org provides a more in-depth overview of the profession:

psychiatrists are qualified to assess both the mental and physical aspects of psychological problems, prescribe medications, and they spend much of their time with patients on medication management as a course of treatment.

Education

In North America, the total amount of schooling required is between 12–15 years, including four years’ undergrad in science, two years prep for medical school, and an additional four years in medical school. The psychiatric student must have a postgraduate education certification before applying for a Postgraduate Residency. Postgrad takes another four years for a psychiatrist to train in diagnosis, psychopharmacology, mental health treatment, and other aspects of medical care.

Types of Psychiatrists and Disorders Treated 

1. Adolescent psychiatrists care for youth under the age of 18. They focus on disorders such as attention deficit hyperactivity, major depression, and autism, asperger syndrome.
2. General adult psychiatrists focus on the age group between 18–65 and treat schizophrenia, disorders such as anxiety, attention, personality, adjustment, psychotic, and bipolar.
3. An Addiction psychiatrist treatsdrugs, alcohol, sex, gambling addictions, eating disorders such as bulimia, anorexia, compulsive overeating.
4. Disaster psychiatrists aid patients who have post-traumatic stress disorder (PTSD), stress, and major depressive disorders. Patients can be witnesses of violent crimes, such as sex crimes, murders, terrorist attacks or mass shootings
5. Geriatric psychiatrists center their work withelderly patients who experience dementia, depression, anxiety, schizophrenia, and also practice in hospice and palliative medicine.

Integration of Other Practices

A psychiatrist sometimes combines psychotherapy or modes of “talk therapy” to build the therapist-patient relationship in parallel with prescribing medication and making behavioral observations.

Average Cost Per Session — $100 to $300 USD

Psychologist

Psychologists focus extensively on treating emotional and mental suffering in patients using behavioral intervention. They often work in medical settings; however, they are not physicians and cannot prescribe medications. The National Center for Biotechnology Information provides a concise overview of the role of a psychologist as someone who can:

assess, diagnose, and treat the psychological problems and the behavioral dysfunctions resulting from, or related to physical and mental health. In addition, they play a major role in the promotion of healthy behavior, preventing diseases and improving patients’ quality of life.

In addition to the above explanation, the Canadian Psychological Association describes a psychologist as an individual who studies:

how we think, feel and behave from a scientific viewpoint and apply this knowledge to help people understand, explain and change their behavior.

Education

The amount of training required to become a psychologist depends upon the field of study. (See focus areas below). For example, a clinical psychologist requires an undergraduate degree of four to five years. A doctorate is then required ranging from an additional four to seven years of graduate school. On average, psychologists must attend 8–12 years of university education.

Types of Psychologists and Focus Areas

While many varieties of psychologists exist, the following shortlist is specific to human health and well-being.

1. Clinical psychologists aid clients in their identification of emotional, mental, and behavioral challenges in their lives. Through observation, interviews, and tests, the psychologist will diagnose existing or potential psychological, emotional, or behavioral issues.
2. Cognitive psychologists investigate how people think, including topics such as decision-making and problem-solving. This type of psychologist is interested in how the brain processes, learns, stores, recognizes, and utilizes information. Specializations include memory, language development, attention, problem-solving, or learning disabilities.
3. Developmental psychologists study how and why human beings change throughout their life. Initially concerned with infants and children, the field has expanded to include adolescence, adult development, aging, and the entire lifespan. Developmental psychologists aim to explain how thinking, feeling, and behaviors change throughout life. This field examines change across three major dimensions: physical development, cognitive development, and social-emotional development.
4. Health psychologists study how biological, psychological, and social factors affect overall health and wellness. Many practitioners focus their skills further in subspecialties, including behavioral assessment and intervention, pain management and illness prevention, or health care reform.
5. Personality Psychologists help patients with personality disorders. They look at how a patient’s personality affects the way they deal with the world around them. This branch of psychology researches how various characters cause people to act in social situations, how they react to other people, how they cope with problems, and how they handle the stress in their lives.

Integration of Other Practices

Similar to psychiatrists, psychologists also combine psychotherapeutic practices with their clients to enhance the bond between therapist and patient.

Average Cost Per Session — $80 to $150 USD

Psychotherapist

A psychotherapist offers clients a range of treatments to help with mental health problems, emotional challenges, and some psychiatric disorders.

The modality enables patients to understand their feelings, develop a mind-body connection, and to know when and why they feel positive, anxious, or depressed. Psychotherapy equips people to cope with stressful situations in a more adaptive way. A psychotherapist can utilize experiential or experimental modes of treatment. Medicalnewstoday.com further depicts the process:

Sessions may be one-to-one, in pairs, or in groups. Techniques can include other forms of communication, such as drama, narrative story, or music.

Education

While requirements differ slightly between the United States and Canada, in general, an individual must have an undergraduate degree of three years. Next, an additional four to five years of graduate studies is necessary. For example, to become a certified psychotherapy practitioner within Ontario, Canada, an individual must have 1000 clinical hours completed to apply to the College of Registered Psychotherapists of Ontario (CRPO). Similar requirements exist in the United States and other provinces and territories in Canada.

Types of Psychotherapists and Disorders Treated

1. Cognitive-behavioral therapists (CBT) is a common type of talk therapy. CBT helps clients to become aware of inaccurate or negative thinking and view challenging situations more clearly and learn skills to respond in practical ways. CBT is a useful tool to address emotional challenges. Three examples are: treating mental illness when medications aren’t a good option, learning techniques for coping with stressful life situations and identifying ways to manage emotions.
2. Gestalt psychotherapists help clients integrate the mind and body, to learn the skills to take personal responsibility for their lives and to live in the present moment. Therapy is a method of self-exploration, a mode of truth-telling, and for patients to see themselves as real, physical beings. This new way of being will allow the individual to think more broadly and expand his or her expression of being alive. One key objective is for the psychotherapist to work with clients to improve the quality of their interactions with others.
3. Psychodynamic therapists workwith a variety of methods such as psychoanalysis, hypnosis, and uncovering techniques. These types of psychotherapies interpret unconscious processes and provide insights into the root causes of a client’s difficulties. The client will speak freely about their thoughts and feelings, and the psychotherapist delves into memories that may yield an understanding of present problems. Clients with a wide range of challenges undertake this type of therapy.
4. Interpersonal psychotherapists (IPT) take clients through a brief, attachment-focused treatment that centers on resolving interpersonal problems and symptomatic recovery. It is an empirically supported treatment that follows a highly structured and time-limited approach and is intended to be completed within 12–16 weeks. It has been demonstrated to be an effective treatment for depression and has modified to treat other psychiatric disorders such as bipolar disorder, bulimia nervosa, post-partum depression, and major depressive disorder
5. Group Psychotherapists lead a group of five to 15 patients for an hour or two each week. This type of psychotherapy allows clients to work through their challenges by interacting with a therapist and a group of individuals with similar struggles. Group therapy is held in a safe, confidential setting where members share personal experiences, feelings, and receive feedback and support from the rest of the participants. Clients benefit from developing communication, own awareness, and socialization skills, and learn how to express their issues and accept criticism from others. Many groups target a specific challenge, such as depression, obesity, panic disorder, social anxiety, chronic pain, or substance abuse. Other groups focus more generally on improving social skills, helping people deal with a range of issues such as anger, shyness, loneliness, and low self-esteem.

Integration of Other Practices

Psychotherapists are not doctors and, in general, do not diagnose, nor can a practitioner prescribe drugs to patients. Some psychotherapists are trained in specific areas of psychology and provide both services. Since psychotherapy has a wide range of modalities, in general, psychiatrists and psychologists borrow from the psychotherapy field.

Average Cost Per Session — $100 — $300 USD

Additional Resources

Offsite Links
Please note that the links below are to information and materials not hosted on Medika’s servers and are as such, not subject to our Terms of Use

• psychiatry.org
• angieslist.com
• wikipedia.org — Psychiatrist
• psychologytoday.com — Four Things to Know About Psychiatry
• verywellmind.com — 20 Psychologist Specialties and Job Descriptions
• allpsychologyschools.com — Clinical Psychology Job Description: What You’ll Do
• cpa.ca — What is a Psychologist?
• wikipedia.org — Developmental Psychology
• psychology.org — What is health psychology?
• psychologyschoolguide.net — Personality Psychologist Career Guide
• National Center for Biotechnology Information — The Role Of Psychologists In Health Care Delivery
• medicalnewstoday.com — What is psychotherapy?
• College of Registered Psychotherapists of Ontario
• mayoclinic.org — Cognitive behavioral therapy
• health.usnews.com — What Kind of Therapist — and Which Type of Therapy — Is Right for You?
• apa.org — Understanding Group Therapy

The post The Difference Between A Psychiatrist, Psychologist, and Psychotherapist appeared first on Medika Life.

• Systolic blood pressure 120 (the first number) – indicates how much pressure your blood is exerting against your artery walls when the heart beats.
• Diastolic blood pressure 80 (the second number) – indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.

An easy way to to remember this is that up (or the top number) is when the pressure is up, and the bottom or down number is when the pressure is down. The measurement unit, mm Hg, simply means millimeters of mercury. Mercury was used in the first accurate pressure gauges and is still used in medicine today as the standard unit of measurement for pressure.

Which Number is more important?

Typically, more attention is given to systolic blood pressure (the first number) as a major risk factor for cardiovascular disease for people over 50. In most people, systolic blood pressure rises steadily with age due to the increasing stiffness of large arteries, long-term buildup of plaque and an increased incidence of cardiac and vascular disease.

However, either an elevated systolic or an elevated diastolic blood pressure reading may be used to make a diagnosis of high blood pressure. According to recent studies, the risk of death from ischemic heart disease and stroke doubles with every 20 mm Hg systolic or 10 mm Hg diastolic increase among people from age 40 to 89.

What readings are considered normal?

If your blood pressure falls within the following ranges then it’s considered normal, From 90-120/60-80 mm Hg. These numbers can also be adjusted for age. This chart will help you better understand the numbers

Your Heart Beat (Pulse Rate) and Blood Pressure

While your blood pressure is the force of your blood moving through your blood vessels, your heart rate is the number of times your heart beats per minute.

• They are two separate measurements and indicators of health.
• For people with high blood pressure (HBP or hypertension), there’s no substitute for measuring blood pressure.

A rising heart rate does not cause your blood pressure to increase at the same rate. Even though your heart is beating more times a minute, healthy blood vessels dilate (get larger) to allow more blood to flow through more easily. When you exercise, your heart speeds up so more blood can reach your muscles. It may be possible for your heart rate to double safely, while your blood pressure may respond by only increasing a modest amount.

Can other factors affect my Blood Pressure?

Yes. Each patient needs to be monitored and carefully assessed on an individual basis There are factors that can lead to a temporary elevation of your Blood pressure. You doctor will consider these factors if your blood pressure is unusually high and you can mention these to your Healthcare Provider.

1. White Coat Hypertension

Some people experience white coat hypertension, when blood pressure is elevated in the doctor’s office but not in other settings. These patients need to monitor their blood pressure at home or wear an ambulatory blood pressure monitor that takes your blood pressure every 30 minutes for 24 hours.

While white coat hypertension was formerly considered simple nervousness, recent research suggests otherwise.

A study published in the journal Hypertension found that people with white coat hypertension are at a significantly greater risk for developing sustained high blood pressure than people who have normal blood pressure. One possible explanation is that people with white coat hypertension have a harder time managing stress and anxiety.

2. Stress

Emotional stress and anxiety can temporarily increase blood pressure. Over time, excess stress can take a toll on your cardiovascular system and might lead to permanent blood pressure problems. 

3. Medication

Both over-the-counter and prescription medications can impact your blood pressure. Some medications, like diuretics and blood pressure pills, are designed to lower your blood pressure numbers. Others, like cold and allergy medications, can increase your blood pressure. Be sure to discuss any medication you may be taking with your doctor if you’re assessed with high blood pressure.

4. Activity

Exercise, talking, laughter, and even sex can cause blood pressure fluctuations. These increases are generally small and short lived. If you’ve been running to get your doctors appointment, resting a few minutes before you have your blood pressure taken will negate the effects and allow for a “normal” reading.

5. Food and Drink

What you eat or drink might impact your blood pressure reading. Foods high in tyramine, a substance found in aged foods, can increase blood pressure. This includes foods that are:

• fermented
• pickled
• brined
• cured

Drinks with caffeine can boost blood pressure numbers temporarily, too.

6. Adrenal Issues

Your adrenal system is responsible for hormone production. Adrenal fatigue occurs when your hormone production is low. Your blood pressure may fall as a result. An overactive adrenal system can cause sudden spikes in blood pressure and hypertension.

7. Pheochromocytoma

This rare tumor develops in the adrenal glands and impacts hormone production. It can cause sudden bursts of irregular blood pressure readings with normal spans in between.

Additional Risk Factors

These factors may put you at greater risk for experiencing fluctuating blood pressure:

• high levels of stress
• anxiety
• taking blood pressure pills that aren’t effective or don’t last until your next dose
• tobacco use
• excessive alcohol consumption
• night-shift work

Certain conditions can also increase your risk for developing an abnormal blood pressure. These include:

• diabetes
• pregnancy
• dehydration
• cardiovascular disease
• obstructive sleep apnea
• kidney disease
• thyroid problems
• nervous system problems

Further Resources

1. The American Heart Association
2. Center for Disease Control: Heart Health

The post Understanding Your Blood Pressure appeared first on Medika Life.

Your bile ducts are tubes that carry bile from your liver to your gallbladder and duodenum. Your pancreatic ducts are tubes that carry pancreatic juice from your pancreas to your duodenum. Small pancreatic ducts empty into the main pancreatic duct. Your common bile duct and main pancreatic duct join before emptying into your duodenum.

Why has your doctor requested this test?

Doctors use ERCP to treat problems of the bile and pancreatic ducts. Doctors also use ERCP to diagnose problems of the bile and pancreatic ducts if they expect to treat problems during the procedure. For diagnosis alone, doctors may use noninvasive tests—tests that do not physically enter the body—instead of ERCP.

Doctors perform ERCP when your bile or pancreatic ducts have become narrowed or blocked because of

• gallstones that form in your gallbladder and become stuck in your common bile duct
• infection
• acute pancreatitis
• chronic pancreatitis
• trauma or surgical complications in your bile or pancreatic ducts
• pancreatic pseudocysts 
• tumors or cancers of the bile ducts 
• tumors or cancers of the pancreas 

What happens during the procedure?

Doctors who have specialized training in ERCP perform this procedure at a hospital or an outpatient center. An intravenous (IV) needle will be placed in your arm to provide a sedative. Sedatives help you stay relaxed and comfortable during the procedure. A health care professional will give you a liquid anesthetic to gargle or will spray anesthetic on the back of your throat. The anesthetic numbs your throat and helps prevent gagging during the procedure. The health care staff will monitor your vital signs and keep you as comfortable as possible. In some cases, you may receive general anesthesia.

You’ll be asked to lie on an examination table. The doctor will carefully feed the endoscope down your esophagus, through your stomach, and into your duodenum. A small camera mounted on the endoscope will send a video image to a monitor. The endoscope pumps air into your stomach and duodenum, making them easier to see.

During ERCP, the doctor

• locates the opening where the bile and pancreatic ducts empty into the duodenum
• slides a thin, flexible tube called a catheter through the endoscope and into the ducts
• injects a special dye, also called contrast medium, into the ducts through the catheter to make the ducts more visible on x-rays
• uses a type of x-ray imaging, called fluoroscopy, to examine the ducts and look for narrowed areas or blockages

The doctor may pass tiny tools through the endoscope to

• open blocked or narrowed ducts.
• break up or remove stones.
• perform a biopsy or remove tumors in the ducts.
• insert stents—tiny tubes that a doctor leaves in narrowed ducts to hold them open. A doctor may also insert temporary stents to stop bile leaks that can occur after gallbladder surgery.

The procedure usually takes between 1 and 2 hours.

What do you need to do?

You should talk with your doctor about any allergies and medical conditions you have and all prescribed and over-the-counter medicines, vitamins, and supplements you take, including

• arthritis medicines 
• aspirin or medicines that contain aspirin
• blood thinners 
• blood pressure medicines 
• diabetes medicines
• nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen

Your doctor may ask you to temporarily stop taking medicines that affect blood clotting or interact with sedatives. You typically receive sedatives during ERCP to help you relax and stay comfortable.

Tell your doctor if you are, or may be, pregnant. If you are pregnant and need ERCP to treat a problem, the doctor performing the procedure may make changes to protect the fetus from x-rays. Research has found that ERCP is generally safe during pregnancy.

Arrange for a ride home

For safety reasons, you can’t drive for 24 hours after ERCP, as the sedatives or anesthesia used during the procedure needs time to wear off. You will need to make plans for getting a ride home after ERCP.

Don’t eat, drink, smoke, or chew gum

To see your upper GI tract clearly, you doctor will most likely ask you not to eat, drink, smoke, or chew gum during the 8 hours before ERCP.

The post Endoscopic Retrograde Cholangiopancreatography (ERCP) appeared first on Medika Life.

Often heralded as one of the most important scientific advances in molecular biology, PCR revolutionized the study of DNA to such an extent that its creator, Kary B. Mullis, was awarded the Nobel Prize for Chemistry in 1993.

What is PCR used for?

Once amplified, the DNA produced by PCR can be used in many different laboratory procedures. For example, most mapping techniques in the Human Genome Project (HGP) relied on PCR.

PCR is also valuable in a number of laboratory and clinical techniques, including DNA fingerprinting, detection of bacteria or viruses (particularly AIDS), and diagnosis of genetic disorders. This technique has featured prominently in global testing for the novel Corona Virus (SARS-nCoV2).

How does PCR work?

To amplify a segment of DNA using PCR, the sample is first heated so the DNA denatures, or separates into two pieces of single-stranded DNA. Next, an enzyme called “Taq polymerase” synthesizes – builds – two new strands of DNA, using the original strands as templates.

This process results in the duplication of the original DNA, with each of the new molecules containing one old and one new strand of DNA. Then each of these strands can be used to create two new copies, and so on, and so on. The cycle of denaturing and synthesizing new DNA is repeated as many as 30 or 40 times, leading to more than one billion exact copies of the original DNA segment.

The entire cycling process of PCR is automated and can be completed in just a few hours. It is directed by a machine called a thermocycler, which is programmed to alter the temperature of the reaction every few minutes to allow DNA denaturing and synthesis.

PCR’s role in Covid19 testing

The info-graphic below will help you visualize the testing procedures for Covd19. This article will focus only on the PCR testing and not on the identification of antibodies with Serological Testing. PCR will assess if you are infected, whereas the antibodies test checks to see if you were infected.

The Diagnostic or PCR Test

This test uses a sample of mucus typically taken from a person’s nose or throat. The test may also work on saliva — that’s under investigation. It looks for the genetic material of the coronavirus. The test uses PCR (polymerase chain reaction), which greatly amplifies the viral genetic material if it is present. That material is detectable when a person is actively infected.

Generally speaking, in terms of producing a reliable result, these are the best tests. However, a few days may pass before the virus starts replicating in the throat and nose, so the test isn’t guaranteed to identify someone who has recently been infected. Swabs can also sometimes fail to pick up signs of active infection.

The post Polymerase Chain Reaction (PCR) Testing appeared first on Medika Life.

Red Blood Cells

Red blood cells (RBC) are also called erythrocytes. They deliver oxygen from your lungs to your tissues and organs. Blood cells constantly die and your body makes new ones. Red blood cells live about 120 days. Red blood cells are the most common type of blood cell and your principal means of delivering oxygen to the body tissues—via blood flow through the circulatory system.

The cytoplasm of erythrocytes is rich in hemoglobin, an iron-containing biomolecule that can bind oxygen and is responsible for the red color of the cells. Carbon monoxide is so dangerous because it binds far better to hemoglobin than oxygen.

White Blood Cells

White blood cells (WBCs), also called leukocytes or leucocytes. They are a component of the immune system that is involved in protecting the body against both infectious disease and foreign invaders. All white blood cells are produced and derived from cells in the bone marrow known as hematopoietic stem cells. Leukocytes are found throughout the body, including the blood and lymphatic system. Some white blood cells live less than a day, but others live much longer.

All white blood cells have nuclei, which distinguishes them from the other blood cells, such as red blood cells and platelets. The two main categories of white blood cells are granulocytes and agranulocytes.

Platlets

Platelets, also called thrombocytes, help blood to clot when you have a cut or wound. Bone marrow, the spongy material inside your bones, makes new blood cells. and platelets live about 6 days. Like red cells, platelets have no nucleus. However, unlike red cells that originate in the marrow as nucleated cells and lose their nucleus, platelets are produced by budding off from a giant multi nucleated marrow cell called a megakaryocyte.

Blood Plasma

Blood plasma is the pale yellow colored liquid component of blood that normally holds the blood cells in whole blood in suspension. It makes up about 55% of the body’s total blood volume. It is the intravascular fluid part of extracellular fluid (all body fluid outside of cells).

It is mostly water (up to 95% by volume), and contains dissolved proteins (6–8%) (i.e.—serum albumins, globulins, and fibrinogen), glucose, clotting factors, electrolytes (Na+, Ca2+, Mg2+, HCO3−, Cl−, etc.), hormones, and carbon dioxide . Plasma also serves as the protein reserve of the human body. It plays a vital role in an intravascular osmotic effect that keeps electrolytes in balanced form and protects the body from infection and other blood disorders.

How Blood is Typed (classified)

Blood types are determined by the presence or absence of certain antigens – substances that can trigger an immune response if they are foreign to the body.  Since some antigens can trigger a patient’s immune system to attack the transfused blood, safe blood transfusions depend on careful blood typing and crossmatching.

There are four major blood groups determined by the presence or absence of two antigens – A and B – on the surface of red blood cells. In addition to the A and B antigens, there is a protein called the Rh factor, which can be either present (+) or absent (–), creating the 8 most common blood types (A+, A-, B+, B-, O+, O-, AB+, AB-).

We use one of two systems to classify blood, the ABO system or the Rh System. The Rh System simply classifies you as being Rh+ or Rh-. Being positive means simply your blood has the Rh protein antigen, being negative indicates the protein antigen is not present in your blood. The ABO system identifies the presence, or absence, of A,B, AB antigens in your blood

• Donors with blood type A… can donate to recipients with blood types A and AB
• Donors with blood type B… can donate to recipients with blood types B and AB
• Donors with blood type AB… can donate to recipients with blood type AB only
• Donors with blood type O… can donate to recipients with blood types A, B, AB and O (O is the universal donor: donors with O blood are compatible with any other blood type)

Rh-negative blood is given to Rh-negative patients, and Rh-positive or Rh-negative blood may be given to Rh-positive patients. The rules for plasma are the reverse. Things become more complicated with the addition of the Rh Factor protein. the info-graphic provided below expands the full combinations of the donor/ recipient relationship.

Note: The universal red cell donor has Type O negative blood.The universal plasma donor has Type AB blood.

Prevalence of Blood Types Globally

Just how widespread are certain blood types within the general population? AB- is by far the rarest. Refer to the info-graphic below for other blood types.

Inheriting Blood Types

Like eye color, blood type is passed genetically from your parents. Whether your blood group is type A, B, AB or O is based on the blood types of your mother and father. This makes blood typing an integral part of paternity suits. The table below will explain the combinations in more detail.

Note: If you have questions about paternity testing or about blood group inheritance, your primary care physician should be able to provide you with an appropriate referral. Testing difficulties can cause exceptions to the above patterns. ABO blood typing is not sufficient to prove or disprove paternity or maternity.

The post Blood, Types and ABO Testing appeared first on Medika Life.

Antigens are any substance that stimulates the immune system to produce antibodies. Antigens can be bacteria, viruses, or fungi that cause infection and disease. They can also be substances, called allergens, that bring on an allergic reaction. Common allergens include dust, pollen, animal dander, bee stings, or certain foods.

The Five Classes of Antibodies

There are five different kinds of antibodies, IgG, IgA, IgM, IgD, and IgE. Ig is the abbreviation for immunoglobulin, or antibody. Laboratories use Serological Testing to identify these antibodies in samples.

IgG antibodies are the most common and the most important. They circulate in the blood and other body fluids, defending against invading bacteria and viruses. The binding of IgG antibodies with bacterial or viral antigens activates other immune cells that engulf and destroy the antigens. The smallest of the antibodies, IgG moves easily across cell membranes. In humans, this mobility allows the IgG in a pregnant woman to pass through the placenta to her fetus, providing a temporary defense to her unborn child.

IgA antibodies are present in tears, saliva, and mucus, as well as in secretions of the respiratory, reproductive, digestive, and urinary tracts. IgA functions to neutralize bacteria and viruses and prevent them from entering the body or reaching the internal organs.

IgM is present in the blood and is the largest of the antibodies, combining five Y-shaped units. It functions similarly to IgG in defending against antigens but cannot cross membranes because of its size. IgM is the main antibody produced in an initial attack by a specific bacterial or viral antigen, while IgG is usually produced in later infections caused by the same agent.

IgD is present in small amounts in the blood. This class of antibodies is found mostly on the surface of B cells—cells that produce and release antibodies. IgD assists B cells in recognizing specific antigens.

IgE antibodies are present in tiny amounts in serum and are responsible for allergic reactions. IgE can bind to the surface of certain cells called mast cells, which contain strong chemicals, including histamine. When an allergen such as pollen binds with its specific IgE antibody, it stimulates the release of histamine from the mast cell. The irritating histamine causes the symptoms of an allergic reaction, such as runny nose, sneezing, and swollen tissues.

Can we produce antibodies in a laboratory?

Yes. Antibody production is carried out in the body by B cells. There are various methods for antibody production in the laboratory. Monoclonal antibodies can be produced through the use of hybridoma cells in vitro. Polyclonal antibodies are typically manufactured in rabbits.

The post Learn About Antibodies and Antigens appeared first on Medika Life.

Several methods can be used to detect antibodies and antigens, including ELISA, agglutination, precipitation, complement-fixation, fluorescent antibodies and more recently chemiluminescence. Serological testing features prominently in Covid-19 testing.

It is used to test a patients sample for the presence of antibodies to the SARS nCoV2 virus that causes Covid-19. The presence of these antibodies tells us that the patient was infected with the virus. The test cannot be used to determine if you are currently or newly infected, that requires a NAAT based test that searches for actual viral material rather than antibodies and antigens

What do we use Serological Testing for?

Blood typing is typically performed using serologic methods. The antigens on a person’s red blood cells, which determine their blood type, are identified using reagents that contain antibodies, called antisera. When the antibodies bind to red blood cells that express the corresponding antigen, they cause red blood cells to clump together (agglutinate). These clumps can then be identified visually.

Serologic tests also play a key role in transfusion medicine. Prior to a blood transfusion,the test is used for crossmatching, a process that ensures a donor and recipient are compatible. The direct antiglobulin test is performed to detect if antibodies are bound to red blood cells inside the person’s body, which is abnormal and can occur in conditions like autoimmune hemolytic anemia, hemolytic disease of the newborn and transfusion reactions.

In Immunology, Serologic tests can help to diagnose autoimmune disorders by identifying abnormal antibodies directed against a person’s own tissues.

The importance of Serology

Serological surveys are often used by epidemiologists to determine the prevalence of a disease in a population. Such surveys are sometimes performed by random, anonymous sampling from samples taken for other medical tests or to assess the prevalence of antibodies of a specific organism or protective titre of antibodies in a population.

These surveys are potentially the most direct and informative technique available to infer the dynamics of a population’s susceptibility and level of immunity. The emergence of the tests usefulness in tracking viral outbreaks and measuring prevalence in communities across the globe has been made evident by the Coronavirus Pandemic of 2019/20

The post Serological Testing appeared first on Medika Life.