Emerging data suggest that ACE2 receptors are expressed in multiple regions of the human and mouse brain, including the motor cortex, posterior cingulate cortex, ventricles, substantia nigra, olfactory bulb, middle temporal gyrus, ventrolateral medulla, nucleus of tractus solitarius, and dorsal motor nucleus of the vagus nerve A and on several key cell types that make up the central nervous system, including neurons, microglia, astrocytes, and oligodendrocytes B. This figure was created by an author L. A, Coronavirus CoV has been shown to spread via the transcribrial route from the olfactory epithelium along the olfactory nerve to the olfactory bulb within the central nervous system. B, CoV has been shown to spread retrograde via transsynaptic transfer using an endocytosis or exocytosis mechanism and a fast axonal transport FAT mechanism of vesicle transport to move virus along microtubules back to neuronal cell bodies. A, Infected vascular endothelial cells have been shown to spread severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 to glial cells in the central nervous system. B, Known as the Trojan horse mechanism , infected leukocytes can cross the blood-brain barrier to infect the central nervous system.
Literature Review | UNSW Current Students
International sustainable development goals for the elimination of viral hepatitis as a public health problem by highlight the pressing need to optimize strategies for prevention, diagnosis and treatment. Selected or transmitted resistance associated mutations RAMs and vaccine escape mutations VEMs in hepatitis B virus HBV may reduce the success of existing treatment and prevention strategies. These issues are particularly pertinent for many settings in Africa where there is high HBV prevalence and co-endemic HIV infection, but lack of robust epidemiological data and limited education, diagnostics and clinical care. The prevalence, distribution and impact of RAMs and VEMs in these populations are neglected in the current literature. Although tenofovir has a high genetic barrier to resistance, it is of concern that emerging data suggest polymorphisms that may be associated with resistance, although the precise clinical impact of these is unknown. Overall, there is an urgent need for improved diagnostic screening, enhanced laboratory assessment of HBV before and during therapy, and sustained roll out of tenofovir in preference to lamivudine alone. Further data are needed in order to inform population and individual approaches to HBV diagnosis, monitoring and therapy in these highly vulnerable settings.
Chemotherapy: oral side effects and dental interventions -a review of the literature
Pain management in patients with chronic liver disease poses unique challenges for clinicians. Many of the commonly used over-the-counter and prescription pain relievers like acetaminophen, non-steroidal anti-inflammatory drugs NSAIDs , and opiates are metabolized through the liver. Adverse events from analgesics are all too common, potentially fatal, and often avoidable in patients with chronic liver disease, especially in those with cirrhosis or hepatitis.
Correspondence Address: Dr. E-mail: dandrea dent. He participated in more than 50 published manuscripts, more than presentations and serves as invited reviewer in more than 15 journals. This is an open access article licensed under the terms of Creative Commons Attribution 4.