Treatment after Post Exposure Prophylaxis PEP

WHAT IS THE TREATMENT AFTER EXPOSURE?

Prophylaxis means disease prevention. Post-exposure prophylaxis (PEP) means taking antiretroviral drugs (ARVs) as soon as possible after exposure to HIV, so that the exposure will not result in HIV infection. These drugs are only available by prescription. The PEP should be taken as soon as possible after exposure to HIV but certainly within 72 hours. Treatment with 2 or 3 ARVs should continue for 4 weeks, if tolerated.

WHO SHOULD USE PEP?

Occupational exposure:

The PEP has been standard procedure since 1996 for workers in the health area are exposed to HIV. Workers start taking medications within a few hours after exposure. Usually the exposure is from an accidental needle stick with a needle containing HIV-infected blood. PEP reduced the rate of HIV infection from workplace exposures by 79%. However, some workers may be infected with HIV who take PEP.

Other exhibitions:

In 2005 the Centers for Disease Control (CDC) has reviewed information on PEP. They have decided to be available also in situations not related to work. People can be exposed by having unprotected sex, in cases of rupture of a condom during sex, or sharing needles to inject drugs. In a study of PEP in 400 cases of possible sexual exposure to HIV, not one person became infected with HIV.

SHOULD PEP BE USED FOR NON-OCCUPATIONAL EXPOSURE?

Exposures at work are usually an incident that occurs only once. Others may be due to risk behaviors that often occur. Some think that PEP might encourage this unsafe behavior if people think that PEP is an easy way to avoid HIV infection.

There are other reasons why PEP might not be a good idea for non-occupational:

There have been no studies to show that PEP works for non-occupational exposure. It is not known how soon have to start PEP after exposure.

PEP is not a "morning after pill." PEP is a program that includes several medications to be taken at least 30 days and cost between $ 600 and $ 1,000.

For best results, you should take every dose of every PEP medication. Skipping doses may result in HIV infection. You can also allow the virus to develop drug resistance. If that happens they stop working.

The medications have side effects. Approximately 40% of workers did not complete PEP regimen due to side effects.

Despite these concerns, there is great interest in the use of PEP for non-occupational exposures. Most programs include counseling to inform and encourage people to avoid exposure to HIV.

HOW IS THE PEP?

The PEP should be initiated as soon as possible after exposure to HIV.

The Public Health in the US recommends using a combination of three antiretroviral approved for four weeks. Previous guidelines were based on the severity of exposure to HIV. This has been eliminated in the guidelines published in 2013. It is now recommended that all exposures are treated the same way.

WHAT ARE THE SIDE EFFECTS?

The most common side effects from PEP medications are nausea and feeling sick. Other possible side effects include headaches, fatigue, vomiting, and diarrhea. For more information, see the fact sheets on individual ARVs.

IN A NUTSHELL

Post-exposure prophylaxis (PEP) is the use of ARVs as soon as possible after exposure to HIV to prevent infection with the virus. PEP can reduce the rate of HIV infection in the area of ??workers health by 79%.

They have not seen the benefits of PEP for non-occupational exposure. This use of PEP is controversial because some believe it may encourage the practice of risky behaviors.

PEP is a program of four weeks and two or three ARVs, several times a day. The medications have serious side effects that may hinder completion of the program. PEP is not 100% effective and there is no guarantee that will prevent infection with HIV.

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Pre Exposure Prophylaxis PrEp

WHAT IS PRE-EXPOSURE PROPHYLAXIS?

PrEP stands for Pre-exposure prophylaxis. Prophylaxis means disease prevention. PrEP is a new HIV prevention option for HIV-negative individuals to reduce their risk of HIV infection. PrEP for HIV prevention is the use of antiretroviral medications (ARVs) by HIV-negative individuals to reduce risk. Large research studies showed that PrEP could help prevent new HIV infections when used by people at high risk of getting HIV.

The only good research on PrEP is based on using the combination pill Truvada. Research showed over 90% reduction in HIV infections when taken four times a week PrEP taken daily reduced HIV infections by 99%. There is not enough information on other medications. We don’t know yet if other drugs or dose timing (like a few times a week instead of every day) might also be a good way to reduce risk of HIV.

Truvada as PrEP was studied in people who were at high risk of HIV infection. HIV-negative men who have sex with men, transgender women, and heterosexuals at high risk were studied. Results in these studies have varied, Major studies showed that daily Truvada as PrEP can reduce risk of infection between 44% and 90%. The studies showed that PrEP worked best for people who took the medication every day. 

HOW IS PrEP TAKEN?

PrEP is currently one tablet of Truvada daily. It can be taken with food, or between meals.There is research ongoing to look at other medications for PrEP.Truvada contains two medications, tenofovir (Viread) and emtricitabine (Emtriva). Truvada is only available with a prescription.

WHO SHOULD USE PrEP?

PrEP is more than simply taking HIV pills. The US Centers for Disease Control and Prevention (CDC) has issued guidelines for the use of PrEP. One set of guidelines is for men who have sex with men. Another is for heterosexuals.

• PrEP should be used by people who are at high risk of becoming infected with HIV by sexual activity

• PrEP should be part of an overall HIV prevention program including condoms and counseling

• Before taking PrEP, people should be tested to confirm that they are not already infected with HIV

• People using PrEP should continue to be tested to make sure they have not been infected

• They should also be tested for kidney damage, hepatitis B and any sexually transmitted diseases 

HOW SHOULD PEOPLE USING PrEP BE MONITORED?

The CDC guidelines recommend that people taking PrEP be seen every 2-3 months in order to:

• Test for HIV infection

• Check for side effects of Truvada

• Check for problems taking PrEP every day

• Reinforce condom use and other prevention messages

WHAT ARE THE LIKELY SIDE EFFECTS?

The most common side effects seen in the studies of Truvada as PrEP include headache, nausea, vomiting, rash and loss of appetite. In some people, tenofovir can increase creatinine and transaminases. These are enzymes related to the kidneys and liver. High levels can indicate damage to these organs. Long-term use of tenofovir can damage the kidneys.

Tenofovir can reduce bone mineral density . Calcium or vitamin D supplements may be helpful. This is especially true for people with osteopenia or osteoporosis.

Levels of lactic acid in the blood increase in some people taking tenofovir and emtricitabine. Liver problems including “fatty liver” may also occur.

In rare cases, people taking emtricitabine had some temporary changes in skin color.

DOES PrEP HAVE RISKS?

People with HIV have used Truvada, tenofovir and emtricitabine, for several years. They are generally easy to take. Possible long-term side effects include loss of bone mineral density and kidney damage.

Some people worry that people taking PrEP might think they are totally protected. They might be less careful about their sexual behavior. So far, this does not appear to be true.

THE BOTTOM LINE

Pre-exposure prophylaxis (PrEP) is the use of the antiretroviral medication Truvada before exposure to HIV, to reduce the risk of HIV infection. When Truvada as PrEP is used correctly and consistently, it can reduce the rate of HIV infection by sexual activity by as much as 90%.

The benefits of PrEP are potentially very high for reducing new HIV infections in people who recognize their risk of infection and can take Truvada to protect themselves. Some people fear PrEP may encourage unsafe behaviors, but this has not been seen.


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New treatment a man with paralysis can walk again

After four years in bed, a man who had lost the movement of more than half of her body, able to walk again thanks to a new cell transplant treatment of your nasal cavity to the spinal cord.

Darek Fidyka In 2010, a Bulgarian man who then was 34 years old, was attacked repeatedly in the back with a knife. As a result of aggression, Fidyka his spinal cord was cut in two, losing the sensitivity of his body from the chest down.

Since then the patient had undergone various treatments, all unsuccessful, to regain feeling in part of his body paralyzed. In 2012 Fidyka started an experimental treatment that had the support of researchers from the Institute of Neurology at University College London and doctors at University Hospital in Wroclaw, Poland, with the result that, four years after the attack that fell on a bed, Darek was finally able to walk again with the aid of a support.

After four years in bed, a man who had lost the movement of more than half of her body, able to walk again thanks to a new cell transplant treatment of your nasal cavity to the spinal cord.

Darek Fidyka In 2010, a Bulgarian man who then was 34 years old, was attacked repeatedly in the back with a knife. As a result of aggression, Fidyka his spinal cord was cut in two, losing the sensitivity of his body from the chest down.

Since then the patient had undergone various treatments, all unsuccessful, to regain feeling in part of his body paralyzed. In 2012 Fidyka started an experimental treatment that had the support of researchers from the Institute of Neurology at University College London and doctors at University Hospital in Wroclaw, Poland, with the result that, four years after the attack that fell on a bed, Darek was finally able to walk again with the aid of a support.

The explanation of the operation in a graphical released by the BBC

The explanation of the operation in a graphical released by the BBC

The research made possible the start of the recovery of Derek Fidyka was conducted by the professor and researcher English Geoffrey Reisman, who since 1985 has studied the cells of the olfactory ensheathing glia (OEC, for its acronym in English), which is They found in the nose, which have an enormous capacity for nerve regeneration. Polish Pawel Tabakov neurosurgeon leaned on research and collaboration Reisman for transplanting cells OEC Fidyka his spinal cord.

In the first operation which was subjected to the patient, it was extracted one of the olfactory bulbs, thanks to this it was possible to grow the CSG cells, which were introduced through microinjection into the spinal cord of Fidyka a few weeks after the first surgery.

In a third surgery will nervous extracted ankle that was transplanted bone beside her, to serve as a support cell renewal while producing tissue. Three months later Fidyka realized that the operation was successful when he felt the muscle of his left leg began to grow. Six months after the third intervention Bulgarian could already take small steps with the help of a support and care for their physical therapists.

television program  BBC Panorama , Fidyka can now drive your car and move with the help of a walker. Furthermore, also partially he recovered sensations in the intestine, bladder and sexual functions.

Scientists do not yet know if Fidyka is an exceptional patient (apparently the first to regain mobility after having severed the spine), or if the treatment can be replicated and help other people with paralysis. For now, both Geoffrey Reisman as Pawel Tabakov are seeking funds to achieve operating OEC cells treatment in ten patients with spinal cord problems, before we can say whether his speech will always get stimulate the regeneration of this part of the body.


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Function of Vitamins

Alternatives for a diet rich in calcium

It is well known to all that cow's milk and dairy products are the best foods to provide us with calcium, because naturally contain vitamin D, essential for calcium absorption. But there are other foods that are capable of providing calcium such as vegetables, vegetables, legumes and fruits.

As a result, you can maintain a diet rich in calcium without resorting to dairy and given the problems that are emerging today because of multiple allergies and intolerances. Here we tell you which products are the best source of calcium , an essential element in a healthy and balanced diet.

Four key groups that we should focus are divided:

Vegetables: mainly include spinach, broccoli, cabbage, cabbage or onions.

Legumes: in this case chickpeas, lentils and soybeans.

Fruits: orange juice plus vitamin provide multiple benefits is a major source of calcium. We should also mention nuts, such as hazelnuts, almonds and walnuts among others.

Fish: in this group, sardines and squid are the two more calcium foods can give us.

Now we find it easier to develop a diet rich in calcium and prevent diseases caused by the lack or excess of this mineral in our bodies such as osteoporosis, decalcification, hypocalcemia, rickets in bones, stunted growth, among other conditions.

If you want to prevent these conditions or have symptoms of any of them, schedule an appointment by going to the Doc, on line platform that provides you with a medical directory with more than 20, 000 specialists who can schedule an appointment. With this service you can turn to a dietitian to help you plan a rich in calcium and according to your balanced diet.


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Do you admire your partner

Do not love who does not admire. Love without admiration is only friendship.

A relationship that is not only healthy but also gratifying, stimulating and enjoyable for its two protagonists involves a large dose of mutual admiration . While the basis of a good relationship is based largely on qualities that are proper to also friendly relationship (support, companionship, empathy, availability to the other, reciprocity) the truth is that the admiration and privacy They make the relationship is unique and genuine ; and satisfy desires and needs that no other relationship can satisfy. Intimacy and admiration become the couple in that special relationship that reaches dimensions of the person qualitatively different from other relationships.

The admiration may also represent the starting point of the relationship, the reason for the decision to pair it. Just admiring the other, recognizing him as different, special, mysterious and worthy of all our attention, initially born the couple .

Does this mean to cause admiration, therefore, indifference and threatening relationship?

You can not say that when you are just admiring the couple breaks up necessarily, because experience tells me that a couple can never be certain statements so emphatically and there are so many different types of couples and individuals in the world. However, the dissolution of the admiration is asymptomatic and usually involves a crisis that will end in rupture, or not, depending on how resuelv a.

Admiration to assume that at least one member of the couple ceases to feel unique, rare and valuable ; while the other passes to feel discouraged, and attracted little devoid of challenges . The relationship is as rewarding as expensive to maintain, and all those boosters that only the couple can provide longer exceptional to the recipient if the person who provides is not particularly valuable and therefore worthy of admiration.

What is a well understood admiration?

We might say that admiration is a well understood that it is not used to instrumentalize the relationship, unbalance or exercising on it a power struggle . Healthy admiration we talked a couple is supposed to reciprocal and both a motivation and an incentive for change and self-improvement. This kind of admiration allows the two partners will encourage and learn from the other, plus it involves multiplying the strengths that together, as a team possess. Admiration for the other reflects the immense value is given as "irreplaceable partner" , so that one does not need to the couple as a concept but this couple in particular.

In addition, this kind of admiration that I mean strengthens and strengthens the couple as it makes us put on the other the same dose of admiration that we place ourselves in pride; as if, somehow, the positive qualities of the couple also speak positively about ourselves, we have had the good sense to choose it.


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Young Revolutionizing Health

Innovative projects that improve health through social entrepreneurship

Ashoka and Boehringer Ingelheim reward 10 innovative health projects led by young people between 16 and 24 years

It is often said that young people are more creative than the other strata of the population because its critical nature allows them to question all existing and create from there, innovative solutions to all kinds of problems. Proof of this is the list of the ten winning projects this year Making More Health Challenge.

Making More Health is a global initiative created by Ashoka and Boehringer Ingelheim, in which support innovative projects that contribute to improving the health of individuals and communities, thanks to social entrepreneurs and young talents between 16 and 24 years. The alliance wants to achieve change through innovative entrepreneurs who provide health projects to society.

The winning projects this year are:

Being Inclusive: inclusive is an alternative fashion created by Nerea Mayoral, 24, to fight for visible and standardize heterogeneous body image combining fashion and psychology of appearance.

Dexinde: is a project of inclusive sport where children with and without disabilities live experiences through the sport, creating healthy habits and improving their quality of life. Cecilia Monroy is 24 and leads the project from the sports team of the same.

The other side: with only 16 years, Irene Rodriguez is developing the project 'The other side', in order to make the oppressed theater workshops for families of patients with schizophrenia and give them the opportunity to express their feelings and problems, helping to improve family relationships.

HealthEye: created by Jonathan Hurtado, 22, is the social network to connect people with the same rare disease. In HealthEye you can connect with people with similar problems, answer questions with medical specialists and discover all available resources on the disease.

Immunity: is a board game that revolves around the immune system and infections, also associated with an educational web platform aimed at teaching in schools and health institutions. Victor Pereira, 24, is the scientific coordinator - teacher project, which has a team of 7 people.

Lazaret: Alejandro Bass, 24, directs Lazaret, a device for blind people, which collects information from the environment by a camera placed in a cap or collar and translated by vibrations in the back of a shirt tailored.

Mottivapp: is an application that helps the user to pursue the achievement of their goals and dreams, making their way towards excellence. Cristina Massip, 22 years old, is currently in the process of turning this idea into reality.

Music Awakening: listening music with headphones life improves the lives of people with Alzheimer's and other dementias, reducing behavioral disorders, and reducing the use of drugs. Maria Olmedo is 22 and working on this project with his brother and other health professionals in Cájar, Granada.

Break the silence: Carla Herrero, 19, created 'Break the Silence' in order to support and give hope to young people with psychological disorders or abuse, and in turn, connect them with treatment and recovery.

Vital Signs: is a wireless device for people suffering from cardiovascular disease with a more comfortable and secure life. The device records the heart's activity and detect abnormalities and stroke with 4 hours in advance. Jose Manuel Romero is 23 and is the production manager of this project led by two younger.


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TEN TIPS FOR IMPROVING SEXUALITY

According to the expert and member of the Association of Specialists in Sexology  these are the steps you should take a woman who claims to have some form of sexual dysfunction and is interested not only overcome, but enrich this area health

1. standardize the concept of masturbation to demystify and remove guilt or shame. For this you should consult a specialist in sexology.

2. Promote a space of one's privacy. It is advisable to devote some time alone, without haste or concerns.

3. Know the genital anatomy and its functions. This, through self-examination that allows viewing the genitals. For this you can use a mirror.

4 .sexual self-stimulation, with the aim of obtaining pleasure and achieve orgasm. You can follow the steps outlined in the book "Technical training masturbation" of

Lobitz and LoPicolo, but always guided by a specialist in sexology, which serves the psychological and emotional aspect of dysfunction and the times and adapt to the

exercises physical characteristics and psychological needs of each woman.

5. Encourage sexual fantasies, through movies and erotic readings.

6.  Use appropriate toys and lubricants obtained in specialist shops.

7.  Involve the couple, showing how women masturbate, and encourages sexual fantasy, self-confidence in itself, and complicity.

8.  Want to be desired. Let love each by itself and enjoy it, doing the pleasurable feelings obtained with orgasm masturbatory practices, in order to fully incorporate

aware.

9. Yielding to curiosity and expand pleasant experiences, to new forms of stimulation, without shame.

10. self-appraise the body as the most precious and valuable thing you have.

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Female intimacy much to learn

In the past 40 years several US studies have shown that women suffer more sexual dysfunction than men. A named research entitled "The frequency of sexual dysfunction in normal couples" (1978), Frank E. specialists, C. Anderson and D. Rubinstein, established a prevalence of sexual problems in couples, 40% for males and 60% for women.

Other doctors like David Nathan, who during the eighties evaluated the frequency with which these complexities in couples present, placed the issue between 1 to 15% in men and from 1 to 35% in women.

HIGHEST NUMBER OF MEN dysfunctions

Meanwhile, in 1990, Carey MP IP Spector and found a prevalence of 4 to 10% of the population, and at the end of the decade, Laumann EO, Paik and RC A. Rosen set a precedence of 31% for men and 43% for women, according to the Guide to Good Clinical Practice in sexual dysfunctions the Ministry of Health of Spain, published in 2004.

For the psychologist and member of the Spanish organization Actio-Applied Psychology, Raquel De Laorden, these figures are far from the current. According to the specialist, "43% of women experience some sexual disorder, 35% of men."

However, many females still do not know this reality. Mistakenly believe that the malfunctioning of this type only affect the male population. As happened to Rosario Gomez, a 25-year-old who says Efe that after appoint some sexual dysfunction, was "unknown" and states that "thought that this problem only happens to men."

Words such as vaginismus, involuntary constriction of the muscles of women to attempt intercourse, or dyspareunia genitals, recurrent genital pain associated with sexual intercourse, are still alien to many women. "The lack of knowledge about such issues enables these disturbances occur," according to comments the medical and member of the Association of Specialists in Sexology, Ana Belen Romero.

However, in 2012 this women's issues resonated strongly in the media when it appeared a survey by the University of Chicago (USA) and was published in the Journal of the American Medical Association in 1999. The study concluded that the prevalence of sexual dysfunction is higher in the female population than the male, and specified that "43% of women being 18 and 59 have experienced some form of sexual dysfunction throughout their lives."

This survey, however, went further and managed to find out what kind of sexual disorders were more common in the female population. The result: 21% of women between 18 and 29 years claimed that he suffered any pain during intercourse, while 27% speak of "unpleasant" experiences.

In this vein, the Department of Urology and Psychiatry at the University of California (USA), said "nearly 40% of women have never sought treatment or assistance" to these problems.

DISCLAIMER YOUR BODY

Why the female population continues hiding this kind of dysfunction when it is established that sexual health is an integral part of human life ?.

For example, there is a scene from the American TV series "Orange Is the New Black", illustrating the reason for this difficulty. In the middle of a conversation, one of the prison realizes how little he knows his genitals. You do not know your true appearance, or how they work, which leads her to investigate her private parts with the help of a mirror.

Here, if it is part of the fiction, it is more common than it seems. Of Laorden notes that "many women are unaware of their own body and genitals, specifically the function of the clitoris."

What, then, young women who have never had sex out of fear or misinformation? Or with those who do not yet have adequate sex education and also tend to associate this practice with guilt? Are they more likely to have a sexual disorder related to pain ?.

For medical and sexual health specialist Ana Belen Romero, "these disorders are related to the psychological aspect and can arise even during the first sexual relations."

These problems are due to factors such as fear of intimacy, coupled with the fear of rejection by the couple, inadequate education and the association of sex with immorality or guilt, and the role of women in sex, where it prevails the idea of satisfying the man, according to Efe De Laorden. Romero insists that such ideas still "weigh heavily on our culture and should be demystified." It draws attention, for example, on the design of female masturbation. He says, "is still a complete taboo in our society."

Against this, the psychologist and sexologist Cristina Martínez, adviser to the Spanish Association for Sexual Health, notes that "women, unlike men, do not dare to live naturally masturbation and that creates a great lack of their sexuality ".

Martinez also said that "women usually are used to be the man who discovers his own pleasure without having to herself and this is because many have never explored their genital area, which generates an occult or biggest taboo in women than in men. "

In sum, according to Romero, "to avoid sexual problems women should be in the hands of an expert to help you resolve these dysfunctions and, once found together where the problem is, your sex life may favor the auto-eroticism".

This, in short, "allows you to discard fears, taboos and shame, because the knowledge base of the female body is also essential to avoid sexual disorder.

It is true that if a woman does not even know his anatomy, if you do not know what their hot spots, or what touch can make you orgasm, can hardly talk to your partner and know what you really like, "says Romero.

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