| 00:00 | Here, we down here is an of, of, of really not |
|
| 00:05 | uh because we all been on antibiotics one time or another. And you |
|
| 00:09 | , it was typically a 10 day course of antibiotics don't stop premature. |
|
| 00:16 | , uh on penicillin for strep throat , uh takes a couple of |
|
| 00:22 | uh feels good and stops. So after three more days suffers a |
|
| 00:27 | like, well, I'm not surprised you, you, you didn't, |
|
| 00:32 | the whole course, you didn't knock out sufficiently enough. So you had |
|
| 00:36 | that still survived. Now, now no more antibiotic coming in, the |
|
| 00:41 | pressure is off and now they can to proliferate again. Hence coming down |
|
| 00:47 | a relapse. Ok. So certainly of antibiotics contributes to, to |
|
| 00:55 | And so this what we want to the whole of this out here. |
|
| 00:58 | . So, um the, you , when we consider the whole |
|
| 01:04 | um there's lots of part, large of the world doesn't um you don't |
|
| 01:12 | a prescription to get antibiotics number Ok. It's not just antibiotics are |
|
| 01:17 | out there. Willy nilly, people using them for, for whatever |
|
| 01:21 | especially if they have a viral Nobody takes the time to figure |
|
| 01:26 | Ok. Is it a viral infection not? Um, let's just give |
|
| 01:30 | . Right. So, kind of shotgun approach. And so, |
|
| 01:33 | here in the US, uh, go to the, er, |
|
| 01:38 | it's full of people. Right. . You know, there's limited personnel |
|
| 01:43 | there. Uh, are you gonna the time to do a sample |
|
| 01:46 | and isolate the bacterium and figure out it's actually resistant to. Maybe, |
|
| 01:52 | , maybe no. The the solution throw antibiotics and one of them will |
|
| 01:58 | . Ok. So broad spectrum, ? And so it, it will |
|
| 02:02 | what you got. OK. So kind of approach is of course, |
|
| 02:06 | a good one. Ok? Um not probably even more problematic is the |
|
| 02:14 | of antibiotics in animals, right? the foods we eat. Ok. |
|
| 02:21 | antibiotic use uh in that in, animal farming is to um so other |
|
| 02:30 | , one, the the big money is to um rep amateur produce, |
|
| 02:38 | babies and then they grow up, become part of the engine that feeds |
|
| 02:43 | process. So uh antibiotics use for is to increase survival of young, |
|
| 02:51 | up. Also many places are gonna , especially with chicken farm is |
|
| 02:56 | those conditions, right? You get spread. So you gotta put antibiotics |
|
| 03:03 | a situation like that uh or large of, of life. OK. |
|
| 03:10 | of course, is money. Tends to be the bottom line. |
|
| 03:15 | uh so there are all kinds of . Uh You can, you |
|
| 03:18 | you can analyze, uh I saw of analyzing wastewater, the amount of |
|
| 03:23 | and wastewater would blow your mind. all of these antibiotic everywhere um is |
|
| 03:32 | contributes to this heavily, right? you're just providing the selective pressure for |
|
| 03:37 | things to proliferate. OK. So and not to mention an example shown |
|
| 03:44 | , state of course random box, though you feel good um don't use |
|
| 03:48 | else's prescription, you don't know what for. OK. Um So uh |
|
| 03:55 | know, these, it is a because the bottom line is, excuse |
|
| 04:00 | , let me just do this real . Um is to, you don't |
|
| 04:06 | to uh give the opportunity for uh . You don't want to give the |
|
| 04:14 | for pa for um resistant type right? And these are all providing |
|
| 04:20 | for that to happen. OK. um what's the solution? Well, |
|
| 04:28 | I said, if you're a doctor in the er and you have a |
|
| 04:31 | of patients, what are you gonna ? Are you gonna see her? |
|
| 04:35 | know that a rapid ID testing can in, right? Just say |
|
| 04:38 | here's what we want, maybe we , maybe, you know, do |
|
| 04:42 | full isolation which can take two or days, but you get a rapid |
|
| 04:47 | , at least that's better than doing . OK. Then just do the |
|
| 04:51 | approach. Ok. So, you , it's, it's, uh, |
|
| 04:55 | something that has to be dealt But, um, uh, it |
|
| 04:59 | is, you know, in terms antibiotic, use of the animals and |
|
| 05:02 | like that. But, you it's, it's, it's a problem |
|
| 05:05 | it will continue to be a which means we have to keep trying |
|
| 05:08 | find you into that and that's typically , done through taking what we have |
|
| 05:14 | and chemically modifying to kind of slightly them somewhat. OK. Um |
|
| 05:20 | so uh those of you that will in this arena, which will be |
|
| 05:24 | of you, you will be facing on a daily basis. Um Any |
|
| 05:30 | about that. So um combining OK. Uh is, is a |
|
| 05:38 | thing to do because you can kind take advantage of different properties of two |
|
| 05:44 | antibiotics and they work better together, would be a synergistic effect. Uh |
|
| 05:48 | sometimes the choices you can make a choice and the two sometimes don't work |
|
| 05:54 | very well. OK. So a effect of course, would be one |
|
| 05:59 | uh they were better better together than do a lot. OK. And |
|
| 06:04 | this example here. Um so this uh uh that disc diffusion method. |
|
| 06:12 | what you do is you have this is obviously just a small |
|
| 06:16 | uh picture of a larger plate. . And you would have a lot |
|
| 06:22 | bacteria on the bottom, right? you put your discs of antibiotic on |
|
| 06:27 | and then you see, OK. I seeing, am I not seeing |
|
| 06:32 | in the presence of antibiotics? Remember the antibiotics gonna diffuse out right in |
|
| 06:37 | surrounding um me? OK. And the resistance of the bacteria or sensitivity |
|
| 06:46 | the bacteria, it correlates to the clear zone, right? So that |
|
| 06:52 | course, is this zone is a of no, no gross. |
|
| 07:00 | So the bacteria are sensitive to them much more. So when you |
|
| 07:05 | because the the zone here is a of both and back of this |
|
| 07:11 | three antibiotics in this area here because diffuse together in that, in that |
|
| 07:16 | . Uh back here, for is a small zone. So |
|
| 07:21 | it's not as good by itself, ? Or here by itself but together |
|
| 07:27 | see this big zone. So that's of an idea that OK, this |
|
| 07:30 | working well together, OK. Um antibiotics uh that bon acid is |
|
| 07:40 | it's one that is a um beta. So beta lactamase is the |
|
| 07:48 | bugs enzyme that will chew up the . OK. So clonic acid actually |
|
| 07:58 | that and actually will chew up that that metal laase. OK. So |
|
| 08:03 | leaves something like amoxicillin and as Tron those are both work on the cell |
|
| 08:11 | synthesis inhibiting cell wall synthesis. So that that now alleviates so they these |
|
| 08:18 | can do their job and work on cell synthesis because it's being left alone |
|
| 08:24 | the beta lactamase that the pathogen might to chew them up. And so |
|
| 08:30 | clonic acid works on that guy and that one away and these guys can |
|
| 08:34 | their thing. So that's kind of , that's a synergistic effect. |
|
| 08:38 | Um Streptomycin and penicillin. So put on again. So, w synthesis |
|
| 08:46 | , right? And so it by that action, it actually makes the |
|
| 08:54 | easier to get into the cell. works inside the cell protein synthesis. |
|
| 09:00 | um so it makes it easier for to get in by penicillin doing its |
|
| 09:04 | kind of weakening the cell wall and it up. So that and the |
|
| 09:10 | and getting in so that too would synergistic. OK? Now these two |
|
| 09:16 | , are working against each other. this is an example of uh this |
|
| 09:24 | is bacterial static. OK? And it'll stop growth. OK? This |
|
| 09:34 | penicillin again, right? So all , but it's gonna be most effective |
|
| 09:41 | bacteria that are fast growing, So, so that definitely counteracting each |
|
| 09:46 | . You have one drug that's stopping , one drug that works best when |
|
| 09:51 | are actively growing. So that's So that would be a um antagonistic |
|
| 09:59 | . OK. So uh but it's common to have, this is a |
|
| 10:03 | combo to have or especially this with with, with, with one of |
|
| 10:09 | solo synthesis type of that. Um That any question? OK. |
|
| 10:18 | um now maybe this here, this an easy one. So actually, |
|
| 10:25 | you were in lab, you did that this week. OK. So |
|
| 10:29 | , here's this diffusion method. So get to see the whole plate, |
|
| 10:33 | this picture, you see the whole here. OK. And so uh |
|
| 10:39 | see, we have a recurring ut infection urine have performed this diffusion |
|
| 10:43 | OK. So the patient's sample, . And the zones of inhibition. |
|
| 10:49 | remember you're measuring across this diameter OK. So, and you can |
|
| 10:56 | different levels of resistance to being fully , fully sensitive or somewhere in the |
|
| 11:02 | . OK. So that data, don't think it's hard to pick out |
|
| 11:06 | you're gonna pick one even though it not be super great. Um It's |
|
| 11:13 | best of these four. OK. Which one is that with someone like |
|
| 11:22 | ? So you're only gone, you're nurse and here's a 60 year old |
|
| 11:26 | . What if you can tell her to take? What are you gonna |
|
| 11:28 | ? Take, take, take, , take, you gonna die, |
|
| 11:32 | know, I'm good or something. second. Which one? Right? |
|
| 11:40 | course. All right. It's not great. You'd like it to be |
|
| 11:44 | more in this range, but it's be in that range. OK. |
|
| 11:50 | . So if that's all you Well, that's certainly what you're gonna |
|
| 11:54 | because all the other ones are certainly the resistant range, right? These |
|
| 11:59 | . Ok. So, um, know, but, but, |
|
| 12:05 | uh, again another, uh, why, you know, pick a |
|
| 12:11 | spectrum, not, not a pro , uh, antic, uh, |
|
| 12:17 | do a test like this, you , to, to narrow down force |
|
| 12:20 | least and not just throw everything, throw the whole kitchen sink in |
|
| 12:25 | So, um, I think yeah, so this concludes chapter |
|
| 12:31 | So we'll get into a little bit diseases. Um So, but I |
|
| 12:37 | set uh first is uh I you know, read the pages here |
|
| 12:44 | terms of the diseases to be cut. So, um and so |
|
| 12:49 | this list here. This is, have two lists. One is kind |
|
| 12:53 | by system, body system because that's your book, that's how most books |
|
| 13:00 | , set this topic up. And these are particular strains and how they |
|
| 13:06 | to each body system. OK? you basically have at least one example |
|
| 13:11 | every one of these. OK. again, the point here is that |
|
| 13:15 | chapter on the genital urinary system has than one. OK. So you're |
|
| 13:21 | , but you only have to worry one. OK? And same for |
|
| 13:24 | example. OK. The next part this is that the list, |
|
| 13:31 | So it has both bacteria, it viruses, it has a few um |
|
| 13:40 | . OK? And what to All right. So grand thing or |
|
| 13:46 | fits all right, we can do grand stand on the protozoan. Uh |
|
| 13:50 | morphology um is it cox I rod a change uh disease caused? That's |
|
| 13:58 | no brainer, a distinguishing feature. I try to pick diseases that actually |
|
| 14:03 | have at least the most of they kind of distinguishing features to |
|
| 14:06 | OK. Um For example, like the steria, that one, that's |
|
| 14:12 | only one that actually grows at refrigeration . That's an example. OK. |
|
| 14:19 | OK. So one strategy you might is something like this. OK? |
|
| 14:24 | have some kind of a table and can do an Excel spreadsheet, what |
|
| 14:28 | you and I have a list that can think of another column or |
|
| 14:36 | right? So maybe something like uh you have a column that hands |
|
| 14:41 | maybe don't remember the source of infection reservoir. OK? Is one you |
|
| 14:51 | think of something else, but it's trying to, you know, |
|
| 14:55 | have a document that kind of has all spelled out for you. And |
|
| 15:00 | just do examples of different features OK. So, you know, |
|
| 15:05 | is to be honest, the the to 26 and diseases is heavily, |
|
| 15:10 | know, just kind of looking it and over repetition. OK. If |
|
| 15:14 | have it all spelled out for you this, then uh it makes it |
|
| 15:19 | . Uh And also if you think um connections between these OK. So |
|
| 15:25 | , each disease pathogen is its right? But there may be |
|
| 15:31 | So example, here is reservoirs actually because a number of the diseases, |
|
| 15:36 | reservoir is a human, right? that might be good to know. |
|
| 15:42 | . So, and I'll, I'll these out as we go through. |
|
| 15:46 | . So um so we start let's just go ahead and answer this |
|
| 15:53 | . We start with um skin and tissue infections. And uh that is |
|
| 16:02 | ? Of course, that and strep all about. OK. Um |
|
| 16:34 | Counting down. Let's see. So if you answered uh the one that's |
|
| 16:50 | is shingles. Shingles is due to smallpox uh chickenpox, sorry chickenpox virus |
|
| 16:59 | shingles. Uh All the other ones correct. OK. So, um |
|
| 17:09 | and actually the shingles uh small uh virus is also part of the skin |
|
| 17:13 | small uh and soft tissue infection. all, all of those are part |
|
| 17:18 | check. Yeah. So, uh Caucus. Uh the one to worry |
|
| 17:24 | here in terms of pathogen is uh , step of aureus, epidermitis. |
|
| 17:30 | is a very common skin inhabitant. . Um Kind of forms kind of |
|
| 17:35 | colonies. If you did the um you had a lab, you did |
|
| 17:39 | , that experiment where you were uh putting your fingers on the auger or |
|
| 17:44 | or whatever it was, you it depends, see what they're |
|
| 17:47 | see what's in the lab that will in your hands. You probably got |
|
| 17:51 | yellow colonies like we um uh epidermitis epidermis. Uh It can uh it |
|
| 18:00 | cause some infections, uh contaminated Uh The infections with it aren't nearly |
|
| 18:07 | serious as they are with staphylococcus Ok. So remember the coagulase uh |
|
| 18:13 | , right? That's that rare factor staff particularly staph aureus have um where |
|
| 18:19 | is positive. They can uh they form blood clots kind of surround themselves |
|
| 18:23 | that, with that fibrous material clot kind of uh form a cocoon, |
|
| 18:30 | to speak, um hiding themselves from immune system. The uh uh so |
|
| 18:37 | grow factors. Uh we've talked about before. So they have a broad |
|
| 18:41 | toxins. Uh they can resist they have a way to, to |
|
| 18:47 | destroy uh antibodies. Uh So remember um the protein protein A, |
|
| 18:54 | So we can actually take the antibody neutralize it, so to speak. |
|
| 18:58 | So it's not effective against it. Resistance. Uh There's uh there are |
|
| 19:05 | major antibiotic resistance forms, the MRS and BRS A. Um And so |
|
| 19:11 | course, they are gram positive. very nice that's Dey Cos. Um |
|
| 19:19 | so the uh these are typically opportunistic . So they, they staph auras |
|
| 19:26 | typically on your membranes, particular your . Ok. Um It can be |
|
| 19:31 | your skin somewhat but they uh really cause an issue if they typically do |
|
| 19:37 | puncture wound or a scratch, uh through like hair fossils, uh openings |
|
| 19:43 | the skin they can get there. and then the things that can cause |
|
| 19:48 | different types of skin infections. And just only showing this for informational |
|
| 19:53 | This one here, different types So any kind of rash, right |
|
| 20:01 | be caused by so many different right? Both microbial and nonmicrobial, |
|
| 20:06 | ? Allergens can cause a rash. um there and there is this is |
|
| 20:11 | , I didn't realize there were so different types. I was in a |
|
| 20:14 | office, actually very sweet and um a chart and there's like 1215 different |
|
| 20:24 | of, of, of these um and so characterized by again, don |
|
| 20:31 | notice. But uh all these things see uh are fluid filled. So |
|
| 20:37 | if you had chickenpox, you get of these crusty uh pustules that filled |
|
| 20:43 | fluid or pus, et cetera. are not so much macular rash, |
|
| 20:48 | is more different. So, I , before here, just, just |
|
| 20:52 | skin infections and non skin infections cause different types of eruptions on the |
|
| 20:58 | Ok. Um Now, back to different types of skin infections. |
|
| 21:05 | um so Cicis um again, these kind of when they infect the hair |
|
| 21:11 | , whether it's on the um on skin or uh your eyelashes, that's |
|
| 21:16 | the ST is. Uh car uh fewer bundles of boiling part for |
|
| 21:23 | with that maybe um is a form the heart. Not, uh, |
|
| 21:27 | , uh that's that action of that the staph. Um, it's typically |
|
| 21:32 | to be punctured and then you have drain it to, to treat |
|
| 21:37 | Um, impetigo is a uh superficial of uh skin infection creating these kind |
|
| 21:46 | crusty sores. Ok. Uh, common little kids. Uh, auto |
|
| 21:52 | inoculation is kind of when you it can spread it. Ok. |
|
| 21:56 | what auto inoculation is. And you , little kids aren't always the cleanest |
|
| 22:01 | , right? Running around doing And uh they can, it's very |
|
| 22:06 | for them to, to have you know, 678 years old, |
|
| 22:11 | nothing serious but um it uh certainly . Uh And so as we go |
|
| 22:17 | staff and strep, you know, the the skin infection types differ in |
|
| 22:25 | of how deep they get, So you can have superficial layers like |
|
| 22:30 | , but then you can get into what's called E recip, which is |
|
| 22:35 | a little bit below that then like fasciitis, which is a flesh eating |
|
| 22:40 | . And that now you're getting our to the bone, you can get |
|
| 22:43 | as bad. And that all relates the I'm sorry. Uh Yeah. |
|
| 22:51 | and skull and skin syndrome is one those is also very superficial layers. |
|
| 22:55 | and that can be caused by a all these kind of skin infections can |
|
| 23:00 | caused by an initial scratch that maybe quickly treated or something and it kind |
|
| 23:05 | builds a little bit. Um the and skin kind of produces um the |
|
| 23:11 | layers are kind of split apart by enzymes and toxins that the staff has |
|
| 23:18 | creates kind of like a blistering type effect that you see there. Um |
|
| 23:24 | if we go as we go into strep, OK. Streptococcus of |
|
| 23:30 | gonna positive again, but chain So here, here you see strep |
|
| 23:35 | um uh that can produce rash. This would be uh I think it |
|
| 23:41 | called a fever. There's a bright rash. Um This is a necro |
|
| 23:46 | of fasciitis. You can see exposure bone here. OK. So now |
|
| 23:50 | talking about really, in fact, turn apart layers of tissue. |
|
| 23:57 | So um and so with gram but streptococcus, OK. So they are |
|
| 24:04 | classified and this is on a historical through their growth pattern, a reaction |
|
| 24:12 | the blood A OK. And that's you see here. So, and |
|
| 24:18 | was real cute about this and and they struck the theyre out the |
|
| 24:24 | according to their particular designation, So you have alpha strep beta, |
|
| 24:31 | ? And then gamma. OK. the uh beta, he uh I'm |
|
| 24:37 | , alpha hemolysis, which is you should, you can't spread in |
|
| 24:41 | way. You see a definite clear with the beta. That's, that's |
|
| 24:45 | beta Mses literally clear all around the the loss is partial sis but if |
|
| 24:55 | character the dark green color, the , OK. That's due to the |
|
| 25:00 | of the hemoglobin change the color. . So our red blood cells are |
|
| 25:04 | of hemoglobin. OK. Um Beta is complete clearing. Uh The historical |
|
| 25:11 | for this is what's called um uh uh group A strep. OK. |
|
| 25:18 | , Pyogenes, pyogenes is a cause a lot of different type of skin |
|
| 25:22 | , strep throat, uh necrotizing uh very syphilis, another type of |
|
| 25:29 | infection. Um it's called a So a number of different types, |
|
| 25:35 | your g hemolysis shows no hemolysis. . No re greening of your blood |
|
| 25:42 | or clearing. Um but it doesn't there's not pathogens in the group because |
|
| 25:48 | are pathogens among enterococcus. That's typically shows that kind of pattern. |
|
| 25:54 | So collectively you can look at these this way, right? So each |
|
| 25:59 | and so a suspected strep infection, is what you do. You put |
|
| 26:06 | on blood ar and you see what of pattern or am I seeing |
|
| 26:10 | Is it alpha beta gamma? Because know that each group is a thicker |
|
| 26:17 | . Ok. So this beer dance kind of a historical name assigned to |
|
| 26:22 | , to this subgroup mutans. These uh tooth infections, uh dental caries |
|
| 26:28 | basically uh uh tooth, uh the decay, uh plaque to form biofilms |
|
| 26:35 | your teeth, that kind of sticky you might feel in the morning, |
|
| 26:39 | feel that plaque, uh of that's due to a biofilm. |
|
| 26:43 | Endocarditis. So this is a uh talk about it later but it, |
|
| 26:48 | relates to that. New cancer is common uh bacterium you see in your |
|
| 26:54 | . Ok. So the problems that occur is if you have like a |
|
| 26:58 | procedure, like a root canal, a tooth pull, right? These |
|
| 27:03 | opportunities for where the bacteria in your actually get into your system, |
|
| 27:08 | Which is why if you have one those procedures, you always are given |
|
| 27:11 | bunch of antibiotics typically. Um but can get in there and cause uh |
|
| 27:16 | into your body and cause issues. is one of those, it's an |
|
| 27:20 | of the lining of the heart. streptococcus ammonia. Ok. This |
|
| 27:28 | this is one we'll talk about later the context of respiratory infections because it's |
|
| 27:33 | number one cause of pneumonia. Um Beyond behind v viral pneumonia are |
|
| 27:42 | more common, but this is the one right behind it. Uh uh |
|
| 27:48 | . So uh mening, it can progress from pneumonia to meningitis as |
|
| 27:52 | Ok. And so um the pyogenes course, is the beta hemolytic number |
|
| 27:59 | different diseases it causes and then heus cause uh gastrointestinal type infection. So |
|
| 28:07 | kind of different from the other ones are skin infection, respiratory. This |
|
| 28:11 | can cause issues in the gut. . Um So the uh uh viral |
|
| 28:19 | . So we talked about these So remember the M protein is one |
|
| 28:22 | is multifunctional, it can bind uh a binding function to cells. So |
|
| 28:29 | a streptococcus pneumonia has this. So pyogenes um but it allows them to |
|
| 28:35 | to yourselves. OK. But it has this activity of inactivated, complement |
|
| 28:42 | immune system defenses and can um also um pegs. OK. So um |
|
| 28:51 | you can uh in the absence of , you can prevent phagocytosis, but |
|
| 28:57 | can form antibodies to it and then will help with the optimization. Remember |
|
| 29:02 | ? OK. Um The other interesting here is that it can have a |
|
| 29:08 | of Hyaluronic acid. OK? So you remember your cells, right, |
|
| 29:16 | cells are stuck together by hyaluronic acid and stick them together and you stick |
|
| 29:24 | top of a foundation of college So if you're making a capsule of |
|
| 29:31 | acid, your body thinks it's part your own system, right? Because |
|
| 29:37 | body used to think Hyaluronic acid, what holds your cells together. So |
|
| 29:41 | we have a bacteria that has a in it. So that's gonna make |
|
| 29:45 | appear kind of invisible to uh from body's immune system because it thinks it's |
|
| 29:51 | component of your own body, Having Hyaluronic acid cat, that's |
|
| 29:55 | very sneaky. OK? And then course, it also has hyaluronidase, |
|
| 30:02 | ? So remember hyaluronidase collagen a, are things that enable to get into |
|
| 30:07 | layers of your skin. Ok. so, from superficial to deeper and |
|
| 30:13 | uh sort of kinase is a thing uh can uh that can destroy a |
|
| 30:18 | clot, right. So now it be intrigued that way. Um So |
|
| 30:22 | has a variety of different uh r and so rheumatic fever. So, |
|
| 30:28 | course, we wear a strep throat actually different skin infections can actually begin |
|
| 30:35 | many cases with strep throat and then then it progresses from there to something |
|
| 30:41 | little more serious. Ok. So fever is the result of you producing |
|
| 30:50 | to these and protein, right? you have a, you have a |
|
| 30:54 | infection, there's antibodies to this, ? And the antibodies do work on |
|
| 31:00 | , right? Promoting optimization. But antibodies, apparently there's a similarity between |
|
| 31:06 | m proteins and your um uh heart proteins that similarity structure. So anybody |
|
| 31:15 | produce to this can you can also on the cardiac tissue. And so |
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| 31:21 | what rheumatic fever is as a result that. So this term here is |
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| 31:26 | . Ok. So what we call secondary immune response, the primary one |
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| 31:31 | you forming antibodies to the end The secondary part is those antibodies now |
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| 31:39 | acting on your cardiac tissue, causing inflammation and you know, it |
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| 31:44 | be serious, you can end up heart fail. So uh but |
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| 31:48 | that's what rheumatic fever is, they one of these secondary cross reactions with |
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| 31:54 | box to your own tissues. Uh you're a syphilis. So this is |
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| 32:00 | it's like we saw with staff and uh like the skull skin syndrome or |
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| 32:07 | , these are upper more superficial layers skin. Now, as we get |
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| 32:13 | AYS, now we're getting deeper and necrotic fasciitis even more. So. |
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| 32:17 | . And the ability to do that on, you know, the presence |
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| 32:20 | these, how you run a how you run a ase enzymes, |
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| 32:24 | ase uh various toxins that enable uh to occur. And so, um |
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| 32:32 | the thermal layer is uh is below official layer um shown. Oh |
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| 32:38 | Here, this is the top one the uh uh AY. OK. |
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| 32:46 | then uh and so the red color come out from uh inflammation uh |
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| 32:52 | destroying capillaries. And so the blood . And so she give me a |
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| 32:59 | color, but certainly the necros fascy is a, is certainly a step |
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| 33:05 | a above that. And so now getting into deeper into tissues, you |
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| 33:10 | the bone, um toxins being killing cells. And so this will |
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| 33:15 | a rapid treatment in terms of cutting that dead tissue. Ok. And |
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| 33:20 | can get it worse as you may to amputate a limb to, to |
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| 33:24 | sort of survive this. Ok. it, it can spread very |
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| 33:29 | So um that is, let's Ok. Um, so that's Staph |
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| 33:38 | strep. Ok. So the last of the skin infections and, and |
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| 33:43 | tissue infections is the shingles virus. . Or chickenpox. Ok. It |
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| 33:47 | out as chickenpox. So this is uh what's called herpes virus. |
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| 33:55 | Zoster, I think the more common nowadays is, is human, um |
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| 34:00 | virus, they call it hhhhb. think it's not the more common term |
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| 34:06 | for human herpes virus. And so it's acquired uh it is, you |
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| 34:12 | , of course, chicken pox is most of us have as a |
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| 34:15 | right? Your rash, ok. in the rash, uh so pustules |
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| 34:20 | have fluid in those uh bumps, to speak, understand and that act |
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| 34:26 | virus. Uh So what happens is typically it's, it's acquired through inhalation |
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| 34:32 | then after about a couple of it kind of settles into the virus |
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| 34:36 | into your skin cells and that's where rash that pops up. Ok? |
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| 34:40 | so chickenpox is, there's nothing that's fatal usually. Ok, except |
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| 34:45 | extreme cases. But uh it does a rash that you get over with |
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| 34:50 | symptoms typically. But then it it persist in the body. So the |
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| 34:54 | infection, right? So we can travel in your peripheral nerves which are |
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| 34:58 | the surface and then into your uh nervous system. Ok. It's actually |
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| 35:05 | , the DNA of the virus is persists in these um neurons. |
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| 35:11 | And so as a chickenpox form, has its characteristic bumps on the |
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| 35:18 | right? Um But later on, can reappear. So it's basically the |
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| 35:24 | virus is just appearing in a different . OK. Um And this, |
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| 35:29 | course, this transition can be The signals is a condition of older |
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| 35:36 | , my age, not, not people. OK. Um And so |
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| 35:41 | , it's, it's like I it persists in the nerve cells uh |
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| 35:46 | is awakened, so to speak by or probably more typically, um as |
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| 35:52 | get older, the system doesn't work well. OK. And so that |
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| 35:56 | trigger an outbreak. OK. And outbreak typically occurs along nerves uh under |
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| 36:03 | skin, you have nerves, it's of, it follows the pattern of |
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| 36:08 | nerve you see, here's a major that's kind of right here uh across |
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| 36:13 | chest and side, that's what we here. And so it kind of |
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| 36:17 | it's following the pattern of the nerve it's kind of, and so it |
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| 36:22 | of comes out and erupts in those those parts uh of regions rather, |
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| 36:28 | it can create kind of a burning stinging sensation um and somewhat painful than |
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| 36:34 | others. But uh certainly it is , I'm sure. Um but there |
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| 36:39 | uh treatments. So, Acyclovir is we talked about last time and in |
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| 36:45 | context of antiviral drugs. So we the common ones for different types of |
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| 36:50 | viruses. Ok. Um So that prevents the uh production of nuclear |
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| 36:57 | in the virus. So we can't . Uh There is a vaccine, |
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| 37:01 | course, the vaccine is recommended for , my age, not young |
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| 37:06 | Uh If you've had chickenpox as a and you get shingles, typically the |
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| 37:13 | , you get outbreak is not as because you do have some resistance to |
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| 37:18 | . If you, if you overcome chickenpox as a kid, you still |
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| 37:22 | some of those that resistance left on fight, the, the shingles |
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| 37:27 | Uh, but you still typically have symptoms, but there's not that if |
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| 37:31 | haven't had uh chickenpox and then you it as an older person and it |
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| 37:37 | out of shingles and then those are where it may be severe, |
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| 37:40 | in terms of maybe possibly damage things that. Ok. So, |
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| 37:46 | again, so this is of the we talked about today, right? |
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| 37:51 | Stus Streptococcus. This is the one we're talking about today. Uh, |
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| 37:56 | crush it, ok. That is we're gonna do today. So we're |
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| 38:03 | continue, uh, keep going on systems. Ok? I think. |
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| 38:17 | , yeah, central nervous system next |
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