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Infectious Disease: Hepatitis

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Awareness of blood-borne infections and burden of occupational exposures to blood and body fluids among health care personnel in a tertiary care teaching hospital
Conclusion: Though majority of HCP had fair awareness of BBIs, it did not translate into adequate adherence to UPs and safe practices. High burden of OEs and their poor reporting emphasize the need to motivate our HCP to adhere to safe work practices and to promptly seek professional counselling after exposures. There is an urgent need to educate HCP about the availability and effectiveness of PEP for HIV and hepatitis B. A uniform national policy for prevention and reporting of OEs has to be framed.
Source: Indian Journal of Occupational and Environmental Medicine - March 28, 2017 Category: Occupational Health Authors: Swetharani KV Vinod Abdoul Hamide Tarun K Dutta KT Harichandrakumar Source Type: research

Travel Characteristics and Pretravel Health Care Among Pregnant or Breastfeeding U.S. Women Preparing for International Travel.
CONCLUSION: Most pregnant and breastfeeding travelers seen for pretravel health consultations traveled to destinations with high risk for vector-borne or other travel-related diseases. Destination-specific preventive interventions were frequently underused. PMID: 29112671 [PubMed - as supplied by publisher]
Source: Obstetrics and Gynecology - November 3, 2017 Category: OBGYN Authors: Hagmann SHF, Rao SR, LaRocque RC, Erskine S, Jentes ES, Walker AT, Barnett ED, Chen LH, Hamer DH, Ryan ET, Global TravEpiNet Consortium and the Boston Area Travel Medicine Network Tags: Obstet Gynecol Source Type: research

Critical flicker frequency is diagnostic of minimal hepatic encephalopathy
The objective of the study is to evaluate the accuracy of diagnosis of minimal hepatic encephalopathy with critical flicker frequency (CFF). The study was conducted on 180 patients with post hepatitis C liver cirrhosis and on 60 healthy subjects as control. Patients and controls were divided into four groups: group 1 (60), healthy individuals as a control group; group 2 (60), patients with liver cirrhosis (Child class A); group 3 (60), patients with liver cirrhosis (Child class B); and group 4 (60), patients with liver cirrhosis (Child class C). All participants were subjected to estimation of CFF, line drawing test, compl...
Source: Journal of Investigative Medicine - November 23, 2017 Category: Research Authors: Esmat, S., Garem, N. E., Raslan, H., Elfekki, M., Sleem, G. A. Tags: Original research Source Type: research

A More Precise Definition of Precision Medicine?
By DAVID SHAYWITZ, MD The appeal of precision medicine is the promise that we can understand disease with greater specificity and fashion treatments that are more individualized and more effective. A core tenet (or “central dogma,” as I wrote in 2015) of precision medicine is the idea that large disease categories – like type 2 diabetes – actually consist of multiple discernable subtypes, each with its own distinct characteristics and genetic drivers. As genetic and phenotypic research advances, the argument goes, diseases like “type 2 diabetes” will go the way of quaint descriptive diagnoses like “dropsy”...
Source: The Health Care Blog - November 28, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Broad Institute CAD Circulation Disease Categories Gimish Model of Disease Kathiresan Khera Massachussetts General Hospital Source Type: blogs

How 2016 Drug Spending Stacks Up
We have written many times about the way growth in drug spending has significantly been below the growth rate of overall national healthcare spending, despite the media spotlight on the issue. Total nominal United States health care spending increased at a rate of 4.3% and reached $3.3 trillion in 2016. Per capita spending on health care also increased by $354, totaling $10,348. Health spending growth did decelerate in 2016, however, following faster growth in 2014 and 2015 associated with coverage expansions under the Affordable Care Act and strong retail prescription drug spending growth. In 2016 the slowdown was broad...
Source: Policy and Medicine - January 4, 2018 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Lack of Correlation of Liver Tests With Fibrosis Stage at Diagnosis in Pediatric Primary Sclerosing Cholangitis
Conclusions:Pediatric PSC patients cared for at a regional referral center had relatively mild disease compared with previously published reports, with low MRCP stricture scores despite significant liver fibrosis. Liver tests at presentation did not correlate with MRCP stricture score or liver fibrosis stage, suggesting the need for future studies to identify potential biomarkers of disease severity. Objectives: The aims of this study were to characterize pediatric primary sclerosing cholangitis (PSC) at a regional referral-based institution, including scoring of biliary stricturing and liver fibrosis and correlation a...
Source: Journal of Pediatric Gastroenterology and Nutrition - January 23, 2018 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research

Willingness to care for blood-borne virus-infected patients in Thailand
ConclusionsAround 4 in 10 Thai nurses in our sample were unwilling to care for HIV- or HCV-infected patients. Minimizing the risk of nosocomial transmission and improving the public perception of infected individuals may help improve nurses ’ willingness to care for such patients, in Thailand or elsewhere.
Source: Occupational Medicine - March 5, 2018 Category: Respiratory Medicine Source Type: research

Occupational exposure during emergency department thoracotomy: A prospective, multi-institution study
CONCLUSIONS Our results suggest that the risk of occupational exposure should not deter providers from performing EDT. Despite the small risk of viral transmission, our data revealed practices that may place health care providers at unnecessary risk of occupational exposure. Regardless of the lifesaving nature of the procedure, improved universal precaution compliance with personal protective equipment is paramount and would further minimize occupational exposure risks during EDT. LEVEL OF EVIDENCE Therapeutic/care management study, level III.
Source: The Journal of Trauma: Injury, Infection, and Critical Care - July 1, 2018 Category: Orthopaedics Tags: 2018 EAST Podium Source Type: research

Spectrum of Pediatric Autoimmune Liver Disease and Validation of Its Diagnostic Scores in Indian Children
Conclusions: In Indian subcontinent, pediatric AILD subjects usually present with advanced hepatic disease, but may have a good outcome if timely therapy can be instituted. Associated autoimmune disorders should be carefully screened. There is no difference in the predictive value of the available diagnostic scores for pediatric AILD.
Source: Journal of Pediatric Gastroenterology and Nutrition - September 22, 2018 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research

Hepatitis B virus core protein dimer ‑dimer interface is critical for viral replication.
Hepatitis B virus core protein dimer‑dimer interface is critical for viral replication. Mol Med Rep. 2018 Nov 02;: Authors: Zheng CL, Fu YM, Xu ZX, Zou Y, Deng K Abstract Hepatitis B virus (HBV) core protein (HBc) serves pivotal roles in the viral life cycle, particularly serving as the basic unit for capsid assembly, and is closely associated with HBV genome replication and progeny virion production. Previous studies have demonstrated that HBc has at least two functional interfaces; two HBc monomers form a homodimer via an intradimer interface, and then 90 or 120 homodimers form an icosahedral capsi...
Source: Molecular Medicine Reports - November 3, 2018 Category: Molecular Biology Tags: Mol Med Rep Source Type: research

Family Medicine: Data Driven Practice with Emphasis on Underserved Patients
Family physicians' role and interest in caring for underserved or undertreated patients is quite evident in this issue of JABFM. One in 5 family physicians provide urgent or emergency care, which is particularly important in rural areas. Methods and resources for obtaining information about social determinants of health are variable. A data-rich article considers how family medicine practice ownership might be associated with quality outcomes. We have articles on using text messages to increase HIV testing and colon cancer screening for Latino patients. For patients with significant behavioral health disorders, 1 article c...
Source: Journal of the American Board of Family Medicine - May 7, 2019 Category: Primary Care Authors: Bowman, M. A., Neale, A. V., Seehusen, D. A. Tags: Editors ' Note Source Type: research

Hepatitis C Update and Expanding the Role of Primary Care Hepatitis C Update and Expanding the Role of Primary Care
PCPs knowledgable in HCV treatment and management are needed to help control the epidemic. Find resources here.Journal of the American Board of Family Medicine
Source: Medscape Hiv-Aids Headlines - July 26, 2019 Category: Infectious Diseases Tags: Family Medicine/Primary Care Journal Article Source Type: news

Critical State of Disaster Preparedness
Disasters both natural and anthropogenic are increasing in intensity and frequency. 2018 marked the eighth consecutive year in which greater than seven high-consequence natural disasters occurred in the United States alone. These numbers do not include mass shootings or disease outbreaks, such as measles, influenza, and hepatitis A.
Source: Critical Care Clinics - August 22, 2019 Category: Intensive Care Authors: Marie R. Baldisseri, Mary Jane Reed, Randy S. Wax Tags: Preface Source Type: research

Alcohol use disorder and liver transplant: new perspectives and critical issues.
Abstract Alcoholic liver disease is a consolidated indication for liver transplantation, but many unsolved issues can be highlighted. Patients with alcohol use disorder develop peculiar comorbidities that can become contraindications for transplantation. Moreover, a number of social and psychological patterns should be evaluated to select candidates with a low risk of alcohol relapse and adequate post-transplant adherence. In this context, the 6-month rule is too rigid to be widely applied. A short period of abstinence (1 to 3 months) is useful to estimate recovery of liver function and, possibly to avoid transpla...
Source: The Korean Journal of Internal Medicine - April 2, 2020 Category: Internal Medicine Authors: Gitto S, Aspite S, Golfieri L, Caputo F, Vizzutti F, Grandi S, Patussi V, Marra F Tags: Korean J Intern Med Source Type: research

The sixth revolution in pediatric vaccinology: immunoengineering and delivery systems.
Abstract Infection is the predominant cause of mortality in early life, and immunization is the most promising biomedical intervention to reduce this burden. However, very young infants fail to respond optimally to most vaccines currently in use, especially neonates. In 2005, Stanley Plotkin proposed that new delivery systems would spur a new revolution in pediatric vaccinology, just as attenuation, inactivation, cell culture of viruses, genetic engineering, and adjuvantation had done in preceding decades. Recent advances in the field of immunoengineering, which is evolving alongside vaccinology, have begun to inc...
Source: Pediatric Research - September 13, 2020 Category: Pediatrics Authors: Soni D, Bobbala S, Li S, Scott EA, Dowling DJ Tags: Pediatr Res Source Type: research