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Infectious Disease: Hepatitis

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Critical Care Management in Cirrhosis
Abstract The critical care management of cirrhotic patients involves a multidisciplinary team approach, including the hepatologist and intensivist, to address life-threatening complications and to provide comprehensive care for multi-organ failure commonly seen in these patients. A systematic approach to the diagnosis and therapy of multi-organ system dysfunction is essential to optimize the intensive care management of these complex patients, with a goal to stabilize them for possible liver transplantation. This review provides a system-based approach for the intensive care management of critically ill cirrhotic patients.
Source: Current Hepatitis Reports - February 7, 2015 Category: Infectious Diseases Source Type: research

Acute Liver Failure: Outcome and Value of Pediatric End-Stage Liver Disease Score in Pediatric Cases
Conclusions High PELD scores at diagnosis were accurate predictors of a poor prognosis in our patients with ALF. This model may help in the clinical management of this entity, although prospective validation is needed.
Source: Pediatric Emergency Care - June 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

The Role of Liver Function in the Setting of Cirrhosis with Chronic Infection and Critical Illness
This article discusses the role of liver function in the patient with a systemic critical illness in contrast to the worsened pathophysiology of the patient with cirrhosis secondary to chronic HCV infection and critical illness, inpatient and posthospitalization management of the critically ill patient with chronic HCV-related cirrhosis, and the nursing implications and recommendations for future research for this population.
Source: Critical Care Nursing Clinics of North America - December 13, 2016 Category: Nursing Authors: Susan Lee, Latanja Divens, Leanne H. Fowler Source Type: research

Analysis Shows Health Care Cost Predictions Grossly Incorrect
This study, once again disproves the misleading claims that pharmacy benefit managers and insurers (among others) make about spending on new innovative medicines. The report found that predictions of health care costs made prior to the introduction of new medicines were often dramatically overstated. The study points to the example of new cholesterol-lowering medicines, also known as PCSK9 inhibitors. The Institute for Clinical and Economic Review (ICER) predicted that the one-year cost of the two PCSK9 inhibitors would be $7.2 billion. However, in reality, based on reported sales, the actual cost will be approximately $8...
Source: Policy and Medicine - January 5, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Hypoxic hepatitis — its biochemical profile, causes and risk factors of mortality in critically-ill patients: A cohort study of 565 patients
Conclusion Older age, higher SAPS-II, LDH, INR and bilirubin levels, concomitant AKI and the need for vasopressors were all factors associated with increased mortality. The diagnosis of HH was an important harbinger of mortality in this population, which appears to be driven mainly by the severity of the underlying conditions.
Source: Journal of Critical Care - April 29, 2017 Category: Gastroenterology Source Type: research

The New Mexico Peer Education Project: Filling a Critical Gap in HCV Prison Education.
CONCLUSIONS: Prison peer educators can learn to effectively teach HCV prevention and harm reduction strategies and disease specific information to their peers. PMID: 30449762 [PubMed - in process]
Source: Journal of Health Care for the Poor and Underserved - November 21, 2018 Category: International Medicine & Public Health Authors: Thornton K, Sedillo ML, Kalishman S, Page K, Arora S Tags: J Health Care Poor Underserved Source Type: research

Update on acute liver failure
Purpose of review: Although advances in critical care management and liver transplantation have improved survival in acute liver failure (ALF), mortality remains significant. An evidence base to support management has been lacking, due to the condition's rarity, severity and heterogeneity. The purpose of this review is to critically appraise the latest evidence, updating clinicians on the current understanding of the best management. Recent findings: Transplant-free survival in acetaminophen-related ALF has improved considerably, such that reconsidering thresholds for transplant is required, perhaps utilizing biomarkers of...
Source: Current Opinion in Critical Care - March 5, 2015 Category: Nursing Tags: GASTROINTESTINAL SYSTEM: Edited by Andre Van Gossum Source Type: research

How is the Affordable Care Act doing?
By Michael Hochman, MD, MPH and Pieter Cohen, MD (follow us at @slowmedupdates or on the web.) As the Affordable Care Act (ACA) enters its third active year, we’re taking a look at an interesting summary of its benefits and barriers to health care so far that was recently published in The New England Journal of Medicine. In this paper, Dr. Benjamin Sommers, assistant professor of health policy and economics at the Harvard T.H. Chan School of Public Health, explains that the number of uninsured individuals in the United States has fallen from roughly 50 million in 2010 to between 30 and 34 million as of 2015. This co...
Source: New Harvard Health Information - January 21, 2016 Category: Consumer Health News Authors: Updates in Slow Medicine Tags: Health care affordable care act Source Type: news

 Clinical characteristics of liver failure from a systemic cause: A report from an advanced critical care center.
CONCLUSION: In this study, among the patients with ALF other than fulminant hepatitis, those with a high SOFA score on admission exhibited a poor prognosis. In addition, oral warfarin use prior to disease onset was found to be a factor which indicated a good prognosis. PMID: 26845603 [PubMed - as supplied by publisher]
Source: Annals of Hepatology - February 5, 2016 Category: Gastroenterology Tags: Ann Hepatol Source Type: research

Top Policy and Medicine Stories for 2015
  At the end of each year, we attempt to give you an overview of what happened in previous year and give some spin on predictions for the coming year, much like an end-of-the-year family newsletter. For those who are a bit more nostalgic, here is a link to our 2014 story. Perhaps the End of Off Label Lawsuits? With the Amarin Injunction, Caronia standing for two years without any pushback from the government, and the recent settlement with Pacira, there seems to be a trend of the FDA pulling away from off-label citations. Perhaps this trend is a signal of the end of cases against manufacturers for off label pr...
Source: Policy and Medicine - December 30, 2015 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Acute liver failure
This article provides a practical approach to the diagnosis and management of critically ill patients with ALF.
Source: Anaesthesia and intensive care medicine - February 27, 2015 Category: Anesthesiology Source Type: research

Becoming a Digital Contributor: A Reflection on the Expanding WikiProject Medicine Course
By: Christine Greipp, MLIS, fourth-year medical student, University of New England College of Osteopathic Medicine The Expanding WikiProject Medicine course at UCSF, described in a recent Academic Medicine article, intrigued me for a number of reasons. With a master of library science, I had been a medical librarian before a medical student. My prior work was in consumer health and patient education within a tertiary hospital. I firmly believe that medicine is at its best a partnership between physicians and patients. So I naturally jumped at the chance to participate in this project, which has the admirable and ambitious...
Source: Academic Medicine Blog - January 17, 2017 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Trainee Perspective humanities in medicine medical education medical students research Source Type: blogs

Hepatitis B Vaccination, Screening, and Linkage to Care: Best Practice Advice From the American College of Physicians and the Centers for Disease Control and Prevention.
Abstract Background: Vaccination, screening, and linkage to care can reduce the burden of chronic hepatitis B virus (HBV) infection. However, recommendations vary among organizations, and their implementation has been suboptimal. The American College of Physicians' High Value Care Task Force and the Centers for Disease Control and Prevention developed this article to present best practice statements for hepatitis B vaccination, screening, and linkage to care. Methods: A narrative literature review of clinical guidelines, systematic reviews, randomized trials, and intervention studies on hepatitis B vaccinatio...
Source: Annals of Internal Medicine - November 21, 2017 Category: Internal Medicine Authors: Abara WE, Qaseem A, Schillie S, McMahon BJ, Harris AM, High Value Care Task Force of the American College of Physicians and the Centers for Disease Control and Prevention Tags: Ann Intern Med Source Type: research

Round and Round It Spins - Our Latest Health Care Revolving Door Roundup
DiscussionThe revolving door has been a chronic problem for the US, but seems to only be getting worse.  We saw plenty of examples of people transiting the door to or from the US executive branch during the George W Bush and Obama administrations.  We are still seeing people transiting the door from the latter administration.  However, the number of people transiting the door into the Trump administration seems unprecedented, although admittedly that impression is based on series of cases, not systematic quantitative studies.So, as I have said before, most recentlyin August, 2017,The revolving door is a spec...
Source: Health Care Renewal - October 8, 2017 Category: Health Management Tags: Donald Trump health care corruption regulatory capture revolving doors Source Type: blogs

The hepatitis B care cascade using administrative claims data, 2016.
CONCLUSIONS: We identified gaps in linkage to care and treatment in commercially insured adults with CHB. PMID: 32835460 [PubMed - as supplied by publisher]
Source: The American Journal of Managed Care - July 31, 2020 Category: Health Management Authors: Harris AM, Osinubi A, Nelson NP, Thompson WW Tags: Am J Manag Care Source Type: research