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Infectious Disease: Hepatitis

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Practice Patterns of Family Physicians With and Without Addiction Medicine Board Certification
Discussion: While only a small proportion of family physicians carry dual ADM board certification, those that do disproportionately serve vulnerable populations while retaining broad scope of care. Further work is needed to examine whether SUD treatment access could be addressed by implementing models that support dually certified physicians in consultative and educational efforts that would amplify their impact across the primary care workforce.
Source: Journal of the American Board of Family Medicine - July 26, 2021 Category: Primary Care Authors: Tong, S. T., Morgan, Z. J., Bazemore, A. W., Eden, A. R., Fitzgerald, R. M., Peterson, L. E. Tags: Brief Reports Source Type: research

Severe Complications From Infectious Mononucleosis After Prolonged Steroid Therapy
We present a case of an adolescent boy who presented to his primary care physician with symptoms consistent with uncomplicated IM that was treated with a prolonged course of steroids. Subsequently, he developed worsening symptoms, including fevers, headache, vomiting, and left-sided facial swelling. He presented to a pediatric emergency department in decompensated septic shock as a result of polymicrobial bacteremia. During his hospital course, he developed pulmonary septic emboli, a sinus thrombus, an empyema, and orbital cellulitis complicated by Pott puffy tumor. In this case report, we summarize the current literature ...
Source: Pediatric Emergency Care - December 1, 2021 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Risk of hepatitis B infection in pediatric acute lymphoblastic leukemia in a tertiary care center from South India
ConclusionsHBV infection poses a serious problem in patients with ALL. Hence we propose that in India, in addition to screening for HBsAg, patients with leukemia should also be screened for anti‐HBc. Improved hepatitis B vaccine coverage in the community under the universal immunization programme and introduction of HBV nucleic acid test (NAT) for blood donations should also help in addressing the problem. Pediatr Blood Cancer © 2014 Wiley Periodicals, Inc.
Source: Pediatric Blood and Cancer - May 4, 2014 Category: Cancer & Oncology Authors: B. Guruprasad, S. Kavitha, B.S. Aruna Kumari, B.R. Vijaykumar, B.G. Sumati, Sinha Mahua, L. Appaji, R.S. Jayshree Tags: Research Article Source Type: research

Sacubitril - Valsartan, a "New Threshold of Hope" or Hype for Heart Failure?
Summer must be over, because the next new blockbuster drug appears to be here.  At the end of August, the media heralded the results of a study of a new product for congestive heart failure (CHF) from Novartis.Novartis' New "Game Changer" The New York Times article was fairly restrained, simply saying ithas shown a striking efficacy in prolonging the lives of people with heart failureThe Reuters article's headline saidNew Novartis drug may upend heart failure treatmentIn Forbes, Matthew Herper called it aGame ChangerThe accompanying editorial in the New England Journal of Medicine (1) suggested the drugmay well repres...
Source: Health Care Renewal - September 3, 2014 Category: Health Management Tags: CHF clinical trials evidence-based medicine manipulating clinical research Novartis sacubitril Source Type: blogs

Examining State Prison Health Care Spending: Cost Drivers And Policy Approaches
Health care and corrections have emerged as fiscal pressure points for states in recent years as rapid spending growth in each area has competed for finite revenue. Not surprisingly, health care spending for prison inmates—the intersection of these two spheres—also has risen swiftly. Yet this trend of rising health care costs for prisoners may have been reversed in many states, according to a new report by the State Health Care Spending Project, a collaboration between The Pew Charitable Trusts and the John D. and Catherine T. MacArthur Foundation. Total correctional health care expenditures and per-inmate spending inc...
Source: Health Affairs Blog - November 4, 2014 Category: Health Management Authors: Maria Schiff Tags: Aging All Categories Chronic Care Health Reform Long-Term Care Source Type: blogs

How Hepatitis C Is Shining A Light On Critical Gaps In Payment Reform
Since December 2013, regulatory approval of new treatments for hepatitis C have brought long simmering debates on drug pricing and value to full boil. The drugs—Gilead’s Sovaldi and successor combination treatment Harvoni, AbbVie’s Viekira Pak—represent significant steps forward for treatment in hepatitis C, demonstrating cure rates well above 90 percent in the clinical trial setting as well as greater tolerability for patients. This unprecedented effectiveness, however, has come at a high cost, with treatment ranging from $63,000 for an eight-week course of Harvoni on the low end to above $150,000 for Sova...
Source: Health Affairs Blog - February 3, 2015 Category: Health Management Authors: Kavita Patel, Morgan Romine, and Gregory Daniel Tags: All Categories Business of Health Care Chronic Care Health Care Costs Health Reform Insurance Long-Term Care Payment Pharma Policy Spending Source Type: blogs

Entresto: Blockbuster, or Just Over Hyped? - Whatever, It Will Cost $4500 a Year
The newest drug for congestive heart failure, Entresto, a fixed combination of valsartan and sacubitril, has just hit the market at an elevated price.  Like other drugs recently introduced as blockbusters, the high price does not seem clearly justified by clinical evidence about the drug's benefits and harms.   Questions Raised by the One Big Published Controlled Trial Last year, we discussed the hoopla around a study of a new drug for congestive heart failure (CHF),(1) a fixed combination of valsartan and sacubitril. Also, on the now defunct CardioExchange blog, Dr Vinay Prasad discussed the same study (look her...
Source: Health Care Renewal - July 30, 2015 Category: Health Management Tags: CHF clinical trials Entresto evidence-based medicine manipulating clinical research Novartis sacubitril Source Type: blogs

ECHO Improves Rural Physician Access to Subspecialty Expertise
The Project Extension for Community Healthcare Outcomes (ECHO) was started at the University of New Mexico School of Medicine, after several noticed extraordinarily long waits for hepatitis C care in New Mexico. The effort has resulted in an international effect, with more than ninety hubs participating in the effort, offering subspecialist guidance to primary care physicians, nurses, and other clinicians across the United States and in twelve other countries. The hub-and-spoke model used in ECHO had previously been used to transform the field of aviation, and is now being applied to the continuing education of primary ca...
Source: Policy and Medicine - December 21, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Brucellosis in Pediatric Patients: A Review of 114 Cases from Asir Region
Over a period of four years, 114 children (> 28 days to≤ 12 years) with seropositive brucellosis were admitted to Khamis Mushayt Civil Hospital, constituting 1% of all pediatric admissions. History of contact with domestic animals and ingestion of raw milk was positive, and over 84% of the patients were from the rural areas of Asir. The male:female ratio was 1.2:1, over 59% were of≤ 5 years of age. Common clinical features observed were fever (80.7%), hepatosplemomegaly (38%), arthropathies (29%), and anemia (34%). Over 36% of the children were undernourished. Serological identification of etiological agents revea...
Source: Annals of Saudi Medicine - May 2, 2017 Category: Journals (General) Tags: ISSUE 3 Source Type: research

Long ‐term outcomes of de novo autoimmune hepatitis in pediatric liver transplant recipients
Abstract The long‐term course and outcome of DAIH is unknown. A retrospective multicenter study assessing associations and long‐term consequences of DAIH developing in a transplanted allograft is presented. Children with DAIH were followed from diagnosis until death, re‐LT, or transfer of care and for a minimum of 1 year. A total of 31 patients of 1833 (1.7%) LT were identified; 29 followed for a median of 7.1 years (range, 1.6‐15); 52% had no rejection preceding diagnosis of DAIH. Transaminases fell following treatment with steroids and antimetabolites (ALT 108 vs 39 U/L (P=.002); AST 112 vs 52 U/L (P=.003); GGT...
Source: Pediatric Transplantation - May 29, 2017 Category: Transplant Surgery Authors: Udeme D. Ekong, Patrick McKiernan, Mercedes Martinez, Steven Lobritto, Deirdre Kelly, Vicky L. Ng, Estella M. Alonso, Yaron Avitzur Tags: ORIGINAL ARTICLE Source Type: research

Use of glucocorticoids in the critical care setting: science and clinical evidence
Publication date: Available online 15 October 2019Source: Pharmacology & TherapeuticsAuthor(s): Edward D. Chan, Michael M. Chan, Mallory M. Chan, Paul E. MarikAbstractGlucocorticoids (GC) in all its various forms and formulations are likely one of the most commonly used pharmacologic agents in medicine. Their use can be profoundly therapeutic but are also associated with a myriad of acute and chronic side effects. It is fairly well-accepted in the medical community that GC can be life-saving when used in critically ill patients with severe exacerbations of asthma and chronic obstructive pulmonary disease, HIV-associated pn...
Source: Pharmacology and Therapeutics - October 16, 2019 Category: Drugs & Pharmacology Source Type: research

Autoimmune phenomena in treated and naive pediatric patients with chronic viral hepatitis.
Authors: Păcurar D, Dijmărescu I, Dijmărescu A, Pavelescu M, Andronie M, Becheanu C Abstract Chronic viral hepatitis has been incriminated for inducing autoimmune events, but it is a known fact that interferon-based therapies also promote autoimmunity. We conducted an observational prospective study which included 114 pediatric patients with chronic viral hepatitis B and C. The patients were divided in 2 groups, the first group consisted of treatment-naive patients; the second group included patients who had received interferon-based therapy. We aimed to determine whether the ones who received treatment are more...
Source: Experimental and Therapeutic Medicine - December 11, 2019 Category: General Medicine Tags: Exp Ther Med Source Type: research

Comparison of Recommendations for Treatment of Chronic Hepatitis C Virus Infection in Children and Adolescents: A Position Paper of the Federation of International Societies of Pediatric Gastroenterology, Hepatology, and Nutrition
Conclusions: There is strong consensus on treating all adolescents with chronic HCV infection with DAA and on delaying therapy in younger children until these agents are approved for them. Interferon-based therapies should be avoided. Specific recommendations regarding which DAA regimen to use and treatment duration varied significantly. Key stakeholders need to convene to standardize therapeutic strategies at a global level if we are to eradicate HCV in children.
Source: Journal of Pediatric Gastroenterology and Nutrition - April 27, 2020 Category: Gastroenterology Tags: Society Papers Source Type: research

Outcomes of Severe Seronegative Hepatitis-associated Aplastic Anemia: A Pediatric Case Series
Conclusions: We found that ATG-based IST induced remission of hepatitis in patients with steroid-refractory HAAA. This is also an appropriate initial treatment for severe Aplastic Anemia, though may not prevent the need for HSCT. We propose that equine ATG based IST at standard dosing regimen for sAA is a therapy that in select cases can be considered early on in the treatment course and could lead to a sustained remission of both hepatitis and sAA. This should be considered in collaboration with a pediatric hematologist.
Source: Journal of Pediatric Gastroenterology and Nutrition - January 30, 2021 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research

Clinical and biochemical profile of scrub typhus patients at a tertiary care hospital in Northern India
CONCLUSION: Scrub typhus is often misdiagnosed or diagnosed late due to its wide clinical spectrum overlapping with clinical presentation of other commonly prevalent tropical diseases. One should always consider the differential diagnosis of scrub typhus while evaluating a young febrile patient of rural background, with features of single or multiple organ dysfunction and laboratory findings of leucocytosis, thrombocytopenia and elevation of transaminases.PMID:34041194 | PMC:PMC8140274 | DOI:10.4103/jfmpc.jfmpc_1162_20
Source: Primary Care - May 27, 2021 Category: Primary Care Authors: Sudhir K Verma Kamlesh K Gupta Rajesh K Arya Vivek Kumar D Himanshu Reddy Shyam C Chaudhary Satyendra K Sonkar Satish Kumar Neeraj Verma Deepak Sharma Source Type: research