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Infectious Disease: Hepatitis

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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

Pediatric Care for Immigrant, Refugee, and Internationally Adopted Children
Immigrant children are a diverse group and include refugees, asylees, and internationally adopted children. They have various infectious disease risk factors, depending on conditions within their country of origin, journey, and current living conditions. Infectious disease screening should take place within the framework of a comprehensive medical evaluation in the medical home. Some screening is recommended for all immigrant children including hepatitis B, syphilis, HIV, tuberculosis, and intestinal parasites; other diseases can be tested for based on individual risks. Although guidelines and resources are available, ther...
Source: Pediatric Clinics of North America - November 16, 2021 Category: Pediatrics Authors: Aimee Abu-Shamsieh, Soe Maw Source Type: research

Fourth Time is the (Anti)Charm? - UK NICE Highlights "Uncertainties in the Evidence Base" About Sovaldi
As we have discussed, (here, here and here), while anger continues to build about the $1000/ pill price sought by Gilead for its new antiviral drug for hepatitis C, Sovaldi (sofosbuvir), almost all public discussion still treats the drug as miraculous.  However, my reading of some key trials, and reviews by three groups of evidence-based medicine experts, suggested that the evidence supporting the drug is actually weak and unclear, and hardly suggests it is miraculous.NICE Weighs In Now, as first noted by the indomitable Ed Silverman in his revived PharmaLot blog, the National Institute for Health and Care Excellence ...
Source: Health Care Renewal - June 20, 2014 Category: Health Management Tags: anechoic effect clinical trials evidence-based medicine executive compensation Gilead health care prices manipulating clinical research Sovaldi Source Type: blogs

Implementing hospital‐based baby boomer hepatitis c virus screening and linkage to care: Strategies, results, and costs
CONCLUSIONSThis inpatient HCV screening program diagnosed chronic HCV infection in 4.2% of tested patients and linked >80% to follow‐up care. Yet access to therapy is challenging for largely uninsured populations, and most programmatic costs of the program are not currently covered. Journal of Hospital Medicine 2015. © 2015 Society of Hospital Medicine
Source: Journal of Hospital Medicine - May 29, 2015 Category: Hospital Management Authors: Barbara J. Turner, Barbara S. Taylor, Joshua T. Hanson, Mary Elizabeth Perez, Ludivina Hernandez, Roberto Villarreal, Poornachand Veerapaneni, Kristin Fiebelkorn Tags: Original Research Source Type: research

N-Linked Glycosylation at an Appropriate Position in the Pre-S2 Domain Is Critical for Cellular and Humoral Immunity against Middle HBV Surface Antigen.
In conclusion, N-linked glycosylation at an appropriate position in pre-S2 domain is an essential requirement for DNA vaccine expressing MHBs. PMID: 26062906 [PubMed - in process]
Source: The Tohoku Journal of Experimental Medicine - June 13, 2015 Category: Research Authors: Liu H, Wang S, Jia Y, Li J, Huang Z, Lu S, Xing Y Tags: Tohoku J Exp Med Source Type: research

Bill Clinton, Paid to Speak to Biotech Conference, Extolled $1000 Pill to Prevent "Liver Rot," Despite Lack of Evidence that It Does
ConclusionHow distorted is health care these days.  Misinformation, even disinformation seems to dominate evidence and logic.  Concerns about health care dysfunction are suppressed by the anechoic effect.  Perhaps inspired by the generic managers who now run health care organizations, everyone seems to have become a health care expert, and so the reach of viewpoints on health care seems to be more about the celebrity of their proponents rather than their knowledge, or the logic and evidence underlying their views.As a start, true health care reform has to somehow liberate good clinical evidence from where it...
Source: Health Care Renewal - July 1, 2015 Category: Health Management Tags: Clinton Foundation evidence-based medicine Gilead hepatitis C Sovaldi Source Type: blogs

Why we are #ProudtobeGIM: A general internal medicine top 10 list
A strong wind would have knocked Geraldine to the ground. At 78 pounds, she was underweight, chronically ill, and in need of acute medical or psychosocial care every time she came to the clinic. A survivor of domestic violence with severe mental illness, she had a history of substance abuse and was infected with both HIV and Hepatitis C. In chronic pain but too high a risk to prescribe opioids, her suicide attempts this past year neared the double digits. But you know what? Unless she was in the hospital, she never missed an appointment in the primary care clinic. A sweet, kind woman with complete biopsychosocial disarray,...
Source: Kevin, M.D. - Medical Weblog - September 15, 2015 Category: Journals (General) Authors: Tags: Education Primary care Source Type: blogs

Finding Common Ground in the Search for Better Patient Care and Outcomes
By JOE V. SELBY, MD A basic rule of scientific discovery is that the answers you get are only as good as the questions you ask. That is certainly the case in health care. Traditionally, it has been the sole responsibility of health researchers to develop questions for study that, when answered, can provide reliable and relevant information for patients and clinicians. For the most part, they’ve done an exceptional job, as evidenced by countless discoveries about the nature of disease and remarkable advances in diagnosing, preventing and treating them. But when researchers are the only ones determining scientific inquiry,...
Source: The Health Care Blog - October 7, 2015 Category: Consumer Health News Authors: Simon Nath Tags: THCB Source Type: blogs

Pharmaceutical Pricing – A Reminder of the Value Equation
We previously wrote about the actions Congress is taking to "combat rising prescription drug prices," and the rhetoric politicians of all stripes are using in an attempt to force public opinion on their side. HHS has announced a pharmaceutical pricing forum set for November 20, Congress has committees on both sides working toward a "solution," and Hillary Clinton has said that if she is elected president, she would "demand a stop to excessive profiteering and marketing" by the drug industry. Often left out those discussions includes the value of medications, PhRMA has recently released a forty-deck slideshow that addresse...
Source: Policy and Medicine - November 25, 2015 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Why Patient Voices Are Important
Editor’s Note: Be sure to check out the collection of articles in the March issue and our new blog content for more on the patient voice in medicine. I used to live on a short dirt road where everyone knew everyone else. We recognized each others’ children and would often share childcare responsibilities. A part of our extended neighborhood family for me included occasional medical consultations. I would hear about a neighbor’s call to his doctor to be seen for a cough and fever and the appointment that could not be scheduled for a week. I would bring my stethoscope over to the neighbor’s house to see if he really ...
Source: Academic Medicine Blog - March 22, 2016 Category: Universities & Medical Training Authors: David P. Sklar, M.D. Tags: Featured From the Editor listening to patients patient centered care patient voice physician-patient relationship Source Type: blogs

Quality Measure Core Set Implementation Plan
Discussion on Medicare Part B Drug Payment Model DemonstrationMedPAC Votes for Sweeping Revisions to Medicare Part DMedPAC Meeting on Part B Drug Payment Policy 
Source: Policy and Medicine - April 17, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Massachusetts Cost Trend Report and Suggestions
This report built on those four areas in its analysis and recommendations. Findings The report found that Massachusetts' healthcare spending grew by 4.8% in 2014. This amount exceeded the spending benchmark, but likely because of growth in MassHealth spending (driven in part by enrollment growth) and spending on prescription drugs across all market sectors. However, despite the high growth in prescription drug spending, total per capita spending growth was under the benchmark in all major market segments, including MassHealth. The report also found that Massachusetts performed well "relative to the rest of the U.S. o...
Source: Policy and Medicine - June 7, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

New Analysis Shows Out-of-Pocket Spending Based on List Price
New analysis from Amundsen Consulting, a division of QuintilesIMS, shows that more than half of commercially insured patients’ out-of-pocket spending for brand medicines is based on full list prices. Even though rebates paid by biopharmaceutical companies can substantially reduce the prices insurers and pharmacy benefit managers (PBMs) pay for brand medicines, insurers use list prices—rather than discounted prices—to determine how much to charge patients with deductibles and coinsurance. The newly released data show cost sharing for nearly one in five brand prescriptions filled in the commercial market is based...
Source: Policy and Medicine - May 2, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

No, I ’m not settling for family medicine
During a recent internal medicine rotation, a senior resident expressed disappointment that I’ve chosen a career in family medicine. He was concerned that my talents would be wasted, because — in his words — I wouldn’t get to care for the “more complex patients” he sees in internal medicine. Although I appreciated his confidence in my abilities, I felt my heart sink, as it does each time I am faced with misinformed perceptions about family medicine. I thought back to my last family medicine rotation, and the following patients came to mind: A young woman with a previous diagnosis of idi...
Source: Kevin, M.D. - Medical Weblog - May 16, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/lauren-abdul-majeed" rel="tag" > Lauren Abdul-Majeed < /a > Tags: Physician Primary care Source Type: blogs

Case Report: Acute Hepatitis E in a Pediatric Traveler Presenting with Features of Autoimmune Hepatitis: A Diagnostic and Therapeutic Challenge.
Abstract Hepatitis E virus (HEV) is globally the most common cause of acute viral hepatitis. In industrialized countries, HEV infection can be seen in travelers returning from hyperendemic countries or in individuals at risk for autochthonous infection due to zoonotic exposure. Hepatitis E virus infection is often unrecognized and at times misdiagnosed because of nonspecific findings that can overlap with other causes of hepatitis, including autoimmune hepatitis (AIH). Although most cases of acute HEV infection resolve spontaneously and do not require treatment, life-threatening acute liver failure may occur in so...
Source: The American Journal of Tropical Medicine and Hygiene - October 22, 2018 Category: Tropical Medicine Authors: Minkoff NZ, Buzzi K, Williamson AK, Hagmann SHF Tags: Am J Trop Med Hyg Source Type: research