1.

Adibi P, Ghassemian R, Alavian SM, Ranjbar M, Mohammadalizadeh AH, Nematizadeh F, Mamani M, Rezazadeh M, Keramat F, Ardalan A, Esmaeili A, Zali MR. Effectiveness of hepatitis B vaccination in children of chronic hepatitis B mothers. Saudi Med J. 2004 Oct;25(10):1414-8.

Research Center for Gastroenterology and Liver Diseases, Isfahan University of Medical Sciences, Isfahan, Iran. adibi@med.mui.ac.ir

OBJECTIVE: Although all newborns in Iran have been vaccinated against hepatitis B since March 1993, routine screening of pregnant women has not been conducted in prenatal care programs, yet transmission of hepatitis B via the maternal-fetal route is still a viable likelihood, which must be entertained. METHODS: The subjects were divided into 2 groups. The exposed group comprised 97 vaccinated children whose mothers were seropositive for hepatitis B surface antigen (HBsAg) and had not received hepatitis immunoglobulin at birth. The unexposed group consisted of 87 vaccinated children whose mothers were seronegative for hepatitis B surface antigen. We compared these 2 groups to determine the efficacy of vaccine alone in high-risk children. This study was conducted in Tehran, Iran, from June 2002 to December 2002. All children were born after 1993. RESULTS: Chronic infection (HBsAg positivity) was detected in 14.3% of children in the exposed group. There were no instances of chronic infection in the unexposed group (relative risk [RR]=13.48, 95% confidence intervals [CI] 1.8-100.02). Previous infection of hepatitis B (HBcAb positivity) was found in 29 (29.9%) children in the exposed group, but only one (1.2%) in the unexposed group (RR=26.01, 95% CI: 3.61-186.95). Immunity (HBsAb positivity) in the exposed group measured 48 (49.5%) and unexposed group measured 56 (64.4%) (R.R=0.76, 95% CI: 0.59-0.99). CONCLUSION: Vaccination alone did not induce immunity against hepatitis B in high-risk children; it seems that routine screening of pregnant women is necessary for determining whether neonates need hepatitis B immunoglobulin after birth.

2.

Cervera R, Asherson RA, Acevedo ML, Gomez-Puerta JA, Espinosa G, De La Red G, Gil V, Ramos-Casals M, Garcia-Carrasco M, Ingelmo M, Font J. Antiphospholipid syndrome associated with infections: clinical and microbiological characteristics of 100 patients. Ann Rheum Dis. 2004 Oct;63(10):1312-7. Review.

Servei de Malalties Autoimmunes, Hospital Clinic, Villarroel 170, 08036-Barcelona, Catalonia, Spain. rcervera@clinic.ub.es

OBJECTIVE: To describe and analyse the clinical characteristics of 100 patients with antiphospholipid syndrome (APS) associated with infections. METHODS: Patients were identified by a computer assisted search (Medline) of published reports to locate all cases of APS published in English, Spanish, and French from 1983 to 2003. The bilateral Fisher exact test was used for statistics. RESULTS: 59 female and 41 male patients were identified (mean (SD) age, 32 (18) years (range 1 to 78)): 68 had primary APS, 27 had systemic lupus erythematosus, two had "lupus-like" syndrome, two had inflammatory bowel disease, and one had rheumatoid arthritis. APS presented as a catastrophic syndrome in 40% of cases. The main clinical manifestations of APS included: pulmonary involvement (39%), skin involvement (36%), and renal involvement (35%; nine with renal thrombotic microangiopathy, RTMA). The main associated infections and agents included skin infection (18%), HIV (17%), pneumonia (14%), hepatitis C (13%), and urinary tract infection (10%). Anticoagulation was used in 74%, steroids in 53%, intravenous immunoglobulins in 20%, cyclophosphamide in 12%, plasma exchange in 12%, and dialysis in 9.6%. Twenty three patients died following infections and thrombotic episodes (16 with catastrophic APS). Patients given steroids had a better prognosis (p = 0.024). The presence of RTMA and requirement for dialysis carried a worse prognosis (p = 0.001 and p = 0.035, respectively). CONCLUSIONS: Various different infections can be associated with thrombotic events in patients with APS, including the potentially lethal subset termed catastrophic APS. Aggressive treatment with anticoagulation, steroids, and appropriate antibiotic cover is necessary to improve the prognosis.

3.

Colletti JE, Homme JL, Woodridge DP. Unsuspected neonatal killers in emergency medicine. Emerg Med Clin North Am. 2004 Nov;22(4):929-60. Review.

Department of Pediatric and Adolescent Medicine, Mayo Medical School, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. colletti.james@mayo.edu

A neonate presenting to the emergency department can present a challenge to even the most experienced clinician. This article has focused on four deceiving and potentially devastating neonatal diseases. 1. Neonatal herpes is a potentially devastating illness without pathognomonic signs or symptoms. Early recognition and therapy can reduce mortality markedly. Although no specific sign or symptom is diagnostic,the diagnosis should be strongly considered in the presence of HSV risk factors, atypical sepsis, unexplained acute hepatitis, or focal seizure activity. Acyclovir therapy should be initiated before viral dissemination or significant CNS replication occurs. 2. Pertussis is a disease in which infants are at greatest risk of death or severe complication. Neonatal pertussis often presents in an atypical manner, lacking the classic signs and symptoms such as the "whoop."More common signs and symptoms include cough, feeding difficulty,low-grade fever, emesis, increasing respiratory distress, apnea, cyanosis,and seizures. Management should include hospitalization, supportive care, and antibiotics. 3. Congenital heart defects, particularly ductal-dependent lesions, may have an initial asymptomatic period that culminates in a rapidly progressive and fatal course. A neonate with CHD presents with shock refractory to volume resuscitation or pressor support. Resuscitative efforts are ineffective unless PGE, is administered. 4. Inborn errors of metabolism often are unsuspected because of their protean and heterogeneous nature. Signs and symptoms are subtle,are nonspecific, and often mimic other, more common diseases.An elevated index of suspicion, along with application and correct interpretation of a select few laboratory tests, is the key to making a diagnosis. Therapy is relatively straightforward and focused on resuscitation followed by prevention of catabolism and correction of specifically identified abnormalities.Although these disorders are relatively uncommon, prompt diagnosis and therapy can lead to a decrease in morbidity and mortality. The key is to maintain a high index of suspicion.

4.

Gea-Banacloche JC, Opal SM, Jorgensen J, Carcillo JA, Sepkowitz KA, Cordonnier C.  Sepsis associated with immunosuppressive medications: an evidence-based review. Crit Care Med. 2004 Nov;32(11 Suppl):S578-90. Review.

National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.

OBJECTIVE: In 2003, critical care and infectious disease experts representing 11 international organizations developed management guidelines for sepsis associated with immunosuppressive medications that would be of practical use for the bedside clinician, under the auspices of the Surviving Sepsis Campaign, an international effort to increase awareness and improve outcome in severe sepsis. DESIGN: The process included a modified Delphi method, a consensus conference, several subsequent smaller meetings of subgroups and key individuals, teleconferences, and electronic-based discussion among subgroups and among the entire committee. METHODS: The modified Delphi methodology used for grading recommendations built on a 2001 publication sponsored by the International Sepsis Forum. We undertook a systematic review of the literature graded along five levels to create recommendation grades from A to E, with A being the highest grade. Pediatric considerations to contrast adult and pediatric management are in the article by Parker et al. on p. S591. CONCLUSION: Immunosuppressed patients, by definition, are susceptible to a wider spectrum of infectious agents than immunologically normal patients and, thus, require a broader spectrum antimicrobial regimen when they present with sepsis or septic shock. Special expertise managing immunosuppressed patient populations is needed to predict and establish the correct diagnosis and to choose appropriate empiric and specific agents and maximize the likelihood that patients will survive these microbial challenges.

5.

Goldenberg NA, Graham DK, Liang X, Hays T. Successful treatment of severe aplastic anemia in children using standardized immunosuppressive therapy with antithymocyte globulin and cyclosporine A. Pediatr Blood Cancer. 2004 Dec;43(7):718-22.

Division of Hematology, Oncology, and BMT, Department of Pediatrics, UCHSC/The Children's Hospital, Denver, Colorado 80128, USA. neil.goldenberg@uchsc.edu

BACKGROUND: Given the heterogeneity of published data in US children, we sought to evaluate outcomes of a standardized immunosuppressive therapy (IST) regimen for severe aplastic anemia (SAA) at The Children's Hospital (Denver, CO). METHODS: We retrospectively analyzed the records of 16 children diagnosed from 1990 to 2003 and treated by IST, among whom 14 received the standardized regimen of antithymocyte globulin (ATG) and cyclosporine A (CsA). Serial hematologic parameters, complications, transfusion requirements, and time to response were assessed. RESULTS: One child who died from a pre-existing Aspergillus infection prior to expected IST response was excluded from the analysis. Overall (transfusion-independent) response to IST was 100% (13/13), without any relapses or clinically evident leukemic/myelodysplastic transformations after a median follow-up time of 4.4 years (range: 10 months-13.3 years). CONCLUSIONS: This report documents excellent outcome using combination ATG and CsA IST for pediatric SAA. 2004 Wiley-Liss, Inc.

6.

Kilbourne AM, Cornelius JR, Han X, Pincus HA, Shad M, Salloum I, Conigliaro J, Haas GL. Burden of general medical conditions among individuals with bipolar disorder. Bipolar Disord. 2004 Oct;6(5):368-73.

VA Pittsburgh Healthcare System, University of Pittsburgh, Pittsburgh, PA 15240, USA. 1amy.kilbourne@med.va.gov

OBJECTIVE: Treatment of coexisting medical comorbidities may reduce the risk of adverse outcomes among patients with bipolar disorder. We determined the prevalence of general medical conditions in a population-based sample of patients diagnosed with bipolar disorder in the Veterans Administration (VA). METHODS: We conducted a cross-sectional study of patients (n = 4310) diagnosed with bipolar disorder in fiscal year 2001 receiving care at VA facilities located within the mid-Atlantic region. General medical conditions were assessed using ICD-9 codes, and we compared the prevalence of each condition in our bipolar sample with national data on the VA patient population. RESULTS: The mean age was 53 (SD = 13), 10% were women, and 12% African-American. The mean age of the VA national patient population was higher (58 years). The most prevalent conditions among patients with bipolar disorder included cardiovascular (e.g. hypertension, 35%), endocrine (e.g. hyperlipidemia, 23%; diabetes, 17%), and alcohol use disorder (25%). When compared with national data, the prevalence of diabetes was higher in the bipolar cohort than in the national cohort (17.2% versus 15.6%; p = 0.0035). Hepatitis C was more common in the bipolar group than the national cohort (5.9% versus 1.1%; p < 0.001). Lower back pain (15.4% versus 10.6%; p < 0.0001) and pulmonary conditions (e.g. COPD: 10.6% versus 9.4%; p = 0.005) were also more prevalent among the bipolar cohort than the VA national cohort. CONCLUSIONS: Individuals with bipolar disorder possess a substantial burden of general medical comorbidity, and are occurring at an earlier age than in the general VA patient population, suggesting the need for earlier detection and treatment for patients with bipolar disorder.

7.

Lu CY, Chiang BL, Chi WK, Chang MH, Ni YH, Hsu HM, Twu SJ, Su IJ, Huang LM, Lee CY.. Waning immunity to plasma-derived hepatitis B vaccine and the need for boosters 15 years after neonatal vaccination. Hepatology. 2004 Dec;40(6):1415-20.

Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.

Neonatal immunization with hepatitis B (HB) vaccine is highly effective; however, more needs to be learned about the duration of protection and indications for boosters. We measured antibody to HB core antigen (anti-HBc), HB surface antigen (HBsAg), and pre- and postbooster titers of HBsAg antibody (anti-HBs) 15 years after primary neonatal immunization with plasma-derived HB vaccines in 2 cohorts of 15-year-old children. Group A consisted of 78 children who were born to HB e antigen-positive HBsAg carrier mothers and had developed protective levels of anti-HBs antibodies (> or =10 mIU/mL) following HB immunization. Group B consisted of 113 apparently healthy children whose anti-HBs titers after vaccination were unknown. Anti-HBs was undetectable (antibody titer <10 mIU/mL) in 29.9% in group A and 62.4% in group B (P < .001). Anti-HBc was detected in 33.3 % in group A and 4.4 % in group B (P < .001). After a single booster dose of HB vaccine, 2.7% in group A and 3.3% in group B remained anti-HBs-negative. A blunted serological response was noted in approximately 20% in both groups. One HBsAg carrier was detected in group A (1.3%) and 4 in group B (3.5%). Fifteen years after neonatal immunization with plasma-derived HB vaccine, a large proportion of children exhibited waning immunity. This poses the risk of breakthrough infection. A single booster augmented the serological response to the vaccine in most but not all subjects. In conclusion, our findings suggest that one or more booster immunizations are needed in seronegative subjects by at least 15 years following neonatal immunization with plasma-derived HB vaccine.

8.

Tsai YH, Hsu RW, Huang KC, Chen CH, Cheng CC, Peng KT, Huang TJ. Systemic Vibrio infection presenting as necrotizing fasciitis and sepsis. A series of thirteen cases. J Bone Joint Surg Am. 2004 Nov;86-A(11):2497-502.

Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chia-Yi, No. 6, West Sec, Chia-Pu Road, Putz City, Chia-Yi County, 613, Taiwan. orma2244@adm.cgmh.org.tw

BACKGROUND: Vibrio species are an uncommon cause of necrotizing fasciitis and primary septicemia, which are likely to occur in patients with hepatic disease, diabetes mellitus, adrenal insufficiency, and immunocompromised conditions. These organisms are found in warm sea waters and are often present in raw oysters, shellfish, and other seafood. The purposes of the present report were to describe a series of patients who had this potentially lethal infection and to identify clinical features associated with a poor prognosis. METHODS: We retrospectively reviewed the records of thirteen patients (ten men and three women) who had necrotizing fasciitis and sepsis caused by Vibrio species. All patients had a history of contact with seawater or raw seafood. Eight patients had a hepatic disease such as hepatitis or cirrhosis of the liver, three had diabetes mellitus (without hepatic disease), and two had chronic renal or adrenal insufficiency (without hepatic disease). RESULTS: Twelve patients underwent fasciotomy or limb amputation. Five patients (38%) died within two to six days after admission, and eight patients survived. Patients with a systolic blood pressure of < or =90 mm Hg and leukopenia in the emergency room had a significantly higher mortality rate (p < 0.05). CONCLUSIONS: The diagnosis of Vibrio necrotizing fasciitis should be suspected when a patient has the appropriate clinical findings and a history of contact with seawater or raw seafood. The treatment should begin as early as possible, essentially when the patient has symptoms of sepsis. Although emergency fasciotomy or limb amputation did not reduce the mortality rate in this series, we consider such operations to be an important aspect of treatment.

9.

Barbara JA. The rationale for pathogen-inactivation treatment of blood components.
Int J Hematol. 2004 Nov;80(4):311-6. Review.

National Blood Service, Colindale, London, UK. john.barbara@nbs.nhs.uk

Blood transfusion provides an ideal portal of entry for microorganisms. Although current residual risks of microbial infection by transfusion are extremely low in the developed world, the requirements for even safer blood are paradoxically increasing. Such requirements are partly a legacy of the tragic transmissions of human immunodeficiency virus (HIV) by blood early in the acquired immunodeficiency syndrome pandemic and are legally expressed in consumer protection laws imposing strict product liability. Enhanced safety is called for, not only for recognized agents (especially bacteria, which cause most current transfusion-transmissible infections [TTIs]and have only recently been addressed) but also for potential future "emerging" TTIs. These possibilities are not merely theoretical. TTIs of HIV-1, HIV-2, hepatitis B virus vaccine escape mutants, human herpesvirus 8, West Nile fever virus, and variant Creutzfeld-Jakob disease amply demonstrate the continual emergence of such threats. For recognized agents, the possibilities of test errors, misreporting, process-control failures, and false-negative results (although rare with modern automation) remain. In principle, an all-embracing, pan-effective microbe-inactivation procedure offers a potential solution to blood safety concerns. Such procedures may also allow the removal of several existing antimicrobial interventions. However, blood services remain to be convinced that the various prerequisites for safe and effective pathogen inactivation have been met. Not the least of these prerequisites is that all blood components can be inactivated to provide a single streamlined alternative blood safety strategy. Furthermore, the huge potential value of effective pathogen-inactivation systems for developing countries should not be forgotten once such systems are perfected.

10.

Godfroid F, Denoel P, de Grave D, Schuerman L, Poolman J. Diphtheria-tetanus-pertussis (DTP) combination vaccines and evaluation of pertussis immune responses. Int J Med Microbiol. 2004 Oct;294(5):269-76. Review.

Research & Development, GlaxoSmithKline Biologicals, Rue de l'Institut 89, B-1330 Rixensart, Belgium.

Diphtheria-tetanus-pertussis (DTP) combination vaccines based on inactivated whole-cell Bordetella pertussis (DTPw) or purified acellular pertussis components (DTPa) facilitate vaccine administration and will allow further co-administration such as with pneumococcal conjugates. Safety and immunogenicity studies are needed to demonstrate non-inferiority between combinations and the separate vaccines. The immunological non-inferiority is based on threshold antibody levels that represent correlates of protection. However, in case of pertussis, correlates of protection have not been defined or accepted. We describe the clinical evaluation of DTPa- and DTPw-based combinations and demonstrate their immunological non-inferiority as compared to their separately administered licensed counterparts. With respect to antibody responses against pertussis, a number of evaluations (vaccine response rates and geometric mean concentrations (GMCs) for anti-PT, anti-FHA, anti-PRN or anti-BPT; reverse cumulative distribution curves) are described. We also demonstrate that the B. pertussis mouse lung clearance model is able to predict clinical efficacy of licensed DTPa and DTPw vaccines and represents a useful tool to evaluate new combination vaccines.

11.

Moylett EH, Hanson IC. Mechanistic actions of the risks and adverse events associated with vaccine  administration. J Allergy Clin Immunol. 2004 Nov;114(5):1010-20; quiz 1021. Review.

Department of Allergy and Immunology, Baylor College of Medicine, Houston, TX 77030, USA.

Vaccine-preventable disease levels in the United States are at or near record lows. Most parents today have never seen a case of diphtheria, measles, or other once commonly encountered infectious diseases now preventable by vaccine administration. As a result, some parents wonder why their children must receive shots for diseases that do not seem to exist. Myths and misinformation about vaccine safety abound and can confuse parents who are trying to make sound decisions about their children's health care. However, we cannot take continued high immunization coverage levels for granted. A successful vaccination program, like a successful society, depends on the cooperation of every individual to ensure the good of all. This review outlines for clinical allergists-immunologists the molecular basis for the risks and adverse events associated with vaccine administration so that they can be better informed as experts on vaccine-associated adverse reactions.

11434.   Adibi P, Ghassemian R, Alavian SM, Ranjbar M, Mohammadalizadeh AH, Nematizadeh F, Mamani M, Rezazadeh M, Keramat F, Ardalan A, Esmaeili A, Zali MR. Effectiveness of hepatitis B vaccination in children of chronic hepatitis B mothers. Saudi Med J. 2004 Oct;25(10):1414-8.

11435.    Aggarwal R, Ranjan P. Preventing and treating hepatitis B infection. BMJ. 2004 Nov 6;329(7474):1080-6. Review.

11436.    Andriulli A, Persico M, Iacobellis A, Maio G, Di Salvo D, Spadaccini A, Bacca D, Leandro G, Ventrella F, Mangia A. Treatment of patients with HCV infection with or without liver biopsy. J Viral Hepat. 2004 Nov;11(6):536-42.

11437.     Arase Y, Ikeda K, Tsubota A, Suzuki F, Suzuki Y, Saitoh S, Kobayashi M, Akuta N, Someya T, Hosaka T, Sezaki H, Kobayashi M, Kumada H. Interferon therapy for 2 years or longer reduces the incidence of hepatocarcinogenesis in patients with chronic hepatitis C viral infection. Intervirology. 2004 Nov-Dec;47(6):355-61.

11438.     Armstrong L, Isaacs D, Evans N. Severe neonatal toxoplasmosis after third trimester maternal infection. Pediatr Infect Dis J. 2004 Oct;23(10):968-9.

11439.     Canepa J. Possible herbal treatment for C4HCV patients who are not suitable for interferon based treatment. Saudi Med J. 2004 Nov;25(11):1778;

11440.    Cervera R, Asherson RA, Acevedo ML, Gomez-Puerta JA, Espinosa G, De La Red G, Gil V, Ramos-Casals M, Garcia-Carrasco M, Ingelmo M, Font J. Antiphospholipid syndrome associated with infections: clinical and microbiological characteristics of 100 patients. Ann Rheum Dis. 2004 Oct;63(10):1312-7. Review.

11441.     Chan DF, Li AM, Chu WC, Chan MH, Wong EM, Liu EK, Chan IH, Yin J, Lam CW, Fok TF, Nelson EA. Hepatic steatosis in obese Chinese children. Int J Obes Relat Metab Disord. 2004 Oct;28(10):1257-63.

11442.    Chang AH, Kirsch CM, Mobashery N, Johnson N, Levitt LJ. Streptococcus bovis septic shock due to contaminated transfused platelets. Am J Hematol. 2004 Nov;77(3):282-6.

11443.    Chen NL, Bai L, Li L, Chen PL, Zhang C, Liu CY, Deng T, Chen H, Jia KM, Zhou ZQ.  Apoptosis pathway of liver cells in chronic hepatitis. World J Gastroenterol. 2004 Nov 1;10(21):3201-4.

11444.    Chu WC, Leung TF, Chan KF, Yeung DK, Yeung TK, Cheung HM, Hon EK, Liew CT, Lam WW. Wilson's disease with chronic active hepatitis: monitoring by in vivo 31-phosphorus MR spectroscopy before and after medical treatment. AJR Am J Roentgenol. 2004 Nov;183(5):1339-42.

11445.    Colletti JE, Homme JL, Woodridge DP. Unsuspected neonatal killers in emergency medicine. Emerg Med Clin North Am. 2004 Nov;22(4):929-60. Review.

11446.    Copley L. C is for communication. Nurs Stand. 2004 Nov 3-9;19(8):19.

11447.    Daniele B, Bencivenga A, Megna AS, Tinessa V. Alpha-fetoprotein and ultrasonography screening for hepatocellular carcinoma. Gastroenterology. 2004 Nov;127(5 Suppl 1):S108-12. Review.

11448.    De Cock L, Hutse V, Verhaegen E, Quoilin S, Vandenberghe H, Vranckx R. Detection of HCV antibodies in oral fluid. J Virol Methods. 2004 Dec 15;122(2):179-83.

11449.    Di Martino V, Lebray P, Myers RP, Pannier E, Paradis V, Charlotte F, Moussalli J, Thabut D, Buffet C, Poynard T. Progression of liver fibrosis in women infected with hepatitis C: long-term benefit of estrogen exposure. Hepatology. 2004 Dec;40(6):1426-33.

11450.    Dragoteanu M, Cotul SO, Tamas S, Piglesan C. Nuclear medicine dynamic investigations of diffuse chronic liver diseases and portal hypertension. Rom J Gastroenterol. 2004 Dec;13(4):351-7.

11451.     Eltahawy AT, Jiman-Fatani AA, Al-Alawi MM. A fatal non-01 Vibrio cholerae septicemia in a patient with liver cirrhosis. Saudi Med J. 2004 Nov;25(11):1730-1.

11452.    Evrard S, Le Moine O, Deviere J, Yengue P, Nagy N, Adler M, Van Gossum A.  Unexplained digestive bleeding in a cirrhotic patient. Gut. 2004 Dec;53(12):1771; quiz answer 1780.

11453.    Fattovich G, Zagni I, Ribero ML, Castagnetti E, Minola E, Lomonaco L, Scattolini C, Fabris P, Boccia S, Giusti M, Abbati G, Felder M, Rovere P, Redaelli A, Tonon A, Tomba A, Montanari R, Paternoster C, Distasi M, Fornaciari G, Tositti G, Rizzo C, Suppressa S, Pantalena M, Noventa F, Tagger A. A randomized trial of prolonged high dose of interferon plus ribavirin for hepatitis C patients nonresponders to interferon alone. J Viral Hepat. 2004 Nov;11(6):543-51.

11454.    Fernandez-Rodriguez CM, Gutierrez ML, Serrano PL, Lledo JL, Santander C, Fernandez TP, Tomas E, Cacho G, Nevado M, Casas ML. Factors influencing the rate of fibrosis progression in chronic hepatitis C. Dig Dis Sci. 2004 Nov-Dec;49(11-12):1971-6.

11455.    Forton DM, Thomas HC, Taylor-Robinson SD. Central nervous system involvement in hepatitis C virus infection. Metab Brain Dis. 2004 Dec;19(3-4):383-91. Review.

11456.    Gea-Banacloche JC, Opal SM, Jorgensen J, Carcillo JA, Sepkowitz KA, Cordonnier C.  Sepsis associated with immunosuppressive medications: an evidence-based review. Crit Care Med. 2004 Nov;32(11 Suppl):S578-90. Review.

11457.    Gill ML, Atiq M, Sattar S, Khokhar N. Non-endoscopic parameters for the identification of esophageal varices in patients with chronic hepatitis. J Pak Med Assoc. 2004 Nov;54(11):575-7.

11458.    Goldenberg NA, Graham DK, Liang X, Hays T. Successful treatment of severe aplastic anemia in children using standardized immunosuppressive therapy with antithymocyte globulin and cyclosporine A. Pediatr Blood Cancer. 2004 Dec;43(7):718-22.

11459.    Harrison SA, Neuschwander-Tetri BA. Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. Clin Liver Dis. 2004 Nov;8(4):861-79, ix. Review.

11460.    Jones EA. Fatigue complicating chronic liver disease. Metab Brain Dis. 2004 Dec;19(3-4):421-9. Review.

11461.    Kilbourne AM, Cornelius JR, Han X, Pincus HA, Shad M, Salloum I, Conigliaro J, Haas GL. Burden of general medical conditions among individuals with bipolar disorder. Bipolar Disord. 2004 Oct;6(5):368-73.

11462.    Koklu S, Koksal AS, Asil M, Kiyici H, Coban S, Arhan M. Probable sulbactam/ampicillin-associated prolonged cholestasis. Ann Pharmacother. 2004 Dec;38(12):2055-8.

11463.    Kondo M, Okazaki H, Takai K, Nishikawa J, Ohta H, Uekusa T, Yoshida H, Tanaka K. Intrahepatic splenosis in a patient with chronic hepatitis C. J Gastroenterol. 2004 Oct;39(10):1013-5.

11464.   Kukka C. Bloodborne infections: should they be disclosed? Is differential treatment necessary? J Sch Nurs. 2004 Dec;20(6):324-30. Review.

11465.    Li LJ, Yang Q, Huang JR, Xu XW, Chen YM, Fu SZ. Effect of artificial liver support system on patients with severe viral hepatitis: a study of four hundred cases. World J Gastroenterol. 2004 Oct 15;10(20):2984-8.

11466.    Liaw YF, Sung JJ, Chow WC, Farrell G, Lee CZ, Yuen H, Tanwandee T, Tao QM, Shue K, Keene ON, Dixon JS, Gray DF, Sabbat J; Cirrhosis Asian Lamivudine Multicentre Study Group. Lamivudine for patients with chronic hepatitis B and advanced liver disease. N Engl J Med. 2004 Oct 7;351(15):1521-31.

11467.   Lu CY, Chiang BL, Chi WK, Chang MH, Ni YH, Hsu HM, Twu SJ, Su IJ, Huang LM, Lee CY. Waning immunity to plasma-derived hepatitis B vaccine and the need for boosters 15 years after neonatal vaccination. Hepatology. 2004 Dec;40(6):1415-20.

11468.    Mao YM, Zeng MD, Lu LG, Wan MB, Li CZ, Chen CW, Fu QC, Wang JY, She WM, Cai X, Ye J, Zhou XQ, Wang H, Wu SM, Tang MF, Zhu JS, Chen WX, Zhang HQ.  Capsule oxymatrine in treatment of hepatic fibrosis due to chronic viral hepatitis: a randomized, double blind, placebo-controlled, multicenter clinical study. World J Gastroenterol. 2004 Nov 15;10(22):3269-73.

11469.    Miller EB, Friedman JA. Takayasu's arteritis and hepatitis C: a new association? Clin Rheumatol. 2004 Oct;23(5):479.

11470.    Minami M, Okanoue T. Evidence-based medicine on domestic data. J Gastroenterol. 2004 Oct;39(10):1019-20.

11471.    Rich JD, Taylor LE, Allen SA. Screening for hepatitis C virus infection in adults. Ann Intern Med. 2004 Oct 5;141(7):575-6;

11472.    Roque-Afonso AM, Grangeot-Keros L, Roquebert B, Desbois D, Poveda JD, Mackiewicz V, Dussaix E. Diagnostic relevance of immunoglobulin G avidity for hepatitis A virus. J Clin Microbiol. 2004 Nov;42(11):5121-4.

11473.    Samandari T, Bell BP, Armstrong GL. Quantifying the impact of hepatitis A immunization in the United States, 1995-2001. Vaccine. 2004 Oct 22;22(31-32):4342-50.

11474.   Sarin SK, Sandhu BS, Sharma BC, Jain M, Singh J, Malhotra V. Beneficial effects of 'lamivudine pulse' therapy in HBeAg-positive patients with normal ALT*. J Viral Hepat. 2004 Nov;11(6):552-8.

11475.   Thomson EC, Main J. Advances in hepatitis B and C. Curr Opin Infect Dis. 2004 Oct;17(5):449-59. Review.

11476.    Totan M, Yildiz G, Kalayci AG. An uncommon presentation: chronic meningococcaemia associated with cholestatic hepatitis in a Turkish child. J Trop Pediatr. 2004 Dec;50(6):372-4.

11477.   Tsai YH, Hsu RW, Huang KC, Chen CH, Cheng CC, Peng KT, Huang TJ.  Systemic Vibrio infection presenting as necrotizing fasciitis and sepsis. A series of thirteen cases. J Bone Joint Surg Am. 2004 Nov;86-A(11):2497-502.

11478. Uppal M, Rai R, Srinivas CR. Leflunomide included drug rash and hepatotoxicity. Indian Joural of Dermatology. 2004 Jul-Sep;49(3): 154-155

11478.  Uppal M, Rai R, Srinivas CR. Leflunomide included drug rash and hepatotoxicity. Indian Journal of Dermatology. 2004 Jul-Sep;49(3):154-155.

Pathogenesis:

11479.    Ahmad K. Pakistan:a cirrhotic state? Lancet. 2004 Nov 20;364(9448):1843-4.

11480.   Alvarez-Ruiz SB, Garcia-Rio I, Aragues M, Fraga J, Locertales Pueyo J, Fernandez-Herrera J, Garcia-Diez A. Leucocytoclastic vasculitis, hepatitis C virus-associated mixed cryoglobulinaemia with biclonal gammopathy and Waldenstrom macroglobulinaemia. Br J Dermatol. 2004 Oct;151(4):937-9.

11481.   Ayranci U, Kosgeroglu N. Needlestick and sharps injuries among nurses in the healthcare sector in a city of western Turkey. J Hosp Infect. 2004 Nov;58(3):216-23.

11482.    Barbara JA. The rationale for pathogen-inactivation treatment of blood components. Int J Hematol. 2004 Nov;80(4):311-6. Review.

11483.    Beeching NJ, Clarke PD, Kitchin NR, Pirmohamed J, Veitch K, Weber F. Comparison of two combined vaccines against typhoid fever and hepatitis A in healthy adults. Vaccine. 2004 Nov 15;23(1):29-35.

11484.    Chuang E, Del Vecchio A, Smolinski S, Song XY, Sarisky RT. Biomedicines to reduce inflammation but not viral load in chronic HCV--what's the sense? Trends Biotechnol. 2004 Oct;22(10):517-23. Review.

11485.    Emerson SU, Purcell RH. Running like water--the omnipresence of hepatitis E. N Engl J Med. 2004 Dec 2;351(23):2367-8.

11486.    Godfroid F, Denoel P, de Grave D, Schuerman L, Poolman J. Diphtheria-tetanus-pertussis (DTP) combination vaccines and evaluation of pertussis immune responses. Int J Med Microbiol. 2004 Oct;294(5):269-76. Review.

11487.    Golla K, Epstein JB, Cabay RJ. Liver disease: current perspectives on medical and dental management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004 Nov;98(5):516-21. Review.

11488.    Gray WL. Simian varicella: a model for human varicella-zoster virus infections. Rev Med Virol. 2004 Nov-Dec;14(6):363-81. Review.

11489.    Hanna JN, Hills SL, Humphreys JL. Impact of hepatitis A vaccination of Indigenous children on notifications of hepatitis A in north Queensland. Med J Aust. 2004 Nov 1;181(9):482-5.

11490.   Hu J, Nguyen D. Therapy for chronic hepatitis B: the earlier, the better? Trends Microbiol. 2004 Oct;12(10):431-3. Review.

11491.   Huang Y, Fan XG, Wang ZM, Zhou JH, Tian XF, Li N. Identification of helicobacter species in human liver samples from patients with primary hepatocellular carcinoma. J Clin Pathol. 2004 Dec;57(12):1273-7.

11492.   Jacobsen KH, Koopman JS. Declining hepatitis A seroprevalence: a global review and analysis. Epidemiol Infect. 2004 Dec;132(6):1005-22. Review.

11493.    Jee SH, Ohrr H, Sull JW, Samet JM. Cigarette smoking, alcohol drinking, hepatitis B, and risk for hepatocellular carcinoma in Korea. J Natl Cancer Inst. 2004 Dec 15;96(24):1851-6.

11494.    Kermode M. Healthcare worker safety is a pre-requisite for injection safety in developing countries. Int J Infect Dis. 2004 Nov;8(6):325-7.

11495.     Kordi R, Wallace WA. Blood borne infections in sport: risks of transmission, methods of prevention, and recommendations for hepatitis B vaccination. Br J Sports Med. 2004 Dec;38(6):678-84; discussion 678-84. Review.

11496.    Manns MP, Wedemeyer H. Treatment of hepatitis C in HIV-infected patients: significant progress but not the final step. JAMA. 2004 Dec 15;292(23):2909-13.

11497.   Mariano A, Mele A, Tosti ME, Parlato A, Gallo G, Ragni P, Zotti C, Lopalco P, Pompa MG, Graziani G, Stroffolini T. Role of beauty treatment in the spread of parenterally transmitted hepatitis viruses in Italy. J Med Virol. 2004 Oct;74(2):216-20.

11498.   Nolan T, Altmann A, Skeljo M, Streeton C, Schuerman L. Antibody persistence, PRP-specific immune memory, and booster responses in infants immunised with a combination DTPa-HBV-IPV/Hib vaccine. Vaccine. 2004 Nov 15;23(1):14-20.

11499.     Nurkka A, Joensuu J, Henckaerts I, Peeters P, Poolman J, Kilpi T, Kayhty H.  Immunogenicity and safety of the eleven valent pneumococcal polysaccharide-protein D conjugate vaccine in infants. Pediatr Infect Dis J. 2004 Nov;23(11):1008-14.

11500.     Parke FA, Reveille JD. Anti-tumor necrosis factor agents for rheumatoid arthritis in the setting of chronic hepatitis C infection. Arthritis Rheum. 2004 Oct 15;51(5):800-4.

11501.    Phillips SD, Waksman JC. Hepatorenal solvent toxicology. Clin Occup Environ Med. 2004 Nov;4(4):731-40, vi. Review.

11502.    Plug I, van der Bom JG, Peters M, Mauser-Bunschoten EP, de Goede-Bolder A, Heijnen L, Smit C, Zwart-van Rijkom JE, Willemse J, Rosendaal FR. Thirty years of hemophilia treatment in the Netherlands, 1972-2001. Blood. 2004 Dec 1;104(12):3494-500.

11503.    Poland GA, Jacobson RM. Clinical practice: prevention of hepatitis B with the hepatitis B vaccine. N Engl J Med. 2004 Dec 30;351(27):2832-8. Review. Erratum in: N Engl J Med. 2005 Feb 17;352(7):740.

11504.   Pompili M, Basso M, Grieco A, Vecchio FM, Gasbarrini G, Rapaccini GL. Recurrent acute hepatitis associated with use of cetirizine. Ann Pharmacother. 2004 Nov;38(11):1844-7.

11505.    Reichman LB, Lardizabal A, Hayden CH. Considering the role of four months of rifampin in the treatment of latent tuberculosis infection. Am J Respir Crit Care Med. 2004 Oct 15;170(8):832-5.

Vaccines:

11506.    Beeching NJ. Hepatitis B infections.BMJ. 2004 Nov 6;329(7474):1059-60.

11507.   Centers for Disease Control and Prevention (CDC). Vaccination coverage among children entering school--United States, 2003-04 school year. MMWR Morb Mortal Wkly Rep. 2004 Nov 12;53(44):1041-4.

11508.   Moylett EH, Hanson IC. Mechanistic actions of the risks and adverse events associated with vaccine administration. J Allergy Clin Immunol. 2004 Nov;114(5):1010-20; quiz 1021. Review.

11509.   Shah C, Lemke S, Singh V, Gentile T. Case reports of aplastic anemia after vaccine administration. Am J Hematol. 2004 Oct;77(2):204.

11510.   Song BJ, Katial RK. Update on side effects from common vaccines. Curr Allergy Asthma Rep. 2004 Nov;4(6):447-53. Review.

11511.   Sorabjee JS, Garje R. Vaccinated but not immunized: protection against hepatitis B in medical staff in the developing world. J Hosp Infect. 2004 Oct;58(2):164-5.

11512.   Tejedor JC, Omenaca F, Garcia-Sicilia J, Verdaguer J, Van Esso D, Esporrin C, Molina V, Muro M, Mares J, Enrubia M, Moraga F, Garcia-Corbeira P, Dobbelaere K, Schuerman L; Spanish DTPa-HBV-IPV/Hib-076 Study Group. Immunogenicity and reactogenicity of a three-dose primary vaccination course with a combined diphtheria-tetanus-acellular pertussis-hepatitis B-inactivated polio-haemophilus influenzae type b vaccine coadministered with a meningococcal C conjugate vaccine. sPediatr Infect Dis J. 2004 Dec;23(12):1109-15.

11513.  Viviani S, Mendy M, Jack AD, Hall AJ, Montesano R, Whittle HC. EPI vaccines-induced antibody prevalence in 8-9 year-olds in The Gambia. Trop Med Int Health. 2004 Oct;9(10):1044-9.

11514.   Wallace LA, Bramley JC, Ahmed S, Duff R, Hutchinson SJ, Carman WF, Kitchin NR, Goldberg DJ. Determinants of universal adolescent hepatitis B vaccine uptake. Arch Dis Child. 2004 Nov;89(11):1041-2.

11515.   Wickham S. Hepatitis B vaccination: whose right? Pract Midwife. 2004 Oct;7(9):43.

11516.    Yuen MF, Lim WL, Chan AO, Wong DK, Sum SS, Lai CL. 18-year follow-up study of a prospective randomized trial of hepatitis B vaccinations without booster doses in children. Clin Gastroenterol Hepatol. 2004 Oct;2(10):941-5.

Therapy:

11517.   Das P. Infectious disease surveillance update. Lancet Infect Dis. 2004 Nov;4(11):657.

11518.    Davern TJ 2nd. Acetaminophen hepatotoxicity. Hepatology. 2004 Oct;40(4):1021-2; discussion 1022.

11519.    Dionisio D, Esperti F, Messeri D, Vivarelli A. Priority strategies for sustainable fight against HIV/AIDS in low-income countries. Curr HIV Res. 2004 Oct;2(4):377-93. Review.

11520.    Karayiannis P. Current therapies for chronic hepatitis B virus infection. Expert Rev Anti Infect Ther. 2004 Oct;2(5):745-60. Review.

11521.    Keystone EC. The utility of tumour necrosis factor blockade in orphan diseases. Ann Rheum Dis. 2004 Nov;63 Suppl 2:ii79-ii83. Review.

11522.     Pawlotsky JM. Hepatitis C: it's a long way to new therapy, it's a long way to go... Gastroenterology. 2004 Nov;127(5):1629-32.

11523.     Satake M. Infectious risks associated with the transfusion of blood components and pathogen inactivation in Japan. Int J Hematol. 2004 Nov;80(4):306-10. Review.

11524.    Sharma DC. India to use AD syringes to stem infection from reused needles. Lancet Infect Dis. 2004 Oct;4(10):601.

11525.    Spurgeon D. Canada pledges cash for more victims of blood-bank debacle. Nature. 2004 Dec 2;432(7017):540.

11526.    Tong W, Hurley S, Hayashi PH. Reconsidering hepatorenal syndrome. Throw in the towel? Not so fast! Postgrad Med. 2004 Dec;116(6):15-6, 21-4.

11527.   Watson KJ. Surgeon, test (and heal) thyself: sharps injuries and hepatitis C risk. Med J Aust. 2004 Oct 4;181(7):366-7. Review.

11528.        Zekry A, Patel K, Muir A, McHutchison JG. Tinkering and tailoring with HCV therapy: can we get away with less? Hepatology. 2004 Dec;40(6):1249-51. Review.