HEPATITIS

January, 2005

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:

10981.  Adams LA, Lindor KD, Angulo P. The prevalence of autoantibodies and autoimmune hepatitis in patients with nonalcoholic Fatty liver disease. Am J Gastroenterol. 2004 Jul;99(7):1316-20.

10982.  Ambrosetti A, Zanotti R, Pattaro C, Lenzi L, Chilosi M, Caramaschi P, Arcaini L, Pasini F, Biasi D, Orlandi E, D'Adda M, Lucioni M, Pizzolo G. Most cases of primary salivary mucosa-associated lymphoid tissue lymphoma are associated either with Sjoegren syndrome or hepatitis C virus infection. Br J Haematol. 2004 Jul;126(1):43-9.

10983.  Ashish K, Gupta S, Gupta P. Co-infection of HBV and HCV in patients of liver disease a study in North India. Indian Med Gaz 2004; 138(2): 57-62.

10984.  Bacon BR. Chronic hepatitis C and normal ALT: considerations for treatment. Am J Gastroenterol. 2004 Sep;99(9):1706-7.

10985.  Bollens D, Guiguet M, Tangre P, Rollinat L, Rachline A, Meynard JL, Girard PM, Benlian P, Meyohas MC. Major hypertriglyceridemia in HIV-infected patients on antiretroviral therapy: a role of the personal and family history. Infection. 2004 Aug;32(4):217-21.

10986.  Bruden DL, McMahon BJ, Hennessy TW, Christensen CJ, Homan CE, Williams JL, Sullivan DG, Gretch DR, Cagle HH, Bulkow LR. Estimating the date of hepatitis C virus infection from patient interviews and antibody tests on stored sera. Am J Gastroenterol. 2004 Aug;99(8):1517-22.

10987.  Chawla Y. Management of hepatitis C in immunocompetent patients. Gastroenterol Today 2002; 6(4): 195-8.

10988.  Di Bisceglie AM. Screening for hepatocellular carcinoma: being old is not all bad. Am J Gastroenterol. 2004 Aug;99(8):1477-8.

10989.  Grabhorn E, Schulz A, Helmke K, Hinrichs B, Rogiers X, Broering DC, Burdelski M, Ganschow R. Short- and long-term results of liver transplantation in infants aged less than 6 months. Transplantation. 2004 Jul 27;78(2):235-41.

10990.  Hajeer AH, Memish ZA, Al-Knawy BA. Laboratory diagnosis of Hepatitis C virus infection. A change to common practice. Saudi Med J. 2004 Jul;25(7):827-9. 

10991.  Ito K, Fujita T, Shimizu A, Koike S, Sasaki K, Matsunaga N, Hibino S, Yuhara M. Multiarterial phase dynamic MRI of small early enhancing hepatic lesions in cirrhosis or chronic hepatitis: differentiating between hypervascular hepatocellular carcinomas and pseudolesions. AJR Am J Roentgenol. 2004 Sep;183(3):699-705.

10992.  Mancini C, Pisani G, Azzi A, Luisa Zerbini M, Gentili G, Mario Bisso G; MS participants. Inter-laboratory comparison of qualitative and quantitative detection of hepatitis C (HCV) virus RNA in diagnostic virology: a multicentre study (MS) in Italy. J Clin Virol. 2004 Aug;30(4):313-9.

10993.  Nagpal AK. Viral markers and selection for treatment in chronic hepatitis B and C. Gastroenterol Today 2002; 6(4):183-7.

10994.  Park SA, Heo K. Prominent cerebellar symptoms with unusual magnetic resonance imaging findings in acquired hepatocerebral degeneration. Arch Neurol. 2004 Sep; 61(9): 1458-60.

10995.  Poynard T, Munteanu M, Imbert-Bismut F, Charlotte F, Thabut D, Le Calvez S, Messous D, Thibault V, Benhamou Y, Moussalli J, Ratziu V. Prospective analysis of discordant results between biochemical markers and biopsy in patients with chronic hepatitis C. Clin Chem. 2004 Aug;50(8):1344-55. 

10996.  Sakhuja P, Malhotra V, Gondal R, Sarain SK, Thaku V. Histological profile of liver disease in patients with dual hepatitis B and C virus infection. Indian J Path Microbiol 2003; 46(4):555-8.

10997.  Saltik-Temizel IN, Kocak N, Ozen H, Demir H. Serum hyaluronic acid concentrations in children with cirrhosis. Indian J Gastroenterol. 2004 Jul-Aug;23(4):129-30.

10998.  Shidrawi R, Ali Al-Huraibi M, Ahmad Al-Haimi M, Dayton R, Murray-Lyon IM. Seroprevalence of markers of viral hepatitis in Yemeni healthcare workers. J Med Virol. 2004 Aug;73(4):562-5.

10999.  Sum SS, Wong DK, Yuen MF, Yuan HJ, Yu J, Lai CL, Ho D, Zhang L. Real-time PCR assay using molecular beacon for quantitation of hepatitis B virus DNA. J Clin Microbiol. 2004 Aug;42(8):3438-40.

11000.  Toivola DM, Ku NO, Resurreccion EZ, Nelson DR, Wright TL, Omary MB. Keratin 8 and 18 hyperphosphorylation is a marker of progression of human liver disease. Hepatology. 2004 Aug;40(2):459-66.

11001.  Wang N, Gao XQ, Han JX. Simultaneous detection of HBV and HCV by multiplex PCR normalization. World J Gastroenterol. 2004 Aug 15;10(16):2439-43.

11002.  Wightman F, Walters T, Ayres A, Bowden S, Bartholomeusz A, Lau D, Locarnini S, Lewin SR. Comparison of sequence analysis and a novel discriminatory real-time PCR assay for detection and quantification of Lamivudine-resistant hepatitis B virus strains. J Clin Microbiol. 2004 Aug;42(8):3809-12.

11003.  Williams J. Guidelines to determine who should be tested for hepatitis C. Nurs Times. 2004 Jul 13-19;100(28):28-9. Review.

11004.  Wu XZ, Chen D, Zhao LS, Yu XH, Wei M, Zhao Y, Fang Q, Xu Q. Early diagnosis of bacterial and fungal infection in chronic cholestatic hepatitis B. World J Gastroenterol. 2004 Aug 1;10(15):2228-31.

11005.  Yuan HJ, Yuen  MF, Wong DK, Sum SS, Lai CL. Clinical evaluation of the digene hybrid capture II test and the COBAS AMPLICOR monitor test for determination of hepatitis B virus DNA levels. J Clin Microbiol. 2004 Aug;42(8):3513-7.

11006.  Zechini B, Pasquazzi C, Aceti A. Correlation of serum aminotransferases with HCV RNA levels and histological findings in patients with chronic hepatitis C: the role of serum aspartate transaminase in the evaluation of disease progression. Eur J Gastroenterol Hepatol. 2004 Sep;16(9):891-6.

Pathogenesis:

11007.  Almond LM, Boffito M, Hoggard PG, Bonora S, Raiteri R, Reynolds HE, Garazzino S, Sinicco A, Khoo SH, Back DJ, Di Perri G. The relationship between nevirapine plasma concentrations and abnormal liver function tests. AIDS Res Hum Retroviruses. 2004 Jul;20(7):716-22.

11008.  Antonelli A, Ferri C, Pampana A, Fallahi P, Nesti C, Pasquini M, Marchi S, Ferrannini E.  Thyroid disorders in chronic hepatitis C. Am J Med. 2004 Jul 1;117(1):10-3.

11009.  Choi KJ, Lim CW, Yoon MY, Ahn BY, Yu YG. Quantitative analysis of the interaction between the envelope protein domains and the core protein of human hepatitis B virus. Biochem Biophys Res Commun. 2004 Jul 2;319(3):959-66.

11010.  de Lalla C, Galli G, Aldrighetti L, Romeo R, Mariani M, Monno A, Nuti S, Colombo M, Callea F, Porcelli SA, Panina-Bordignon P, Abrignani S, Casorati G, Dellabona P. Production of profibrotic cytokines by invariant NKT cells characterizes cirrhosis progression in chronic viral hepatitis. J Immunol. 2004 Jul 15;173(2):1417-25.

11011.  Eroglu C, Leblebicioglu H, Gunaydin M, Turan D, Sunbul M, Esen S, Sanic A. Distinguishing hepatitis B virus (HBV) genotype D from non-D by a simple PCR. J Virol Methods. 2004 Aug;119(2):183-7.

11012.  Furione M, Maserati R, Gatti M, Baldanti F, Cividini A, Bruno R, Gerna G, Mondelli MU. Dissociation of serum and liver hepatitis C virus RNA levels in patients coinfected with human immunodeficiency virus and treated with antiretroviral drugs. J Clin Microbiol. 2004 Jul;42(7):3012-6.

11013.  Gonzalez-Calvin JL, Gallego-Rojo F, Fernandez-Perez R, Casado-Caballero F, Ruiz-Escolano E, Olivares EG. Osteoporosis, mineral metabolism, and serum soluble tumor necrosis factor receptor p55 in viral cirrhosis. J Clin Endocrinol Metab. 2004 Sep;89(9):4325-30.

11014.  Habu D, Shiomi S, Tamori A, Takeda T, Tanaka T, Kubo S, Nishiguchi S. Role of vitamin K2 in the development of hepatocellular carcinoma in women with viral cirrhosis of the liver. JAMA. 2004 Jul 21;292(3):358-61.

11015.  Jardi R, Rodriguez-Frias F, Buti M, Schaper M, Valdes A, Martinez M, Esteban R, Guardia J.  Usefulness of dried blood samples for quantification and molecular characterization of HBV-DNA. Hepatology. 2004 Jul;40(1):133-9.

11016.  Lee J, Shin MK, Lee HJ, Yoon G, Ryu WS. Three novel cis-acting elements required for efficient plus-strand DNA synthesis of the hepatitis B virus genome. J Virol. 2004 Jul;78(14):7455-64.

11017.  Liu J, Guo Y, Xue CF, Li YH, Huang YX, Ding J, Gong WD, Zhao Y. Effect of vector-expressed siRNA on HBV replication in hepatoblastoma cells. World J Gastroenterol. 2004 Jul 1;10(13):1898-901.

11018.  Messerini L, Novelli L, Comin CE. Microvessel density and clinicopathological characteristics in hepatitis C virus and hepatitis B virus related hepatocellular carcinoma. J Clin Pathol. 2004 Aug;57(8):867-71.

11019.  Murakami H, Akbar SM, Matsui H, Horiike N, Onji M. Decreased interferon-alpha production and impaired T helper 1 polarization by dendritic cells from patients with chronic hepatitis C. Clin Exp Immunol. 2004 Sep;137(3):559-65.

11020.  Ni Q, Chen Z, Yao HP, Yang ZG, Liu KZ, Wu LL. Inhibition of human La protein by RNA interference downregulates hepatitis B virus mRNA in 2.2.15 cells. World J Gastroenterol. 2004 Jul 15;10(14):2050-4.

11021.  Ovejero C, Cavard C, Perianin A, Hakvoort T, Vermeulen J, Godard C, Fabre M, Chafey P, Suzuki K, Romagnolo B, Yamagoe S, Perret C. Identification of the leukocyte cell-derived chemotaxin 2 as a direct target gene of beta-catenin in the liver. Hepatology. 2004 Jul;40(1):167-76.

11022.  Pemberton PW, Aboutwerat A, Smith A, Burrows PC, McMahon RF, Warnes TW. Oxidant stress in type I autoimmune hepatitis: the link between necroinflammation and fibrogenesis? Biochim Biophys Acta. 2004 Aug 4;1689(3):182-9.

11023.  Saez A, Losa M, Lo Iacono O, Lozano C, Alvarez E, Pita L, Garcia-Monzon C. Diagnostic and prognostic value of virologic tests in vertical transmission of hepatitis C virus infection: results of a large prospective study in pregnant women. Hepatogastroenterology. 2004 Jul-Aug;51(58):1104-8.

11024.  Soffredini R, Rumi MG, Parravicini ML, Ronchi G, Del Ninno E, Russo A, Colombo M. Serum levels of hepatitis C virus core antigen as a marker of infection and response to therapy. Am J Gastroenterol. 2004 Sep;99(9):1738-43.

11025.  Tomer Y, Villanueva R. Hepatitis C and thyroid autoimmunity: is there a link? Am J Med. 2004 Jul 1;117(1):60-1. 

11026.  Valenti L, De Feo T, Fracanzani AL, Fatta E, Salvagnini M, Arico S, Rossi G, Fiorelli G, Fargion S. Cytotoxic T-lymphocyte antigen-4 A49G polymorphism is associated with susceptibility to and severity of alcoholic liver disease in Italian patients. Alcohol Alcohol. 2004 Jul-Aug;39(4):276-80.

11027.  Wu KL, Lu SN, Changchien CS, Chiu KW, Kuo CH, Chuah SK, Liu JW, Lin MC, Eng HL, Chen SS, Lee CM, Chen CL. Sequential changes of serum aminotransferase levels in patients with severe acute respiratory syndrome. Am J Trop Med Hyg. 2004 Aug;71(2):125-8.

11028.  Yang G, Pevear DC, Collett MS, Chunduru S, Young DC, Benetatos C, Jordan R. Newly synthesized hepatitis C virus replicon RNA is protected from nuclease activity by a protease-sensitive factor(s). J Virol. 2004 Sep;78(18):10202-5.

11029.  Zhao L, Mou DC, Leng XS, Peng JR, Wang WX, Huang L, Li S, Zhu JY. Expression of cancer-testis antigens in hepatocellular carcinoma. World J Gastroenterol. 2004 Jul 15;10(14):2034-8.

Vaccines:

11030.  Cutts FT, Hall AJ. Vaccines for neonatal viral infections: hepatitis B vaccine. Expert Rev Vaccines. 2004 Aug;3(4):349-52. Review.

11031.  Eriksen EM, Perlman JA, Miller A, Marcy SM, Lee H, Vadheim C, Zangwill KM, Chen RT, DeStefano F, Lewis E, Black S, Shinefield H, Ward JI. Lack of association between hepatitis B birth immunization and neonatal death: a population-based study from the vaccine safety datalink project. Pediatr Infect Dis J. 2004 Jul;23(7):656-62.

11032.   Rubinstein E. Vaccination and autoimmune diseases: the argument against. Isr Med Assoc J. 2004 Jul;6(7):433-5. 

11033.  Vijaya Kumar V, Hari R, Parthiban R, Mehta J, Thyagarajan SP. Evaluation of Immunogenicity and safety of genevac b: a new recombinant hepatitis b vaccine in comparison with engerix b and shanvac b in healthy adults. Indian Journal of Medical Microbiology. 2004 Jan; 22(1): 34-8

Therapy:

11034.  D'Souza R, Foster GR. Diagnosis and treatment of chronic hepatitis B. J R Soc Med. 2004 Jul;97(7):318-21. Review. 

11035.  Lahousen T, Hegenbarth K, Ille R, Lipp RW, Krause R, Little RR, Schnedl WJ. Determination of glycated hemoglobin in patients with advanced liver disease. World J Gastroenterol. 2004 Aug 1;10(15):2284-6.

11036.  Matthews SC, Paulus MP, Dimsdale JE. Contribution of functional neuroimaging to understanding neuropsychiatric side effects of interferon in hepatitis C. Psychosomatics. 2004 Jul-Aug;45(4):281-6. Review.

11037.  McClain CJ, Song Z, Barve SS, Hill DB, Deaciuc I. Recent advances in alcoholic liver disease. IV. Dysregulated cytokine metabolism in alcoholic liver disease. Am J Physiol Gastrointest Liver Physiol. 2004 Sep;287(3):G497-502. Review.

11038.  Morisco F, Vitaglione P, Carbone A, Stingo S, Scarpati S, Ascione A, Marmo R, Fogliano V, Caporaso N. Tomato-based functional food as interferon adjuvant in HCV eradication therapy. J Clin Gastroenterol. 2004 Jul;38(6 Suppl):S118-20.

11039.  Stark JJ. Prevention of hepatocellular carcinoma. Ann Intern Med. 2004 Jul 6;141(1):77; author reply 77-8. 

11040.  Theurl I, Zoller H, Obrist P, Datz C, Bachmann F, Elliott RM, Weiss G. Iron regulates hepatitis C virus translation via stimulation of expression of translation initiation factor 3. J Infect Dis. 2004 Aug 15;190(4):819-25. 

11041.  Zignol M, Peracchi M, Tridello G, Pillon M, Fregonese F, D'Elia R, Zanesco L, Cesaro S.  Assessment of humoral immunity to poliomyelitis, tetanus, hepatitis B, measles, rubella, and mumps in children after chemotherapy. Cancer. 2004 Aug 1;101(3):635-41.

 

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April, 2005  
 

 

Some Selected Abstracts:

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.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:  

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.ian 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.

                                                               Back

July, 2005

 

Some Selected Abstracts:

1.

Arguedas MR, Drake BB, Kapoor A, Fallon MB. Carboxyhemoglobin levels in cirrhotic patients with and without hepatopulmonary syndrome. Gastroenterology. 2005 Feb;128(2):328-33.

University of Alabama at Birmingham Liver Center, Birmingham, AL 35294, USA.

BACKGROUND AND AIMS: Heme oxygenase (HO) catalyzes hemoglobin into bilirubin, iron, and carbon monoxide (CO), a known vasodilator. HO expression and CO production as measured by blood carboxyhemoglobin (COHb) levels increase in experimental hepatopulmonary syndrome (HPS) and contribute to vasodilatation. Whether CO contributes to HPS in humans is unknown. Our aim was to assess if arterial COHb levels are increased in cirrhotic patients with HPS relative to those without HPS. METHODS: We collected data prospectively in stable nonsmoking outpatients with cirrhosis. Demographic and clinical data and room-air arterial blood gases were collected and analyzed. HPS was diagnosed using established criteria. RESULTS: A total of 159 patients were studied. HPS was present in 27 (17%) patients. Mean age was 52 +/- 9 years, 54% were men, and hepatitis C and/or alcohol were the most common causes (53%). Fourteen percent were Child-Pugh class A, 53% were Child-Pugh class B, and 33% were Child-Pugh class C. Demographic and clinical features were similar between HPS and non-HPS patients except for the Child-Pugh score, which was lower in patients with HPS. Arterial Pa o 2 levels were lower and the alveolar-arterial oxygen gradient was higher in patients with HPS ( P < .001). COHb levels were increased in HPS relative to non-HPS ( P < .001) and correlated with Pa o 2 ( P < .001) and Aa po 2 ( P < .001) levels. CONCLUSIONS: COHb levels are increased in cirrhotic patients with HPS and correlate with gas exchange abnormalities. These results are consistent with findings in experimental HPS and suggest that CO may contribute to human HPS.

2.

Devarbhavi H, Alvares JF, Kumar KS. Severe falciparum malaria simulating fulminant hepatic failure. Mayo Clin Proc. 2005 Mar;80(3):355-8.

Department of Gastroenterology, St. John's Medical College Hospital, Bangalore, India. d_harshad@vsnl.net

OBJECTIVE: To identify clinical and laboratory features of patients with malarial hepatitis simulating fulminant hepatic failure (MHsFHF) and distinguish it from viral FHF. PATIENTS AND METHODS: At a tertiary care unit in Bangalore, India, we compared clinical and laboratory characteristics of 25 patients with MHsFHF with those of 25 patients with viral FHF from November 1996 to January 2000. RESULTS: No statistically significant differences were seen in duration of jaundice, altered consciousness, and the interval between onset of jaundice and altered consciousness between the 2 groups. Hepatomegaly and splenomegaly were present in 72% and 48% of patients with MHsFHF and in 12% and 0% of patients with viral FHF (P<.001), respectively. The MHsFHF group had a significantly lower hemoglobin level (9.3 g/dL vs 12.9 g/dL), total leukocyte count (9.1 x 10(9)/L vs 18 x 10(9)/L), platelet count (44.8 x 10(9)/L vs 218.6 x 10(9)/L), and transaminases (alanine aminotransferase, 86.2 U/L vs 1230.0 U/L; aspartate aminotransferase, 131.9 U/L vs 720.0 U/L) (P<.001). Thrombocytopenia and elevated serum urea nitrogen were universal in patients with MHsFHF. Prothrombin time was abnormal in all patients with viral FHF and in only 1 patient with MHsFHF. Of patients with MHsFHF, 24% died; of patients with viral FHF, 76% died (P=.02). CONCLUSIONS: In endemic areas, severe malaria should be considered in the differential diagnosis of FHF. Hepatomegaly and normal prothrombin time in the setting of FHF are suggestive of malaria, and a peripheral blood smear should be obtained for diagnostic confirmation.

3.

Fujioka S, Karashima K, Inoue A, Takami H, Nishikawa N, Saito Y. Case of infectious endocarditis predicted by orbital color Doppler imaging. Jpn J Ophthalmol. 2005 Jan-Feb;49(1):46-8.

Department of Ophthalmology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan. fujioka-sa@mc.pref.osaka.jp

BACKGROUND: There are no specific ocular findings for infectious endocarditis. We report a case of infectious endocarditis detected by combining orbital color Doppler imaging (CDI) and ophthalmological findings. CASE: A 47-year-old man suffered from lumbar pain and low-grade fever. He had undergone heart surgery for a ventricular septal defect and received blood transfusions 20 years earlier, and he had started interferon therapy for chronic hepatitis C 8 months previously. Systemic examinations suggested either collagen disease, malignant lymphoma, or infectious disease. OBSERVATIONS: The patient underwent a complete ophthalmological examination, including CDI. Ophthalmoscopy showed multiple cotton-wool patches in both eyes and branch retinal artery occlusion in the left eye. Orbital CDI showed that bilateral ophthalmic arteries and central retinal arteries flowed synchronously with abnormal waves composed of three narrow, sharp peaks. These findings were suggestive of a cardiac valve disorder, which can lead to embolisms. Echocardiography established the diagnosis of infectious endocarditis. CONCLUSIONS: To the best of our knowledge, this is the first reported case of infectious endocarditis detected by orbital CDI.

4.

Rabe C, Musch A, Schirmacher P, Kruis W, Hoffmann R. Acute hepatitis induced by an Aloe vera preparation: a case report. World J Gastroenterol. 2005 Jan 14;11(2):303-4.

Department of Medicine, Evangelisches Krankenhaus, Koeln Kalk, Germany. rabe@uni-bonn.de

AIM: Aloe vera, plant extracts of Aloe barbadensis miller, is widely used in phytomedicine. The first case of acute hepatitis due to this compound was described. METHODS: Description of a clinical case. RESULTS: Hepatitis in a 57-year old female could be linked to the ingestion of Aloe barbadensis miller compounds. The patient's hepatitis resolved completely after discontinuing this medication. CONCLUSION: The case emphasizes the importance of considering phytopharmaceutical over-the-counter drugs as causative agents of hepatitis.

5.

Saenger R, Maechler G, Potreck M, Zepp F, Knuf M, Habermehl P, Schuerman L. Booster vaccination with hexavalent DTPa-HBV-IPV/Hib vaccine in the second year of life is as safe as concomitant DTPa-IPV/Hib + HBV administered separately. Vaccine. 2005 Jan 19;23(9):1135-43.

GlaxoSmithKline GmbH & Co. KG, Theresienhoehe 11, 80339, Munich, Germany. roland.saenger@gsk.com

The safety and reactogenicity of a booster dose of GSK Biologicals' hexavalent DTPa-HBV-IPV/Hib vaccine (N=4725) was compared with the separate administration of GSK Biologicals' DTPa-IPV/Hib and HBV vaccines (N=4474) in two open, randomized multicenter studies (A and B). Solicited symptoms occurring within 4 days of vaccination were recorded on diary cards and serious adverse events (SAEs) were collected throughout the study period. In Study A (N=1149), incidences of solicited symptoms were similar in both groups; there were no SAEs either reported within 4 days of vaccination or considered to be causally related to vaccination. In study B (N=8050), where fever was the only solicited symptom, rectal temperature > or =39.5 degrees C was observed in 2.5% and 2.8% of the subjects, respectively. Fever > or =40.0 degrees C was rare (0.6%), and only two cases of febrile convulsions were recorded during the 4 days following vaccination both in the control group. Large swelling reactions (defined as local injection site swelling with diameter >50 mm, noticeable diffuse injection site swelling or noticeable increased circumference of the injected limb) were reported following 2.3% of the booster vaccine doses, regardless of the vaccine used. Extensive swelling reactions involving an adjacent joint were reported in 0.1% of the subjects. Two SAEs, both reported after booster doses of DTPa-IPV/Hib and HBV vaccines administered separately, were considered by the investigators to be related to vaccination. Both resolved completely without sequelae. The hexavalent DTPa-HBV-IPV/Hib vaccine and the DTPa-IPV/Hib and HBV vaccines administered separately have similar good reactogenicity and safety profiles when given as booster doses in the second year of life.

6.

Tarantola A, Rachline A, Konto C, Houze S, Sabah-Mondan C, Vrillon H, Bouvet E; Group for the Prevention of Occupational Infections in Health Care Workers. Occupational Plasmodium falciparum malaria following accidental blood exposure: a case, published reports and considerations for post-exposure prophylaxis. Scand J Infect Dis. 2005;37(2):131-40.

Bichat-Claude Bernard University Hospital, Paris, France. a.tarantola@invs.sante.fr

A French nurse presented Plasmodium falciparum malaria 10 d after a needlestick while sampling blood in a source patient with malaria. As did the source patient, the nurse recovered fully although diagnosis was delayed and her malaria severe. We proceeded to a thorough description of the transmission profile of P. falciparum following occupational needlestick. A review of the literature found 21 published reports of occupational malaria including our own, documenting 22 P. falciparum infections. One of these was lethal. The mean incubation time to fever onset was documented in 21 reports including our own and is 11.60 +/- 3.38 d (median 12.0, range 4-17 d). The incubation period was compatible to that found in experimental anopheline bites or transfusion malaria. The transmission profile cites a pathogen which may be more easily transmissible by occupational exposure to blood than human immunodeficiency virus (HIV) or hepatitis C virus (HCV). Undiagnosed malaria in non-immune health care workers can be lethal. Presumptive treatment of malaria is widely available and well tolerated. Clinicians should consider P. falciparum malaria when faced with a febrile patient who has or may have been exposed to biological fluids. Further research is needed in the field of P. falciparum prophylaxis following accidental exposure to a malaria patient's blood.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:  

  1. Abdallah MA, Hull C, Horn TD. Necrolytic acral erythema: a patient from the United States successfully treated with oral zinc. Arch Dermatol. 2005 Jan;141(1):85-7.

  2. Akhtar S, Moatter T, Akhtar Saeed. Hepatitis C Virus infection in polytransfused thalassemic children in Pakistan. Indian Pediat 2004, 41(10), 1072-3.

  3. 12086.     Allain JP. Hepatitis C virus in blood donation. Lancet. 2005 Jan 22;365(9456):276-8.  

  4. Blal CA, Passos SR, Horn C, Georg I, Bonecini-Almeida MG, Rolla VC, De Castro L. High prevalence of hepatitis B virus infection among tuberculosis patients with and without HIV in Rio de Janeiro, Brazil. Eur J Clin Microbiol Infect Dis. 2005 Jan;24(1):41-3.

  5. Cardenas A. Hepatorenal syndrome: a dreaded complication of end-stage liver disease. Am J Gastroenterol. 2005 Feb;100(2):460-7. Review.  

  6. Coulehan J. My injury, your blood. Hastings Cent Rep. 2005 Jan-Feb;35(1):10-1.

  7. Devarbhavi H, Alvares JF, Kumar KS. Severe falciparum malaria simulating fulminant hepatic failure. Mayo Clin Proc. 2005 Mar;80(3):355-8.  

  8. Ding HG, Xiang HP, Shan J, Zhou L, Ma B, Liu M, Wang JT. A scoring model for predicting the prognosis of severe viral hepatitis. Chin Med J (Engl). 2005 Feb 5;118(3):249-51.

  9. Fioredda F, Plebani A, Hanau G, Haupt R, Giacchino M, Barisone E, Balbo L, Castagnola E. Re-immunisation schedule in leukaemic children after intensive chemotherapy: a possible strategy. Eur J Haematol. 2005 Jan;74(1):20-3. 

  10. Fujioka S, Karashima K, Inoue A, Takami H, Nishikawa N, Saito Y. Case of infectious endocarditis predicted by orbital color Doppler imaging. Jpn J Ophthalmol. 2005 Jan-Feb;49(1):46-8.

  11. Guglin M. Intravenous amiodarone: offender or bystander? Crit Care Med. 2005 Jan;33(1):245-6.

  12. Hou CH, Yang RS, Hou SM. Hospital-based allogenic bone bank--10-year experience. J Hosp Infect. 2005 Jan;59(1):41-5.  

  13. Ioannou GN, Weiss NS, Boyko EJ, Kahn SE, Lee SP. Contribution of metabolic factors to alanine aminotransferase activity in persons with other causes of liver disease. Gastroenterology. 2005 Mar;128(3):627-35.  

  14. Katz HT, Haque SJ, Hsieh FH. Pediatric hypereosinophilic syndrome (HES) differs from adult HES. J Pediatr. 2005 Jan;146(1):134-6. Review.  

  15. Lim AK, Taylor-Robinson SD, Patel N, Eckersley RJ, Goldin RD, Hamilton G, Foster GR, Thomas HC, Cosgrove DO, Blomley MJ. Hepatic vein transit times using a microbubble agent can predict disease severity non-invasively in patients with hepatitis C. Gut. 2005 Jan;54(1):128-33.  

  16. Nunez M, Soriano V. Hepatotoxicity of antiretrovirals: incidence, mechanisms and management. Drug Saf. 2005;28(1):53-66. Review.  

  17. Potolidis E, Mantadakis E, Zeniodi MH, Samonis G. Rifampin plus pyrazinamide-induced hepatitis requiring hospitalization in a 30-y-old male with latent tuberculosis. Scand J Infect Dis. 2005;37(2):155-7.  

  18. Rabe C, Musch A, Schirmacher P, Kruis W, Hoffmann R. Acute hepatitis induced by an Aloe vera preparation: a case report. World J Gastroenterol. 2005 Jan 14;11(2):303-4.  

  19. Raimondo G, Pollicino T, Squadrito G. What is the clinical impact of occult hepatitis B virus infection? Lancet. 2005 Feb 19;365(9460):638-40.

  20. Ruhl CE, Everhart JE. Coffee and caffeine consumption reduce the risk of elevated serum alanine aminotransferase activity in the United States. Gastroenterology. 2005 Jan;128(1):24-32.  

  21. Sheffield JS, Laibl VR, Roberts SW, Wendel GD Jr. False positive results for the AUSZYME monoclonal test. Obstet Gynecol. 2005 Feb;105(2):449-50.  

  22. Shike H, Shimizu C, Kanegaye J, Foley JL, Burns JC. Quantitation of adenovirus genome during acute infection in normal children. Pediatr Infect Dis J. 2005 Jan;24(1):29-33.  

  23. Siebert U, Wasem J, Rossol S, Sroczynski G, Aidelsburger P, Ravens-Sieberer U, Kurth BM, Manns MP, McHutchison JG, Wong JB. Antiviral treatment initiation costs in chronic hepatitis C. Gut. 2005 Jan;54(1):172-3.  

  24. Smit W, Reekers J, Schultz MJ. Malaise, anorexia, progressive limb paresis and multiple defects in the kidneys. Neth J Med. 2005 Jan;63(1):38, 40.  

  25. Tarantola A, Rachline A, Konto C, Houze S, Sabah-Mondan C, Vrillon H, Bouvet E; Group for the Prevention of Occupational Infections in Health Care Workers. Occupational Plasmodium falciparum malaria following accidental blood exposure: a case, published reports and considerations for post-exposure prophylaxis. Scand J Infect Dis. 2005;37(2):131-40. Review.  

  26. Venkataravanamma P, Rau A T K. Severe thrombocytopenia in association with hepatitis A. Indian Pediat 2004, 41(11), 1178-9. 

  27. Weng ZH, Cai SQ. Analysis of prognosis on patients with severe viral hepatitis using the model for end-stage liver disease. World J Gastroenterol. 2005 Feb 14;11(6):899-902.  

  28. Zhang FK, Zhang JY, Jia JD. Treatment of patients with alcoholic liver disease. Hepatobiliary Pancreat Dis Int. 2005 Feb;4(1):12-7. Review.

Pathogenesis:

  1. Arguedas MR, Drake BB, Kapoor A, Fallon MB. Carboxyhemoglobin levels in cirrhotic patients with and without hepatopulmonary syndrome. Gastroenterology. 2005 Feb;128(2):328-33.

  2. Iwasa Y, Michor F, Nowak MA. Virus evolution within patients increases pathogenicity. J Theor Biol. 2005 Jan 7;232(1):17-26.

  3. Luby S, Hoodbhoy F, Jan A, Shah A, Hutin Y. Long-term improvement in unsafe injection practices following community intervention. Int J Infect Dis. 2005 Jan;9(1):52-9.

  4. Mok J, Pembrey L, Tovo PA, Newell ML; European Paediatric Hepatitis C Virus Network. When does mother to child transmission of hepatitis C virus occur? Arch Dis Child Fetal Neonatal Ed. 2005 Mar;90(2):F156-60.

  5. Stevens AM, Hermes HM, Lambert NC, Nelson JL, Meroni PL, Cimaz R.  Maternal and sibling microchimerism in twins and triplets discordant for neonatal lupus syndrome-congenital heart block. Rheumatology (Oxford). 2005 Feb;44(2):187-91.

  6. Yu JS, Kim YH, Rofsky NM. Dynamic subtraction magnetic resonance imaging of cirrhotic liver: assessment of high signal intensity lesions on nonenhanced T1-weighted images. J Comput Assist Tomogr. 2005 Jan-Feb;29(1):51-8.

Therapy:

  1. Dawson AJ. An ethical argument in favour of routine hepatitis B vaccination in very low-incidence countries. Lancet Infect Dis. 2005 Feb;5(2):120-5.

  2. Inoue M, Yoshimi I, Sobue T, Tsugane S; JPHC Study Group. Influence of coffee drinking on subsequent risk of hepatocellular carcinoma: a prospective study in Japan. J Natl Cancer Inst. 2005 Feb 16;97(4):293-300.

  3. Khaliq AA, Smego RA. Barber shaving and blood-borne disease transmission in developing countries. S Afr Med J. 2005 Feb;95(2):94, 96.

  4. Klein HG. Pathogen inactivation technology: cleansing the blood supply. J Intern Med. 2005 Mar;257(3):224-37. Review.

  5. Middleton DB, Zimmerman RK, Mitchell KB. Vaccine schedules and procedures. J Fam Pract. 2005 Jan;54(1 Suppl):S37-50. Review.

  6. Ramsey CD, Celedon JC. The hygiene hypothesis and asthma. Curr Opin Pulm Med. 2005 Jan;11(1):14-20. Review.

  7. Saenger R, Maechler G, Potreck M, Zepp F, Knuf M, Habermehl P, Schuerman L. Booster vaccination with hexavalent DTPa-HBV-IPV/Hib vaccine in the second year of life is as safe as concomitant DTPa-IPV/Hib + HBV administered separately. Vaccine. 2005 Jan 19;23(9):1135-43.

  8. Winstock AR. High risk groups are still not being vaccinated. BMJ. 2005 Jan 22;330(7484):198;

                                                    Back

October, 2005

 

Some Selected Abstracts:

1.

Chan HL, Kwan AC, To KF, Lai ST, Chan PK, Leung WK, Lee N, Wu A, Sung JJ. Clinical significance of hepatic derangement in severe acute respiratory syndrome. World J Gastroenterol. 2005 Apr 14;11(14):2148-53.

Department of Medicine and Therapeutics, Chinese University of Hong Kong, China.

AIM: Elevation of alanine aminotransferase (ALT) level is commonly seen among patients suffering from severe acute respiratory syndrome (SARS). We report the progression and clinical significance of liver derangement in a large cohort of SARS patient. METHODS: Serial assay of serum ALT was followed in patients who fulfilled the WHO criteria of SARS. Those with elevated ALT were compared with those with normal liver functions for clinical outcome. Serology for hepatitis B virus (HBV) infection was checked. Adverse outcomes were defined as oxygen desaturation, need of intensive care unit (ICU) and mechanical ventilation and death. RESULTS: Two hundred and ninety-four patients were included in this study. Seventy (24%) patients had elevated serum ALT on admission and 204 (69%) patients had elevated ALT during the subsequent course of illness. Using peak ALT >5XULN as a cut-off and after adjusting for potential confounding factors, the odds ratio of peak ALT >5X ULN for oxygen desaturation was 3.24 (95%CI 1.23-8.59, P = 0.018), ICU care was 3.70 (95%CI 1.38-9.89, P = 0.009), mechanical ventilation was 6.64 (95%CI 2.22-19.81, P = 0.001) and death was 7.34 (95%CI 2.28-24.89, P = 0.001). Ninety-three percent of the survived patients had ALT levels normalized or were on the improving trend during follow-up. Chronic hepatitis B was not associated with worse clinical outcomes. CONCLUSION: Reactive hepatitis is a common complication of SARS-coronavirus infection. Those patients with severe hepatitis had worse clinical outcome.

2.

Ding HG, Shan J, Zhang B, Ma HB, Zhou L, Jin R, Tan YF, He LX Combined human growth hormone and lactulose for prevention and treatment of multiple organ dysfunction in patients with severe chronic hepatitis B. World J Gastroenterol. 2005 May 21;11(19):2981-3.

Department of Gastroenterology and Hepatology, Beijing Youan Hospital, Capital University of Medical Sciences, Beijing 100054, China. dinghuiguo@medmail.com.cn

AIM: To evaluate the efficiency and safety of combined recombinant human growth hormone (rhGH) and lactulose for treatment and/or prevention of multiple organ dysfunction in patients with chronic severe hepatitis B. METHODS: Forty-eight inpatients with chronic severe hepatitis B were randomly divided into rhGH group (n=28) and control group (n=20). In rhGH group, 4-4.5 IU of rhGH was injected intramuscularly once daily for 2-4 wk, and 100 mL of enema containing 30 mL of lactulose, 2 g of metronidazole and 0.9% saline was administered every 2 d for 2-4 wk. Their symptoms and complications were noted. Liver and kidney functions were analyzed by an Olympus analyzer. Serum GH, IGF-1, IGFBP1 and IGFBP3 were measured by ELISA. RESULTS: Clinical symptoms of 90% of these patients in rhGH group were obviously improved. The total effectiveness in rhGH group was better than that in control group (75% vs 40%, P<0.05). After 2- and 4-wk treatment of rhGH respectively, serum albumin (26.1+/-4.1 vs 30.2+/-5.3, 31.9+/-5.1 g/L), prealbumin (79.6+/-28.0 vs 106.6+/-54.4, 108.4+/-55.0 g/L), cholesterol (76.3+/-16.7 vs 85.6+/-32.3, 96.1+/-38.7 mg/dL), and IGFBP1 (56.8+/-47.2 vs 89.7+/-50.3 ng/mL after 2 wk) were significantly increased compared to control group (P<0.05). However, serum GH was decreased. The increase of serum IGF1 and IGFBP3 after rhGH treatment was also observed. CONCLUSION: rhGH in combination with lactulose may be beneficial to the prevention and treatment of multiple organ dysfunction in patients with chronic severe hepatitis.

3.

Maddrey WC. Drug-induced hepatotoxicity: 2005. J Clin Gastroenterol. 2005 Apr;39(4 Suppl 2):S83-9.

University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-8570, USA. wcmaddrey@utsouthwestern.edu

The removal from the marketplace of several widely prescribed drugs due to hepatotoxicity has attracted considerable attention. Now under extensive review are means by which we can better identify hepatic risk prior to federal approval. Assessment of risk-to-benefit ratios regarding a novel agent with hepatotoxicity issues (especially one for a life-threatening condition) requires considerable judgment and education on the part of prescribers and patients. The spectrum of drug-induced liver injury is broad with simulation of almost all unknown liver disorders. Drug-induced liver injuries often have a somewhat characteristic signature, as regards type of injury (hepatocellular vs cholestatic) and time of onset. The diagnosis of drug-induced liver injury is often one of exclusion with initial suspicion based on circumstantial evidence. Factors affecting susceptibility to drug-induced injury include age, sex, concomitant use of other drugs, and genetic polymorphism in metabolic pathways involved in activation or disposition of therapeutic drugs. Drug-drug interactions present particular problems in patients, often elderly, who are receiving several drugs simultaneously. Mechanisms of drug-induced liver injury are many and varied. With many drugs, intermediary products produced during metabolism are highly reactive and toxic. In these situations, the balance between the rate of production of the metabolite and the effectiveness of the drug may determine whether or not hepatic injury occurs.

4.

Sharp GB, Lagarde F, Mizuno T, Sauvaget C, Fukuhara T, Allen N, Suzuki G, Tokuoka S. Relationship of hepatocellular carcinoma to soya food consumption: a cohort-based, case-control study in Japan. Int J Cancer. 2005 Jun 10;115(2):290-5

Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan. gsharp@niaid.nih.gov

To determine if the risk of hepatocellular carcinoma (HCC) is reduced by consumption of soya foods, we conducted a case-control study within a cohort of Japanese A-bomb survivors. We compared the prediagnosis consumption of isoflavone-rich miso soup and tofu to HCC risk, adjusting for hepatitis B (HBV) and C (HCV) viral infections, the major HCC risk factors in this population. The study included 176 pathologist-confirmed cases of HCC diagnosed in 1964-1988 and 560 controls who died of diseases other than liver cancer. We examined dietary information collected at least 2 years before diagnosis or death and tissue-based measures of viral hepatitis. Using logistic regression, crude ORs were 0.5 (95% CI 0.29-0.95) and 0.5 (95% CI 0.20-0.99) for high vs. low miso soup and tofu intake, respectively. Adjusting for year of birth, sex, HBV, HCV and other factors, the OR for miso soup was unchanged at 0.5 (95% CI 0.14-1.55), and miso results were similar when ORs were recalculated separately for earlier and later birth cohorts to assess consistency of results. The adjusted OR for tofu was 0.9 (95% CI 0.20-3.51). We also found a statistically significant (p < 0.0001) interaction between sex and HCV, with risk of HCC being substantially higher for women. We conclude that consumption of miso soup and other soya foods may reduce HCC risk. Copyright 2005 Wiley-Liss, Inc

5.

 Sooriakumaran P, McAndrew HF, Kiely EM, Spitz L, Pierro A. Peritoneovenous shunting is an effective treatment for intractable ascites. Postgrad Med J. 2005 Apr;81(954):259-61.

Great Osmond Street Hospital for Children, London, UK. p.s@doctors.org.uk

AIM AND METHODS: A retrospective review was carried out of children undergoing peritoneovenous shunting for intractable ascites. RESULTS: 11 children, aged 3 months to 12 years (median 31 months) underwent peritoneovenous shunting over the past 17 years. The duration of ascites ranged from one month to 2.5 years (median two months). The primary pathology consisted of previous surgery in eight (three neuroblastoma, one renal carcinoma, one hepatoblastoma, one adrenal teratoma, one renal artery stenosis, and one diaphragmatic hernia), and cytomegalovirus hepatitis, lymphatic hypoplasia, and lymphohistiocytosis in one patient each. All patients had failed to respond to previous treatment including peritoneal drainage in six patients, diuretics in five, and parenteral nutrition in five. There were no intraoperative problems. Postoperative complications included pulmonary oedema in three patients, shunt occlusion in three, infection in two, and wound leakage in one. Ascites resolved after shunting in 10 patients. Five shunts were removed one to three years after insertion without recurrence of ascites. Three others are free of ascites with shunts in place for less than one year postoperatively. Three children died from their underlying disease: two after resolution of ascites (neuroblastoma) and one in whom the ascites failed to resolve (lymphohisticytosis). CONCLUSIONS: Peritoneovenous shunting is an effective treatment for symptomatic intractable ascites in children (10 of 11 successful cases in this series). Elective removal of the shunt after one year is recommended.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:  

12677.  Assy N, Schlesinger S, Hussein O. Elevated plasma protein C levels correlate with the presence of fatty liver (NASH and NAFLD). Gut. 2005 May;54(5):729.

12678.  Becker-Merok A, Nossent H. Antiphospholipid antibody syndrome in autoimmune hepatitis. Isr Med Assoc J. 2005 Apr;7(4):268-9.

12679.  Chan HL, Kwan AC, To KF, Lai ST, Chan PK, Leung WK, Lee N, Wu A, Sung JJ. Clinical significance of hepatic derangement in severe acute respiratory syndrome. World J Gastroenterol. 2005 Apr 14;11(14):2148-53.

12680.  Chua R, Keogh A, Miyashita M. Novel use of sildenafil in the treatment of portopulmonary hypertension. J Heart Lung Transplant. 2005 Apr;24(4):498-500.

12681.  Colli A, Massironi S, Faccioli P, Conte D. "Pseudotumoral" hepatic areas in acute alcoholic hepatitis: a computed tomography and histological study. Am J Gastroenterol. 2005 Apr;100(4):831-6.

12682.  Craxi A, Camma C. Prevention of hepatocellular carcinoma. Clin Liver Dis. 2005 May;9(2):329-46, viii. Review.

12683.  Davila JA, Morgan RO, Shaib Y, McGlynn KA, El-Serag HB. Diabetes increases the risk of hepatocellular carcinoma in the United States: a population based case control study. Gut. 2005 Apr;54(4):533-9.

12684.  Desbois D, Grangeot-Keros L, Roquebert B, Roque-Afonso AM, Mackiewicz V, Poveda JD, Dussaix E. Usefulness of specific IgG avidity for diagnosis of hepatitis A infection. Gastroenterol Clin Biol. 2005 May;29(5):573-6.

12685.  Ding HG, Shan J, Zhang B, Ma HB, Zhou L, Jin R, Tan YF, He LX. Combined human growth hormone and lactulose for prevention and treatment of multiple organ dysfunction in patients with severe chronic hepatitis B. World J Gastroenterol. 2005 May 21;11(19):2981-3.

12686.  Foster GR. Apoptotic cell death: the caspase-cleavage "gold rush". Lancet. 2005 Apr 9-15;365(9467):1293-4.

12687.  Genova NJ. A fresh look at clinical excellence. JAAPA. 2005 Apr;18(4):55-6.

12688.  Hirota M, Kaneko T, Sugimoto H, Kure S, Inoue S, Takeda S, Nakao A.  Intrahepatic circulatory time analysis of an ultrasound contrast agent in liver cirrhosis. Liver Int. 2005 Apr;25(2):337-42.

12689.  Irshad M. Serum lipoprotein (a) levels in liver diseases caused by hepatitis. Indian J Med Res 2004;120(6):542-5.

12690.  Ito K, Shiraki K, Sakai T, Yoshimura H, Nakano T. Portal hypertensive colopathy in patients with liver cirrhosis. World J Gastroenterol. 2005 May 28;11(20):3127-30.

12691.  Javor ED, Ghany MG, Cochran EK, Oral EA, DePaoli AM, Premkumar A, Kleiner DE, Gorden P. Leptin reverses nonalcoholic steatohepatitis in patients with severe lipodystrophy. Hepatology. 2005 Apr;41(4):753-60.

12692.  Josephsen G. Images in clinical medicine. Mixed cryoglobulinemia. N Engl J Med. 2005 Jun 23;352(25):2627.

12693.  Kirkham C, Harris S, Grzybowski S. Evidence-based prenatal care: part II. Third-trimester care and prevention of infectious diseases. Am Fam Physician. 2005 Apr 15;71(8):1555-60. Review.

12694.  Lim AK, Patel N, Eckersley RJ, Kuo YT, Goldin RD, Thomas HC, Cosgrove DO, Taylor-Robinson SD, Blomley MJ. Can Doppler sonography grade the severity of hepatitis C-related liver disease? AJR Am J Roentgenol. 2005 Jun;184(6):1848-53.

12695.  Maddrey WC. Drug-induced hepatotoxicity: 2005. J Clin Gastroenterol. 2005 Apr;39(4 Suppl 2):S83-9. Review.

12696.  Makwana N, Riordan FA. Prospective study of community needlestick injuries. Arch Dis Child. 2005 May;90(5):523-4.

12697.  Malde AD. Viral Hepatitis and anaesthesiologist. Indian J Anaesth 2004; 48(4):264-75.

12698.  Manukyan MN, Demirkalem P, Gulluoglu BM, Tuney D, Yegen C, Yalin R, Aktan AO. Retained abdominal gallstones during laparoscopic cholecystectomy. Am J Surg. 2005 Apr;189(4):450-2.

12699.  McGillis JP. White adipose tissue, inert no more! Endocrinology. 2005 May;146(5):2154-6.

12700.  Meier M, Woywodt A, Hoeper MM, Schneider A, Manns MP, Strassburg CP.  Acute liver failure: a message found under the skin. Postgrad Med J. 2005 Apr;81(954):269-70.

12701. Myers JP. New recommendations for the treatment of tuberculosis. Curr Opin Infect Dis. 2005 Apr;18(2):133-40. Review.

12702.  Nahon P, Ganne-Carrie N, Degos F, Nahon K, Paries J, Grando V, Chaffaut C, Njapoum C, Christidis C, Trinchet JC, Chevret S, Beaugrand M. Serum albumin and platelet count but not portal pressure are predictive of death in patients with Child-Pugh A hepatitis C virus-related cirrhosis. Gastroenterol Clin Biol. 2005 Apr;29(4):347-52.

12703.  Narbey A. Update on viral hepatitis. Nurs Times. 2005 May 17-23;101(20):55-7. Review.

12704.  Padda M. Malarial hepatitis simulating fulminant hepatic failure. Mayo Clin Proc. 2005 Jun;80(6):828;

12705.  Pan L, Jia ZS, Chen L, Fu EQ, Li GY. Effect of anti-tuberculosis therapy on liver function of pulmonary tuberculosis patients infected with hepatitis B virus. World J Gastroenterol. 2005 Apr 28;11(16):2518-21.

12706.  Pendino GM, Mariano A, Surace P, Caserta CA, Fiorillo MT, Amante A, Bruno S, Mangano C, Polito I, Amato F, Cotichini R, Stroffolini T, Mele A; ACE Collaborating Group. Prevalence and etiology of altered liver tests: a population-based survey in a Mediterranean town. Hepatology. 2005 May;41(5):1151-9.

12707.  Quiroga JA, Carreno V. HCV-indeterminate blood donors or occult HCV infection? Lancet. 2005 Apr 30-May 6;365(9470):1540-1.

12708.  Saffar MJ, Rezai MS. Long-term antibody response and immunologic memory in children immunized with hepatitis B vaccine at birth. Indian J Pediat 2004; 41(12): 232-7.

12709.   Sargent S. The aetiology, management and complications of alcoholic hepatitis. Br J Nurs. 2005 May 26-Jun 8;14(10):556-62. Review.

12710.  Sharp GB, Lagarde F, Mizuno T, Sauvaget C, Fukuhara T, Allen N, Suzuki G, Tokuoka S. Relationship of hepatocellular carcinoma to soya food consumption: a cohort-based, case-control study in Japan. Int J Cancer. 2005 Jun 10;115(2):290-5.

12711.  Singh V, Katyal R, Kochhar RK, Basin DK, Aggarwal RP. Study of Hepatitis B and C viral markers in patients of chronic liver disease. Indian J Med Microbiol 2004;22(4): 269-70(sc).

12712.  Sooriakumaran P, McAndrew HF, Kiely EM, Spitz L, Pierro A. Peritoneovenous shunting is an effective treatment for intractable ascites. Postgrad Med J. 2005 Apr;81(954):259-61.

12713.  Strazzabosco M, Fabris L, Spirli C. Pathophysiology of cholangiopathies. J Clin Gastroenterol. 2005 Apr;39(4 Suppl 2):S90-S102. Review.

12714.  Terrault NA. Sex and hepatitis C. Am J Gastroenterol. 2005 Apr;100(4):825-6.

Pathogenesis:

12715.  Hernandez B, Shiramizu B. Viruses and cancer. Hawaii Med J. 2005 Apr;64(4):106-8. Review.

12716.  Jahani MR, Alavian SM, Shirzad H, Kabir A, Hajarizadeh B. Distribution and risk factors of hepatitis B, hepatitis C, and HIV infection in a female population with "illegal social behaviour". Sex Transm Infect. 2005 Apr;81(2):185.

12717.  Katzberg RW. Contrast medium-induced nephrotoxicity: which pathway? Radiology. 2005 Jun;235(3):752-5. Review.

12718.  Stine SW, Song I, Choi CY, Gerba CP. Application of microbial risk assessment to the development of standards for enteric pathogens in water used to irrigate fresh produce. J Food Prot. 2005 May;68(5):913-8.

Vaccines:

12719.  Tabor E. Persistence of antibody after hepatitis B vaccine and the question of boosters. Hepatology. 2005 Apr;41(4):940; author reply 941.

Therapy:

12720.  Aslam F, Syed JA. Seeking a safer blood supply. Lancet. 2005 Apr 23-29;365(9469):1464.

12721.  Burke J. Breastfeeding. Am J Nurs. 2005 May;105(5):15.

12722.  Chan CY, Lee SD. More on the need for boosters 15 years after neonatal vaccination. Hepatology. 2005 Apr;41(4):940-1;

12723.  Das Gupta A, Mania RN, Sahu GN. Treatment of HIV related tuberculosis: experience from a tertiary care hospital in eastern India. Lung India. 2005 Jan-Mar; 22(1): 5-11.

12724. Fioredda F, Giacchino M, Castagnola E. Assessment of humoral immunity to poliomyelitis, tetanus, hepatitis B, measles, rubella, and mumps in children after chemotherapy. Cancer. 2005 Apr 15;103(8):1758-9; author reply 1760.

12725.  Fonseca MO, Pang LW, de Paula Cavalheiro N, Barone AA, Heloisa Lopes M. Randomized trial of recombinant hepatitis B vaccine in HIV-infected adult patients comparing a standard dose to a double dose. Vaccine. 2005 Apr 22;23(22):2902-8.

12726.  Kurugol Z, Mutlubas F, Ozacar T. A two-dose schedule for combined hepatitis A and B vaccination in children aged 6-15 years. Vaccine. 2005 Apr 22;23(22):2876-80.

12727.  Lobato MN, Reves RR, Jasmer RM, Grabau JC, Bock NN, Shang N; 2RZ Study Group. Adverse events and treatment completion for latent tuberculosis in jail inmates and homeless persons. Chest. 2005 Apr;127(4):1296-303.

12728.  Lok AS. The maze of treatments for hepatitis B. N Engl J Med. 2005 Jun 30;352(26):2743-6.

12729.  Owens DK, Black M. Assessing the benefits and costs of new therapies for hepatitis B virus infection. Ann Intern Med. 2005 May 17;142(10):863-4.

12730.  Rivest P, Grenier L, Lonergan G, Bedard L. Varicella vaccination for grades 4 and 5 students: from theory to practice. Can J Public Health. 2005 May-Jun;96(3):197-200.

12731.  Thakur V, Sarin SK, Rehman S, Guptan RC, Kazim SN, Kumar S. Role of HBV genotype in predicting response to lamivudine therapy in patients with chronic hepatitis B. Indian Journal of Gastroenterology. 2005 Jan-Feb; 24(1): 12-15.

12732.  Wenzel RP, Edmond MB.  Patient-to-patient transmission of hepatitis C virus. Ann Intern Med. 2005 Jun 7;142(11):940-1.

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