Hepatic shock differential diagnosis and risk factors: A review article

Context: Liver as an important organ has a vital role in physiological processes in the body. Different causes can disrupt normal function of liver. Factors such as hypo-perfusion, hypoxemia, infections and some others can cause hepatic injury and hepatic shock. Evidence Acquisition: Published research resources from 2002 to May 2015 in some databases (PubMed, Scopus, Index Copernicus, DOAJ, EBSCO-CINAHL, Science direct, Cochrane library and Google scholar and Iranian search database like SID and Iranmedex) were investigated for the present study. Results: Different causes can lead to hepatic shock. Most of these causes can be prevented by early resuscitation and treatment of underlying factors. Conclusions: Hepatic shock is detected in ill patients, especially those with hemodynamic disorders. It can be prevented by early treatment of underlying disease. There is no definite treatment for hepatic shock and should be managed conservatively. Hepatic shock in patients can increase the mortality rate. © 2015, Kowsar Corp

Frequency and distribution of macroalgae in coastal zone of Kish Island

Three main groups of macroalgae have been studied along 4 transects in Kish Island. Sampling were carried out during highest tidal time, bimonthly for one year. All sampling were made by applying quadrates (0.5XO.5m) randomly along the intertidal zone. The collected specimen were identified and their frequency and biomass were determined. Statistical results showed that Rizocolunium impelexum had the most frequency within green algae. Also, the most abundance occured in the first transect (Saffain), in the upper mid littoral zone (U.M.L) and during the first collection (March). Among the brown algae Cystoseira had the most abundance in the first transect and medium mid-littoral (M.M.L) in the fourth utllcction (September). Champia Japonica (red algae), had the most abundance Compared to the other 13 species in the first transect and in medium mid-littoral regions (M.M.L). From the obtained information that in the first transect were located in the domestic sewage effluent region, the diversity and abundance of chlorophyta were the most. This can be due to existence and abundance of elements and nutrients. With the observation in the second transect (south western), algal species diversity especially brown and red algae were very high

Health Literacy and Medication Practices in Senior Housing Residents

Objective: To conduct a descriptive analysis of health literacy, knowledge of prescribed medications, and methods of administering medications in a cohort of senior housing residents.https://scholarworks.uvm.edu/comphp_gallery/1027/thumbnail.jp

Seroepidemiology of hepatitis E virus infection in patients undergoing maintenance hemodialysis: Systematic review and meta-analysis

Patients undergoing regular hemodialysis (HD) are at an extreme risk of acquiring bloodstream infections compared to the general population. Hepatitis E virus (HEV) infection is an important emerging health issue in these patients. To date, numerous studies have investigated the seroprevalence of HEV among HD patients across the world; however, the data are conflicting. The present study aimed to measure the exposure rate of HD patients to HEV infection by estimating the overall seroprevalence of HEV in this high-risk group. A systematic literature search was carried out using five electronic databases from inception to January 10, 2020, with standard keywords. Pooled seroprevalence estimates with 95 confidence intervals (CIs) were calculated using a random intercept logistic regression model. The seroprevalence of HEV increased from 6.6 between the years of 1994 and 2000 to 11.13 from 2016 to 2020. Blood transfusion was associated with a nearly 2-fold increase in the rate of HEV seropositivity (OR = 1.99; 95 CI: 1.50-2.63, P <.0001, I2 = 6.5). HEV seroprevalence among patients with HD for more than 60 months was significantly higher than those with HD for less than 60 months (27.69, 95 CI: 20.69-35.99 vs 15.78, 95CI: 8.85-26.57, respectively) (P =.06). Our results indicated increased exposure of HD patients with HEV infection over the last decade. We concluded that blood transfusion and duration of HD are considerable risk factors for acquiring HEV infection among HD patients. © 2020 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therap

Efficacy of tenofovir disoproxil fumarate therapy in nucleoside-analogue naive Iranian patients treated for chronic hepatitis B

Background: Tenofovir disoproxil fumarate (TDF) is a new effective treatment option for patients with chronic hepatitis B (CHB). Objectives: To evaluate TDF efficacy in nucleos(t)ide analogues (NAs)-naive Iranian patients with CHB. Patients and Methods: The NA-naive patients received TDF for at least six months. The primary endpoint was the proportion of patients achieving a complete virological response (CVR) during the treatment. Multivariate Cox regression analysis determined predictive factors independently associated with the time to CVR. The secondary endpoints were biochemical and serological responses, frequency of virological breakthrough, genotypic resistance development, safety and tolerability. Results: In all, 93 patients (64.5 hepatitis B e antigen HBeAg-negative) were eligible. Of these, 70 patients completed 24 months of treatment. The cumulative CVR rates in HBeAg-negative and HBeAg-positive patients were 87% versus 53% at 24 months, respectively. The multivariate Cox regression model showed only HBeAg positivity at baseline and a high baseline HBV DNA level were independent factors predicting a CVR. No patient achieved hepatitis B surface antigen (HBsAg) and HBeAg loss or seroconversion and no virologic breakthrough occurred. A new amino acid substitution (rtD263E) was observed to develop in 60% of patients with viremia. Conclusions: The cumulative CVR rates showed that patients with HBeAg-negative have better virologic respond than those with HBeAg-positive during the same period. The rtD263E mutation might be associated with partial resistance to TDF. © 2015, Kowsar Corp

Effectiveness of methadone maintenance treatment in prevention of hepatitis C virus transmission among injecting drug users

Background: Injecting drug users (IDUs) are a major and most important risk factor for rising hepatitis C virus (HCV) prevalence in Iran. Objectives: The objective of this study was to determine the effectiveness of methadone maintenance treatment (MMT) in prevention of HCV infection transmission among IDUs. Patients and Methods: A mathematical modeling has been used to estimate number of HCV infections averted. The input parameters used in the model were collected by self-reported method from 259 IDUs before registering and one year after MMT. Nonparametric statistical tests have been used to compare risky injecting and sexual behaviors among IDUs before and after participating in MMT program. Deterministic sensitivity analyses were done to show the effects of parameters' uncertainty on outcome. Results: Of the 259 participants, 98.4 (255) were men, the mean age ± SD was 33.1 ± 7.58 years and HCV prevalence was 50. The studied IDUs reported lower rate of risky injecting and sexual behavior after participation in MMT program. The cumulative incidence of HCV per 100 IDUs due to sharing injection and unsafe sexual contact with MMT program were 13.84 (95 CI: 6.17 -21.51), 0.0003 (0.0001 - 0.0005) and without it 36.48 (25.84 - 47.11) and 0.0004 (0.0002-0.0006) respectively. Conclusions: The MMT program is an effective intervention to prevent HCV infection transmission, although it is essential to compare its effectiveness with other interventions before implementing it in nationwide. © 2013, Kowsar Corp.; Licensee Kowsar Ltd

E-selectin gene polymorphisms in Iranian chronic hepatitis B patients

Background and Aims: The aim of this study was to detect the substitutions Ser128Arg (A128C) and Leu554Phe (T554C) which are responsible for E-selectin polymorphisms in patients with chronic hepatitis B and healthy controls. We investigated possible association of the Ser128Arg and Leu554Phe gene polymorphisms in the E-selectin gene with susceptibility to chronic hepatitis B. Methods: Sixty-three patients with chronic hepatitis B virus infection and 150 healthy subjects were recruited sequentially as they presented to clinic. Classification of chronic hepatitis B virus (HBV)-infected patients was as asymptomatic carrier state (34 patients) and chronic hepatitis B (29 patients). Genomic DNA was isolated from anticoagulated peripheral blood Buffy coat using Miller�s salting-out method. The presence of the E-selectin gene polymorphisms was determined by using polymerase chain reaction amplification refractory mutation system (ARMS). Results: Distribution of E-selectin 128 (A+C-, A+C+, A-C+) genotypes and E-selectin 554 (C+T-, T+C-, C+T+) genotypes were not statistically different in chronic hepatitis B patients and controls (P=0.41 and 0.96, respectively). Also, two groups had no significant difference in distribution of frequencies of allele 128A (P=0.41), 128C (P=0.15), allele 554C (P=0.85), and allele 554T (P=0.76). Carrying of allele 128A (OR=0.58, 95 CI=0.16-2.12), 128C (OR=1.52, 95 CI=0.84-2.74), 554C (OR=1.24, 95 CI=0.12-12.08), and allele 554T (OR=0.88, 95 CI=0.38-2.01) were not risk factors for susceptibility to chronic hepatitis B infection. Conclusions: Carrying E-selectin gene polymorphisms of Ser128Arg and Leu554Phe is not considered risk factor for susceptibility to chronic hepatitis B infection. © 2007, Kowsar Medical Publishing Company. All rights reserved

Integrated analysis of gene expression profiles reveals deregulation of the immune response genes during different phases of chronic hepatitis B infection

© 2017, Kowsar Corp.Background: The natural history of chronic hepatitis B (CHB) infection is divided into different phases including immune tolerance (IT), immune clearance (or immune active [IA]), inactive carrier (IC), and reactivation. Despite utilizing high-throughput data, the distinct immunological mechanisms of these phases have been insufficiently investigated. Objectives: The aim of the present study was to determine candidate disease-associated genes and significantly altered biological processes for each phase of CHB infection. Methods: The gene expression profiles of 83 CHB patients (22 IT, 50 IA, and 11 IC phases) were obtained from gene expression omnibus (GEO dataset: GSE65359) and analyzed by bioinformatics tools. Several plugins of Cytoscape software were used to construct protein-protein interaction (PPI) networks and measure their topological properties. Subsequently, functional annotation and signaling pathway enrichment were carried out using the database for annotation, visualization and integrated discovery (DAVID) and Kyoto encyclopedia of genes and genomes (KEGG). Results: 449 and 452 deregulated genes were identified in IT-IA and IA-IC patients, respectively. Gene ontology and KEGG pathway analyses showed that several immune response-associated genes and signaling pathways (i.e. cytokine-cytokine receptor interaction, chemokine signaling pathway and T cell receptor signalling pathway) were upregulated in the IA phase, but downregulated in the IC phase. The LCK (encoding a tyrosine kinase) was determined as the most important hub gene of both constructed PPI networks. Furthermore, other immune response-associated genes such as CXCR3, VCAN, MYC, and STAT1 were found to be the important hub genes in clinical phases of CHB. Conclusions: The immune response-related pathways were found to be up and downregulated in the immune clearance phase and inactive carrier phase of CHB, respectively. The LCK hub gene might help the pathogenesis of different phases of CHB and serve as a therapeutic target for the treatment of hepatitis B virus