HEPATITIS B: WHO SHOULD BE TREATED?

U ovom trenutku dostupna terapija za liječenje hepatitisa B rijetko može eradicirati infekciju (normalizacija ALT, negativizacija HBV DNK, serokonverzija HBsAg u anti-HBs). U posljednje 4 godine postignuti su manji pomaci u pogledu uspješnosti liječenja. Promjene u odnosu na ranije hrvatske konsenzus konferencije iz 2005. i 2009. g. su temeljene na stajalištima osuvremenjene Konsenzus konferencije Američkog društva za istraživanje jetre iz 2009., Konsenzus konferencije Europske udruge za istraživanje jetre (EASL) iz 2012.g. te Smjernicama Azijsko-Pacifičke udruge za istraživanje jetre (APASL) iz 2012. g. U ovom radu ćemo navesti samo razlike u odnosu na ranije spomenute Hrvatske smjernice iz 2005. i 2009. godine. Novosti se odnose na primjenu neinvazivnih metoda za prosudbu fibroze, kvantifikaciju HBsAg u cilju predviđanja ishoda liječenja, registraciju novih lijekova i neke nove preporuke u cilju učinkovitijeg i racionalnijeg liječenja. Novosti su i preporuke za liječenje bolesnika u posebnim okolnostima što uključuje liječenje trudnica, bolesnika s rezistencijom na lijekove, bolesnika s koinfekcijama, jetrenom dekompenzacijom, bolesnika na imuno i kemoterapiji i bolesnika nakon transplantacije jetre te bolesnike s HCC.Currently, therapy for hepatitis B has a limited effect and can rarely eradicate infection (ALT normalization, undetectable HBV DNA, HBsAg/anti-HBs seroconversion). Minimal progress in terms of treatment success has been achieved in the past four years. Changes from the previous Croatian Consensus Conferences in 2005 and 2009 are based on standings of the Consensus Conference of the American Association for the Study of Liver Disease (AASLD) 2009, Consensus Conference of the European Association for the Study of Liver (EASL) 2012, and Asia-Pacific Association Guidelines for the Study of Liver (APASL) 2012. In this paper, we will mention only differences in relation to the before mentioned Croatian guidelines from 2005 and 2009. New developments relating to the application of noninvasive methods for assessing fibrosis, quantification of HBsAg to predict treatment outcome, registration of new drugs, and some new recommendations for more efficient and rational treatment will be reviewed. New findings as well as recommendations for the treatment of patients in special circumstances including treatment of pregnant women, patients with drug resistance, patients with co-infection, hepatic decompensation, patients on immune and chemotherapy, patients after liver transplantation, and patients with HCC will also be included

Snakebites in Mostar Region, Bosnia and Herzegovina

The aim of this study was to provide an overview of the snakebites in patients hospitalized at the Mostar Clinical Hospital, admitted between 1983 and 2006. A total of 341 patients were recorded, with moderate men predominance (52.8%). Majority of patients were bitten for the first time (99.1%). In 98.8% of patients snakebite occurred to the bare skin, most commonly during June to September period (64.2%). Snakebites were the commonest in agricultural workers (48.1%). Until 2003 all admitted patients were treated according to Russel’s scheme (3-anti). As of 2003 new treatment scheme was applied, resulting in the reduction of antidote and supportive treatment use, causing a reduction in the number of clinically apparent allergic reactions. Serum sickness was recorded in only 2 patients, while lethal outcome was recorded in one (0.3%). Overall results indicate that lethality of snakebite is low, and that patients were often administered treatment without medical indication. High number of tourists as well as the presence of the peace keeping troops and other visiting personnel in this region make the snakebites and awareness on snakes not only a local issue, but also more general concern

Structural and magnetic properties of mechanochemically synthesized LaFe1-xCrxO3 (x = 0.5 and 0.75)

Perovskite oxides with the composition LaFe1-xCrxO3 (x = 0.5 and 0.75) have been studied. The samples have been prepared using the mechanochemical treatment. A mixture of crystalline La(OH)3, Fe2O3 and Cr2O3 powders in stoichiometric ratio was mechanochemically treated in a planetary ball mill up to 40 h of milling. The mechanochemical formation of the LaFe1-xCrxO3 perovskite phase was followed by X-ray diffraction and magnetization measurements. The Rietveld refinement of the XRD data shows that the compounds crystallize in an orthorhombic perovskite structure with a random distribution of the Fe and Cr cations at the B sublattice. All structural and microstructural parameters were analyzed. In addition, magnetic measurements for LaFe0.5Cr0.5O3 show clear antiferromagnetic ordering bellow 250 K, which supports above conclusion of random distribution of Fe and Cr cations

Orbital non-Fermi-liquid behavior in cubic ruthenates

We peruse various anomalous physical responses of the cubic (ferromagnetic SrRuO3 and paramagnetic CaRuO3) ruthenates, such as fractional power-law conductivity, anomalous Raman line shapes, and Hall currents. We show how these exciting power-law observations are naturally described within a new, local (orbital) non-Fermi-liquid state arising from strong, multiorbital Coulomb interactions. Introducing a multiorbital, correlated model treated within the dynamical mean-field theory, we also find two distinct relaxation rates for relaxation of transport in complete agreement with experiment

Magnetotransport properties of CaTixRu1-xO3 (x=0, 0.07)

Electrical resistance, transversal magnetoresistance and the Hall effect were studied on polycrystalline CaTixRu1-xO3 (x = 0, 0.07) samples using a conventional Quantum Design PPMS-9 equipment in the temperature range 2-300 K and magnetic field up to 9 T. Substantial differences were found between the two samples: (i) opposite to the metallic character of CaRuO3, the substituted sample has insulating-like electrical resistance; (ii) the magnetoresistance of the substituted sample changes the sign from negative to positive values with increasing temperature. The magnetoresistance of CaRuO3 is negative, the sign reversal is induced by magnetic field and only at temperatures below 15 K, such a behaviour is predicted for clustered systems; (iii) the Hall voltage in pure CaRuO3 also changes sign from negative to positive values above 35 K. This temperature coincides with the observed magnetic transition temperature, indicating that the magnetic state and the carrier character interrelate.13th Czech and Slovak Conference on Magnetism (CSMAG07), Jul 09-12, 2007, Kosice, Slovaki

Structural and magnetic properties of mechanochemically synthesized LaFe1-xCrxO3 (x = 0.5 and 0.75)

Perovskite oxides with the composition LaFe1-xCrxO3 (x = 0.5 and 0.75) have been studied. The samples have been prepared using the mechanochemical treatment. A mixture of crystalline La(OH)3, Fe2O3 and Cr2O3 powders in stoichiometric ratio was mechanochemically treated in a planetary ball mill up to 40 h of milling. The mechanochemical formation of the LaFe1-xCrxO3 perovskite phase was followed by X-ray diffraction and magnetization measurements. The Rietveld refinement of the XRD data shows that the compounds crystallize in an orthorhombic perovskite structure with a random distribution of the Fe and Cr cations at the B sublattice. All structural and microstructural parameters were analyzed. In addition, magnetic measurements for LaFe0.5Cr0.5O3 show clear antiferromagnetic ordering bellow 250 K, which supports above conclusion of random distribution of Fe and Cr cations

Ti-induced ferromagnetism and the specific heat of CaTixRu1-xO3 (x=0, 0.005, 0.03)

The influence of Ti substitution on the specific heat of the CaTixRu1-xO3 system at low concentrations x = 0, 0.005, and 0.03 was studied in the temperature range of 2-300 K at magnetic fields tip to 9 T. Small peak was revealed in the C/T vs. T-2 dependence at around 3 K, which are field sensitive (the electronic specific heat coefficient gamma linearly decreases with the increase in magnetic field), and might be connected to some kind of magnetic ordering. The coefficient gamma is suppressed also by Ti substitution.13th Czech and Slovak Conference on Magnetism (CSMAG07), Jul 09-12, 2007, Kosice, Slovaki

Low temperature anomalies in the specific heat and magnetic susceptibility of Na0.7CoO2 samples

We present a comparative study of Na0.7CoO2 samples obtained from three different sources and prepared by different methods. The specific heat and magnetic susceptibility measurements in the temperature range 2-300 K show substantial influence on the observed anomalies, which underlines that the system is extremely sensitive to preparation protocols.13th Czech and Slovak Conference on Magnetism (CSMAG07), Jul 09-12, 2007, Kosice, Slovaki

VIRAL HEPATITIS - CROATIAN CONSENSUS STATEMENT 2013

Hrvatske konsenzus konferencije o virusnim hepatitisima održane su 2005. i 2009. g. (1). S obzirom na brojne nove spoznaje o epidemiologiji, dijagnostici i liječenju virusnih hepatitisa (poglavito kroničnog hepatitisa C genotipa 1) u protekle četiri godine, 28. veljače 2013. g. održana je nova Hrvatska konsensus konferencija o virusnim hepatitisima u Zagrebu. Sažeti tekst ove Hrvatske konsenzus konferencije o virusnim hepatitisima sadrži prikaz novih spoznaja o epidemiologiji virusnih hepatitisa, serološkoj i mo¬lekularnoj dijagnostici virusnih hepatitisa, određivanju polimorfizma promotora gena za IL-28, procjeni stadija fibroze, algoritmu dijagnostičkog praćenja bolesnika, liječenju kroničnog hepatitisa C (genotipovi 1-6) i hepatitisa B, liječenju specijalnih populacija (djeca, bolesnici na dijalizi, bolesnici liječeni transplantacijom, osobe s HIV/HCV koinfekcijom) i nuspojavama liječenja.Croatian Consensus Conferences on Viral Hepatitis took place in 2005 and 2009. Considering the numerous novel concepts on the epidemiology, diagnosis and management of viral hepatitis (chronic hepatitis C genotype 1 in particular) that have emerged in the past four years, a new Croatian Consensus Conference on Viral Hepatitis was held in Zagreb on February 28, 2013. The abridged text of the Croatian Consensus Conference on Viral Hepatitis 2013 presents the new concepts on the epidemiology of viral hepatitis, serologic and molecular diagnosis of viral hepatitis, determination of the IL-28 gene promoter polymorphism, fi¬brosis grading, algorithm for patient diagnostic follow up, treatment of chronic hepatitis C (genotypes 1-6) and hepatitis B, treat¬ment of special populations (children, dialysis patients, transplanted patients, individuals with HIV/HCV co-infection), and therapy side effects