41 research outputs found
Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2008 update
Large amounts of new data on the natural history and treatment of chronic hepatitis B virus (HBV) infection have become available since 2005. These include long-term follow-up studies in large community-based cohorts or asymptomatic subjects with chronic HBV infection, further studies on the role of HBV genotype/naturally occurring HBV mutations, treatment of drug resistance and new therapies. In addition, Pegylated interferon α2a, entecavir and telbivudine have been approved globally. To update HBV management guidelines, relevant new data were reviewed and assessed by experts from the region, and the significance of the reported findings were discussed and debated. The earlier “Asian-Pacific consensus statement on the management of chronic hepatitis B” was revised accordingly. The key terms used in the statement were also defined. The new guidelines include general management, special indications for liver biopsy in patients with persistently normal alanine aminotransferase, time to start or stop drug therapy, choice of drug to initiate therapy, when and how to monitor the patients during and after stopping drug therapy. Recommendations on the therapy of patients in special circumstances, including women in childbearing age, patients with antiviral drug resistance, concurrent viral infection, hepatic decompensation, patients receiving immune-suppressive medications or chemotherapy and patients in the setting of liver transplantation, are also included
Perfil clínico-laboratorial de crianças vivendo com HIV/AIDS por transmissão vertical em uma cidade do Nordeste brasileiro Clinical and laboratory profile of children living with vertically transmitted HIV/AIDS in a city in northeastern Brazily
INTRODUÇÃO: a transmissão vertical constitui a principal via de infecção infantil pelo vírus HIV-1 (vírus da imunodeficiência humana). A presente pesquisa tem como objetivo estudar a evolução clínica e laboratorial de crianças vivendo com HIV/AIDS decorrente da transmissão vertical. MÉTODOS: trata-se de um estudo descritivo, retrospectivo, realizado a partir da coleta de dados em prontuário médico de todas as crianças atendidas em um Serviço de Assistência Especializada, no período de janeiro de 1998 a junho de 2006. RESULTADOS: foram avaliadas 80 crianças que preencheram critérios de inclusão. Observou-se que em 56 (70%) crianças, o diagnóstico da infecção pelo HIV na mãe deu-se após o parto e que em 44 (55%) o parto foi via vaginal. Amamentação ao seio materno foi documentada em 56 (70%) crianças e esta variou de um mês até mais de 12 meses. A não utilização ou uso incompleto do Protocolo ACTG 076 foi documentado em 63 (78,5%) casos. CONCLUSÕES: os dados observados em nosso estudo são bastante preocupantes e revelam falha na assistência materno-infantil, especialmente voltada para prevenção da transmissão.<br>INTRODUCTION: Vertical transmission constitutes the main route for child infection by the HIV-1 virus (human immune deficiency virus). This study aimed to investigate the clinical and laboratory evolution of children with vertically transmitted HIV/AIDS. METHODS: This was a retrospective descriptive study based on data gathered from the medical records of all the children who were seen at a specialized care unit between January 1998 and June 2006. RESULTS: Eighty children who met the inclusion criteria were evaluated. In the cases 56 (70%) of the children, their mothers were diagnosed as HIV-positive after childbirth. The delivery was vaginal for 44 (55%) of the children. Fifty-six children (70%) were breastfed by their mothers for periods ranging from one to more than 12 months. Failure to use or incomplete use of the ACTG 076 protocol was documented in 63 (78.5%) of the cases. CONCLUSIONS: The findings from our study are a cause for considerable concern and show failures of medical care for mothers and children, particularly with regard to prevention of transmission
Neural effects of short-term training on working memory
Working memory training has been the focus of intense research interest. Despite accumulating behavioral work, knowledge about the neural mechanisms underlying training effects is scarce. Here we show that seven days of training on an n back task lead to substantial performance improvements in the trained task; furthermore, the experimental group shows cross modal transfer as compared to an active control group. In addition, there are two neural effects that emerged as a function of training: first, increased perfusion during task performance in selected regions, reflecting a neural response to cope with high task demand; second, increased blood flow at rest in regions where training effects were apparent. We also found that perfusion at rest was correlated with task proficiency, probably reflecting an improved neural readiness to perform. Our findings are discussed within the context of the available neuroimaging literature on n back training