Downgrading MELD Improves the Outcomes after Liver Transplantation in Patients with Acute-on-Chronic Hepatitis B Liver Failure

Background: High score of model for end-stage liver diseases (MELD) before liver transplantation (LT) indicates poor prognosis. Artificial liver support system (ALSS) has been proved to effectively improve liver and kidney functions, and thus reduce the MELD score. We aim to evaluate whether downgrading MELD score could improve patient survival after LT. Methodology/Principal Findings: One hundred and twenty-six LT candidates with acute-on-chronic hepatitis B liver failure and MELD score $30 were included in this prospective study. Of the 126 patients, 42 received emergency LT within 72 h (ELT group) and the other 84 were given ALSS as salvage treatment. Of the 84 patients, 33 were found to have reduced MELD score (,30) on the day of LT (DGM group), 51 underwent LT with persistent high MELD score (N-DGM group). The median waiting time for a donor was 10 for DGM group and 9.5 days for N-DGM group. In N-DGM group there is a significantly higher overall mortality (43.1$30 was effective i

Prevalence and trend of hepatitis C virus infection among blood donors in Chinese mainland: a systematic review and meta-analysis

<p>Abstract</p> <p>Background</p> <p>Blood transfusion is one of the most common transmission pathways of hepatitis C virus (HCV). This paper aims to provide a comprehensive and reliable tabulation of available data on the epidemiological characteristics and risk factors for HCV infection among blood donors in Chinese mainland, so as to help make prevention strategies and guide further research.</p> <p>Methods</p> <p>A systematic review was constructed based on the computerized literature database. Infection rates and 95% confidence intervals (95% CI) were calculated using the approximate normal distribution model. Odds ratios and 95% CI were calculated by fixed or random effects models. Data manipulation and statistical analyses were performed using STATA 10.0 and ArcGIS 9.3 was used for map construction.</p> <p>Results</p> <p>Two hundred and sixty-five studies met our inclusion criteria. The pooled prevalence of HCV infection among blood donors in Chinese mainland was 8.68% (95% CI: 8.01%-9.39%), and the epidemic was severer in North and Central China, especially in Henan and Hebei. While a significant lower rate was found in Yunnan. Notably, before 1998 the pooled prevalence of HCV infection was 12.87% (95%CI: 11.25%-14.56%) among blood donors, but decreased to 1.71% (95%CI: 1.43%-1.99%) after 1998. No significant difference was found in HCV infection rates between male and female blood donors, or among different blood type donors. The prevalence of HCV infection was found to increase with age. During 1994-1995, the prevalence rate reached the highest with a percentage of 15.78% (95%CI: 12.21%-19.75%), and showed a decreasing trend in the following years. A significant difference was found among groups with different blood donation types, Plasma donors had a relatively higher prevalence than whole blood donors of HCV infection (33.95% <it>vs </it>7.9%).</p> <p>Conclusions</p> <p>The prevalence of HCV infection has rapidly decreased since 1998 and kept a low level in recent years, but some provinces showed relatively higher prevalence than the general population. It is urgent to make efficient measures to prevent HCV secondary transmission and control chronic progress, and the key to reduce the HCV incidence among blood donors is to encourage true voluntary blood donors, strictly implement blood donation law, and avoid cross-infection.</p

Função muscular esquelética e composição corporal de pacientes com hipertireoidismo submetidos ao treinamento contra resistência Skeletal muscle performance and body composition of patients with hyperthyroidism submitted to strength training

O hipertireoidismo está associado a uma fraqueza muscular generalizada que é parte da manifestação clínica inicial de cerca de 80% dos pacientes. A recuperação da performance muscular esquelética durante o tratamento do hipertireoidismo depende tanto do aumento da massa muscular quanto da melhoria da função intrínseca da musculatura esquelética. Por outro lado, o treinamento contra resistência aumenta a força e a endurance muscular em diferentes grupos de indivíduos. O objetivo do presente trabalho foi avaliar o efeito deste tipo de treinamento sobre a recuperação da função muscular esquelética de pacientes portadores de hipertireoidismo. Os pacientes, atendidos no ambulatório de endocrinologia, diagnosticados clínica e laboratorialmente com doença de Graves, foram submetidos, antes do tratamento e quatro meses após, a medidas antropométricas e testes de força máxima e endurance musculares (sustentando 30% da carga máxima) de quatro movimentos [handgrip esquerdo (HE) e direito (HD), legpress (LEG), flexão plantar de tornozelo (FPT) e supino reto (SR)]. Após a avaliação inicial, os pacientes foram divididos em dois grupos: 1) controle (GC - tratamento medicamentoso) e 2) treinamento (GT - acrescentado treinamento contra resistência individualizado 2X/semana). Os resultados (GC, n = 3; GT, n = 4; todas do sexo feminino) mostram: <img src="/img/revistas/rbme/v7n1/a04tab01.gif"> Os autores concluem que o treinamento contra resistência parece favorecer aumento da massa e da performance muscular esquelética em pacientes com hipertireoidismo.<br>Hyperthyroidism is associated with a general muscle weakness, which is part of the initial clinical manifestation of about 80% of patients. The recovery of skeletal muscle performance during hyperthyroidism treatment depends on both greater muscle mass and improved muscle function. Strength training is an effective method to improve muscle strength and endurance. The purpose of this study was to evaluate the effect of this type of training on the recovery of the skeletal muscle function of patients with hyperthyroidism. Patients referred to the Endocrinology Out-Patient Clinic with clinical diagnosis and laboratory confirmation of Grave's disease were submitted, before the treatment and 4 months later, to anthropometric measurements and determination of maximal static strength and endurance (sustaining 30% of the maximal force) of four movements [left handgrip (LH), right handgrip (RH), legpress (LEG), ankle plantar flexion (APF) and supine benchpress (SP)]. After the first evaluation, the patients were divided into two groups: 1) control (CG- drug treatment) and 2) training (TG- added individualized strength training twice a week). Results (CG, n=3; TG, n=4; all women) showed: <img src="/img/revistas/rbme/v7n1/a04tab02.gif"> The authors concluded that strength training seems to favor an increase in skeletal muscle mass and performance in patients with hyperthyroidism

Refining the late-Holocene coastline and delta development of the northern Yangtze River delta : combining historical archives and OSL dating

Historical documents provide a general chronological overview of the environmental evolution of the Yangtze River delta (YRD) during the last ca. 2000 years; however, absolute dating of the region’s late Holocene sediment is relatively rare. Optically stimulated luminescence (OSL) dating has been increasingly applied to the age determination of Holocene deposits in deltaic environments. In this study, three 23–27 m long drill cores running from south to north were collected from the Qihai plain of the northern YRD in order to reconstruct the history of this region’s formation since the late Holocene. A total of 24 samples from the three cores were subjected to OSL dating using coarse silt-sized (45–63 μm) quartz. The OSL ages range from approximately 190–3490 a revealing that the age of the delta front and delta plain facies in the coring sites are younger than 500 a while the sediments in the underlying prodelta facies are older than 2000 a. On the basis of the large age gap between the two set of deposits, we suspect that the coring sites remained submerged from 2000 to 500 years ago. As the central core has older and coarser sandy deposits than the neighbouring cores, we infer that the central core was located on a sandy mouth bar, while other cores sat within distributary channels within the estuary. The OSL ages are consistent with both the chronology implied by historical documents and other stratigraphic records in the area. This study enhances the chronological framework of land formation and delta evolution in the Qihai plain area of the YRD and thereby consolidates the conclusions derived from the application of a single technique alone