The influence of hepatitis C infection and interferon-α therapy on thyrotropin blocking and stimulating autoantibodies in Graves' ophthalmopathy: a case report

<p>Abstract</p> <p>Background</p> <p>Hepatitis C virus is a highly immunogenic pathogen often inducing autoimmune activation changes and this can often be further exacerbated by Interferon therapy. As HCV is lymphocytotropic, it can modulate T cell and B cell antibody responses, affecting many endocrine organs, most commonly the thyroid.</p> <p>Case presentation</p> <p>We hereby describe a case of fluctuating and wavering thyrotropin autoantibodies of both stimulating and blocking nature in the setting of Graves's ophthalmopathy, hepatitis C infection and interferon-α, causing hypo- and subsequently hyper-thyroidism. The autoantibody profile was clearly modified during interferon therapy and settled into a new equilibrium at the completion of treatment.</p> <p>Conclusion</p> <p>The case highlights the possible existence of a dual thyroid autoantibody population associated with hepatitis C, and its modulation by interferon therapy, which further compounds the difficulties in the assessment thyroid disease in this setting.</p

The Spectrum of Autoimmune Thyroid Disease in the Short to Medium Term Following Interferon-α Therapy for Chronic Hepatitis C

Autoimmune thyroid diseases are common manifestations of hepatitis C infection, exacerbated by interferon-based treatment. However, the occurrence and pattern of thyroid disease in the short/medium term following the completion of IFN-based therapy is relatively unknown and there are very few previous reports regarding the specific spectrum of autoimmune thyroid disease that may follow such therapy. We hereby report 3 cases which demonstrate the range of thyroid diseases that may occur following interferon therapy. The hypothesis advanced is that in the pathogenesis of these conditions there must be both triggering and sustaining mechanisms as thyroid diseases occur well outside the immediate effect window of pegylated interferon. This paper suggests the need to continue thyroid surveillance in IFN-treated HCV patients following the completion of therapy, perhaps for the first 6 months

Generating The All-Hazards Intelligence Synthesis Model In The Homeland Security Intelligence Enterprise

The United States all-hazards homeland security operational and intelligence domains are multijurisdictional, multiagency, and multidisciplinary intelligence challenges for all-hazards intelligence analysts. A common analytical conceptual framework is needed to help unify homeland security intelligence enterprise analysts who work in an all-hazards, all-source, all-crimes, and all-disciplinary intelligence environment. A unifying all-hazards intelligence synthesis model that unites intelligence analysts with the law-enforcement, cybersecurity, technology, and natural science disciplines, would benefit the homeland security and intelligence domain enterprises. The purpose of the applied research was to discover and generate an all-hazards analysis model that enables the production of risk-informed applied intelligence products in a pluralistic intelligence environment that is privacy, civil rights, and civil liberties compliant. A comprehensive literature review was conducted following the four-step collect, analyze, synthesize, and apply process. This process is derived from proven knowledge, information, and risk management programs, as well as proven intelligence analysis methodologies, for gathering information about adversarial, cyber, technological, and natural hazards and threats to social, technological, and environmental resources. The research resulted in the generation of a universal all-hazards intelligence synthesis model that may be applicable to systems safety engineering, criminal, political, military, economic, social, and medical intelligence activities

Spaces of life; spaces of death : the relationship of the house (uma) to the production of space and identity in a Rereiket Community, Mentawai

Within the general context of articulating a new approach to the ethnography of the Mentawai islands, in this thesis I argue that exogenous totalizing perspectives brought to the study of this area have reduced the complexity of identities as these are lived by the islands’ inhabitants. I propose a theoretical, particularist remedy to this tendency in the context of assessing the nature of the contribution of the House (uma), and notably the collection of ancestral heirlooms kept within it, to the production of identity as it is lived and worked out by various groups (suku) in a small community on Siberut, the largest of the four islands making up the Mentawai group. The reproduction of a space of ‘life’ by humans for themselves and the confining of the vehicles of death, the sanitu (ghosts), to their own space is achieved through the mobilization of the House (uma) as an ‘agent’ towards this end. This is achieved through major ritual form, the puliaijat, designed not merely to clarify the distinction, to mark the identity and therefore the spaces of ‘life’, but to actually create this space, so separating the living members of one suku from the dead of another (sanitu). This separation occurs by means of the House which is simultaneously a reproduction of the identity of the House as a social entity. Thus, rather than looking at the House (uma) as a either a collection of boards, beams, and nails or a reified social fact, I argue that it is best viewed as a contextually produced complex of spaces brought into being through the being-in-the-world of the people affiliated to it as they go about the all-important business of (re)producing a habitable space o f ‘life’ in the cosmos

Patient reported frequency of lupus flare: associations with foundation makeup and sunscreen use

Objective: To test the hypothesis that usage of foundation makeup (FM) and sunscreen lotion (SS), used individually or in combination, is associated with significant changes in the likelihood of lupus symptom exacerbation. Methods: Self-reported flare days (SRF) and use of FM and SS products, were retrospectively examined in 80 Caucasian Australian women with ACR classified SLE for a year. Negative binomial regression modelled SRF days (outcome) against independent FMSS variable and covariates: age; diagnosis years; outdoor hours; BMI; stress; immune therapy medication (ITM) use. Results: Statistically significant inverse associations between SRF days and FMSS use were found. Protective effects were statistically significant (p < 0.05) for combined FMSS exposure days (OR 0.998, CI 0.997 - 1.0) and FM alone (OR 0.603, CI 0.363 - 1.0). Significant associations consistent with increased SRF risk were seen in sub-analysis models for participants taking ITM: univariate model (OR 1.968, p = 0.03); multivariate model for FMSS (OR 2.11, CI 1.161 - 3.835); FM days (OR 1.855, CI 1.023 - 3.364). Results show SRF day reduction of 0.15% for each day of product exposure. Conclusion: Study results highlight protective effects of wearing FM with or without SS. This reduction in flare days ultimately has potential to improve quality of life in SLE patients

The natural history of interferon-α induced thyroiditis in chronic hepatitis c patients: a long term study

<p>Abstract</p> <p>Background</p> <p>Autoimmune thyroid disease is a common complication of patients with chronic hepatitis C undergoing combination pegylated interferon-α and ribavirin treatment. A small proportion develops interferon-induced thyroiditis of which the long term natural history is unknown and how it compares with de novo thyroiditis. The aim of the study is to determine the natural history of thyroid disease including antibody profile in this particular setting 36 months from the completion of therapy.</p> <p>Methods</p> <p>A cohort of 18 hepatitis C patients (mean age 45 ± 8 years (standard deviation)) who developed exclusively thyroiditis in this setting was followed every 12 months after the completion of therapy for 36 months. Investigations included thyrotropin, free tetra-iodothyronine, free tri-iodothyronine levels and thyroid autoantibodies.</p> <p>Results</p> <p>None of the patients developed any long term thyroid disease. Two patients had a prolonged hypothyroid phase of the thyroiditis early after the completion of treatment but recovered fully. The remaining 16 patients remained euthyroid. Similarly, thyroid autoantibodies all declined and returned to reference range.</p> <p>Conclusions</p> <p>The long term natural history in this small series of interferon induced thyroiditis was benign. If a larger series confirms a similar outcome then there is no long term residual effect on thyroid function and follow-up testing would not be warranted.</p

NONLINEAR REGRESSION FUNCTIONS FOR FORAGE NUTRIENT DISAPPEARANCE FROM BAGS INCUBATED IN THE RUMEN

Seven nonlinear regression functions are compared for fitting rumen in situ disappearance data. The standard function is based on a simple one-compartment model. In addition, we consider a time lag modification, a two-compartment model, and functions based on underlying probability models for degradation time. The empirical suitability of the seven regression functions are assessed using two in situ experiments involving forages fed to dairy cows. A function based on the loglogistic distribution is shown to have empirical and theoretical advantages

Valuing Transgenic Cotton Technologies Using a Risk/Return Framework

Stochastic Efficiency with Respect to a Function (SERF) is used to rank transgenic cotton technology groups and place an upper and lower bound on their value. Yield and production data from replicated plot experiments are used to build cumulative distribution functions of returns for nontransgenic, Roundup Ready, Bollgard, and stacked gene cotton cultivars. Analysis of Arkansas data indicated that the stacked gene and Roundup Ready technologies would be preferred by a large number of risk neutral and risk averse producers as long as the costs of the technology and seed are below the lower bounds calculated in this manuscript.cotton, financial risk, market value, SERF, transgenic, Agribusiness, Crop Production/Industries, Risk and Uncertainty, Q12, Q16,

Exacerbation of hepatitis C induced subclinical hypoadrenalism by Interferon-alpha2beta: A case report

Adrenal disease is an uncommon manifestation of hepatitis C infection and its related treatment regimen. This is a case of subclinical hypoadrenalism, probably induced by hepatitis C infection and further exacerbated by interferon-α2β and Ribavirin therapy. The adrenal deterioration during the treatment course was observed closely with 24-hour salivary profiles and 250 μg adrenocorticotropin stimulation tests using parallel serum and salivary cortisol concentrations. A number of possible pathogenic mechanisms are discussed, and the controversy over its management is emphasized

Research in Medical Education: Balancing Service and Science*

Since the latter part of the 1990’s, the English-speaking medical education community has been engaged in a debate concerning the types of research that should have priority. To shed light on this debate and to better understand its implications for the practice of research, 23 semi-structured interviews were conducted with “influential figures” from the community. The results were analyzed using the concept of “field” developed by the sociologist Pierre Bourdieu. The results reveal that a large majority of these influential figures believe that research in medical education continues to be of insufficient quality despite the progress that has taken place over the past 2 decades. According to this group, studies tend to be both redundant and opportunistic, and researchers tend to have limited understanding of both theory and methodological practice from the social sciences. Three factors were identified by the participants to explain the current problems in research: the working conditions of researchers, budgetary restraints in financing research in medical education, and the conception of research in the medical environment. Two principal means for improving research are presented: intensifying collaboration between PhD’s and clinicians, and encouraging the diversification of perspectives brought to bear on research in medical education