Antiviral combination therapy in chronic hepatitis B

An outbreak of parenterally transmitted hepatitis was probably first recorded in 1885 by Lurman who reported the occurrence of jaundice among personnel of a Bremen factory after revaccination against smallpox. Of 1289 individuals vaccinated in one day, 191 developed jaundice 2 to 8 months after administration of glycerinated human lymph preparations. The illness usually began with fatigue,anorexia and gastrointestinal complaints followed by jaundice and often pruritus; it generally lasted a total of 4 to 6 weeks.Personnel vaccinated on another day with another vaccine preparation as well as those who left the job before revaccination were not affected, Comparison of the water supply, domicile, alcohol abuse and vaccine exposure indicated the latter as the probable cause of the outbreak (1,2,3). In 1945 MacCallum postulated that, on the basis of differences in incubation period and mode of transmission, two different agents cause hepatitis: hepatitis A and hepatitis B. He was not able to isolate the infectious agents (4). In 1967 Krugman and Giles confirmed the existence of two types of hepatitis:one with a short and one with a long incubation period (5). In 1965 Blumberg had already discovered an antigen in the serum of an Australian aboriginal which he called 'Australia antigen' (6). In 1968 Prince identified an antigen in the serum of patients with post-transfusion hepatitis, an antigen which he called SH antigen (7). The antigens discovered by Blumberg and Prince were found to be identical and represent the hepatitis B surface antigen. Between 1968 and 1973 the other principal viral antigens <HBeAg,HBcAg) and their antibodies were identified (8,9). The electron microscopy features of the virus were described by Dane in 1970. In the blood of infected patients the large complete virus particle (diameter 42 nm), small 22 nm spherical surface antigen particles and tubular forms (length 100 nm,diameter 22 nm) were found (10). Infection with the hepatitis B virus is characterized not only by production of infectious complete virus particles (Dane particles) but also by an enhanced production of incomplete viral particles made up entirely of HBsAg without HBcAg, DNA-polymerase activity or HBV-DN

Beter laat dan nooit : over de noodzaak tot implementatie van antivirale therapie bij chronische virale hepatitis B en C

Ovaj rad pod nazivom Kineski emitivni turizam i utjecaj na Europsku uniju bavi se gospodarskim, društvenim, političkim i turističkim razvojem Kine te pokazuje turistička kretanja prema Europi. Gospodarska, i djelomično sve otvorenija politika Narodne Republike Kine značajno doprinosi povećanju kineskom emitivnom turizmu. To se odnosi na međunarodni turizam, receptivni turizam i sve veći emitivni turizam u Kini. Pomoću pojednostavljenog ADS (approved destination status) postupka, povećanja obrazovanja i prihoda u kućanstvima, te sve više slobodnog vremena kao i pravo na regulirani odmor, kineskom stanovništvu se sve više omogućuje putovanje izvan granica svoje zemlje. Na temelju analize znanstvene literature, socio-ekonomskih turističkih podataka i uključivanja izvora iz znanstvenih članaka, u ovome se radu prikazuju pokretači turizma,razvoj, politika kao i bitne institucije turističke industrije koje sudjeluju u stvaranju turizma kao takvog

A randomised study on the efficacy and safety of an automated Tru-Cut needle for percutaneous liver biopsy

BACKGROUND: We studied whether the theoretical advantages of a spring-loaded liver biopsy needle exist in clinical practice and if so if they are dependent upon the experience of the physician performing the biopsy. METHODS: In a stratified randomised study we enrolled 215 consecutive patients to compare the safety and efficacy of a new automatic biopsy gun (Acecut) with that of a standard Tru-Cut needle. RESULTS: A total of 464 biopsies were performed. The endpoints of the study were number of needle passes needed per patient, tissue yield of each needle pass and post-biopsy complications. The performance of the automatic needle was superior and more consistent with respect to tissue yield compared with the Tru-Cut needle (median yield 100% and 80%, respectively; p < 0.001). The difference was most marked for inexperienced physicians. There was no difference between the two needles in the number of passes needed. More post-biopsy pain and post-biopsy use of analgesics were observed in the automatic needle group (p = 0.04). CONCLUSION: The automatic Tru-Cut needle offers an advantage, particularly for physicians with no or limited experience in liver biopsies. However more post-biopsy pain and post-biopsy use of analgesics were observed in the automatic needle group

Association between a progesterone receptor mutation and hepatitis E sero-positivity in liver transplant recipients

Problem: We investigated if the PROGINS mutation increases the risk of hepatitis E virus (HEV) infection in liver transplant recipients. PROGINS was analyzed through KASP assay; HEV serologies assessed via enzyme-linked immunosorbent assay and multiplex cytokine assays were evaluated in plasma with the ProcartaPlex human immunoassay. Seventy liver transplant recipients were evaluated, of which 23 (33%) were HEV immunoglobuln G (IgG)-positive (HEV+). The frequency of PROGINS in the HEV+ group was 34%, compared with 14% in those that were HEV IgG negative (HEV−). Cytokine measurements in a sub-set of samples from HEV+/PROGINS+ individuals showed decreased plasma levels of monokine induced by gamma interferon, a proliferation-inducing ligand, and stem cell factor, as well as increased levels of eotaxin-3 and interleukin-31 compared with those HEV−/PROGINS− samples. Our findings suggest an association between the PROGINS mutation and seropositivity for HEV in liver transplant recipients with consequent distorted cytokine levels

Management and outcome of hepatocellular adenoma with massive bleeding at presentation

AIM To evaluate outcome of acute management and risk of rebleeding in patients with massive hemorrhage due to hepatocellular adenoma (HCA). METHODS This retrospective cohort study included all consecutive patients who presented to our hospital with massive hemorrhage (grade II or III) due to ruptured HCA and were admitted for observation and/or intervention between 1999-2016. The diagnosis of HCA was based on radiological findings from contrastenhanced magnetic resonance imaging (MRI) or pathological findings from biopsy or resection of the HCA. Hemorrhage was diagnosed based on findings from computed tomography or MRI. Medical records were reviewed for demographic features, clinical presentation, tumor features, initial and subsequent management, short- and long-term complications and patient and lesion follow-up. RESULTS All patients were female (n = 23). Treatment in the acute phase consisted of embolization (n = 9, 39.1%), conservative therapy (n = 13, 56.5%), and other intervention (

Connecting Berezinskii-Kosterlitz-Thouless and BEC Phase Transitions by Tuning Interactions in a Trapped Gas.

We study the critical point for the emergence of coherence in a harmonically trapped two-dimensional Bose gas with tunable interactions. Over a wide range of interaction strengths we find excellent agreement with the classical-field predictions for the critical point of the Berezinskii-Kosterlitz-Thouless (BKT) superfluid transition. This allows us to quantitatively show, without any free parameters, that the interaction-driven BKT transition smoothly converges onto the purely quantum-statistical Bose-Einstein condensation transition in the limit of vanishing interactions.This work was supported by AFOSR, ARO, DARPA OLE, and EPSRC [Grant No. EP/K003615/1]. N. N. acknowledges support from Trinity College, Cambridge, R. P. S. from the Royal Society, and K. G. H. V. from DAAD.This is the author accepted manuscript. The final version is available from APS via http://dx.doi.org/10.1103/PhysRevLett.114.25530

Development of a quantitative real-time detection assay for hepatitis B virus DNA and comparison with two commercial assays

A highly reproducible and sensitive real-time detection assay based on TaqMan technology was developed for the detection of hepatitis B viru