13 research outputs found
Woodchuck hepatitis virus core gene deletions and proliferative responses of peripheral blood mononuclear cells stimulated by an immunodominant epitope: a viral immune escape in the woodchuck model of chronic hepatitis B?
Marmota monax and its natural infection by
woodchuck hepatitis virus (WHV) could be used as a
predictive model for evaluating mechanisms of viral
persistence during chronic hepatitis B virus (HBV) infection. The aim of this study was to investigate the
presence of viral variants in the core gene of chronically
WHV-infected woodchucks that showed two different
patterns of peripheral blood mononuclear cells’ (PBMCs’)
responses after stimulation with a specific WHV core
peptide. Sequences’ analysis of the WHV core region
from eight WHV chronically infected woodchucks have
been performed after in vitro stimulation with an immunodominant epitope of the WHV core protein (amino
acids [aa] 96-110). Following this stimulation, positive
PBMC responses at each point of follow-up were observed for four animals (group A), and weak immune
responses at one or a few points of follow-up were observed for the remaining four animals (group B). The
WHV core gene sequences contained amino acid deletions (aa 84-126, aa 84-113) in three of four group A
animals and in none of group B animals. In the group A
animals, the same deletions were observed in liver specimens and in two of four tumor specimens. Hepatocellular carcinoma (HCC) was diagnosed in all group A
animals and in one group B animal. In conclusion, internal deletions in the core region correlated with a sustained PBMC response to the immunogenic peptide (96-
110) of the core protein. A possible role of this relationship in hepatocarcinogenesis could be hypothesized;
however, this needs to be investigated in patients with
chronic HBV infection. The evaluation of virus-specific
T-cell responses and T-cell epitopes that are possibly
related to the mechanisms of viral evasion should be
further investigated in order to design combined antiviral
and immune approaches to control chronic HBV
infection
Satisfaction with psychiatric in-patient care as rated by patients at discharge from hospitals in 11 countries
Purpose: There is disregard in the scientific literature for the evaluation of psychiatric in-patient care as rated directly by patients. In this context, we aimed to explore satisfaction of people treated in mental health in-patient facilities. The project was a part of the Young Psychiatrist Program by the Association for the Improvement of Mental Health Programmes. Methods: This is an international multicentre cross-sectional study conducted in 25 hospitals across 11 countries. The research team at each study site approached a consecutive target sample of 30 discharged patients to measure their satisfaction using the five-item study-specific questionnaire. Individual and institution level correlates of ‘low satisfaction’ were examined by comparisons of binary and multivariate associations in multilevel regression models. Results: A final study sample consisted of 673 participants. Total satisfaction scores were highly skewed towards the upper end of the scale, with a median total score of 44 (interquartile range 38–48) out of 50. After taking clustering into account, the only independent correlates of low satisfaction were schizophrenia diagnosis and low psychiatrist to patient ratio. Conclusion: Further studies on patients’ satisfaction should additionally pay attention to treatment expectations formed by the previous experience of treatment, service-related knowledge, stigma and patients’ disempowerment, and power imbalance.</p