Sunday, December 12, 2010

Hepatitis Monday News: IL-28B Genotype & What Is The Doc really looking at in a CBC

A journey toward diagnosis
During '90s, Hep C mystified
December 13, 2010
What would my life be like today if I'd chickened out? If I'd lived an illusion of perfect health, come of age without the constant, nagging undercurrent of disease? Instead, one day in the spring of 1996, a few months after the blood drive, a letter arrived at my parents' house. It was from the Red Cross, and it explained that my donation had been destroyed because it contained antibodies for "non-A, non-B hepatitis."
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From Natap:
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Treating HCV and HBV in Patients with HIV:
On the Cusp of Change in 2010
Listen to the Audio Discussion.
Faculty: Douglas T. Dieterich, MDCME:
Release Date: 11/03/2010 Expiration Date: 11/03/2011


Sun Dec 12, 2010, 10:41 PM EST
He said that, once into his early 40s, he started feeling ill. He subsequently got his gallbladder removed, although that was not his biggest problem. During the surgery, which was done through laparoscopy, the doctors found that Sullivan's liver had been damaged beyond repair by Hepatitis C
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They were twice as likely to die of lung cancer and three times as likely to die of cirrhosis of the liver, the study showed.
WHEN Diane Lake began visiting her late husband's resting place at Long Island National Cemetery in Farmingdale, she became alarmed by what she saw nearby: memorial markers that showed many of her husband's fellow Vietnam veterans had died even younger than he had.
The markers, spaced along a wall where the ashes of her husband, Spc. 4th Class Robert Lake, and others are interred, indicate which war a veteran served in, along with rank and branch of service.
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He said the whole batch of interferon from which thousands of patients of hepatitis C could have benefited had expired.
The Ministry of Science and Technology’s Joint Adviser Shaharyar Khan said the case had been referred to the FIA with the approval of Secretary Irfan Nadeem and Joint Secretary Khalid Saddiq and Finance and Accounts Officer Naghmana Ashfaq remained in touch with the inquiry
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Cure for the no-Roche blues
FLORENCE --
Miracle drugs roll off the assembly line at
Roche Carolina’s plant east of Florence by the thousands every day. The 300,000-square foot facility’s lineup of high-tech drugs includes pills that fight cancer, hepatitis, the flu and even (in the recent past, anyway) unwanted fat.
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Outbreak Reporting
The timeliness of infectious disease outbreak detection and reporting has improved since 1996 — but more in some geographic regions than in others.

In today's around-the-clock news environment, recognition of — and response to — events seems to be faster than ever before. But is this the case for outbreaks of infectious diseases? To find out, researchers analyzed the entire WHO public record of Disease Outbreak News and catalogued selected WHO-verified outbreaks that occurred between 1996 and 2009.

During the study period, 398 WHO-confirmed outbreaks occurred; 281 of them had a definable start date and were included in the analysis.

The illnesses most commonly reported were cholera (29%), yellow fever (12%), meningitis (9%), avian influenza (9%), and dengue (5%); the WHO geographic regions most commonly involved were Africa (53%), the eastern Mediterranean (11%), the western Pacific (11%), and the Americas (10%).
Between 1996 and 2009, the median time from outbreak start to outbreak discovery decreased from 30 to 14 days, and the median time from outbreak start to public communication about the outbreak decreased from 40 to 19 days.
Overall, the timeliness of outbreak discovery improved by 7% per year, and the timeliness of public communication by 6% per year. However, the improvements in discovery were statistically significant only for the western Pacific region, and the improvements in reporting only for the western Pacific and eastern Mediterranean regions.

Comment: As highlighted by the outbreaks of severe acute respiratory syndrome and 2009 H1N1 influenza, the ability to identify and respond quickly to communicable disease outbreaks arising anywhere in the world is of global importance. Efforts to further improve reporting capabilities — particularly in Africa — need to be supported.
Richard T. Ellison III, MD

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HIV/AIDS

From NATAP:Long-Term Control of HIV by CCR5 Delta32/Delta32 Stem-Cell Transplantation Brief Report - publication pdf attached

Kevin EG Perry
(The Guardian, London, online, December 7, 2010)"Although India remains a stratified society in many ways, caste is no bar to sex work. In a country where women are rarely in control of their own finances, all classes can find themselves forced to turn to prostitution. Many of the women have been widowed or divorced and find themselves barred from other forms of employment. Others may be single or married, but work in secret to supplement their family's meagre income

Shan Juan(China Daily, December 4, 2010)"Currently, despite a low prevalence nationwide, the epidemic is rising sharply among high-risk groups…according to China's Action Plan to Prevent and Control HIV/AIDS (2011-2015)...curbing the trend of transmission among those groups is crucial for the overall goal of AIDS control…Meanwhile, efforts to educate the general public should also be intensified…To better deliver consulting and medication, health authorities will try to detect as many of the infected as possible…HIV screening will be expanded to grassroots medical institutions where the technology for quick tests will be adopted


CANCER
Has the Future Already Arrived for ImmunoCellular Therapeutics?
Scientific and pharmaceutical-industry veterans were abuzz last week after the World Cancer Stem Cells Summit with the belief that cancer stem cells (CSC) are the future of oncology research and drug development.Academic heavy-hitters, including Robert Weinberg of MIT and founder of The Whitehead Institute, University of Toronto's Peter Dirks, and Harvard Medical School's Kornelia Polyak, joined industry leaders in showcasing their latest findings on what very well may be the root cause of cancer.


Pomegranate has health benefits of reducing the risk of cardiovascular disease, controlling high blood pressure, and inhibiting viral infections. Other that the above listed benefits, pomegranate also has components in it that can stop the spreading of prostate cancer cells. The components had been identified by researchers at the University of California. With the existence of the components, the cancer cells have weaker attraction to a cancer promoting chemical signal. This finding gives many man hopes to cure prostate cancer which previously has no cure. The research was presented at the 50th annual meeting of the American Society for Cell Biology.


Heart Disease and Death Biomarker, ALS Genetic Mutation, Gender, Race and High Blood Pressure (Week in Review)


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Understanding The Complete Blood Count *CBC

From Dr. Pullman
There are many reasons for a physician to order a complete blood count for a patient. Technology today is such that whether we want to know if you are anemic, if your white blood count is elevated, if your platelet count is low, or if you have abnormalities of any of the specific types of white blood cell, we order a complete blood count(CBC), because the automated machine that gives us any one piece of this information gives us all of this information and more.
This has advantages, but the down side is that we often find minor abnormalities that we have to decide whether or not to further evaluate. So what does a physician really look at in a CBC.
Hematocrit (HCT): This is the percent of the blood that is made up of blood cells. In earlier days this was determined by putting a specimen of whole blood in a capillary tube, plugging one end of the tube with clay, and using a centrifuge to spin the tube until all of the cells precipitate to the bottom leaving the serum is above.
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The percentage was determined by a simple comparative measurement.
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Now this is done by a complex machine. Still this is a simple concept. A low hematocrit is anemia. A high hematocrit is called polycythemia. This is key information. Normal range for men is about 45-52%. For women 37-48% (Keep in mind that normal values vary slightly from one lab to another)
emoglobin(Hb or Hgb): This is the concentration of hemoglobin in the blood. It gives similar information as the hematocrit. A low hemoglobin means anemia. Normal values are > 12 gm/dl in men, > 12gm/dl in women.
White Blood Cell Count (WBC): This is the number of white blood cells per cubic millimeter of blood. High white blood cell counts can suggest infection, leukemia, corticosteroid use, and less common problems. Low white blood cell counts are seen in some viral illnesses, and in conditions where the bone marrow is replaced or suppressed like chemotherapy, cancers, and various infiltrative processes. Normal values are between 4,300-10,800.
Platelet Count (Plt): This is the number of platelets per cubic millimeter of blood. Platelets are the first line of protection to stop bleeding. Low platelet counts can be seen in autoimmune disorders like ITP, in severe infection, in chemotherapy or other toxic bone marrow conditions, and in other bone marrow disorders.

Differential White Blood Cell Count:
The percentage of white blood cells of each of the major types of WBCs is stated as a percentage of the total WBC, as well as an absolute number.
Neutrophils, a.k.a. polymorphonuclear WBC’s or “polys” usually make up the largest percentage of WBC, followed by lymphocytes, monocytes, eosinophils, basophils, and in cases of leukemina and sometimes other bone marrow disorders immature white blood cells called “blasts.” Young neutrophils are called “bands”, short for banded neutrophils, and are suggestive of bacterial infection when present in high numbers. The slang for a high percentage of neutrophiils, especially a high percentage of “bands” is that there is a “left shift” in the WBC.
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Measurements of cell size:
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The CBC usually reports the Mean Corpuscular Volume (MCV), a measurement of the average size of the red blood cells. Low MCV usually suggests iron deficiency, though other causes are possible. High MCV can suggest vitamin B12 or folic acid deficiency, or sometimes rapid red blood cell turnover, as young red blood cells, called reticulocytes, are larger than after they are a few days old. MCHC (Mean Corpuscular Hemoglobin Concentration) is a measurement of the concentration of hemoglobin in the red blood cells. It also suggests iron deficiency when low.

MCH (mean corpuscular hemoglobin) is a similar measurement, with similar meaning. Low suggests iron deficiency. RDW is a measurement of the variability of the size of red blood cells. Honestly I really ignore the RDW generally, but it is supposed to be helpful in determining the cause of anemia. MPV is a measurement of average platelet size.

Don’t worry if every measurement in your CBC is not in the normal range. It is rare to see a CBC in any given individual where every value is in the normal range. It seems like just about everyone has at least one of the minor values outside the normal range.


If the WBC, Hct, Hb, and platelet count are normal, and none of the RBC indices are far outside the normal range, there are no immature white blood cells and the differential white blood cell count is normal or near normal, usually we are reassured that the CBC patient’s blood counts are fine.
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There is evidence that in cirrhotic patients, certain hemodynamic parameters, such as blood pressure and heart rate, are related to the severity of liver disease.
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This study investigated whether non-invasive 24-hour ambulatory blood pressure and heart rate are more closely associated with markers of liver disease severity than conventional office measurements
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Methods:
Ambulatory patients with cirrhosis underwent office blood pressure and heart rate measurements, 24-hour ambulatory blood pressure monitoring and blood laboratory tests.
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Results:
Results: Fifty-one patients (32 men, mean age 57.4+/-11.3 years) completed the study.Twenty six patients had compensated liver cirrhosis (group A) and 25 patients had more advanced liver disease (group B).
Group A and B patients differed significantly both in ambulatory asleep diastolic blood pressure (p less then 0.05) and office diastolic blood pressure (p less then 0.01), which were lower in more advanced liver disease.Office blood pressure and heart rate correlations were similar to or even stronger than ambulatory ones.
Ambulatory blood pressure and heart rate awake-asleep variation (dipping) showed a relatively flat pattern as markers of liver dysfunction were deteriorating.The strongest correlations were found with both ambulatory and office heart rate, which increased as indicators of severity of liver disease were worsening
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Conclusions:
Heart rate seems to be a more reliable marker of ongoing liver dysfunction than blood pressure. Evaluation of blood pressure and heart rate with 24-hour ambulatory measurement does not seem to offer more information than conventional office measurements.
Author: Dimitris TzamouranisAlexandra AlexopoulouSpyros DourakisGeorge StergiouCredits/
Source: BMC Gastroenterology 2010, 10:143


FDA
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Cells reprogrammed to treat diabetes
Testes may be a source of insulin production
Web edition : Sunday, December 12th, 2010
Text Size
PHILADELPHIA - Sperm-forming stem cells in the testes can be converted to insulin-producing cells that could replace diseased ones in the pancreas, researchers from Georgetown University Medical Center in Washington, D.C., reported December 12 at the annual meeting of the American Society for Cell Biology. The new technique is edging closer to producing the amount of insulin needed to cure diabetes in humans
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,Off Topic: Links

A list of the $4. / month supply medications available at Walmart.
Target and others have similar lists.

Anatomy On-line
Anatomy On-line is a nice site to look at diagrams of human anatomy, to allow you to see what muscles, bones, organs, etc. are in various areas
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Now playing in a sky near you: Winter meteor show

By Elizabeth Weise, USA TODAY
Flaming rocks are hurtling toward the Earth upon the arrival of the annual Geminid meteor shower, one of the biggest of the year.
The peak of the week-long shower will come just before dawn Tuesday, but the shooting stars were visible across the world late this past weekend, says Rebecca Johnson, editor of StarDate magazine, which is published by the McDonald Observatory, the University of Texas research unit near Fort Davis, Texas.

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