Tuesday, February 8, 2011

Hepatitis C In The News; VA to test 535 dental patients for infections

VA to test 535 dental patients for infections

By Ben Sutherly, Staff Writer Updated 10:57 AM Tuesday, February 8, 2011
DAYTON — At least 535 veterans who received care at the Dayton VA Medical Center’s dental clinic from 1992 to July 2010 will be offered free screening to see if they were infected when a dentist failed to change his Latex gloves between patients.
The veterans will be tested for Hepatitis B, Hepatitis C and HIV, Dayton VA Director Guy Richardson said Tuesday. .

.Hep C: 'Everyday was painful'
Sultan Mahmood was born in Pakistan and came to live in Bradford in 1993. He was married and had two healthy children, but he started to feel ill in 2001.
He had flu-like symptoms, suffered from nausea, started losing weight and then had jaundice.
"I did not know what was happening to me. Every week another new problem started and I was getting worried."
After months of tests he was diagnosed as having hepatitis C.

Treating Hepatic Hydatid Cysts Using Non-Surgical Approach
08 February 2011
A treatment of Concern, until recently the only definitive treatment for hydatid disease, had been surgery. Different surgical techniques and procedures have been carried out and even in some cases, a liver transplant has been required...

The Link Between Macular Degeneration and Liver Health
Learn why preserving vision and maintaining liver health share several commonalities.
by Nicole Cutler, L.Ac.
As one of the leading causes of irreversible blindness, macular degeneration becomes more of a concern with advancing age. Consequently, this disease is often referred to as age-related macular degeneration (AMD). Although the eyes are physically located quite a distance from the liver, Traditional Chinese Medicine (TCM) theory describes a definitive association between the two. In addition, certain natural supplements that help those with chronic liver disease also help prevent or slow down AMD.

Hepatitis C Cirrhosis;Comparison of Fibroscan, King's Score and Liver Biopsy
Historically, liver biopsy (LB) was the sole method to evaluate the severity of hepatic fibrosis in patients with chronic hepatitis C infection. However, LB is expensive and associated with a risk of severe complications. Therefore, noninvasive tests have been developed to assess the severity of liver fibrosis. ....Keep Reading...

Fatty Liver

Nonalcoholic Liver Disease Rate Exceeds Past EstimatesLast
Updated: February 07, 2011.
The prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis is higher than previously estimated, with Hispanics and those with diabetes at the highest risk, according to a study published in the January issue of Gastroenterology.
MONDAY, Feb. 7 (HealthDay News) -- The prevalence of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) is higher than previously estimated, with Hispanics and those with diabetes at the highest risk, according to a study published in the January issue of Gastroenterology.

Christopher D. Williams, M.D., of the Brooke Army Medical Center in Fort Sam Houston, Texas, and colleagues studied 328 outpatients aged 18 to 70 years to determine the prevalence of NAFLD and NASH. Participants completed a questionnaire and ultrasound. If fatty liver was identified, lab data and a liver biopsy were obtained.

The researchers found the prevalence of NAFLD to be 46 percent, and NASH was confirmed in 12.2 percent of the total cohort. The researchers note that these numbers are higher than previously estimated. Hispanics were found to have the highest prevalence of NAFLD (58.3 percent) and NASH (19.4 percent). NAFLD patients were more likely to be male or older or have hypertension or diabetes. They also had a higher body mass index, ate fast food more often (P = .049), and exercised less than their non-NAFLD counterparts. Evidence of advanced NASH was found in 2.7 percent of patients.

"Although all ethnicities are affected and patients have varying degrees of insulin sensitivity, Hispanics and diabetic patients appear to be at the greatest risk for both NAFLD and NASH," the authors write.


Novel Cancer Surgery; LESSOnc
"The new technique – termed LESSOnc ( Laparo-Endoscopic Single-Site Oncologic surgery ) by the team – promises to be a new surgical option for patients with certain liver cancers"(Media-Newswire.com) - Surgeons at UC San Diego Health System have identified a new application for “scarless” surgery tools that are normally used for natural orifice translumenal endoscopic surgery ( NOTES ).

Published 02/08/2011 - 8:12 a.m. CST

HOUSTON, TX - Always on the forefront of innovative treatments and technologies, the Michael E. DeBakey VA Medical Center (MEDVAMC) now provides Veterans a targeted, painless alternative to open surgery and a medical option for certain inoperable tumors.
The CyberKnife®, an impressive-looking machine resembling a giant robot with a multi-jointed arm that pivots, twists, and turns, can treat tumors anywhere in the body with radiosurgery.

New research shows what a lousy job local TV news does with cancer topics
By: Gary Schwitzer

Tom Jacobs, on the Miller-McCune Smart Journalism site, summarizes two recent studies. Excerpts:
"By focusing on shocking new studies that reveal a "novel or controversial" potential cause of the disease, local television news tends "to cultivate the belief that everything causes cancer," a research team led by Cornell University's Jeff Niederdeppe writes in the Journal of Communication. ... (The researchers) conclude by suggesting scientists and educators might want to give local newscasters a nudge.

Legal ramifications for doctors of patients who drive with hepatic encephalopathy

February's issue of Clinical Gastroenterology & Hepatology reports on the legal ramifications for physicians of patients who drive with hepatic encephalopathy.

Hepatic encephalopathy, a spectrum of neuropsychiatric abnormalities that can occur in patients with liver dysfunction, negatively affects driving performance, but no study has examined legal ramifications.
Dr Stanley Martin Cohen and colleagues from Illinois, USA studied state requirements for reporting hepatic encephalopathy.

In addition, the team investigated whether lawsuits have been completed against physicians or patients for motor vehicle accidents that were related to hepatic encephalopathy.
The researchers contacted motor vehicle departments from all 50 states and examined motor vehicle codes, and legal databases to search for hepatic encephalopathy–related lawsuits.
Definitions of a medically impaired driver varied considerably.
6 of the states had mandatory reporting laws for drivers with medical impairment

Clinical Gastroenterology & Hepatology
The research team observed that no state specifically mentioned hepatic encephalopathy or patients with advanced liver disease.

Only 6 of the states had mandatory reporting laws for drivers who have medical impairment, and 25 of the remaining 44 states provided legal immunity to physicians for reporting such patients.

The research team found that the legal databases did not contain any cases against physicians for failure to warn against driving or diagnose hepatic encephalopathy that resulted in an accident.

The team identified no lawsuits against an encephalopathic patient for causing a motor vehicle accident.

"Hepatic encephalopathy is not specifically addressed in any state vehicle code."
"There are no completed lawsuits against physicians or patients for motor vehicle accidents associated with driving impairment from hepatic encephalopathy."
"In the absence of definitive laws, the onus of responsibility for identifying potentially hazardous drivers might still lie with the physician."

"Physicians should carefully evaluate patients for driving abilities."
Clin Gastroenterol Hepatol 2011: 9(2): 156-60
08 February 2011


Blood testing bungle puts 55 at risk of AIDS
Richard Noone
From: The Daily Telegraph
February 09, 2011 12:00AM

AN error with a blood testing machine has exposed 55 people to the risk of HIV and hepatitis.
The 53 patients and two staff were told on Monday by the Gosford clinic of PRP Diagnostic Imaging, Australia's largest private radiology company, that they had all been tested with the same needle. It recommended they undergo hepatitis B and C and HIV blood tests.
"I sincerely apologise that this has occurred and for any concern this may cause you," the clinic's director Dr Uday Ahluwalia said in a letter sent to patients.

From Medscape Medical News
HIV-Infected Men at Ongoing Risk for HCV Seroconversion, Study Finds
Norra MacReady
Authors and Disclosures

February 7, 2011 — Even with conscientious care and state-of-the-art medication, HIV-infected men are at risk for hepatitis C virus (HCV) seroconversion and should have access to ongoing HCV surveillance, the authors of a new study say. Their findings were published online January 31 and appear in the February print issue of Clinical Infectious Diseases.


Associations between microalbuminuria and animal foods, plant foods, and dietary patterns in the Multiethnic Study of Atherosclerosis - pdf attached - (02/06/11)

HIV Infection, Inflammation, Immunosenescence, and Aging - pdf attached - (02/06/11)

Treatment interruptions explain higher HIV viral load in patients with depression and those who use stimulants
Michael Carter
Published: 08 February 2011
Inconsistent use of antiretroviral therapy is the main explanation for the higher viral loads observed in HIV-positive patients who are depressed or who use stimulant drugs, US investigators report in the February 1st edition of the Journal of Acquired Immune Deficiency Syndromes.
“Inconsistent patterns of ART [antiretroviral therapy] utilization account for the effects of depression and stimulant use on higher HIV viral load,” comment the investigators.


Royal Society Backs Technology To Increase Number Of Livers Available For Transplant
08 February 2011The Royal Society Enterprise Fund announced yesterday that it has participated in a £2.75m Series B investment round for OrganOx Ltd which is developing a medical device that will significantly increase the number of human...

Healthy You

Cannabis Use Linked to Earlier Psychosis
Psychotic illness occurs significantly earlier among marijuana users, results of a meta-analysis suggest.

Gene Linked To Major Depression
Written by Catharine Paddock, PhDGene variants that cause low expression of the brain chemical NPY are linked to negative emotional processing and higher risk of developing some major depressive disorders said US scientists in a new study published this week...

Public Release: 8-Feb-2011
Eggs are now naturally lower in cholesterol
According to new nutrition data from the United States Department of Agriculture's Agricultural Research Service, eggs are lower in cholesterol than previously thought. The USDA-ARS recently reviewed the nutrient composition of standard large eggs, and results show the average amount of cholesterol in one large egg is 185 mg, 14 percent lower than previously recorded. The analysis also revealed that large eggs now contain 41 IU of vitamin D, an increase of 64 percent.


February 07, 2011
Sun exposure and vitamin D linked to MS risk
NEW YORK (Reuters Health) - People who have spent more time in the sun and those with higher vitamin D levels may be less likely to develop multiple sclerosis (MS), according to a new study from Australia.
The results are consistent with previous reports showing that people living close to the equator are less likely to get MS, a chronic disease that affects the central nervous system, than those at higher latitudes. Greater sun exposure, leading to higher vitamin D levels, might explain that difference in risk.
"We've known for decades that the farther away from the equator you live and grew up, the higher the risk of MS," Dr. Thomas Mack, who studies MS at the University of Southern California and was not involved with the research, told Reuters Health. "The question is, what is it that's responsible for that increase? Sunlight is a good bet, and of course vitamin D is a function of sunlight exposure."
In MS, the protective coating around nerve fibers starts breaking down, slowing the speed of signals traveling between the brain and body. Symptoms include problems with balance and muscle coordination and sometimes memory loss and trouble with logical thinking. There is no effective treatment for the condition.
About 350,000 people in the United States suffer from MS, and women are twice as likely as men to get the disease. Health care costs associated with MS are more than $10 billion each year in the U.S.
Vitamin D occurs naturally in certain foods and can be taken in supplements, but it is also manufactured by the body in response to the ultraviolet (UV) radiation in sunlight hitting the skin.
In the current study, researchers led by Dr. Robyn Lucas of The Australian National University identified 216 adults who had just started having the first symptoms of MS between 2003 and 2006. Then they found a comparison group of 395 people from the same regions of Australia as the subjects, who matched them in age and gender, but had no signs or symptoms of MS. The researchers asked everyone in both groups how much time they had spent in the sun and where they had lived at different points in their lives. All participants' skin damage from sun and the levels of vitamin D in their blood were also measured.
On average, people with the first signs of MS had been exposed to a smaller total "UV dose" over the course of their lives, calculated based on how much time they had spent in the sun and how close to the equator they had lived.
People with early MS were also less than half as likely to have high levels of skin damage caused by exposure to sunlight. In addition, vitamin D levels were five to 10 percent lower in subjects with MS than in those without MS, according to the report published in the journal Neurology.
The finding that sun exposure and vitamin D levels may be linked to MS is not a new one -- UV light and vitamin D are known to dampen the kind of abnormal immune system activity that is believed to contribute to MS. But the current study differs from others in an important way, researchers say.
"Our study is the first to be able to look at both sun exposure and vitamin D status right at the very first symptoms that might precede development of MS," Lucas wrote in an e-mail to Reuters Health.
"People, after they are diagnosed with MS, they change their lifestyles," said Dr. Alberto Ascherio, who studies the link between vitamin D and MS at the Harvard School of Public Health and was not involved in the current study. That might include, for example, taking more vitamin D to try to prevent their symptoms from getting worse, which could skew analyses of whether the vitamin has any protective properties before disease sets in.
The current findings do not prove that being exposed to very little sunlight or having low vitamin D levels causes MS. And while the authors tried to show that both sun exposure and vitamin D levels influence risk of MS on their own, other researchers aren't so confident it's possible to separate their effects.
"They may have independent roles, but the reality is it's extremely difficult to sort them out," Ascherio explained. For example, the authors don't know the participants' blood levels of vitamin D over the course of their lives, and it's possible that measuring someone's sun exposure over the years is really just another way of measuring how much vitamin D they had at those times.
Even though more time in the sun might help protect against MS, it is also associated with a higher rate of skin cancer -- so the message of the study is not that more time outside is always better. Nor do the results mean that everyone should load up on vitamin D supplements, said Mack. "Most people have enough vitamin D anyway, at least those people that live in the sunny areas of the world," he explained. "I don't think we know yet that taking vitamin D is going to prevent MS."
The main message of the study, Lucas said, is that "small amounts of sun exposure ... occurring frequently, are probably optimal both for maintaining vitamin D levels and for other health effects."
SOURCE: http://bit.ly/Q5TNl Neurology, online February 7, 2011.

FDA Recall

02/04/2011 Trelstar Watson’s Trelstar (triptorelin pamoate for injectable suspension) product, containing alcohol prep pads

Contain alcohol prep pads that were recently recalled by the Triad Group due to potential contamination with Bacillus cereus

[UPDATED 02/07/2011] Triad Alcohol Prep Pads are a component of Extavia (interferon beta 1-b) packaging marketed by Novartis. The Triad alcohol prep pads should not be used.

February 05, 2011 Qualitest Pharmaceuticals Recalls Hydrocodone Bitartrate and Acetaminophen Tablets and Phenobarbital Tablets

Off The Cuff

Lawsuit Says Gluco-Ease Supplement Dangerous
Plaintiff says supplement caused hepatitis, liver disease
A Pennsylvania plaintiff is suing Penn Herb Co., claiming that the company's Gluco-Ease plus supplement caused cholestatic hepatitis and liver disease.
Isaac Shaw, of Philadelphia, blames Uva Ursi, or bearberry, leaves for his illness. According to the suit, Uva Ursi is “listed on the FDA Poisonous Plant Database” and “contains Hydroquinone, a chemical which is known to be toxic and and a cause of serious liver damage.”

State Will Stop Paying For Some Hospital Re-Admissions
By Martha Bebinger
Feb 8, 2011, 6:47 AM UPDATED 7:07 AM
Listen Now

BOSTON — Medicaid is one of the fastest growing parts of the state budget. To tackle rising health care costs, Gov. Deval Patrick’s administration plans to stop paying hospitals with high rates of re-admissions when low-income patients return within 30 days.
It could be a man who leaves the hospital with new prescriptions and takes the wrong pill four times a day. Or a woman with depression who skips a critical follow-up appointment after surgery. Perhaps it’s a child who goes back to the same activities and has another severe asthma attack. These are all reasons patients return to the hospital shortly after release. They might all be prevented with better instruction inside the hospital, a better hand-off to our doctor outside or more active patient follow-up.

“We are paying for the wrong things,” said Dr. Judy Ann Bigby, secretary for Health and Human Services in Massachusetts. Bigby said it’s not just that the state doesn’t want to pay. Repeat hospitalizations carry risk, “either a hospital-acquired infection or some other type of outcome that demonstrates that the quality of care is not as good as it could be, and it’s costly to the system,” Bigby said.....

Risk of Cancer Increases With Exposure to Low-Dose Radiation from Cardiac Imaging, Study Finds
Exposure to low-dose radiation from cardiac imaging and other procedures after a heart attack is associated with an increased risk of cancer, a new study ...

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