Thursday, August 11, 2011

Hepatitis News Digest For Aug-11 2011

A prospective study of the rate of progression in compensated, histologically advanced chronic hepatitis C
Hepatology August 2011Jules L. Dienstag,1 Marc G. Ghany,2 Timothy R. Morgan,3,4 Adrian M. Di Bisceglie,5 Herbert L. Bonkovsky,6,7 Hae-Young Kim,8 Leonard B. Seeff,9,10 Gyongyi Szabo,11 Elizabeth C. Wright,10 Richard K. Sterling,12 Gregory T. Everson,13 Karen L. Lindsay,14 William M. Lee,15 Anna S. Lok,16 Chihiro Morishima,17Anne M. Stoddard,8 and James E. Everhart9 for the HALT-C Trial Group"In conclusion, we have documented the rate of development of histologically defined cirrhosis in patients with chronic hepatitis C and advanced fibrosis as well as the incidence of clinically meaningful outcomes among patients with noncirrhotic fibrosis, cirrhosis, and early decompensated liver disease. Moreover, we demonstrated the rates at which laboratory abnormalities developed as well as the relationship of platelet count to outcome rate. Such data should be helpful in guiding physicians who follow patients with histologically advanced chronic hepatitis C, preparing them for what outcomes to anticipate and at what annual incidence.....

Metabolic syndrome increases the risk of primary liver cancer in the United States: A study in the SEER-medicare database -
Hepatology August 2011" Metabolic syndrome is recognized as a risk factor for HCC......results of this population-based study indicate that metabolic syndrome is a significant risk factor for development of both types of primary liver cancer, regardless of the presence of all other major HCC and ICC risk factors. As a result, metabolic syndrome may explain a relevant proportion of idiopathic HCC or ICC in the United States. Consequently, approaches to control the recent worldwide epidemic of metabolic syndrome could contribute to a reduction in the liver cancer burden."....

Related; Chronic hepatitis C infection and insulin resistance: two best friends
Insulin resistance and hepatitis C: an evolving story

From CCO-HCV Resistance: Similarities and Differences With HIV
Source: HIV and Hepatitis C Annual Update 2011
Topics covered include:
Overview of Key Similarities and Differences Between HIV and HCV
Life Cycle of HIV
Life Cycle of HCV
Comparison of HIV and HCV Diversity
Therapeutic Implications of Drug Resistance in HCV and HIV: The Importance of a Backbone Regimen and Adhering to Stopping Rules
Baseline Drug Resistance in HCV
Virologic and Therapeutic Barriers to Drug Resistance
Special Considerations for HIV vs HCV Resistance
Role of HCV Subtypes in Drug Resistance
Reversion of Resistance and Cross-Class Resistance in HCV
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From Hepatitis Central
Surprising Data on What Typically Ends the Fight Against Hep C
Despite a less than uplifting prognosis for those with chronic Hepatitis C, it is not a death sentence.
by Nicole Cutler, L.Ac.
Receiving a diagnosis of chronic Hepatitis C can easily feel like a death sentence. That's understandable considering that this infectious disease is hard to cure, is capable of progressively damaging the liver and can lead to a handful of fatal conditions. However, a new study demonstrates that Hepatitis C is far from a fatal illness, as it is surprisingly less lethal than most people realize.
An estimated four to five million Americans are currently living with Hepatitis C. With so many people affected, there is a growing demand to learn as much as we can about this virus and dispel the myths surrounding it.

Hidden number of hepatitis sufferers
MORE than 1,000 people suffer from hepatitis B or C in Bedfordshire but do not even know it.
That is why Bedford Hospital has launched a new campaign to raise awareness of the virus, which is the leading cause of chronic liver disease in the UK.
Bus adverts will be seen throughout town over the next month, and anyone who wants to find out more will be encouraged to visit
Opal Greyson, a hepatitis nurse specialist at Bedford Hospital, said: “The majority of people living with hepatitis in the UK are undiagnosed and are completely unaware that they are even at risk.
“This is not only because it can lay dormant for years, but also because there is a common misconception that only intravenous drug users are at risk of contracting hepatitis.
“With one quick test we can diagnose hepatitis and begin crucial antiviral treatment early. I would encourage anyone who thinks they may be at risk to contact our confidential helpline on 01234 730340 or visit their GP to arrange a test.”

Hepatitis B

Early HBeAg Decrease Predicts Response to Entecavir (Baraclude) for Hepatitis B
Full story: HIV and Hepatitis
Decreases in hepatitis B "e" antigen during the first 6 months of treatment with entecavir are a better indicator than hepatitis B virus DNA levels of which patients will go on to achieve HBeAg seroconversion, according to a recent Chinese study

Hepatitis A

2,000 vaccinated after hepatitis A case reported at Fayetteville Olive Garden
By James Halpin Staff writer
County health officials have so far vaccinated roughly 2,000 people who may have been exposed to hepatitis A while dining at the Olive Garden.
Officials at the clinic vaccinated about 800 people Tuesday and up to an estimated 1,300 more on Wednesday in an effort to prevent the disease in those who dined or worked at the North McPherson Church Road eatery on days when an employee who tested positive was working, Health Department Director Buck Wilson said.
"We probably did almost twice as many (Wednesday) as we did (Tuesday)," Wilson said. "We are noticing that we're more efficient in our delivery. We're fine-tuning our process."


Reliability and predictive validity of a hepatitis-related symptom...
Full story: AIDS Research and Therapy
We aimed to determine the reliability and validity of a hepatitis symptom inventory and to identify predictors of hepatitis C treatment initiation in a cohort of HIV-infected patients.


From Pharmalot
Retractions Of Scientific Studies Are Surging
Over the past decade, the number of medical journals that have issued retractions has climbed precipitously. Since 2001, the overall number of papers that were published in research journals increased 44 percent, but at the same time, the number of papers that were retracted climbed more than 15-fold, according to The Wall Street Journal, citing data from Thomson Reuters.
Put another way, there were just 22 retraction notices that appeared in journals 10 years ago, but 139 were published in 2006 and by last year, the number reached 339. Through July of this year, there were a total 210 retractions, according to Thomson Reuters Web of Science, which maintains an index of 11,600 peer-reviewed journals..... - 15 minutes ago
Prosecutors accused him of obtaining information from an insider about hepatitis C drug trials enabled Greenwich, Connecticut-based FrontPoint to avoid more ...

Healthy You

From UC Berkeley -
The September Wellness Letter

Colloidal silver-Ask the Experts
September 2011

Q: Is it beneficial—and safe—to take colloidal silver?
A: No on both counts.
Colloidal silver is a suspension of fine silver particles, usually marketed as a liquid or as lozenges. Though it’s touted as a cure-all for everything from acne and arthritis to herpes and cancer, there’s no evidence it helps any condition. The FDA banned the use of colloidal silver and silver salts in over-the-counter drugs in 1999, declaring them neither safe nor effective. Dietary supplements containing them can still be sold, however, if they don’t make medical claims. The government has taken action against many companies that do make such claims, but that hasn’t made the products go away.
Silver was used medicinally before less-toxic drugs were developed. And there are still a few approved topical uses for it. But silver has no known function in the body.
It can, on the other hand, have side effects. The silver particles can accumulate in tissues and organs and turn your skin, nails and the whites of your eyes a harmless, but permanent, blue-gray color. Of more concern, colloidal silver can damage the kidneys and nervous system and have other serious effects; it may interfere with some medications, too. Don’t take colloidal silver or silver salts.
By the way: There’s also no credible evidence to back up the farfetched claims made for other “colloidal mineral” products, which typically include a mix of minerals, amino acids, enzymes and other substances.

Flaxseed and Flaxseed Oil
The flax plant yields the fiber from which linen is woven, as well as seeds and oil. Flaxseed oil, also called linseed oil, has many industrial uses. Flaxseed oil also comes in an edible form. Like olive, canola, and most other plant oils, flaxseed is highly unsaturated and heart-healthy. And flaxseeds are rich in yet another very interesting component—lignans—which may have anti-cancer properties. Lignans are a type of fiber, and at the same time a type of phytoestrogen—a chemical similar to the human hormone estrogen. When you eat lignans, bacteria in the digestive tract convert them into estrogen-like substances called enterodiol and enterolactone, which are thought to have anti-tumor effects. Lignans and other flaxseed components may also have antioxidant properties—that is, they may reduce the activity of cell-damaging free radicals. (Flaxseed oil lacks lignans, but some processors add them to their oil.)
Besides lignans, flaxseeds and their oil are also the best food sources of an essential fatty acid, alpha-linolenic acid. "Essential" means we must consume it, because our bodies cannot manufacture it. Essential fatty acids are important for cell membranes, blood pressure regulation, and other functions. Alpha-linolenic acid is an omega-3, similar to some of the fatty acids in fish oil. Omega-3s may reduce blood clotting, thus lessening the chance of a fatal heart attack. Flaxseeds and flaxseed oil may also lower total blood cholesterol, as well as LDL ("bad") cholesterol. But any highly unsaturated oil will do that, particularly if substituted for saturated fats. You can find alpha-linolenic acid in canola oil and walnuts, among other sources.
Claims, purported benefits: Prevents heart disease and cancer.

Bottom line: These claims are overstated. Flaxseed oil is heart-healthy because it contains alpha-linolenic acid. Flaxseed itself (ground or whole) also contains lignans, which may have antioxidant actions and may help protect against certain cancers, though this is far from certain. Add flaxseed and flaxseed oil to your diet if you wish. But don’t take flaxseed supplements. Plant estrogens, like human hormones, are not always benign. At high doses—and no one knows how much is too much—lignans might turn into cancer promoters.

Complementary Medicine / Alternative Medicine

From Medical News Today
Warning For Buyers Of Herbal Medicines! Important Safety Information Missing From Several Products
Herbal medicines are used by many people, who naively believe that just because they are natural there safe. Many products however, have potentially dangerous interactions with other medications and can have similar side effects to conventional drugs. A new study published in BioMed Centrals open access journal BMC Medicine shows key information required for safe use is not contained on several over-the-counter herbal products......

For Your Reading Pleasure

Grand Rounds is a weekly round up of the best health blog posts on the Internet. Each week a different blogger takes turns hosting - me this time around - and summarizes the submissions of the week.

Hosted This Week By; Dr. Deb
As a music lover, I thought I'd give Grand Rounds a vintage vinyl feel. So please make sure your phonographs are ready to go. Thanks to Dr. Val Jones and Dr. Nick Genes for the invite.

A Few Submissions, read more here.

Striving: By Glass Hospital

A moving post about the life and experiences of an 88 year old doctor who gave much to others.

If You Can't Say Something Nice" By Table for One

This post looks at the difficulties doctors face in presenting bad news to patients and their families.

Nine Signs You Should Fire Your Patient: By Insureblog

Well written post on when patients might need to get the boot.

US Rumor and Hospital Report: By Not Running a Hospital

A gloves-off review of the annual hospital review from US News and World Report.

Off The Cuff

Australia: Lost in Translation: Emergency Staff Don't Listen Properly
Julie Robotham (The Sydney Morning Herald, August 10, 2011)
"Hospital emergency departments function almost entirely on undocumented conversations that are frequently misunderstood, which puts patients at risk of wrong diagnosis or treatment, the first big study into the question has found. And the situation is worsening as hospitals are overwhelmed with a growing number of emergency visits, including from an increasing proportion of elderly people with complex conditions and people whose language or cultural background poses extra communication challenges. The research by the University of Technology, Sydney -- based on more than 1000 hours of direct observation in NSW and ACT hospitals -- identified the failure of doctors and nurses to listen properly to patients' descriptions of their illness as particularly problematic."

Health Canada Warns MDs Not to Push Drugs Online
Carly Weeks(The Globe and Mail, Toronto, August 7, 2011)
"Health Canada is warning doctors that they shouldn’t be using their personal websites to promote drugs, medical procedures or other health products…The advisory highlights the challenges of regulating such activities in an online world, where any doctor or health professional can communicate freely with the public…In Canada, the practice known as direct-to-consumer advertising of drugs is forbidden. That means drug companies or other parties are not allowed to run a commercial on air or in print or create a website that promotes a particular drug to treat a particular condition…Health Canada…said it suspects many doctors and health professionals are simply unaware of the law when it comes to online drug promotion. It has issued letters to provincial colleges…to put them on the alert. But the issue raises important questions."

U.S.: Shortchanging Cancer Patients
OpinionEzekiel J. Emanuel, oncologist, professor of medical ethics and health policy at the University of Pennsylvania; former White House adviser(The New York Times, August 6, 2011)
"If the laws of supply and demand were working properly, a drug shortage would cause a price rise that would induce other manufacturers to fill the gap…The underlying reason for this is that cancer patients do not buy chemotherapy drugs from their local pharmacies…Instead, it is their oncologists who buy the drugs, administer them and then bill Medicare and insurance companies for the costs…The Medicare Prescription Drug, Improvement and Modernization Act of 2003…put an end to this arrangement. It required Medicare to pay the physicians who prescribed the drugs based on a drug’s actual average selling price…indirectly…[it] had an unintended consequence…[since it] effectively limits drug price increases, it prevents [a natural economic cycle]…Unfortunately, there is no quick fix, because all solutions require legislation…Shortages in curative cancer treatments are completely unacceptable."

In Memory

From HCV Advocate
In Memoriam: Emmet B. Keeffe, MD
The news of the death of Emmet B. Keeffe, MD on August 8, 2011 shocked and saddened all who knew him. Dr. Keeffe was a kind and generous contributor to the Hepatitis C Support Project and hepatitis C community. He was one of the first experts to contribute to HCV Advocate’s Medical Writers’ Circle and has been a long-time friend to the Project......

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