scholarly journals P228 Cytomegalovirus Infection: is it a cause of flare-up in inflammatory bowel diseases?

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S256-S257
Author(s):  
A Busacca ◽  
R Mascaretti ◽  
L Carrozza ◽  
L Guida ◽  
S De Grazia ◽  
...  
Keyword(s):  
Antiviral Therapy ◽  
Disease Duration ◽  
Antiviral Treatment ◽  
Smoking Habit ◽  
High Dose ◽  
Familial Predisposition ◽  
Disease Outcomes ◽  
Bowel Diseases ◽  
The Impact ◽  
The Relationship

Abstract Background The presence of CMV in blood is quite common in patients with severe flares of ulcerative colitis (UC) and Crohn’s disease (CD) and seems to predict an adverse outcome. The impact of antiviral treatment on CMV in this setting (indications and drug options) is an unresolved issue. Our aim was to reassess the CMV role in patients with IBD hospitalised for severe exacerbations, analysing the relationship between CMV positivity, clinical characteristics, antiviral therapy and disease outcomes. Methods We evaluated a homogeneous cohort of 97 consecutive patients with IBD hospitalised from 2012 to 2018. Data regarding age, gender, smoke, familial predisposition, type of IBD, extent, according to Montreal classification, disease activity (clinical and endoscopic), therapy at the time of relapse were registered in a dedicated database. CMV was tested by PCR in whole blood. The relationship between antiviral therapy and disease outcomes (rate of colectomy, mortality) was analysed. Results Among the 97 patients, 51 were females. In the UC group (67 patients, 69.1%), mean age was 48,8, SD ± 17,7 whereas in the CD group (30 patients, 31%), mean age was 39,9 years (SD ± 15,2). Fifteen per cent of patients had a family predisposition for IBD. There were no differences at baseline between UC and CD, except disease duration (longer in UC) and therapy at the time of relapse (high dose steroids more common in UC). Thirty-one patients (32 %) tested positive for CMV on PCR. Smoking habit, shorter disease duration, therapy on admission (high dose steroid and/or immunomodulators) and endoscopic activity assessed by Mayo endoscopic sub-score were the variables significantly related to CMV positivity. Antiviral therapy was adopted in 22% of patients and the decision to treat was based on clinical judgement and viral load. Treated patients had higher endoscopic activity than untreated (Mayo sub-score 3 vs. 2,6, p < 0,004). The mean hospital duration was longer in treated patients 22.3 ( ± 11.1) days, vs. 14,8(+/−8,6) days. 3 patients underwent surgery within 90 days, 2 patients died; all of them were positive for CMV DNA. No significant differences were observed on either colectomy or mortality rate in relation to the use of antiviral therapy. Conclusion This single-centre study confirms that the CMV reactivation during disease flares of IBD is common and related to disease duration, severe endoscopic lesions, and immunosuppression (high dose steroids and/or immunomodulators).Antiviral drugs do not seem to modify surgical outcomes or mortality but increase the hospitalisation length. However, the retrospective design and the limited sample size of the study do not allow to draw definitive conclusions: the real impact on outcome and the role of antiviral therapy will require adequately powered prospective studies.

scholarly journals Impact of Pentoxifylline and Vitamin E on Ribavirin-Induced Haemolytic Anaemia in Chronic Hepatitis C Patients: An Egyptian Survey

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
M. Assem ◽  
M. Yousri
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Vitamin E ◽  
Antiviral Therapy ◽  
Chronic Hepatitis C ◽  
Haemolytic Anaemia ◽  
Antiviral Treatment ◽  
Control Group ◽  
High Dose ◽  
The Impact

Background/Aim. We evaluate the impact of combined pentoxifylline and high-dose vitamins E to standard antiviral treatment on RBV-induced haemolytic anaemia.Patients and Methods. Selected 200 naïve chronic HCV patients, were randomized to receive either the standard antiviral therapy (peginterferon α-2b and RBV) plus pentoxifylline (800 mg) and high-dose vitamin E (1000 iu) daily (combined group) or received standard antiviral therapy plus placebo only (control group). They were followed up during treatment course and for 6 months posttreatment to assess the occurrence of anaemia and virological response, respectively.Results. RBV dose modification due to anaemia were significantly less in combined group (8.5 versus 21.5%.P<.05).Withdrawal, secondary to sever anemia (Hb<8.5 gm%), was recorded only in 6 (28.6%) patients of the control group. Both (ETR) and (SVR) were significantly higher in combined group than control group by both intention-to-treat analysis (71 versus 56%,P<.05and 66 versus 49%,P<.05) and per-protocol analysis (85.5 versus 70.9%,P<.05and 79.5 versus 62%,P<.05).Conclusion. Pentoxifylline and vitamin E can ameliorate RBV-associated haemolysis; improve compliance and virologic clearance when combined with the standard antiviral therapy in patients with chronic hepatitis C.

scholarly journals Treatment advantage in HBV/HIV coinfection compared to HBV monoinfection in a South African cohort

2019 ◽  
Author(s):  
Tongai G Maponga ◽  
Anna L McNaughton ◽  
Marije Van Schalkwyk ◽  
Susan Hugo ◽  
Chikezie Nwankwo ◽  
...  
Keyword(s):  
South Africa ◽  
Antiviral Therapy ◽  
Clinical Care ◽  
Antiviral Treatment ◽  
Laboratory Data ◽  
University Hospital ◽  
Cross Sectional ◽  
Hiv Coinfection ◽  
Liver Health ◽  
The Impact

ABSTRACTObjectivePrompted by international targets for elimination of hepatitis B virus (HBV) infection, we performed a cross-sectional observational study of adults with chronic HBV (CHB) infection in South Africa, characterising individuals with HBV monoinfection vs. those coinfected with HBV/HIV, to evaluate the impact of therapy and to guide improvements in clinical care as guidelines for antiviral therapy change over time.DesignWe prospectively recruited 115 adults with CHB, over a period of one year at a university hospital in Cape Town, South Africa. HIV coinfection was present in 39 (34%) subjects. We recorded cross-sectional demographic, clinical and laboratory data.ResultsAdults with HBV monoinfection were comparable to those with HBV/HIV coinfection in terms of age, sex and body mass. HBeAg-positive status was more common among those with HIV coinfection (p=0.01). However, compared to HBV/HIV coinfection, HBV monoinfected patients were less likely to have had assessment with elastography (p<0.0001) and less likely to be on antiviral treatment (p<0.0001). The HBV monoinfected group was more likely to have detectable HBV viraemia (p=0.04), and features suggesting underlying liver disease including moderate/severe thrombocytopaenia (p=0.007), elevated bilirubin (p=0.004), and APRI score >2 (p=0.02). Three cases of hepatocellular carcinoma were documented, all in patients with HBV monoinfection.ConclusionIn this setting, individuals with HBV monoinfection are disadvantaged in terms of clinical assessment and appropriate antiviral therapy compared to those with HIV coinfection, associated with relatively worse liver health. Enhanced advocacy, education, resources and infrastructure are required to optimise interventions for CHB.

Serum Vitamin D Levels in Chronic Hepatitis B Patients Before and During Treatment

2019 ◽  
Vol 19 ◽  
Author(s):  
Amal Ahmed Mohamed ◽  
Sabry Abdo ◽  
Ebada Said ◽  
Waleed El Agawy ◽  
Peter Awad ◽  
...  
Keyword(s):  
Vitamin D ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Antiviral Therapy ◽  
Chronic Hepatitis B ◽  
Antiviral Treatment ◽  
Serum Vitamin ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
The Impact

Background & Aims: Hepatitis B is a potentially life-threatening liver infection and it is a major global health problem. Over the past decade, numerous studies have reported that patients with CLD, especially HCV-positive and HBV-positive patients, have decreased 25(OH) D levels. The current study was designed to assess the serum levels of vitamin D [25(OH) D3] in chronic hepatitis B patients, before and during treatment with antiviral therapy. Methods: It was a prospective study in which 80 subjects were enrolled between December 2017 and June 2018. A total of 50 treatment-naïve chronic HBV patients and 30 healthy subjects were recruited. The studied cases received treatment in the form of Lamivudine 100 mg tablet, once daily. Full routine laboratory investigations, HBV DNA measurement by real time PCR; once before initiation of antiviral treatment and again at least 6 months later, serum vitamin D level [25(OH)D3; assessed twice, once before initiation of antiviral treatment and again at least 6 months later; were done for all the patients enrolled in the study. Results: The studied cases showed a significantly low mean serum Vitamin D level when assessed before treatment (21.6 ± 5.8 ng/ml), compared to the level after 6 ms of treatment (31.1 ± 7.3 ng/ml) that was comparable to that of the control group (33.4 ± 5 ng/ml). Conclusion: The present study highlights the impact of antiviral therapy on vitamin D deficiency in CHB patients, where an effective therapy improves vitamin D levels. Meanwhile it is recommended to study the impact of vitamin D replacement and correction on the disease progression or regression.

scholarly journals The Impact of Multispecies Probiotics on Calcium and Magnesium Status in Healthy Male Rats

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3513
Author(s):  
Joanna Suliburska ◽  
Iskandar Azmy Harahap ◽  
Katarzyna Skrypnik ◽  
Paweł Bogdański
Keyword(s):  
Male Rats ◽  
Molar Ratio ◽  
High Dose ◽  
Standard Diet ◽  
Probiotic Properties ◽  
Femur Bone ◽  
Calcium And Magnesium ◽  
Distribution In The Organism ◽  
The Impact ◽  
The Relationship

Although probiotics have been discovered in numerous diseases in the last decade, there is little consensus on the relationship between probiotic properties and minerals balance and their distribution in the organism. This research aimed to evaluate the calcium (Ca) and magnesium (Mg) status in rats on a diet containing multispecies probiotics. Thirty male 10-week-old Wistar rats were selected and divided into three groups (n = 10 rats)—a group fed a standard diet (C), a group fed a low-dose of multispecies probiotics with 2.5 × 109 CFU per day (LD), and a group fed high-dose of multispecies probiotics 1 × 1010 CFU per day (HD) for 6 weeks. The results revealed that HD intake significantly increased the Ca concentration in hair and Mg concentration in femur bones. A significant positive correlation was found between calcium and magnesium levels in hair. The Ca/Mg molar ratio was lower in testicles in the groups with probiotics. In conclusion, multispecies probiotics altered the Ca concentration in hair and Mg level in femur bone, and also changed the molar ratio of these elements in testicles in male rats.

Accent Policy and Accent Modification Enterprises as Potential Indicators of Intercultural Power Relations: A Call for an Updated Research Agenda

2013 ◽  
Vol 3 (1) ◽  
pp. 22-33 ◽  
Author(s):  
Brynne D. Ovalle ◽  
Rahul Chakraborty
Keyword(s):  
International Relations ◽  
Identity Construction ◽  
Social Theory ◽  
Power Relations ◽  
Linguistic Diversity ◽  
Cultural Organization ◽  
Using Data ◽  
The Individual ◽  
The Impact ◽  
The Relationship

This article has two purposes: (a) to examine the relationship between intercultural power relations and the widespread practice of accent discrimination and (b) to underscore the ramifications of accent discrimination both for the individual and for global society as a whole. First, authors review social theory regarding language and group identity construction, and then go on to integrate more current studies linking accent bias to sociocultural variables. Authors discuss three examples of intercultural accent discrimination in order to illustrate how this link manifests itself in the broader context of international relations (i.e., how accent discrimination is generated in situations of unequal power) and, using a review of current research, assess the consequences of accent discrimination for the individual. Finally, the article highlights the impact that linguistic discrimination is having on linguistic diversity globally, partially using data from the United Nations Educational, Scientific and Cultural Organization (UNESCO) and partially by offering a potential context for interpreting the emergence of practices that seek to reduce or modify speaker accents.

Business: Making Cents of Coding Systems: Billing for Professional Services

2010 ◽  
Vol 20 (1) ◽  
pp. 3-8
Author(s):  
Dee Adams Nikjeh
Keyword(s):  
Professional Services ◽  
Speech Language Pathology ◽  
Coding Systems ◽  
Language Pathology ◽  
Program Funding ◽  
Fee Schedule ◽  
Procedure Codes ◽  
Relationship Of ◽  
The Impact ◽  
The Relationship

Abstract Administrators and supervisors face daily challenges over issues such as program funding, service fees, correct coding procedures, and the ever-changing healthcare regulations. Receiving equitable reimbursement for speech-language pathology and audiology services necessitates an understanding of federal coding and reimbursement systems. This tutorial provides information pertaining to two major healthcare coding systems and explains the relationship of these systems to clinical documentation, the Medicare Physician Fee Schedule and equitable reimbursement. An explanation of coding edits and coding modifiers is provided for use in those occasional atypical situations when the standard use of procedural coding may not be appropriate. Also included in this tutorial is a brief discussion of the impact that the Medicare Improvements for Patients and Providers Act of 2008 (HR 6331 Medicare Improvements for Patients and Providers Act [MIPPA], 2008) has had on the valuation of speech-language pathology procedure codes.

The Need to Belong and the Relationship Between Loneliness and Health

2014 ◽  
Vol 22 (4) ◽  
pp. 194-201 ◽  
Author(s):  
Freda-Marie Hartung ◽  
Britta Renner
Keyword(s):  
Individual Differences ◽  
Social Isolation ◽  
Social Situation ◽  
First Year ◽  
Health State ◽  
Need To Belong ◽  
First Year University ◽  
Perceived Social Isolation ◽  
The Impact ◽  
The Relationship

Humans are social animals; consequently, a lack of social ties affects individuals’ health negatively. However, the desire to belong differs between individuals, raising the question of whether individual differences in the need to belong moderate the impact of perceived social isolation on health. In the present study, 77 first-year university students rated their loneliness and health every 6 weeks for 18 weeks. Individual differences in the need to belong were found to moderate the relationship between loneliness and current health state. Specifically, lonely students with a high need to belong reported more days of illness than those with a low need to belong. In contrast, the strength of the need to belong had no effect on students who did not feel lonely. Thus, people who have a strong need to belong appear to suffer from loneliness and become ill more often, whereas people with a weak need to belong appear to stand loneliness better and are comparatively healthy. The study implies that social isolation does not impact all individuals identically; instead, the fit between the social situation and an individual’s need appears to be crucial for an individual’s functioning.

Investigating the Relationship Between Self-Esteem and Stigma Among Young Adults With History of Suicide Attempts

Crisis ◽  
2016 ◽  
Vol 37 (4) ◽  
pp. 265-270 ◽  
Author(s):  
Meshan Lehmann ◽  
Matthew R. Hilimire ◽  
Lawrence H. Yang ◽  
Bruce G. Link ◽  
Jordan E. DeVylder
Keyword(s):  
Young Adults ◽  
Suicide Attempts ◽  
Self Esteem ◽  
High Risk Population ◽  
High Functioning ◽  
People With Mental Illness ◽  
History Of ◽  
The Individual ◽  
The Impact ◽  
The Relationship

Abstract. Background: Self-esteem is a major contributor to risk for repeated suicide attempts. Prior research has shown that awareness of stigma is associated with reduced self-esteem among people with mental illness. No prior studies have examined the association between self-esteem and stereotype awareness among individuals with past suicide attempts. Aims: To understand the relationship between stereotype awareness and self-esteem among young adults who have and have not attempted suicide. Method: Computerized surveys were administered to college students (N = 637). Linear regression analyses were used to test associations between self-esteem and stereotype awareness, attempt history, and their interaction. Results: There was a significant stereotype awareness by attempt interaction (β = –.74, p = .006) in the regression analysis. The interaction was explained by a stronger negative association between stereotype awareness and self-esteem among individuals with past suicide attempts (β = –.50, p = .013) compared with those without attempts (β = –.09, p = .037). Conclusion: Stigma is associated with lower self-esteem within this high-functioning sample of young adults with histories of suicide attempts. Alleviating the impact of stigma at the individual (clinical) or community (public health) levels may improve self-esteem among this high-risk population, which could potentially influence subsequent suicide risk.

Assessing the Impact of Suicide Exclusion Periods on Life Insurance

Crisis ◽  
2010 ◽  
Vol 31 (4) ◽  
pp. 217-223 ◽  
Author(s):  
Paul Yip ◽  
David Pitt ◽  
Yan Wang ◽  
Xueyuan Wu ◽  
Ray Watson ◽  
...  
Keyword(s):  
Life Insurance ◽  
Accidental Death ◽  
Insurance Policy ◽  
Death Rates ◽  
Insurance Policies ◽  
Suicidal Death ◽  
Insured Individual ◽  
The Impact ◽  
Insurance Data ◽  
The Relationship

Background: We study the impact of suicide-exclusion periods, common in life insurance policies in Australia, on suicide and accidental death rates for life-insured individuals. If a life-insured individual dies by suicide during the period of suicide exclusion, commonly 13 months, the sum insured is not paid. Aims: We examine whether a suicide-exclusion period affects the timing of suicides. We also analyze whether accidental deaths are more prevalent during the suicide-exclusion period as life-insured individuals disguise their death by suicide. We assess the relationship between the insured sum and suicidal death rates. Methods: Crude and age-standardized rates of suicide, accidental death, and overall death, split by duration since the insured first bought their insurance policy, were computed. Results: There were significantly fewer suicides and no significant spike in the number of accidental deaths in the exclusion period for Australian life insurance data. More suicides, however, were detected for the first 2 years after the exclusion period. Higher insured sums are associated with higher rates of suicide. Conclusions: Adverse selection in Australian life insurance is exacerbated by including a suicide-exclusion period. Extension of the suicide-exclusion period to 3 years may prevent some “insurance-induced” suicides – a rationale for this conclusion is given.

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