Heplisav-B in Prior Hepatitis B Vaccine Nonresponders: A Case Series

2021 ◽  
Author(s):  
Alan l Williams
Keyword(s):  
At Risk ◽  
Hepatitis B ◽  
Prospective Trial ◽  
Case Series ◽  
Hepatitis B Vaccine ◽  
Service Members ◽  
Military Health ◽  
Institutional Review ◽  
Institutional Review Board Review ◽  
Board Review

ABSTRACT Introduction Hepatitis B is a potentially deadly infection that can be acquired by exposure to infectious human blood or body fluids. While service members and others at occupational risk are routinely vaccinated to prevent hepatitis B, non-responders to this vaccine are at continued risk. Heplisav-B is a newer vaccine that may offer additional protection to those at risk. Materials and Methods Cases of hepatitis B vaccine non-responders who were given Heplisav-B after receiving six or more doses of standard hepatitis B vaccine were collected from existing health records within the military health system after Uniformed Services University of the Health Sciences Institutional Review Board review. Results Twelve of thirteen (92%) prior non-responders who were tested at least 1 month after completing the recombinant Heplisav-B vaccine series demonstrated seroprotection against hepatitis B. Conclusions Ideally, all service members and other at-risk workers should be protected from hepatitis B. This case series suggests that prior non-responders are likely to gain protection from hepatitis B with Heplisav-B vaccination. A prospective trial is warranted for further evaluation of this potential indication.

scholarly journals Lotus Birth: A Case Series Report on Umbilical Nonseverance

2018 ◽  
Vol 58 (1) ◽  
pp. 88-94 ◽  
Author(s):  
Kimberly K. Monroe ◽  
Alexandra Rubin ◽  
Kerry P. Mychaliska ◽  
Maria Skoczylas ◽  
Heather L. Burrows
Keyword(s):  
Hepatitis B ◽  
Vitamin K ◽  
Chart Review ◽  
Clinical Course ◽  
Group B Streptococcus ◽  
Case Series ◽  
Hepatitis B Vaccine ◽  
Case Series Report ◽  
Group B ◽  
Series Report

Lotus birth is the practice of leaving the umbilical cord uncut until separation occurs naturally. Our case series report describes delivery characteristics, neonatal clinical course, cord and placenta management, maternal reasons for a lotus birth, and desire for future lotus births. Between April 2014 and January 2017, six lotus births occurred. Mothers (four of the six) were contacted by phone after giving birth. A chart review was completed on each patient to evaluate if erythromycin ointment, hepatitis B vaccine, and vitamin K (intramuscular or oral) were administered, treatment of the placenta, maternal group B streptococcus status, postnatal infant fevers, infant hemoglobin or hematocrit levels, jaundice requiring phototherapy, and infant readmissions. Three of the six families decided to cut the cord before hospital discharge. No infections were noted. All contacted mothers would elect for a lotus birth again (4/6). One hepatitis B vaccine was given; all others declined perinatal immunization.

Hepatitis B vaccine uptake amongst at-risk infants: Experience from a dedicated inner city clinic

Public Health ◽  
2009 ◽  
Vol 123 (9) ◽  
pp. 625-627 ◽  
Author(s):  
G. Manikkavasagan ◽  
H. El Bashir ◽  
A. Green
Keyword(s):  
At Risk ◽  
Hepatitis B ◽  
Inner City ◽  
Hepatitis B Vaccine ◽  
Vaccine Uptake

scholarly journals Pathology Laboratory Policies and Procedures for Releasing Diagnostic Tissue for Cancer Research

2020 ◽  
Author(s):  
Yao Yuan ◽  
Alison L. Van Dyke ◽  
Valentina I. Petkov ◽  
Sarah Hussey ◽  
Radim Moravec ◽  
...  
Keyword(s):  
Cancer Research ◽  
Cancer Registries ◽  
Ffpe Tissue ◽  
Institutional Review Board ◽  
Pathology Laboratory ◽  
Regulatory Policies ◽  
Institutional Review ◽  
Catchment Areas ◽  
Institutional Review Board Review ◽  
Board Review

Context.— The Surveillance, Epidemiology, and End Results (SEER) cancer registry program is currently evaluating the use of archival, diagnostic, formalin-fixed, paraffin-embedded (FFPE) tissue obtained through SEER cancer registries, functioning as honest brokers for deidentified tissue and associated data. To determine the feasibility of this potential program, laboratory policies for sharing tissue for research needed to be assessed. Objective.— To understand the willingness of pathology laboratories to share archival diagnostic tissue for cancer research and related policies. Design.— Seven SEER registries administered a 27-item questionnaire to pathology laboratories within their respective registry catchment areas. Only laboratories that processed diagnostic FFPE specimens and completed the questionnaire were included in the analysis. Results.— Of the 153 responding laboratories, 127 (83%) responded that they process FFPE specimens. Most (n = 88; 69%) were willing to share tissue specimens for research, which was not associated with the number of blocks processed per year by the laboratories. Most laboratories retained the specimens for at least 10 years. Institutional regulatory policies on sharing deidentified tissue varied considerably, ranging from requiring a full Institutional Review Board review to considering such use exempt from Institutional Review Board review, and 43% (55 of 127) of the laboratories did not know their terms for sharing tissue for research. Conclusions.— This project indicated a general willingness of pathology laboratories to participate in research by sharing FFPE tissue. Given the variability of research policies across laboratories, it is critical for each SEER registry to work with laboratories in their catchment area to understand such policies and state legislation regulating tissue retention and guardianship.

scholarly journals Reconstructing the Face of War

2019 ◽  
Vol 184 (7-8) ◽  
pp. e236-e246 ◽  
Author(s):  
Scott J Farber ◽  
Kerry P Latham ◽  
Rami S Kantar ◽  
Jonathan N Perkins ◽  
Eduardo D Rodriguez
Keyword(s):  
Medical Center ◽  
Case Series ◽  
High Energy ◽  
Senior Author ◽  
Clinical Images ◽  
War Injuries ◽  
Form And Function ◽  
Institutional Review ◽  
Institutional Review Board Review ◽  
And Function

Abstract Introduction Ongoing combat operations in Iraq, Afghanistan, and other theaters have led to an increase in high energy craniomaxillofacial (CMF) wounds. These challenging injuries are typically associated with complex tissue deficiencies, evolving areas of necrosis, and bony comminution with bone and ballistic fragment sequestrum. Restoring form and function in these combat-sustained CMF injuries is challenging, and frequently requires local and distant tissue transfers. War injuries are different than the isolated trauma seen in the civilian sector. Donor sites are limited on patients with blast injuries and they may have preferences or functional reasons for the decisions to choose flaps from the available donor sites. Methods A case series of patients who sustained severe combat-related CMF injury and were treated at Walter Reed National Military Medical Center (WRNMMC) is presented. Our study was exempt from Institutional Review Board review, and appropriate written consent was obtained from all patients included in the study for the use of representative clinical images. Results Four patients treated by the CMF team at Walter Reed National Military Medical Center are presented. In this study, we highlight their surgical management by the CMF team at WRNMMC, detail their postoperative course, and illustrate the outcomes achieved using representative patient clinical images. We also supplement this case series demonstrating military approaches to complex CMF injuries with CMF reconstructive algorithms utilized by the senior author (EDR) in the management of civilian complex avulsive injuries of the upper, mid, and lower face are thoroughly reviewed. Conclusion While the epidemiology and characteristics of military CMF injuries have been well described, their management remains poorly defined and creates an opportunity for reconstructive principles proven in the civilian sector to be applied in the care of severely wounded service members. The War on Terror marks the first time that microsurgery has been used extensively to reconstruct combat sustained wounds of the CMF region. Our manuscript reviews various options to reconstruct these devastating CMF injuries and emphasizes the need for steady communication between the civilian and military surgical communities to establish the best care for these complex patients.

scholarly journals Time Required for Institutional Review Board Review at One Veterans Affairs Medical Center

JAMA Surgery ◽  
2015 ◽  
Vol 150 (2) ◽  
pp. 103 ◽  
Author(s):  
Daniel E. Hall ◽  
Barbara H. Hanusa ◽  
Roslyn A. Stone ◽  
Bruce S. Ling ◽  
Robert M. Arnold
Keyword(s):  
Medical Center ◽  
Veterans Affairs ◽  
Institutional Review Board ◽  
Institutional Review ◽  
Institutional Review Board Review ◽  
Board Review ◽  
Time Required

WHEN SHOULD AT-RISK INFANTS BE BOOSTED WITH HEPATITIS B VACCINE?

The Lancet ◽  
1987 ◽  
Vol 329 (8523) ◽  
pp. 49 ◽  
Author(s):  
L. Viladomiu ◽  
J. Genesca ◽  
J.I. Esteban ◽  
R. Esteban ◽  
J.M. Hernandez ◽  
...  
Keyword(s):  
At Risk ◽  
Hepatitis B ◽  
Hepatitis B Vaccine

Uptake and trends in ordering of funded hepatitis B immunisation for priority populations in Victoria, Australia, 2013–2014

Sexual Health ◽  
2017 ◽  
Vol 14 (2) ◽  
pp. 188
Author(s):  
Jennifer H. MacLachlan ◽  
Benjamin C. Cowie
Keyword(s):  
At Risk ◽  
Hepatitis B ◽  
Risk Groups ◽  
Hepatitis B Vaccine ◽  
People Living With Hiv ◽  
Department Of Health ◽  
Priority Populations ◽  
Living With Hiv ◽  
The Impact ◽  
Over Time

Background The Department of Health and Human Services in Victoria provides funded hepatitis B vaccine to many priority groups at risk of acquiring infection. We aimed to determine the uptake of vaccine ordering for at-risk groups over time, to assess any trends and identify any gaps in prevention of hepatitis B for those at risk. Methods: Routinely collected administrative data regarding the indication for vaccine ordered by practitioners were analysed for the period June 2013 to December 2014. Number of doses and courses distributed was determined and compared with the estimated size of the priority populations. Results: During the 18-month period assessed, 20 498 doses of funded hepatitis B vaccine were ordered, equating to ~5700 complete courses, with the overall number of orders per quarter increasing between 2013 and 2014. The most common indication was being a household or sexual contact of people living with hepatitis B (2803 courses, 49.2% of the total), equating to approximately one course per new chronic hepatitis B notification. The remaining doses were largely distributed to people living with HIV (648 courses, 11.4%), people living with hepatitis C (621 courses, 10.9%), and people who inject drugs (594 courses, 10.4%). Conclusions: This analysis demonstrates that access to hepatitis B immunisation among priority populations appears to have increased in Victoria during 2013–14, however it could still be improved. Continued assessment of these data over time will be important to measure the impact of interventions on increasing the reach of the funded vaccine program.

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