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Sample records for prevented liver infection

  1. Cancer treatment - preventing infection

    Science.gov (United States)

    ... Radiation - preventing infection; Bone marrow transplant - preventing infection; Cancer treatment - immunosuppression ... this is a short-lived side effect of cancer treatment. Your provider may give you medicines to help ...

  2. Removal of waterborne pathogens from liver transplant unit water taps in prevention of healthcare-associated infections: a proposal for a cost-effective, proactive infection control strategy.

    Science.gov (United States)

    Zhou, Z Y; Hu, B J; Qin, L; Lin, Y E; Watanabe, H; Zhou, Q; Gao, X D

    2014-04-01

    Hospital water supplies often contain waterborne pathogens, which can become a reservoir for healthcare-associated infections (HAIs). We surveyed the extent of waterborne pathogen contamination in the water supply of a Liver Transplant Unit. The efficacy of point-of-use (POU) water filters was evaluated by comparative analysis in routine clinical use. Our baseline environmental surveillance showed that Legionella spp. (28%, 38/136), Pseudomonas aeruginosa (8%, 11/136), Mycobacterium spp. (87%, 118/136) and filamentous fungi (50%, 68/136) were isolated from the tap water of the Liver Transplant Unit. 28.9% of Legionella spp.-positive water samples (n = 38) showed high-level Legionella contamination (≥10(3) CFU/L). After installation of the POU water filter, none of these pathogens were found in the POU filtered water samples. Furthermore, colonizations/infections with Gram-negative bacteria determined from patient specimens were reduced by 47% during this period, even if only 27% (3/11) of the distal sites were installed with POU water filters. In conclusion, the presence of waterborne pathogens was common in the water supply of our Liver Transplant Unit. POU water filters effectively eradicated these pathogens from the water supply. Concomitantly, healthcare-associated colonization/infections declined after the POU filters were installed, indicating their potential benefit in reducing waterborne HAIs. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  3. Liver (Hepatocellular) Cancer Prevention

    Science.gov (United States)

    ... factors for some types of cancer, but only smoking can be avoided. Regular exercise and a healthy diet may be protective factors ... may help prevent certain cancers. Risk factors include smoking, being ... enough exercise. Increasing protective factors such as quitting smoking and ...

  4. Prevent Infections During Chemotherapy

    Centers for Disease Control (CDC) Podcasts

    This podcast discusses the importance of preventing infections in cancer patients who are undergoing chemotherapy. Dr. Lisa Richardson, CDC oncologist, talks about a new Web site for cancer patients and their caregivers.

  5. Non-Alcoholic Fatty Liver Disease in HIV Infection.

    Science.gov (United States)

    Macías, Juan; Pineda, Juan A; Real, Luis M

    2017-01-01

    Non-alcoholic fatty liver disease is one of the most frequent chronic hepatic conditions worldwide. The spectrum of non-alcoholic fatty liver disease goes from hepatic steatosis to steatohepatitis, cirrhosis, and hepatocellular carcinoma. Risk factors for non-alcoholic fatty liver disease are metabolic, mainly obesity and the accompanying consequences. Treatment and prevention of non-alcoholic fatty liver disease should target those metabolic abnormalities. The frequency of and the factors associated with hepatic steatosis in HIV infection seem to be similar to those reported in the general population, though direct comparisons are lacking. Hepatic steatosis in HIV infection may also be secondary to antiretroviral drugs or HCV-related factors in HCV-coinfected subjects. However, more recent data suggest that hepatic steatosis in HIV infection represents true non-alcoholic fatty liver disease. As such, management of non-alcoholic fatty liver disease in HIV infection should follow the same principles as in the general population.

  6. Prevent Infections During Chemotherapy

    Centers for Disease Control (CDC) Podcasts

    2011-10-24

    This podcast discusses the importance of preventing infections in cancer patients who are undergoing chemotherapy. Dr. Lisa Richardson, CDC oncologist, talks about a new Web site for cancer patients and their caregivers.  Created: 10/24/2011 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Cancer Prevention and Control (DCPC).   Date Released: 10/24/2011.

  7. Preventing infections when visiting

    Science.gov (United States)

    ... need.) When you visit a patient in the hospital, keep your hands away from your face. Cough or sneeze into a tissue or into the crease of your elbow, not into the air. References Calfee DP. Prevention and control of health care-associated infections. In: Goldman L, Schafer AI, eds. Goldman-Cecil ...

  8. Human immunodeficiency virus infection and the liver.

    Science.gov (United States)

    Crane, Megan; Iser, David; Lewin, Sharon R

    2012-03-27

    Liver disease in human immunodeficiency virus (HIV)-infected individuals encompasses the spectrum from abnormal liver function tests, liver decompensation, with and without evidence of cirrhosis on biopsy, to non-alcoholic liver disease and its more severe form, non-alcoholic steatohepatitis and hepatocellular cancer. HIV can infect multiple cells in the liver, leading to enhanced intrahepatic apoptosis, activation and fibrosis. HIV can also alter gastro-intestinal tract permeability, leading to increased levels of circulating lipopolysaccharide that may have an impact on liver function. This review focuses on recent changes in the epidemiology, pathogenesis and clinical presentation of liver disease in HIV-infected patients, in the absence of co-infection with hepatitis B virus or hepatitis C virus, with a specific focus on issues relevant to low and middle income countries.

  9. Liver Hypertension: Causes, Consequences and Prevention

    Indian Academy of Sciences (India)

    Table of contents. Liver Hypertension: Causes, Consequences and Prevention · Heart Pressure : Blood Pressure · Slide 3 · If you continue to have high BP · Doctor Measures Blood Pressure (BP): Medicines to Decrease BP · LIVER ~ ~ LIFE Rightists vs. Leftists · Slide 7 · Slide 8 · Slide 9 · Liver Spleen - Splanchnic ...

  10. ATTIRE: Albumin To prevenT Infection in chronic liveR failurE: study protocol for a single-arm feasibility trial.

    Science.gov (United States)

    China, Louise; Muirhead, Nicola; Skene, Simon S; Shabir, Zainib; De Maeyer, Roel P H; Maini, Alexander A N; Gilroy, Derek W; O'Brien, Alastair J

    2016-01-25

    Circulating prostaglandin E2 levels are elevated in acutely decompensated cirrhosis and have been shown to contribute to immune suppression. Albumin binds and inactivates this hormone. Human albumin solution could thus be repurposed as an immune restorative drug in these patients.This feasibility study aims to determine whether it is possible and safe to restore serum albumin to >30 g/L and maintain it at this level in patients admitted with acute decompensated cirrhosis using repeated 20% human albumin infusions according to daily serum albumin levels. Albumin To prevenT Infection in chronic liveR failurE (ATTIRE) stage 1 is a multicentre, open label dose feasibility trial. Patients with acutely decompensated cirrhosis admitted to hospital with a serum albumin of albumin solution will be infused, according to serum albumin levels, for up to 14 days or discharge in all patients. The primary end point is daily serum albumin levels for the duration of the treatment period and the secondary end point is plasma-induced macrophage dysfunction. The trial will recruit 80 patients. Outcomes will be used to assist with study design for an 866 patient randomised controlled trial at more than 30 sites across the UK. Research ethics approval was given by the London-Brent research ethics committee (ref: 15/LO/0104). The clinical trials authorisation was issued by the medicines and healthcare products regulatory agency (ref: 20363/0350/001-0001). Will be disseminated through peer reviewed journals and international conferences. Recruitment of the first participant occurred on 26/05/2015. The trial is registered with the European Medicines Agency (EudraCT 2014-002300-24) and has been adopted by the NIHR (ISRCTN 14174793). This manuscript refers to V.4.0 of the protocol; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Preventing Infections in Cancer Patients

    Science.gov (United States)

    ... Protect: Know the Signs and Symptoms of Infection Neutropenia and Risk for Infection Health Care Providers Educational Materials Cancer and Flu How to Prevent Flu from Spreading Flu Symptoms Information for Families and Caregivers Flu Treatment for Cancer Patients and ...

  12. Current concepts on cytomegalovirus infection after liver transplantation.

    Science.gov (United States)

    Lee, Sang-Oh; Razonable, Raymund R

    2010-09-27

    Cytomegalovirus (CMV) is the most common viral pathogen that negatively impacts on the outcome of liver transplantation. CMV cause febrile illness often accompanied by bone marrow suppression, and in some cases, invades tissues including the transplanted allograft. In addition, CMV has been significantly associated with an increased predisposition to allograft rejection, accelerated hepatitis C recurrence, and other opportunistic infections, as well as reduced overall patient and allograft survival. To negate the adverse effects of CMV on outcome, its prevention, whether through antiviral prophylaxis or preemptive therapy, is regarded as an essential component to the medical management of liver transplant patients. Two recent guidelines have suggested that antiviral prophylaxis or preemptive therapy are similarly effective in preventing CMV disease in modest-risk CMV-seropositive liver transplant recipients, while antiviral prophylaxis is the preferred strategy over preemptive therapy for the prevention of CMV disease in high-risk recipients [CMV-seronegative recipients of liver allografts from CMV-seropositive donors (D+/R-)]. However, antiviral prophylaxis has only delayed the onset of CMV disease in many CMV D+/R- liver transplant recipients, and at least in one study, such occurrence of late-onset primary CMV disease was significantly associated with increased mortality after liver transplantation. Therefore, optimized strategies for prevention are needed, and aggressive treatment of CMV infection and disease should be pursued. The standard treatment of CMV disease consists of intravenous ganciclovir or oral valganciclovir, and if feasible, one should also reduce the degree of immunosuppression. In one recent controlled clinical trial, valganciclovir was found to be as effective and safe as intravenous ganciclovir for the treatment of mild to moderate CMV disease in solid organ (including liver) transplant recipients. In this article, the authors review the

  13. Uridine prevents fenofibrate-induced fatty liver.

    Directory of Open Access Journals (Sweden)

    Thuc T Le

    Full Text Available Uridine, a pyrimidine nucleoside, can modulate liver lipid metabolism although its specific acting targets have not been identified. Using mice with fenofibrate-induced fatty liver as a model system, the effects of uridine on liver lipid metabolism are examined. At a daily dosage of 400 mg/kg, fenofibrate treatment causes reduction of liver NAD(+/NADH ratio, induces hyper-acetylation of peroxisomal bifunctional enzyme (ECHD and acyl-CoA oxidase 1 (ACOX1, and induces excessive accumulation of long chain fatty acids (LCFA and very long chain fatty acids (VLCFA. Uridine co-administration at a daily dosage of 400 mg/kg raises NAD(+/NADH ratio, inhibits fenofibrate-induced hyper-acetylation of ECHD, ACOX1, and reduces accumulation of LCFA and VLCFA. Our data indicates a therapeutic potential for uridine co-administration to prevent fenofibrate-induced fatty liver.

  14. Prevention of Infection in Pregnancy

    Directory of Open Access Journals (Sweden)

    William J. Ledger

    1997-01-01

    Full Text Available We believe the prevention of infection-related adverse pregnancy outcome is the most important focus for obstetricians today. An emphasis upon immunization of susceptible women, prevention of transmissible disease by modification of patient behavior, and identification and treatment of silent infections should become standards of practice. This will require educational initiatives for physicians and their patients as well as continued clinical trials to determine costs and effectiveness.

  15. Prevention of Periprosthetic Joint Infection

    Directory of Open Access Journals (Sweden)

    Alisina Shahi

    2015-04-01

    Full Text Available Prosthetic joint infection (PJI is a calamitous complication with high morbidity and substantial cost. The reported incidence is low but it is probably underestimated due to the difficulty in diagnosis. PJI has challenged the orthopaedic community for several years and despite all the advances in this field, it is still a real concern with immense impact on patients, and the healthcare system. Eradication of infection can be very difficult. Therefore, prevention remains the ultimate goal. The medical community has executed many practices with the intention to prevent infection and treat it effectively when it encounters. Numerous factors can predispose patients to PJI. Identifying the host risk factors, patients’ health modification, proper wound care, and optimizing operative room environment remain some of the core fundamental steps that can help minimizing the overall incidence of infection. In this review we have summarized the effective prevention strategies along with the recommendations of a recent International Consensus Meeting on Surgical Site and Periprosthetic Joint Infection.

  16. Prevention of Nosocomial Respiratory Infections

    Directory of Open Access Journals (Sweden)

    N. A. Karpun

    2007-01-01

    Full Text Available Objective: to evaluate the efficiency of an extended package of preventive measures on the incidence of nosocomial respiratory infections in surgical patients at an intensive care unit (ICU. Subjects and methods. The study included 809 patients aged 35 to 80 years. A study group comprised 494 patients in whom an extended package of preventive measures was implemented during 7 months (March-September. A control group consisted of 315 patients treated in 2004 in the same period of time (March-September. The groups were stratified by age, gender, underlying diseases, and APACHE-2 and SOFA scores. The extended package of anti-infectious measures involved a high air purification in ICUs («Flow-M» technology, routine use of ventilatory filters, closed aspiration systems with a built-in antibacterial filter under artificial ventilation for over 2 days. Results. The proposed technologies could reduce the frequency of tracheobronchitis and ventilator-associated pneumonias in the groups of patients at high risk for nosocomial infections substantially (by more than twice. Conclusion. The findings have led to the conclusion that the extended package of preventive measures is effective in preventing respiratory infections in ICU patients. Of special note is the proper prevention of upper airway contamination with pathogenic microorganisms, by employing the closed aspiration systems with a built-in antibacterial filter. The routine use of high-tech consumables in the intensive care of surgical patients causes a considerable decrease in the incidence of nosocomial pneumonia, ventilator-associated pneumonia, and purulent tracheobronchitis and a reduction in the number of microbiological studies. Key words: ventilator-associated pneumonia, prevention of nosocomial infections, closed aspiration system.

  17. Cytomegalovirus infection after liver transplantation: Current concepts and challenges

    Institute of Scientific and Technical Information of China (English)

    Raymund Rabe Razonable

    2008-01-01

    Cytomegalovirus(CMV)is a common viral pathogen that influences the outcome of liver transplantation.In addition to the direct effects of CMV syndrome and tissue-invasive diseases,CMV is associated with an increased predisposition to acute and chronic allograft rejection,accelerated hepatitis C recurrence,and other opportunistic infections,as well as reduced overall patient and allograft survival.Risk factors for CMV disease are often interrelated,and include CMV D+/R-serostatus,acute rejection,female gender,age,use of high-dose mycophenolate mofetil and prednisone,and the overall state of immunity.In addition to the role of CHV-specific CD4+ and CD8+ T lymphocytes,there are data to suggest that functionality of the innate immune system contributes to CMV disease pathogenesis.In one study,liver transplant recipients with a specific polymorphism in innate immune molecules known as Toll-like receptors were more likely to develop higher Ievels of CMV replication and clinical disease.Because of the direct and indirect adverse effects of CMV disease,its prevention,whether through antiviral prophylaxis or preemptive therapy,is an essential component in improving the outcome of liver transplantation.In the majority of transplant centers,antiviral prophylaxis is the preferred strategy over preemptive therapy for the prevention of CMV disease in CMV-seronegative recipients of liver allografts from CMV-seropositive donors(D+/R-).However,the major drawback of antiviral prophylaxis is the occurrence of delayed-onset primary CMV disease.In several prospective and retrospective studies,the incidence of delayed-onset primary CMV disease ranged from 16% to 47% of CMV D+/R-liver transplant recipients.Current data suggests that delayed-onset CMV disease is associated with increased mortality after liver transplantation.Therefore,optimized strategies for prevention and novel drugs with unique modes of action are needed.Currently,a randomized controlled clinical trial is being

  18. Liver (Hepatocellular) Cancer Prevention (PDQ®)—Patient Version

    Science.gov (United States)

    Liver cancer risk factors include hepatitis B and C, cirrhosis, and aflatoxin (poison from certain foods). Learn about these and other risk factors for liver cancer and how to prevent liver cancer in this expert-reviewed and evidence-based summary.

  19. [Infection prevention check-in and infection prevention check-out to prevent nosocomial infections].

    Science.gov (United States)

    Kramer, A; Schilling, M; Heidecke, C D

    2010-02-01

    A precondition for the success of the prevention of SSI is the complete realisation of the proven anti-infective measures in form of the multi-barrier strategy or the so-called bundles. In daily practice it is important to follow the fixed instructions, i. e., to ensure a high compliance. In much the same way as an airline pilot or co-pilot must examine whether all instruments are functioning before each take-off, a comparable procedure should be developed as a pre-operative control for the observance of all -defined measures by the responsible surgeon and for the post-operative supervision by the patient. For the control of the observance of the defined pre-operative prevention measures, a check list with 12 items was developed, named the "infection prevention check-in". The check list is authorised by the responsible surgeon be-fore each operation. For the surveillance of the general hygiene in the post-operative period the "infection prevention check-out" with 14 items was developed. Thereby the patient is able to evaluate the staff's compliance with the hygienic measures at the time of dismissal. With the introduction of the check-lists a simple means is given to involve both the team of the surgeons and the ward staff, together with the patient, into the infection prophylaxis even more effectively. In order to assess the success of those measures, the influence on the rate of SSI is to be determined prospectively. Georg Thieme Verlag Stuttgart, New York.

  20. Liver abscess caused by periodontal bacterial infection with Fusobacterium necrophorum.

    Science.gov (United States)

    Yoneda, Masato; Kato, Shingo; Mawatari, Hironori; Kirikoshi, Hiroyuki; Imajo, Kento; Fujita, Koji; Endo, Hiroki; Takahashi, Hirokazu; Inamori, Masahiko; Kobayashi, Noritoshi; Kubota, Kensuke; Saito, Satoru; Tohnai, Iwai; Watanuki, Kei; Wada, Koichiro; Maeda, Shin; Nakajima, Atsushi

    2011-02-01

    Liver abscess is recognized as a life-threatening disease. However, even in recent years, approximately 50% of liver abscess cases are considered to be cryptogenic. Here, we report a case of liver abscess associated with periodontal bacterial infection by Fusobacterium necrophorum, which is commonly found in the oropharyngeal flora. A 36-year-old man presented with fever and contrast-enhanced abdominal computed tomography revealed multiple liver abscesses. F.necrophorum was isolated from oral smears, liver aspirates and blood samples. Liver abscesses caused by periodontal bacterial infection are rare, however, the incidence is expected to increase in the future, as periodontitis is extremely common and is on the rise as one of the most common chronic infections in the world. A systemic survey including periodontitis may be required for the exact diagnosis of the source of infection. © 2011 The Japan Society of Hepatology.

  1. Pinworm infection masquerading as colorectal liver metastasis.

    Science.gov (United States)

    Roberts, K J; Hubscher, S; Mangat, K; Sutcliffe, R; Marudanayagam, R

    2012-09-01

    Enterobius vermicularis is responsible for a variety of diseases but rarely affects the liver. Accurate characterisation of suspected liver metastases is essential to avoid unnecessary surgery. In the presented case, following a diagnosis of rectal cancer, a solitary liver nodule was diagnosed as a liver metastasis due to typical radiological features and subsequently resected. At pathological assessment, however, a necrotic nodule containing E. vermicularis was identified. Solitary necrotic nodules of the liver are usually benign but misdiagnosed frequently as malignant due to radiological features. It is standard practice to diagnose colorectal liver metastases solely on radiological evidence. Without obtaining tissue prior to liver resection, misdiagnosis of solitary necrotic nodules of the liver will continue to occur.

  2. Liver macrophages: friend or foe during hepatitis B infection?

    Science.gov (United States)

    Faure-Dupuy, Suzanne; Durantel, David; Lucifora, Julie

    2018-05-17

    The Hepatitis B virus chronically infects the liver of 250 million people worldwide. Over the past decades, major advances have been made in the understanding of Hepatitis B virus life cycle in hepatocytes. Beside these parenchymal cells, the liver also contains resident and infiltrating myeloid cells involved in immune responses to pathogens and much less is known about their interplay with Hepatitis B virus. In this review, we summarized and discussed the current knowledge of the role of liver macrophages (including Kupffer cells and liver monocyte-derived macrophages), in HBV infection. While it is still unclear if liver macrophages play a role in the establishment and persistence of HBV infection, several studies disclosed data suggesting that HBV would favour liver macrophage anti-inflammatory phenotypes and thereby increase liver tolerance. In addition, alternatively activated liver macrophages might also play in the long term a key role in hepatitis B associated pathogenesis, especially through the activation of hepatic stellate cells. Therapies aiming at a transient activation of pro-inflammatory liver macrophages should therefore be considered for the treatment of chronic HBV infection. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  3. Enterobiasis (Pinworm Infection): Prevention and Control

    Science.gov (United States)

    ... General Information Pinworm Infection FAQs Epidemiology & Risk Factors Biology Disease Diagnosis Treatment Prevention & Control Resources for Health Professionals Publications Get Email Updates ...

  4. Knowledge, attitude and practice related to liver fluke infection in northeast Thailand

    Institute of Scientific and Technical Information of China (English)

    Natthawut Kaewpitoon; Soraya J Kaewpitoon; Prasit Pengsaa; Chutigan Pilasri

    2007-01-01

    AIM:To investigate the knowledge,attitude and practice (KAP) in prevention and control of liver fluke infection in northeast Thailand.METHODS:A descriptive KAP survey pertaining to liver fluke infection was carried out in June 2005 to October 2006 using structured questionnaires. Data were collected by questionnaires consisting of general parameters,knowledge,attitude,practice,and a history of participation in the prevention and control of liver fluke infection.RESULTS:A total of 1077 persons who were interviewed and completed the questionnaires were enrolled in the study. The majority were females (69.5%) and many of them were 15-20 years of age (37.26%). The questionnaires revealed that information resources on Uver fluke infection included local public health volunteers (31.37%),public health officers (18.72%),televisions (14.38%),local heads of sub-districts (12.31%),doctors and nurses (9.18%),newspaper (5.72),internets (5.37%),and others (12.95%). Fifty-five point eleven percent of the population had a good level of liver fluke knowledge concerning the mode of disease transmission and 79.72% of the population had a good level of prevention and control knowledge with regards to defecation and consumption. The attitude and practice in liver fluke prevention and control were also at a good level with a positive awareness,participation,and satisfaction of 72.1% and 60.83% of the persons studied. However,good health behavior was found in 39.26% and 41.42% of the persons studied who had unhygienic defecation and ate raw cyprinoid's fish. Theresult also showed that 41.25% of the persons studied previously joined prevention and control campaigns.CONCLUSION:The persons studied have a high level of liver fluke knowledge and positive attitude. However,improvement is required regarding personal hygiene specifically with hygienic defecation and consumption of undercooked fish.

  5. Prevention of health care-associated infections.

    Science.gov (United States)

    Hsu, Vincent

    2014-09-15

    Health care-associated infections cause approximately 75,000 deaths annually, in addition to increasing morbidity and costs. Over the past decade, a downward trend in health care-associated infections has occurred nationwide. Basic prevention measures include administrative support, educating health care personnel, and hand hygiene and isolation precautions. Prevention of central line- or catheter-associated infections begins with avoidance of unnecessary insertion, adherence to aseptic technique when inserting, and device removal when no longer necessary. Specific recommendations for preventing central line-associated bloodstream infections include use of chlorhexidine for skin preparation, as a component of dressings, and for daily bathing of patients in intensive care units. Catheter-associated urinary tract infections are the most common device-related health care-associated infection. Maintaining a closed drainage system below the patient reduces the risk of infection. To prevent ventilator-associated pneumonia, which is associated with high mortality, mechanically ventilated patients should be placed in the semirecumbent position and receive antiseptic oral care. Prevention of surgical site infections includes hair removal using clippers, glucose control, and preoperative antibiotic prophylaxis. Reducing transmission of Clostridium difficile and multidrug-resistant organisms in the hospital setting begins with hand hygiene and contact precautions. Institutional efforts to reduce unnecessary antibiotic prescribing are also strongly recommended. Reducing rates of methicillin-resistant Staphylococcus aureus infection can be achieved through active surveillance cultures and decolonization therapy with mupirocin.

  6. Chronic hepatitis E virus infection in liver transplant recipients

    NARCIS (Netherlands)

    Haagsma, Elizabeth B.; van den Berg, Arie P.; Porte, Robert J.; Benne, Cornelis A.; Vennema, Harry; Reimerink, Johan H. J.; Koopmans, Marion P. G.

    Hepatitis E virus (HEV) infection is known to run a self-limiting course. Sporadic cases of acute hepatitis due to infection with HEV genotype 3, present in pig populations, are increasingly recognized. Zoonotic transmission seems infrequent. The entity of unexplained chronic hepatitis after liver

  7. Trichoderma viride infection in a liver transplant recipient

    NARCIS (Netherlands)

    Jacobs, F.; Byl, B.; Bourgeois, N.; Coremans-Pelseneer, J.; Florquin, S.; Depré, G.; van de Stadt, J.; Adler, M.; Gelin, M.; Thys, J. P.

    1992-01-01

    A liver transplant recipient developed infection of a perihepatic haematoma due to Trichoderma viride. Before the infection was diagnosed, the patient received intense immuno-suppressive and prolonged antibacterial and anti-fungal therapies. Although the death of the patient was not directly related

  8. [Epidemiology of infections after liver transplantation in children].

    Science.gov (United States)

    Pawłowska, J

    2001-01-01

    One of the most important problems after solid organ transplantation including liver, remains infections. Multiple risk factors play a role among which the most important are: general patients health before transplantation, prolong operative time, graft function and type of immunosuppression. The most important problems with bacterial, fungal and viral infections was described as well as treatment and profilaxis.

  9. 13 Research Article ABSTRACT Liver diseases in HIV infected ...

    African Journals Online (AJOL)

    2016-11-10

    Nov 10, 2016 ... Liver diseases in HIV infected persons can occur due to hepatitis B virus (HBV) and hepatitis C virus ... immunochromatographic test in Yaoundé central hospital, from ..... Hepatitis. B and C virus co-infection in The TREAT Asia.

  10. Morphological aspects of liver CT in patients with HIV infections

    International Nuclear Information System (INIS)

    Schedel, H.; Wicht, L.; Roegler, G.; Langer, R.; Felix, R.

    1994-01-01

    CT examinations of the liver in HIV-infected patients show more frequent pathological findings. The extended spectrum of differential diagnosis and atypical manifestations of disorders in immunodeficient patients needs to be considered in the interpretation of CT scans. Difficulties in the differential diagnosis of focal hepatic lesions in HIV-infected patients are demonstrated in the following. Besides the relatively common findings in HIV-infection such as hepato- or hepatosplenomegalia, lymphoma, and inflammatory changes of the bowel an infection with Cryptococcus neoformans, hepatitis, and local steatosis of the liver are discussed as the rare causes for suspect computertomographic findings in the live of HIV-infected patients. The examinations were obtained consecutively in 76 HIV-infected patients during abdominal CT staging. (orig.) [de

  11. Moro orange juice prevents fatty liver in mice.

    Science.gov (United States)

    Salamone, Federico; Li Volti, Giovanni; Titta, Lucilla; Puzzo, Lidia; Barbagallo, Ignazio; La Delia, Francesco; Zelber-Sagi, Shira; Malaguarnera, Michele; Pelicci, Pier Giuseppe; Giorgio, Marco; Galvano, Fabio

    2012-08-07

    To establish if the juice of Moro, an anthocyanin-rich orange, may improve liver damage in mice with diet-induced obesity. Eight-week-old mice were fed a high-fat diet (HFD) and were administrated water or Moro juice for 12 wk. Liver morphology, gene expression of lipid transcription factors, and metabolic enzymes were assessed. Mice fed HFD displayed increased body weight, insulin resistance and dyslipidemia. Moro juice administration limited body weight gain, enhanced insulin sensitivity, and decreased serum triglycerides and total cholesterol. Mice fed HFD showed liver steatosis associated with ballooning. Dietary Moro juice markedly improved liver steatosis by inducing the expression of peroxisome proliferator-activated receptor-α and its target gene acylCoA-oxidase, a key enzyme of lipid oxidation. Consistently, Moro juice consumption suppressed the expression of liver X receptor-α and its target gene fatty acid synthase, and restored liver glycerol-3-phosphate acyltransferase 1 activity. Moro juice counteracts liver steatogenesis in mice with diet-induced obesity and thus may represent a promising dietary option for the prevention of fatty liver.

  12. Enterobius vermicularis infection of the liver in a patient with colorectal carcinoma with suspected liver metastasis

    Science.gov (United States)

    Furnée, Edgar J B; Spoto, Clothaire; de Graaf, Melanie J; Smakman, Niels

    2015-01-01

    A 68-year-old man diagnosed with cT3N2 adenocarcinoma of the rectum presented with a synchronous solitary liver metastasis on CT scan. Neoadjuvant chemoradiotherapy was started to downstage the primary tumour. Resection of the rectal tumour followed 3 months after the last radiotherapy session and primary resection of the isolated liver lesion was performed in the intervening period. Histopathological assessment of the liver lesion, however, showed no malignancy, but did reveal a necrotic infection due to Enterobius vermicularis. This parasite is frequently found in the intestines, but only rarely infects the liver. The patient was subsequently treated with the anthelmintic drug mebendazole 100 mg once a week for 2 weeks. Histopathological assessment of the rectal specimen showed complete regression after neoadjuvant chemoradiotherapy without evidence of remaining E. vermicularis, suggesting pinworm eradication. The patient recovered promptly after both surgical procedures. PMID:26546623

  13. Burden of liver disease in Europe: epidemiology and analysis of risk factors to identify prevention policies.

    Science.gov (United States)

    Pimpin, Laura; Cortez-Pinto, Helena; Negro, Francesco; Corbould, Emily; Lazarus, Jeffrey V; Webber, Laura; Sheron, Nick

    2018-05-16

    The burden of liver disease in Europe continues to grow. We aimed to describe the epidemiology of liver diseases and their risk factors in European countries, and identify public health interventions that could impact on these risk factors to reduce the burden of liver disease. As part of the HEPAHEALTH project, commissioned by EASL, we extracted information on historical and current prevalence and mortality from national and international literature and databases on liver disease in 35 countries in the WHO European region, as well as historical and recent prevalence data on their main determinants; alcohol consumption, obesity and hepatitis B and C virus infections. We extracted information from peer-reviewed and grey literature to identify public health interventions targeting these risk factors. The epidemiology of liver disease is diverse and countries cluster with similar pictures, although the exact composition of diseases and the trends in risk factors which drive them is varied. Prevalence and mortality data indicate that increasing cirrhosis and liver cancer may be linked to dramatic increases in harmful alcohol consumption in Northern European countries, and viral hepatitis epidemics in Eastern and Southern European countries. Countries with historically low levels of liver disease may experience an increase in non-alcoholic fatty liver disease in the future, given the rise of obesity across the majority of European countries. Interventions exist for curbing harmful alcohol use, reducing obesity, preventing or treating viral hepatitis, and screening for liver disease at an early stage. Liver disease in Europe is a serious issue, with increasing cirrhosis and liver cancer. The public health and hepatology communities are uniquely placed to implement measures aimed at reducing their causes: harmful alcohol consumption, child and adult obesity prevalence and chronic infection with hepatitis viruses, which will in turn reduce the burden of liver disease. The

  14. Catheter Associated Urinary Tract Infection Prevention bundle

    Directory of Open Access Journals (Sweden)

    O. Zarkotou

    2017-01-01

    Full Text Available Catheter-associated urinary tract infections (CAUTI are among the most common healthcare-associated infections, and potentially lead to significant morbidity and mortality. Multifaceted infection control strategies implemented as bundles can prevent nosocomial infections associated with invasive devices such as CAUTIs. The components of the CAUTI bundle proposed herein, include appropriate indications for catheterization and recommendations for the procedures of catheter insertion and catheter maintenance and care. Avoiding unnecessary urinary catheter use is the most effective measure for their prevention. To minimize the risk of CAUTI, urinary catheters should be placed only when a clinical valid indication is documented and they should be removed as soon as possible; alternatives to catheterization should also be considered. Aseptic insertion technique, maintenance of closed drainage system and strict adherence to hand hygiene are essential for preventing CAUTI. The successful implementation of the bundle requires education and training for all healthcare professionals and evaluation of surveillance data.

  15. Management of Candida infections in liver transplant recipients: current perspectives

    Directory of Open Access Journals (Sweden)

    Lingegowda PB

    2014-07-01

    Full Text Available Pushpalatha B Lingegowda,1–3 Tan Ban Hock1,2,4,5 1Department of Infectious Diseases, Singapore General Hospital, 2DUKE-NUS Graduate Medical School, 3Yong Loo Lin School of Medicine, National University of Singapore, 4SingHealth Internal Medicine Residency Program, 5Faculty of Medicine, National University of Singapore, Singapore Abstract: Liver transplantation has emerged as a widely accepted lifesaving therapeutic option for many patients with a variety of liver diseases. Improved surgical and medical management has led to significant improvements in post-transplant survival rates with a 1 year and 5 year patient survival of 87% and 73%, respectively. A high mortality rate due to infections during the first post-transplant year persists. Invasive candidiasis is recognized as a significant problem associated with high morbidity and mortality. Recent surveillance data has helped to understand the changes in the epidemiology and the evolving trends in the use of antifungal agents for prophylaxis and treatment combined with the challenges of managing these invasive fungal infections, which has led the transplant community to explore the best management strategies. The emergence of resistant fungi and excess costs in managing these invasive fungal infections has added to the complexities of management. In this context, current perspectives in the management of Candida infections in liver transplant recipients will be reviewed. Keywords: Candida infections, management, liver transplant

  16. Tuberculosis Vaccines and Prevention of Infection

    Science.gov (United States)

    Day, Tracey A.; Scriba, Thomas J.; Hatherill, Mark; Hanekom, Willem A.; Evans, Thomas G.; Churchyard, Gavin J.; Kublin, James G.; Bekker, Linda-Gail; Self, Steven G.

    2014-01-01

    SUMMARY Tuberculosis (TB) is a leading cause of death worldwide despite the availability of effective chemotherapy for over 60 years. Although Mycobacterium bovis bacillus Calmette-Guérin (BCG) vaccination protects against active TB disease in some populations, its efficacy is suboptimal. Development of an effective TB vaccine is a top global priority that has been hampered by an incomplete understanding of protective immunity to TB. Thus far, preventing TB disease, rather than infection, has been the primary target for vaccine development. Several areas of research highlight the importance of including preinfection vaccines in the development pipeline. First, epidemiology and mathematical modeling studies indicate that a preinfection vaccine would have a high population-level impact for control of TB disease. Second, immunology studies support the rationale for targeting prevention of infection, with evidence that host responses may be more effective during acute infection than during chronic infection. Third, natural history studies indicate that resistance to TB infection occurs in a small percentage of the population. Fourth, case-control studies of BCG indicate that it may provide protection from infection. Fifth, prevention-of-infection trials would have smaller sample sizes and a shorter duration than disease prevention trials and would enable opportunities to search for correlates of immunity as well as serve as a criterion for selecting a vaccine product for testing in a larger TB disease prevention trial. Together, these points support expanding the focus of TB vaccine development efforts to include prevention of infection as a primary goal along with vaccines or other interventions that reduce the rate of transmission and reactivation. PMID:25428938

  17. Prevention and management of cochlear implant infections.

    Science.gov (United States)

    Gluth, Michael B; Singh, Rajesh; Atlas, Marcus D

    2011-11-01

    Understanding the issues of infection related to an implantable medical device is crucial to all cochlear implant teams. Furthermore, given the risk of central nervous system complications and the relatively high quantity of underlying resource investment associated with cochlear implantation, the stakes of infection are high. The optimal strategies to prevent and manage such infections are still evolving as good-quality prospective data to guide such management decisions are not yet abundant within the medical literature and many recommendations are based on retrospective reviews or anecdotal evidence. We will outline a general strategy to deal with cochlear implant-related infection based on both the authors' experience and the published literature.

  18. Prevention of Infection in Orthopedic Prosthetic Surgery.

    Science.gov (United States)

    Chirca, Ioana; Marculescu, Camelia

    2017-06-01

    Total joint arthroplasty is a generally safe orthopedic procedure; however, infection is a potentially devastating complication. Multiple risk factors have been identified for development of prosthetic joint infections. Identification of patients at risk and preoperative correction of known risk factors, such as smoking, diabetes mellitus, anemia, malnutrition, and decolonization of Staphylococcus carriers, represent well-established actions to decrease the infection risk. Careful operative technique, proper draping and skin preparation, and appropriate selection and dosing of antimicrobials for perioperative prophylaxis are also very important in prevention of infection. Published by Elsevier Inc.

  19. Characterization of HBV integration patterns and timing in liver cancer and HBV-infected livers.

    Science.gov (United States)

    Furuta, Mayuko; Tanaka, Hiroko; Shiraishi, Yuichi; Unida, Takuro; Imamura, Michio; Fujimoto, Akihiro; Fujita, Masahi; Sasaki-Oku, Aya; Maejima, Kazuhiro; Nakano, Kaoru; Kawakami, Yoshiiku; Arihiro, Koji; Aikata, Hiroshi; Ueno, Masaki; Hayami, Shinya; Ariizumi, Shun-Ichi; Yamamoto, Masakazu; Gotoh, Kunihito; Ohdan, Hideki; Yamaue, Hiroki; Miyano, Satoru; Chayama, Kazuaki; Nakagawa, Hidewaki

    2018-05-18

    Integration of Hepatitis B virus (HBV) into the human genome can cause genetic instability, leading to selective advantages for HBV-induced liver cancer. Despite the large number of studies for HBV integration into liver cancer, little is known about the mechanism of initial HBV integration events owing to the limitations of materials and detection methods. We conducted an HBV sequence capture, followed by ultra-deep sequencing, to screen for HBV integrations in 111 liver samples from human-hepatocyte chimeric mice with HBV infection and human clinical samples containing 42 paired samples from non-tumorous and tumorous liver tissues. The HBV infection model using chimeric mice verified the efficiency of our HBV-capture analysis and demonstrated that HBV integration could occur 23 to 49 days after HBV infection via microhomology-mediated end joining and predominantly in mitochondrial DNA. Overall HBV integration sites in clinical samples were significantly enriched in regions annotated as exhibiting open chromatin, a high level of gene expression, and early replication timing in liver cells. These data indicate that HBV integration in liver tissue was biased according to chromatin accessibility, with additional selection pressures in the gene promoters of tumor samples. Moreover, an integrative analysis using paired non-tumorous and tumorous samples and HBV-related transcriptional change revealed the involvement of TERT and MLL4 in clonal selection. We also found frequent and non-tumorous liver-specific HBV integrations in FN1 and HBV-FN1 fusion transcript. Extensive survey of HBV integrations facilitates and improves the understanding of the timing and biology of HBV integration during infection and HBV-related hepatocarcinogenesis.

  20. Can Skin Exposure to Sunlight Prevent Liver Inflammation?

    Directory of Open Access Journals (Sweden)

    Shelley Gorman

    2015-05-01

    Full Text Available Liver inflammation contributes towards the pathology of non-alcoholic fatty liver disease (NAFLD. Here we discuss how skin exposure to sunlight may suppress liver inflammation and the severity of NAFLD. Following exposure to sunlight-derived ultraviolet radiation (UVR, the skin releases anti-inflammatory mediators such as vitamin D and nitric oxide. Animal modeling studies suggest that exposure to UVR can prevent the development of NAFLD. Association studies also support a negative link between circulating 25-hydroxyvitamin D and NAFLD incidence or severity. Clinical trials are in their infancy and are yet to demonstrate a clear beneficial effect of vitamin D supplementation. There are a number of potentially interdependent mechanisms whereby vitamin D could dampen liver inflammation, by inhibiting hepatocyte apoptosis and liver fibrosis, modulating the gut microbiome and through altered production and transport of bile acids. While there has been a focus on vitamin D, other mediators induced by sun exposure, such as nitric oxide may also play important roles in curtailing liver inflammation.

  1. Bacterial infections and hepatic encephalopathy in liver cirrhosis-prophylaxis and treatment.

    Science.gov (United States)

    Piotrowski, Damian; Boroń-Kaczmarska, Anna

    2017-09-01

    Infections are common among patients with liver cirrhosis. They occur more often in cirrhotic patient groups than in the general population and result in higher mortality. One reason for this phenomenon is bacterial translocation from the intestinal lumen that occurs as a consequence of intestinal bacterial overgrowth, increased permeability and decreased motility. The most common infections in cirrhotic patients are spontaneous bacterial peritonitis and urinary tract infections, followed by pneumonia, skin and soft tissue infections. Intestinal bacterial overgrowth is also responsible for hyperammonemia, which leads to hepatic encephalopathy. All of these complications make this group of patients at high risk for mortality. The role of antibiotics in liver cirrhosis is to treat and in some cases to prevent the development of infectious complications. Based on our current knowledge, antibiotic prophylaxis should be administered to patients with gastrointestinal hemorrhage, low ascitic fluid protein concentration combined with liver or renal failure, and spontaneous bacterial peritonitis as a secondary prophylaxis, as well as after hepatic encephalopathy episodes (also as a secondary prophylaxis). In some cases, the use of non-antibiotic prophylaxis can also be considered. Current knowledge of the treatment of infections allows the choice of a preferred antibiotic for empiric therapy depending on the infection location and whether the source of the disease is nosocomial or community-acquired. Copyright © 2017 Medical University of Bialystok. Published by Elsevier B.V. All rights reserved.

  2. Animal models for the study of hepatitis C virus infection and related liver disease

    DEFF Research Database (Denmark)

    Bukh, Jens

    2012-01-01

    Hepatitis C virus (HCV) causes liver-related death in more than 300,000 people annually. Treatments for patients with chronic HCV are suboptimal, despite the introduction of directly acting antiviral agents. There is no vaccine that prevents HCV infection. Relevant animal models are important...... for HCV research and development of drugs and vaccines. Chimpanzees are the best model for studies of HCV infection and related innate and adaptive host immune responses. They can be used in immunogenicity and efficacy studies of HCV vaccines. The only small animal models of robust HCV infection are T......- and B- cell deficient mice with human chimeric livers. Although these mice cannot be used in studies of adaptive immunity, they have provided new insights into HCV neutralization, interactions between virus and receptors, innate host responses, and therapeutic approaches. Recent progress in developing...

  3. Compliance With Infection Prevention Guidelines By Health Care ...

    African Journals Online (AJOL)

    USER

    the health workers' curricular, provision of in-service training in infection ... cheaper infection prevention and control methods7. In Zambia ... Zambia Infection Prevention Guidelines in 2003. This ..... Control (IPC) Policies and Guidelines or.

  4. Zygomycosis Associated with HIV Infection and Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Larry Nichols

    2011-01-01

    Full Text Available Zygomycosis is an increasing threat to patients with human immunodeficiency virus (HIV infection. Zygomycosis (formerly called mucormycosis is the fungal infection with Mucor, Rhizopus, or other species that share a common morphology of large empty pauciseptate hyphae with rare random-angle branching and a collapsed “twisted ribbon” appearance. Morphology allows a specific diagnosis on frozen section or smear prior to growth and identification of the fungi in culture which makes it improtant because treatment is different than that for more common mycoses such as candidiasis and aspergillosis. We present an informative and illustrative case of zygomycosis in a patient with HIV infection and liver transplantation.

  5. Prebiotics for Prevention of Gut Infections

    DEFF Research Database (Denmark)

    Licht, Tine Rask; Ebersbach, Tine; Frøkiær, Hanne

    2012-01-01

    It is our postulate that the field of prebiotic research has until now been characterized by a one-view-fits-all approach, implicating that if a putatively prebiotic compound is good for something, it is good for everything. One area where this implication has been proved insufficient regards...... the putative preventive effect of prebiotics against intestinal pathogenic bacteria. Although indeed most evidence on effects of prebiotics against infections is positive, some studies indicate that prebiotic carbohydrates cause increased susceptibility to specific gastrointestinal infections. Here, we review...... existing knowledge about the impact of prebiotics on infective agents in vitro and in vivo....

  6. Topical silver for preventing wound infection

    NARCIS (Netherlands)

    Storm-Versloot, Marja N.; Vos, Cornelis G.; Ubbink, Dirk T.; Vermeulen, Hester

    2010-01-01

    BACKGROUND: Silver-containing treatments are popular and used in wound treatments to combat a broad spectrum of pathogens, but evidence of their effectiveness in preventing wound infection or promoting healing is lacking. OBJECTIVES: To establish the effects of silver-containing wound dressings and

  7. Hepatitis B and liver cancer knowledge and preventive practices among Asian Americans in the San Francisco Bay Area, California.

    Science.gov (United States)

    Wu, Charlotte A; Lin, Steven Y; So, Samuel K; Chang, Ellen T

    2007-01-01

    Chronic hepatitis B virus (HBV) infection causes liver cancer and disproportionately affects the Asian community in the U.S. In order to advance HBV and liver cancer awareness and prevention, it is important to identify existing gaps in knowledge and preventive practices among Asian Americans. Therefore, the authors administered a written questionnaire to 199 adults in the Asian-American community of the San Francisco Bay Area, California. Although the majority of adults had at least a college education, knowledge regarding HBV transmission, prevention, symptoms, risks, and occurrence was low. Fewer than 60% reported having been tested for HBV, only 31% reported having been vaccinated against HBV, and only 44% reported having had their children vaccinated. Asians, especially those born in China or Southeast Asia, had significantly poorer knowledge regarding HBV and liver cancer than non-Asians. Those with higher knowledge levels were significantly more likely to have been tested for HBV and to have had their children vaccinated. Younger adults, women, Caucasians, more highly educated individuals, those not born in China or Hong Kong, and those with a personal or family history of liver disease were more likely to have taken preventive action against HBV. Our results suggest that HBV and liver cancer knowledge among Asian Americans, especially Chinese Americans, is poor, and that better knowledge is associated with increased preventive practices. Thus, there is a need for increased HBV education and improved community-based interventions to prevent HBV-related liver disease in the high-risk Asian-American community.

  8. Prevention of Recurrent Staphylococcal Skin Infections

    Science.gov (United States)

    Creech, C. Buddy; Al-Zubeidi, Duha N.; Fritz, Stephanie A.

    2015-01-01

    Synopsis Staphylococcus aureus infections pose a significant health burden. The emergence of community-associated methicillin-resistant S. aureus has resulted in an epidemic of skin and soft tissue infections (SSTI), and many patients experience recurrent SSTI. As S. aureus colonization is associated with subsequent infection, decolonization is recommended for patients with recurrent SSTI or in settings of ongoing transmission. S. aureus infections often cluster within households and asymptomatic carriers serve as reservoirs for transmission; therefore, a household approach to decolonization is more effective than measures performed by individuals alone. Other factors, such as environmental surface contamination, may also be considered. Novel strategies for the prevention of recurrent SSTI are needed. PMID:26311356

  9. Inhibitory effect of glutathione on oxidative liver injury induced by dengue virus serotype 2 infections in mice.

    Directory of Open Access Journals (Sweden)

    Juan Wang

    Full Text Available The pathogenesis of dengue virus (DV infection has not been completely defined and change of redox status mediated by depletion of glutathione (GSH in host cell is a common result of viral infection. Our previous study has demonstrated that DV serotype 2 (DV2 infection alters host intracellular GSH levels, and exogenous GSH inhibits viral production by modulating the activity of NF-κB in HepG2 cells. GSH is the most powerful intracellular antioxidant and involved in viral infections. Thus, this study was to investigate whether DV2 infection can induce alteration in redox balance and effect of GSH on the disease in HepG2 xenografts SCID mice. Our results revealed that mice infected with DV2 showed alterations in oxidative stress by increasing the level of malondialdehyde (MDA, an end product of lipid peroxidation, and GSSG/GSH ratio. DV2-infected mice also showed a decrease in the activity of catalase (CAT and total superoxide dismutase (T-SOD in the serum and/or observed organs, especially the liver. Moreover, DV2 infection resulted in elevated serum levels of the cytokines tumor necrosis factor-α and interlukin-6 and obvious histopathological changes in the liver. The administration of exogenous GSH significantly reversed all of the aforementioned pathological changes and prevented significant liver damage. Furthermore, in vitro treatment of HepG2 cells with antioxidants such as GSH inhibited viral entry as well as the production of reactive oxygen species in HepG2 cells. These results suggest that GSH prevents DV2-induced oxidative stress and liver injury in mice by inhibiting proinflammatory cytokine production, and GSH and may be a promising therapeutic agent for prevention of oxidative liver damage during DV infection.

  10. Challenging hepatitis C-infected liver transplant patients

    Directory of Open Access Journals (Sweden)

    Oliver M

    2016-01-01

    Full Text Available Madeleine Oliver,1 Christopher Chiodo Ortiz,2 Jorge Ortiz31University of Toledo College of Medicine, Toledo, OH, 2Bucknell University, Lewisburg, PA, 3Department of Transplant Surgery, University of Toledo Medical Center, Toledo, OH, USA Abstract: Caring for liver transplant patients suffering from chronic hepatitis C virus (HCV infection is a challenging task for transplant surgeons and primary physicians alike. HCV is the leading cause of liver transplantation in the USA and comes with a myriad of complications that increase morbidity and mortality. This review focuses on patient follow-up, spanning from before the liver transplant occurs to the patient's long-term health. Pretransplant, both donor and recipient variables, must be carefully chosen to ensure optimal surgical success. Risk factors must be identified and HCV viral load must be reduced to a minimum. In addition to standard transplant complications, HCV patients suffer from additional problems, such as fibrosing cholestatic hepatitis and widespread viremia. Physicians must focus on the balance of immunosuppressive and antiviral medications, while considering possible side effects from these potent drugs. Over the years following surgery, physicians must identify any signs of failing liver health, as HCV-positive patients have an increased risk for cirrhosis and certain life-threatening malignancies. Keywords: liver transplant, hepatitis C virus, postoperative, cirrhosis, donor and recipient variables, viremia

  11. Is neonatal group B streptococcal infection preventable?

    LENUS (Irish Health Repository)

    Azam, M

    2011-05-01

    Early onset group B streptococcal (EOGBS) infection causes significant neonatal morbidity and mortality. We determined the incidence of EOGBS at Galway University Hospital (GUH) and examined any "missed opportunities" for preventing neonatal infection between 2004 and 2009. Our obstetric approach is risk-based. The incidence was 0.45\\/1,000 live-births; one death and one with neurological sequelae. A single mother received IAP; however we could not determine any potential for reducing cases of EOGBS by improving current IAP usage.

  12. Probiotics and prevention of Clostridium difficile infection.

    Science.gov (United States)

    Goldstein, E J C; Johnson, S J; Maziade, P-J; Evans, C T; Sniffen, J C; Millette, M; McFarland, L V

    2017-06-01

    The role of probiotics as adjunctive measures in the prevention of Clostridium difficile infection (CDI) has been controversial. However, a growing body of evidence has suggested that they have a role in primary prevention of CDI. Elements of this controversy are reviewed and the proposed mechanisms of action, the value and cost effectiveness of probiotics are addressed with a focus on three agents, Saccharomyces boulardii, Lactobacillus rhamnosus GG and the combination of Lactobacillus acidophilus CL1285, Lactobacillus casei LBC80R, Lactobacillus rhamnosus CLR2 (Bio-K+). Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. An integrated stewardship model : Antimicrobial, infection prevention and diagnostic (AID)

    NARCIS (Netherlands)

    Dik, Jan-Willem H.; Poelman, Randy; Friedrich, Alexander W.; Panday, Prashant Nannan; Lo-Ten-Foe, Jerome R.; van Assen, Sander; van Gemert-Pijnen, Julia E. W. C.; Niesters, Hubert G. M.; Hendrix, Ron; Sinha, Bhanu

    2016-01-01

    Considering the threat of antimicrobial resistance and the difficulties it entails in treating infections, it is necessary to cross borders and approach infection management in an integrated, multidisciplinary manner. We propose the antimicrobial, infection prevention and diagnostic stewardship

  14. An integrated stewardship model: antimicrobial, infection prevention and diagnostic (AID)

    NARCIS (Netherlands)

    Dik, Jan-Willem H.; Poelman, Randy; Friedrich, Alexander W.; Panday, Prashant N.; Lo-Ten-Foe, Jerome R.; van Assen, Sander; van Gemert-Pijnen, Julia E.W.C.; Niesters, Hubert G.M.; Hendrix, Ron; Sinha, Bhanu

    2015-01-01

    Considering the threat of antimicrobial resistance and the difficulties it entails in treating infections, it is necessary to cross borders and approach infection management in an integrated, multidisciplinary manner. We propose the antimicrobial, infection prevention and diagnostic stewardship

  15. Yersinia enterocolitica Infection Simulating Lymphoproliferative Disease, after Liver Transplant

    Directory of Open Access Journals (Sweden)

    E. Jakobovich

    2014-01-01

    Full Text Available We describe a 14-year-old girl, who was 13 y after liver transplantation for biliary atresia with an unremarkable postoperative course. She presented with fever of up to 40°C, extreme fatigue, malaise, anorexia, and occasional vomiting. On physical examination the only finding was splenomegaly. Lab results showed hyperglobulinemia and an elevated sedimentation rate. Liver function tests were normal except for mild elevation of γGTP. Abdominal U/S and CT demonstrated an enlarged spleen with retroperitoneal and mesenteric lymph nodes enlargement. An exhaustive evaluation for infectious causes, autoimmune conditions, and malignancy was negative. A full recovery after 5 months prompted testing for self-limited infectious etiologies. Yersinia enterocolitica infection was diagnosed.

  16. Host-Targeting Agents to Prevent and Cure Hepatitis C Virus Infection.

    Science.gov (United States)

    Zeisel, Mirjam B; Crouchet, Emilie; Baumert, Thomas F; Schuster, Catherine

    2015-11-02

    Chronic hepatitis C virus (HCV) infection is a major cause of liver cirrhosis and hepatocellular carcinoma (HCC) which are leading indications of liver transplantation (LT). To date, there is no vaccine to prevent HCV infection and LT is invariably followed by infection of the liver graft. Within the past years, direct-acting antivirals (DAAs) have had a major impact on the management of chronic hepatitis C, which has become a curable disease in the majority of DAA-treated patients. In contrast to DAAs that target viral proteins, host-targeting agents (HTAs) interfere with cellular factors involved in the viral life cycle. By acting through a complementary mechanism of action and by exhibiting a generally higher barrier to resistance, HTAs offer a prospective option to prevent and treat viral resistance. Indeed, given their complementary mechanism of action, HTAs and DAAs can act in a synergistic manner to reduce viral loads. This review summarizes the different classes of HTAs against HCV infection that are in preclinical or clinical development and highlights their potential to prevent HCV infection, e.g., following LT, and to tailor combination treatments to cure chronic HCV infection.

  17. Engineered porous scaffolds for periprosthetic infection prevention

    Energy Technology Data Exchange (ETDEWEB)

    Iviglia, Giorgio, E-mail: giorgio.iviglia@polito.it [Nobil Bio Ricerche Srl, 14037 Portacomaro (Italy); Department of Applied Science and Technology, Institute of Materials Physics and Engineering, Politecnico di Torino, 10121 Torino (Italy); Cassinelli, Clara; Bollati, Daniele [Nobil Bio Ricerche Srl, 14037 Portacomaro (Italy); Baino, Francesco [Department of Applied Science and Technology, Institute of Materials Physics and Engineering, Politecnico di Torino, 10121 Torino (Italy); Torre, Elisa; Morra, Marco [Nobil Bio Ricerche Srl, 14037 Portacomaro (Italy); Vitale-Brovarone, Chiara [Department of Applied Science and Technology, Institute of Materials Physics and Engineering, Politecnico di Torino, 10121 Torino (Italy)

    2016-11-01

    Periprosthetic infection is a consequence of implant insertion procedures and strategies for its prevention involve either an increase in the rate of new bone formation or the release of antibiotics such as vancomycin. In this work we combined both strategies and developed a novel, multifunctional three-dimensional porous scaffold that was produced using hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP), coupled with a pectin (PEC)-chitosan (CHIT) polyelectrolyte (PEI), and loaded with vancomycin (VCA). By this approach, a controlled vancomycin release was achieved and serial bacterial dilution test demonstrated that, after 1 week, the engineered construct still inhibits the bacterial growth. Degradation tests show an excellent behavior in a physiological and acidic environment (< 10% of mass loss). Furthermore, the PEI coating shows an anti-inflammatory response, and good cell proliferation and migration were demonstrated in vitro using osteoblast SAOS-2 cell line. This new engineered construct exhibits excellent properties both as an antibacterial material and as a stimulator of bone formation, which makes it a good candidate to contrast periprosthetic infection. - Highlights: • A novel three-dimensional ceramic scaffold was developed for infection prevention. • Pectin/chitosan coating stabilizes the degradation behavior in acidic environment. • Polyelectrolyte complex allows sustained release of vancomycin. • Inhibition of bacterial proliferation and biofilm formation was assessed. • PEI coating elicits anti-inflammatory response.

  18. Engineered porous scaffolds for periprosthetic infection prevention

    International Nuclear Information System (INIS)

    Iviglia, Giorgio; Cassinelli, Clara; Bollati, Daniele; Baino, Francesco; Torre, Elisa; Morra, Marco; Vitale-Brovarone, Chiara

    2016-01-01

    Periprosthetic infection is a consequence of implant insertion procedures and strategies for its prevention involve either an increase in the rate of new bone formation or the release of antibiotics such as vancomycin. In this work we combined both strategies and developed a novel, multifunctional three-dimensional porous scaffold that was produced using hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP), coupled with a pectin (PEC)-chitosan (CHIT) polyelectrolyte (PEI), and loaded with vancomycin (VCA). By this approach, a controlled vancomycin release was achieved and serial bacterial dilution test demonstrated that, after 1 week, the engineered construct still inhibits the bacterial growth. Degradation tests show an excellent behavior in a physiological and acidic environment (< 10% of mass loss). Furthermore, the PEI coating shows an anti-inflammatory response, and good cell proliferation and migration were demonstrated in vitro using osteoblast SAOS-2 cell line. This new engineered construct exhibits excellent properties both as an antibacterial material and as a stimulator of bone formation, which makes it a good candidate to contrast periprosthetic infection. - Highlights: • A novel three-dimensional ceramic scaffold was developed for infection prevention. • Pectin/chitosan coating stabilizes the degradation behavior in acidic environment. • Polyelectrolyte complex allows sustained release of vancomycin. • Inhibition of bacterial proliferation and biofilm formation was assessed. • PEI coating elicits anti-inflammatory response.

  19. Nrf2 activation prevents cadmium-induced acute liver injury

    International Nuclear Information System (INIS)

    Wu, Kai C.; Liu, Jie J.; Klaassen, Curtis D.

    2012-01-01

    Oxidative stress plays an important role in cadmium-induced liver injury. Nuclear factor erythroid 2-related factor 2 (Nrf2) is a transcription factor that up-regulates cytoprotective genes in response to oxidative stress. To investigate the role of Nrf2 in cadmium-induced hepatotoxicity, Nrf2-null mice, wild-type mice, kelch-like ECH-associated protein 1-knockdown (Keap1-KD) mice with enhanced Nrf2, and Keap1-hepatocyte knockout (Keap1-HKO) mice with maximum Nrf2 activation were treated with cadmium chloride (3.5 mg Cd/kg, i.p.). Blood and liver samples were collected 8 h thereafter. Cadmium increased serum alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) activities, and caused extensive hepatic hemorrhage and necrosis in the Nrf2-null mice. In contrast, Nrf2-enhanced mice had lower serum ALT and LDH activities and less morphological alternations in the livers than wild-type mice. H 2 DCFDA (2′,7′-dichlorodihydrofluoresein diacetate) staining of primary hepatocytes isolated from the four genotypes of mice indicated that oxidative stress was higher in Nrf2-null cells, and lower in Nrf2-enhanced cells than in wild-type cells. To further investigate the mechanism of the protective effect of Nrf2, mRNA of metallothionein (MT) and other cytoprotective genes were determined. Cadmium markedly induced MT-1 and MT-2 in livers of all four genotypes of mice. In contrast, genes involved in glutathione synthesis and reducing reactive oxygen species, including glutamate-cysteine ligase (Gclc), glutathione peroxidase-2 (Gpx2), and sulfiredoxin-1 (Srxn-1) were only induced in Nrf2-enhanced mice, but not in Nrf2-null mice. In conclusion, the present study shows that Nrf2 activation prevents cadmium-induced oxidative stress and liver injury through induction of genes involved in antioxidant defense rather than genes that scavenge Cd. -- Highlights: ► Cadmium caused extensive hepatic hemorrhage and necrosis in Nrf2-null mice. ► Keap1-KD and Keap1-HKO mice were

  20. Nrf2 activation prevents cadmium-induced acute liver injury

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Kai C. [Department of Pharmacology, Toxicology, and Therapeutics, University of Kansas Medical Center, Kansas City, KS (United States); Liu, Jie J. [Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS (United States); Klaassen, Curtis D., E-mail: cklaasse@kumc.edu [Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS (United States)

    2012-08-15

    Oxidative stress plays an important role in cadmium-induced liver injury. Nuclear factor erythroid 2-related factor 2 (Nrf2) is a transcription factor that up-regulates cytoprotective genes in response to oxidative stress. To investigate the role of Nrf2 in cadmium-induced hepatotoxicity, Nrf2-null mice, wild-type mice, kelch-like ECH-associated protein 1-knockdown (Keap1-KD) mice with enhanced Nrf2, and Keap1-hepatocyte knockout (Keap1-HKO) mice with maximum Nrf2 activation were treated with cadmium chloride (3.5 mg Cd/kg, i.p.). Blood and liver samples were collected 8 h thereafter. Cadmium increased serum alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) activities, and caused extensive hepatic hemorrhage and necrosis in the Nrf2-null mice. In contrast, Nrf2-enhanced mice had lower serum ALT and LDH activities and less morphological alternations in the livers than wild-type mice. H{sub 2}DCFDA (2′,7′-dichlorodihydrofluoresein diacetate) staining of primary hepatocytes isolated from the four genotypes of mice indicated that oxidative stress was higher in Nrf2-null cells, and lower in Nrf2-enhanced cells than in wild-type cells. To further investigate the mechanism of the protective effect of Nrf2, mRNA of metallothionein (MT) and other cytoprotective genes were determined. Cadmium markedly induced MT-1 and MT-2 in livers of all four genotypes of mice. In contrast, genes involved in glutathione synthesis and reducing reactive oxygen species, including glutamate-cysteine ligase (Gclc), glutathione peroxidase-2 (Gpx2), and sulfiredoxin-1 (Srxn-1) were only induced in Nrf2-enhanced mice, but not in Nrf2-null mice. In conclusion, the present study shows that Nrf2 activation prevents cadmium-induced oxidative stress and liver injury through induction of genes involved in antioxidant defense rather than genes that scavenge Cd. -- Highlights: ► Cadmium caused extensive hepatic hemorrhage and necrosis in Nrf2-null mice. ► Keap1-KD and Keap1-HKO mice

  1. [Strategies for avoiding hepatitis B infection recurrence following liver transplantation].

    Science.gov (United States)

    Prieto, Martín; García-Eliz, María

    2014-07-01

    Hepatitis B is currently an excellent indication for liver transplantation due to the highly effective strategies of prophylaxis and treatment for recurrent hepatitis B infection. The combined administration of low-dose hepatitis B hyperimmune gamma globulin and a nucleoside/nucleotide analogue with a high genetic barrier to resistance, such as entecavir (except for patients with lamivudine resistance) or tenofovir, represents the standard for the prophylaxis of recurrent hepatitis B infection and is used in most centers. The drawbacks of long-term administration of hyperimmune gamma globulin have led to research on regimens in which this agent is withdrawn after a certain amount of time in combination treatment, a strategy that appears to be safe in patients with undetectable viremia at the time of liver transplantation if the patients adhere to the treatment. In recent years, there has also been research into regimens of gamma-globulin-free prophylaxis, based only on the administration of oral antiviral drugs, which appear to be safe if antivirals with a high genetic barrier to resistance are used. Hepatitis B prophylaxis should be maintained indefinitely; therefore, the total withdrawal of prophylaxis is not an accepted strategy at present in daily clinical practice if not in the context of a clinical trial. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  2. Preventing urinary tract infections in early childhood.

    Science.gov (United States)

    Williams, Gabrielle J; Craig, Jonathan C; Carapetis, Jonathan R

    2013-01-01

    Urinary tract infection (UTI) is common in children, causes them considerable discomfort, as well as distress to parents and has a tendency to recur. Approximately 20% of those children who experience one infection will have a repeat episode. Since 1975, 11 trials of long-term antibiotics compared with placebo or no treatment in 1,550 children have been published. Results have been heterogeneous, but the largest trial demonstrated a small reduction (6% absolute risk reduction, risk ratio 0.65) in the risk of repeat symptomatic UTI over 12 months of treatment. This effect was consistent across sub groups of children based upon age, gender, vesicoureteric reflux status and number of prior infections. Trials involving re-implantation surgery (and antibiotics compared with antibiotics alone) for the sub-group of children with vesicoureteric reflux have not shown a reduction in repeat UTI, with the possible exception of a very small benefit for febrile UTI. Systematic reviews have shown that circumcision reduces the risk of repeat infection but 111 circumcisions would need to be performed to prevent one UTI in unpredisposed boys. Given the need for anaesthesia and the risk of surgical complication, net clinical benefit is probably restricted to those who are predisposed (such as those with recurrent infection). Many small trials in complementary therapies have been published and many suggest some benefit, however inclusion of children is limited. Only three trials involving 394 children for cranberry products, two trials with a total of 252 children for probiotics and one trial with 24 children for vitamin A are published. Estimates of efficacy vary widely and imprecision is evident. Multiple interventions to prevent UTI in children exist. Of those, long-term low dose antibiotics has the strongest evidence base, but the benefit is small. Circumcision in boys reduces the risk substantially, but should be restricted to those at risk. There is little evidence of benefit of

  3. Kinetics of liver macrophages (Kupffer cells) in SIV-infected macaques

    International Nuclear Information System (INIS)

    Ahsan, Muhammad H.; Gill, Amy F.; Alvarez, Xavier; Lackner, Andrew A.; Veazey, Ronald S.

    2013-01-01

    Since the liver drains antigens from the intestinal tract, and since the intestinal tract is a major site of viral replication, we examined the dynamics of liver macrophages (Kupffer cells) throughout SIV infection. Absolute numbers of Kupffer cells increased in the livers in acute infection, and in animals with AIDS. Significantly higher percentages of proliferating (BrdU+) Kupffer cells were detected in acute infection and in AIDS with similar trends in blood monocytes. Significantly higher percentages of apoptotic (AC3+) Kupffer cells were also found in acute and AIDS stages. However, productively infected cells were not detected in liver of 41/42 animals examined, despite abundant infected cells in gut and lymph nodes of all animals. Increased rates of Kupffer cell proliferation resulting in an increase in Kupffer cells without productive infection indicate SIV infection affects Kupffer cells, but the liver does not appear to be a major site of productive viral replication. - Highlights: • Kupffer cells increase in the liver of SIV-infected macaques. • Increased proliferation and apoptosis of Kupffer cells occurs in SIV infection. • Productively infected cells are rarely detected in the liver. • The liver is not a major site for SIV replication

  4. Pathology Laboratories and Infection Prevention and Control

    Directory of Open Access Journals (Sweden)

    R Baral

    2014-11-01

    Full Text Available Laboratory health care workers are vulnerable to infection with the Hospital Acquired Infections (HAIs while receiving, handling and disposing biological samples. Ideally the infrastructure of the lab should be according to the best practices like good ventilation, room pressure differential, lighting, space adequacy, hand hygiene facilities, personal protective equipments, biological safety cabinets etc. Disinfection of the environment, and specific precautions with sharps and microbial cultures should follow the protocols and policies of the Infection Prevention and Control Practices (IPAC. If Mycobacterium tuberculosis or Legionella pneumophila are expected, diagnostic tests should be performed in a bio-safety level 3 facilities (for agents which may cause serious or potentially lethal disease in healthy adults after inhalation. Laboratory access should be limited only to people working in it.Along with the advent of new technologies and advanced treatment we are now facing problems with the dreadful HAIs with Antimicrobial Resistant Organisms (AROs which is taking a pandemic form. According to WHO, hundreds of millions of patients develop HAI every year worldwide and as many as 1.4 million occur each day in hospitals alone. The principal goals for hospital IPAC programs are to protect the patient, protect the health care worker (HCW, visitors, and other persons in the health environment, and to accomplish the previous goals in a cost-effective manner like hand hygiene, surveillance, training of the HCWs, initiating awareness programs and making Best Practices and Guidelines to be followed by everyone in the hospital.The initiation for the best practices in the Pathology Laboratories can be either Sporadic or Organizational. Sporadic initiation is when the laboratories make their own IPAC policies. It has been seen that in few centres these policies have been conceptualized but not materialized. Organizational initiation is much more

  5. Sexually transmitted infections: prevention and management.

    Science.gov (United States)

    Jackson, Denis; Dallabetta, Gina; Steen, Richard

    2004-02-01

    In the early 21st century, STI and HIV have been linked inextricably. Although the focus of this article is STI, some discussion on the diagnosis and management of individuals with HIV infection is necessary. The history of HIV diagnosis in the workplace is checkered. The authors have seen cases of prospective workers being subjected to HIV testing without their knowledge as part of a pre-employment medical examination. If the test came back positive, the men were told that they would not be employed without explanation. This approach is a breech of the human rights of the individual being tested and cannot be condoned. Any HIV testing must be done with the full and informed consent of the individual, with counseling given before and after testing to enable individuals with HIV infection to seek care and protect their families and to give individuals without HIV infection counseling on risk reduction. Men and women who present with an STI are at risk for HIV infection. With increasing options for management and secondary prevention, it is important to recognize people who are at risk. This identification should be done through HIV VCT. The location, funding, and supervision of VCT sites related to workplace populations should be a subject for serious debate. Although fears of mass layoffs after HIV testing largely have been unfounded, it is natural for workers to be fearful, unless there is a clearly articulated policy stating that the company observes and enforces nondiscriminatory practices. The workplace examples show that syndromic STI management, allied to comprehensive prevention programs, can have a genuine and measurable impact on STI prevalence. The potential interventions and partners are listed in Table 2. A community-based, randomized study in Tanzania showed that the institution of a well-managed STI syndromic management program can reduce HIV incidence by up to 40%, in the context of a rising HIV epidemic. Presumptive STI treatment for female sex

  6. Saccharomyces boulardii prevention of the hepatic injury induced by Salmonella Enteritidis infection.

    Science.gov (United States)

    Wu, Daichao; Teng, Da; Wang, Xiumin; Dai, Changsong; Wang, Jianhua

    2014-10-01

    Salmonella enterica subsp. enterica serovar Enteritidis (Salmonella Enteritidis) is the predominant cause of serovar-associated food-borne outbreaks in many countries and causes significant clinical symptoms of liver injury, enteritis, and diarrheal diseases. Saccharomyces boulardii is used in clinical application for prophylaxis and the treatment of a variety of diseases caused by bacterial infection. We used a mouse model of Salmonella Enteritidis infection, which included pretreatment with S. boulardii, to reveal the protection mechanisms of S. boulardii against Salmonella Enteritidis infection, including the translocation of Salmonella Enteritidis to the liver 10 days after Salmonella Enteritidis challenge, and the colonisation of Salmonella Enteritidis and the formation of hepatic tissue lesions in mice after Salmonella Enteritidis challenge on the 10th day. Compared with Salmonella Enteritidis infection in mice, S. boulardii decreased Salmonella Enteritidis translocation to the liver by 96%, and 99% of Salmonella Enteritidis colonised the cecum on the 10th day. Saccharomyces boulardii also abated hepatic tissue injury caused by the infiltration of neutrophilic granulocytes, lymphocytes, and plasmocytes by decreasing the translocation of Salmonella to the liver. These findings demonstrated that S. boulardii is an effective agent in the prevention of the hepatic injury induced by Salmonella Enteritidis infection in a mouse model.

  7. Prevention of recurrent urinary tract infections.

    Science.gov (United States)

    Wagenlehner, F M E; Vahlensieck, W; Bauer, H W; Weidner, W; Piechota, H J; Naber, K G

    2013-03-01

    Urinary tract infections (UTI) are among the most frequent bacterial infections in the community and health care setting. Mostly young and, to some extent, postmenopausal women are affected by recurrent UTI (rUTI) defined as ≥3 UTI/year or ≥2 UTI/half year. In contrast, rUTI is rare in healthy men. On the other hand, rUTI are frequently found in female and male patients with complicating urological factors, e.g. urinary catheters, infection stones. Remediable predisposing factors in uncomplicated rUTI in women are rare. In complicated rUTI the success depends mainly on the possibility to eliminate or at leastimprove the complicating risk factors. Continuous antibiotic prophylaxis or postcoital prophylaxis, if there is close correlation with sexual intercourse, are most effective to prevent rUTI. Nitrofurantoin, trimethoprim (or cotrimoxazole), and fosfomycin trometamol are available as first-line drugs. Oral cephalosporins and quinolones should be restricted to specific indications. Antibiotic prophylaxis reduces the number of uropathogens in the gut and/or vaginal flora and reduces bacterial "fitness". Given the correct indication, the recurrence rate of rUTI can be reduced by about 90%. Due to possible adverse events and the concern of selecting resistant pathogens, according to the guidelines of the European Association of Urology antimicrobial prophylaxis should be considered only after counselling, behavioural modification and non-antimicrobial measures have been attempted. In postmenopausal patients vaginal substitution of oestriol should be started first. Oral or parenteral immunoprophylaxis is another option in patients with rUTI. Other possibilities with varying scientific evidence are prophylaxis with cranberry products, specific plant combinations or probiotics. The prophylaxis of catheter-associated UTI should employ strategies which result in a reduction of frequency and duration of catheter drainage of the urinary tract. The currently available

  8. Association between hepatitis B co-infection and elevated liver stiffness among HIV-infected adults in Lusaka, Zambia.

    Science.gov (United States)

    Vinikoor, Michael J; Mulenga, Lloyd; Siyunda, Alice; Musukuma, Kalo; Chilengi, Roma; Moore, Carolyn Bolton; Chi, Benjamin H; Davies, Mary-Ann; Egger, Matthias; Wandeler, Gilles

    2016-11-01

    To describe liver disease epidemiology among HIV-infected individuals in Zambia. We recruited HIV-infected adults (≥18 years) at antiretroviral therapy initiation at two facilities in Lusaka. Using vibration controlled transient elastography, we assessed liver stiffness, a surrogate for fibrosis/cirrhosis, and analysed liver stiffness measurements (LSM) according to established thresholds (>7.0 kPa for significant fibrosis and >11.0 kPa for cirrhosis). All participants underwent standardised screening for potential causes of liver disease including chronic hepatitis B (HBV) and C virus co-infection, herbal medicine, and alcohol use. We used multivariable logistic regression to identify factors associated with elevated liver stiffness. Among 798 HIV-infected patients, 651 had a valid LSM (median age, 34 years; 53% female). HBV co-infection (12%) and alcohol use disorders (41%) were common and hepatitis C virus co-infection (7.0 kPa (all P 11.0 kPa. Among HIV-HBV patients, those with elevated ALT and HBV viral load were more likely to have significant liver fibrosis than patients with normal markers of HBV activity. HBV co-infection was the most important risk factor for liver fibrosis and cirrhosis and should be diagnosed early in HIV care to optimise treatment outcomes. © 2016 John Wiley & Sons Ltd.

  9. Hepatitis B and C virus infections and liver function in AIDS patients ...

    African Journals Online (AJOL)

    Background: Impaired liver function tests and co-infection with hepatitis viruses in AIDS patients are common in western countries. Objective: To assess liver function and prevalence of co-infection with hepatitis B and hepatitis C viruses in AIDS patients at Chris Hani Baragwanath Hospital. Design: A prospective study.

  10. Donor-derived infections among Chinese donation after cardiac death liver recipients.

    Science.gov (United States)

    Ye, Qi-Fa; Zhou, Wei; Wan, Qi-Quan

    2017-08-21

    To investigate blood cultures of deceased donors and report the confirmed transmission of bacterial infection from donors to liver recipients. We retrospectively studied the results of blood cultures among our donation after cardiac death (DCD) donors and calculated the donor-derived bacterial infection rates among liver recipients. Study participants underwent liver transplantation between January 1, 2010 and February 1, 2017. The study involved a total of 67 recipients of liver grafts from 67 DCD donors. We extracted the data of donors' and patients' characteristics, culture results and clinical outcomes, especially the post-transplant complications in liver recipients, from electronic medical records. We analyzed the characteristics of the donors and the corresponding liver recipients with emphasis put on donor-derived infections. Head trauma was the most common origin of death among our 67 DCD donors (46.3%). Blood taken prior to the procurement operation was cultured for 53 of the donors, with 17 episodes of bloodstream infections developing from 13 donors. The predominant organism isolated from the blood of donors was Gram-positive bacteria (70.6%). Only three (4.5%) of 67 liver recipients developed confirmed donor-derived bacterial infections, with two isolates of multidrug-resistant Klebsiella pneumoniae and one isolate of multidrug-resistant Enterobacter aerogenes. The liver recipients with donor-derived infections showed relation to higher crude mortality and graft loss rates (33.3% each) within 3 mo post transplantation, as compared to those without donor-derived infections (9.4% and 4.7%, respectively). All three liver recipients received appropriate antimicrobial therapy. Liver recipients have high occurrence of donor-derived infections. The liver recipients with donor-derived multidrug-resistant Enterobacteriaceae infections can have good outcome if appropriate antimicrobial therapy is given.

  11. Infection Prevention Practices and Associated Factors among ...

    African Journals Online (AJOL)

    2018-03-01

    Mar 1, 2018 ... Healthcare Workers in Governmental Healthcare Facilities in Addis. Ababa .... personal protective equipments and materials, ... disinfection practice, tuberculosis infection control ..... E. Knowledge and practice of infection.

  12. Chronic hepatitis C infection and liver disease in HIV co-infected patients in Asia

    Science.gov (United States)

    Durier, Nicolas; Yunihastuti, Evy; Ruxrungtham, Kiat; Van Kinh, Nguyen; Kamarulzaman, Adeeba; Boettiger, David; Widhani, Alvina; Avihingsanon, Anchalee; Huy, Bui Vu; Omar, Sharifah Faridah binti Syed; Sanityoso, Andri; Chittmittrapap, Salyavit; Dung, Nguyen Thi Hoai; Pillai, Veena; Suwan-Ampai, Tuangporn; Law, Matthew; Sohn, Annette H.; Matthews, Gail

    2016-01-01

    Data on markers of hepatitis C virus (HCV) disease in HIV-HCV co-infected patients in resource-limited settings are scarce. We assessed HCV-RNA, HCV genotype (GT), IL28B GT, and liver fibrosis (FibroScan®) in 480 HIV-infected patients with positive HCV antibody in four HIV treatment centers in South East Asia. We enrolled 165 (34.4%) patients in Jakarta, 158 (32.9%) in Bangkok, 110 (22.9%) in Hanoi, and 47 (9.8%) in Kuala Lumpur. Overall, 426 (88.8%) were male, the median (IQR) age was 38.1 (34.7–42.5) years, 365 (76.0%) reported HCV exposure through injecting drug use, and 453 (94.4%) were on combination antiretroviral therapy. The median (IQR) CD4 count was 446 (325–614) cells/mm3 and 208 (94.1%) of 221 patients tested had HIV-1 RNA F4). One patient (0.3%) had FibroScan® failure. A high proportion of HIV-HCV co-infected patients had chronic HCV infection. HCV GT1 was predominant, and 62% of patients had liver disease warranting prompt treatment (>=F2). PMID:27917597

  13. Era of liver transplantation: combined anatomic splenectomy and anticoagulant therapy in prevention of portal vein thrombosis after splenectomy.

    Science.gov (United States)

    Hongwei, Chen; Zhang, Liang; Maoping, Li; Yong, Zhang; Chengyou, Du; Dewei, Li

    2015-01-01

    Portal vein thrombosis (PVT) is a common complication following splenectomy in patients with liver cirrhosis and portal hypertension, which also brings difficulties to future possible liver transplantation. This paper retrospectively analyzes the preventive effect of combined anatomic splenectomy and early anticoagulant therapy on post-splenectomy portal vein thrombosis in patients with portal hypertension. We retrospectively analyzed 136 patients who underwent splenectomy at our hospital between January 2010 and December 2013 due to liver cirrhosis and portal hypertension. Patient conditions, such as coagulation function, splenic and portal vein thrombosis, intra-abdominal hemorrhage, pancreatic leakage and intra-abdominal infections, are observed postoperatively. Despite the presence of liver cirrhosis and portal hypertension in patients, early postoperative anticoagulant therapy has no significant impact on coagulation function and intra-abdominal hemorrhage of these patients (p > 0.05). Anatomic splenectomy can reduce the occurrence of complications such as postoperative bleeding, pancreatic leakage and intra-abdominal infections (p splenectomy and early postoperative anticoagulant therapy can reduce post-splenectomy portal vein thrombosis in patients with portal hypertension, and is conducive to the future liver transplantation therapy may be needed by the patients.

  14. No evidence of in vitro and in vivo porcine endogenous retrovirus infection after plasmapheresis through the AMC-bioartificial liver

    NARCIS (Netherlands)

    Di Nicuolo, Giuseppe; van de Kerkhove, Maarten-Paul; Hoekstra, Ruurdtje; Beld, Marcel G. H. M.; Amoroso, Pietro; Battisti, Sonia; Starace, Maria; di Florio, Ernesto; Scuderi, Vincenzo; Scala, Simona; Bracco, Adele; Mancini, Antonio; Chamuleau, Robert A. F. M.; Calise, Fulvio

    2005-01-01

    Background: Currently a number of bioartificial livers (BAL) based on porcine liver cells have been developed as a treatment to bridge acute liver failure patients to orthotopic liver transplantation or liver regeneration. These xenotransplantation related treatments hold the risk of infection of

  15. Increased Expression of TGF-β1 in Correlation with Liver Fibrosis during Echinococcus granulosus Infection in Mice.

    Science.gov (United States)

    Liu, Yumei; Abudounnasier, Gulizhaer; Zhang, Taochun; Liu, Xuelei; Wang, Qian; Yan, Yi; Ding, Jianbing; Wen, Hao; Yimiti, Delixiati; Ma, Xiumin

    2016-08-01

    To investigate the potential role of transforming growth factor (TGF)-β1 in liver fibrosis during Echinococcus granulosus infection, 96 BALB/c mice were randomly divided into 2 groups, experimental group infected by intraperitoneal injection with a metacestode suspension and control group given sterile physiological saline. The liver and blood samples were collected at days 2, 8, 30, 90, 180, and 270 post infection (PI), and the expression of TGF-β1 mRNA and protein was determined by real-time quantitative RT-PCR and ELISA, respectively. We also evaluated the pathological changes in the liver during the infection using hematoxylin and eosin (H-E) and Masson staining of the liver sections. Pathological analysis of H-E stained infected liver sections revealed liver cell edema, bile duct proliferation, and structural damages of the liver as evidenced by not clearly visible lobular architecture of the infected liver, degeneration of liver cell vacuoles, and infiltration of lymphocytes at late stages of infection. The liver tissue sections from control mice remained normal. Masson staining showed worsening of liver fibrosis at the end stages of the infection. The levels of TGF-β1 did not show significant changes at the early stages of infection, but there were significant increases in the levels of TGF-β1 at the middle and late stages of infection (Pgranulosus infection may play a significant role in liver fibrosis associated with E. granulosus infection.

  16. Insulin resistance and liver steatosis in chronic hepatitis C infection genotype 3.

    Science.gov (United States)

    Abenavoli, Ludovico; Masarone, Mario; Peta, Valentina; Milic, Natasa; Kobyliak, Nazarii; Rouabhia, Samir; Persico, Marcello

    2014-11-07

    Hepatitis C virus (HCV) infection is a common chronic liver disease worldwide. Non-alcoholic fatty liver disease and insulin resistance (IR) are the major determinants of fibrosis progression and response to antiviral therapy. The pathogenetic link between IR and chronic HCV infection is complex, and is associated with HCV genotype. Liver steatosis is the most common in the patients infected with genotype 3 virus, possibly due to direct effects of genotype 3 viral proteins. To the contrary, hepatic steatosis in the patients infected with other genotypes is thought to be mostly due to the changes in host metabolism, involving IR. In HCV genotype 3, liver steatosis correlates with viral load, reverts after reaching the sustained virologic response and reoccurs in the relapsers. A therapeutic strategy to improve IR and liver steatosis and subsequently the response to antiviral treatment in these patients is warranted.

  17. Infection prevention and control practices in children's hospitals.

    Science.gov (United States)

    Bender, Jeffrey M; Virgallito, Mary; Newland, Jason G; Sammons, Julia S; Thorell, Emily A; Coffin, Susan E; Pavia, Andrew T; Sandora, Thomas J; Hersh, Adam L

    2015-05-01

    We surveyed hospital epidemiologists at 28 Children's Hospital Association member hospitals regarding their infection prevention and control programs. We found substantial variability between children's hospitals in both the structure and the practice of these programs. Research and the development of evidence-based guidelines addressing infection prevention in pediatrics are needed.

  18. Manual of infection prevention and control

    National Research Council Canada - National Science Library

    Damani, N. N

    2012-01-01

    .... Unlike other books on infection control, the main strength of this book is to provide clear, up-to-date and practical guidance in infection control in an easy to read format which can act as a quick...

  19. Pathogen infection distribution and drug resistance analysis of patients with severe liver disease

    Directory of Open Access Journals (Sweden)

    Xi CHEN

    2018-04-01

    Full Text Available Objective To explore the infection distribution and drug resistance of pathogens in patients with severe liver disease, and provide reference for clinical medication. Methods Retrospective analysis of the microbiological specimens from patients with severe liver disease in Department of Infection of our hospital from August 2014 to November 2016 and the drug susceptibility testing were carried out by means of K-B disc diffusion method after bacterial culturing, and the distribution and drug resistance of pathogens were analyzed. Results Totally 17 of 73 patients with severe liver disease developed hospital infection (23.3%. 104 strains of bacteria were isolated and 78 strains out of them were multidrug-resistant bacteria (75.0%. Among them, 28(26.9% strains were gram-positive coccus, mainly consisting of Staphylococcus aureus and Staphylococcus epidermidis, and 58(55.8% were gram-negative coccus, mainly composed of Escherichia coli, Klebsiella pneumonia and Acinetobacter baumannii, and 18(17.3% strains fungi. S.aureus and enterococci were resistant to penicillin, erythromycin and levofloxacin, the resistance rates were above 80.0%, but had low resistance rates to vancomycin, teicoplanin and tigecycline. The resistance rates of E.coli and K.pneumoniae to piperacillin, cefazolin and cefuroxime sodium were above 85.0%, but they had lower resistance rates to tigecycline and amikacin. Acinetobacter baumannii was 100% resistant to piperacillin and tazobactam, ceftazidime, imipenem and amikacin, but had low resistance to tigecycline and minocycline. Conclusions Multi-drug resistant bacteria are the main bacterial pathogens in patients with severe liver disease and have a high resistance rate to commonly used antibiotics, empirical treatment in the population at high risk of multidrug-resistant bacteria infections requires the use of broad-spectrum or high-grade antibiotics (e.g. carbapenems or tigecycline and drugs against specific pathogenic

  20. Preventing surgical site infections: a surgeon's perspective.

    OpenAIRE

    Nichols, R. L.

    2001-01-01

    Wound site infections are a major source of postoperative illness, accounting for approximately a quarter of all nosocomial infections. National studies have defined the patients at highest risk for infection in general and in many specific operative procedures. Advances in risk assessment comparison may involve use of the standardized infection ratio, procedure-specific risk factor collection, and logistic regression models. Adherence to recommendations in the 1999 Centers for Disease Contro...

  1. Prevention of Recurrent Staphylococcal Skin Infections

    OpenAIRE

    Creech, C. Buddy; Al-Zubeidi, Duha N.; Fritz, Stephanie A.

    2015-01-01

    Staphylococcus aureus infections pose a significant health burden. The emergence of community-associated methicillin-resistant S. aureus has resulted in an epidemic of skin and soft tissue infections (SSTI), and many patients experience recurrent SSTI. As S. aureus colonization is associated with subsequent infection, decolonization is recommended for patients with recurrent SSTI or in settings of ongoing transmission. S. aureus infections often cluster within households and asymptomatic carr...

  2. Intravital imaging of the immune responses during liver-stage malaria infection: An improved approach for fixing the liver.

    Science.gov (United States)

    Akbari, Masoud; Kimura, Kazumi; Houts, James T; Yui, Katsuyuki

    2016-10-01

    The host-parasite relationship is one of the main themes of modern parasitology. Recent revolutions in science, including the development of various fluorescent proteins/probes and two-photon microscopy, have made it possible to directly visualize and study the mechanisms underlying the interaction between the host and pathogen. Here, we describe our method of preparing and setting-up the liver for our experimental approach of using intravital imaging to examine the interaction between Plasmodium berghei ANKA and antigen-specific CD8 + T cells during the liver-stage of the infection in four dimensions. Since the liver is positioned near the diaphragm, neutralization of respiratory movements is critical during the imaging process. In addition, blood circulation and temperature can be affected by the surgical exposure due to the anatomy and tissue structure of the liver. To control respiration, we recommend anesthesia with isoflurane inhalation at 1% during the surgery. In addition, our protocol introduces a cushion of gauze around the liver to avoid external pressure on the liver during intravital imaging using an inverted microscope, which makes it possible to image the liver tissue for long periods with minimal reduction in the blood circulation and with minimal displacement and tissue damage. The key point of this method is to reduce respiratory movements and external pressure on the liver tissue during intravital imaging. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Interleukin-13 is involved in the formation of liver fibrosis in Clonorchis sinensis-infected mice.

    Science.gov (United States)

    Xu, Yanquan; Liang, Pei; Bian, Meng; Chen, Wenjun; Wang, Xiaoyun; Lin, Jinsi; Shang, Mei; Qu, Hongling; Wu, Zhongdao; Huang, Yan; Yu, Xinbing

    2016-07-01

    Clonorchiasis is a chronic infection disease often accompanied by formation of liver fibrosis. Previous study has identified that Clonorchis sinensis (C. sinensis, Cs) infection and CsRNASET2 (a member of CsESPs) immunization can drive Th2 immune response. IL-13, a multifunctional Th2 cytokine, has been widely confirmed to be profibrotic mediator. We want to determine whether IL-13 is involved in the generation of liver fibrosis during C. sinensis infection. A part of mice were infected with C. sinensis or immunized with CsRNASET2, respectively. Another part of mice were intravenously injected with rIL-13. Liver tissues of C. sinensis-infected mice were stained with hematoxylin-eosin and Masson's trichrome, respectively. The transcriptional levels of collagen-I, collagen-III, α-SMA, and TIMP-1 in the livers of infected mice and rIL-13-treated mice were measured by quantitative RT-PCR. Besides, splenocytes of C. sinensis-infected and CsRNASET2-immunized mice were isolated, respectively. The levels of IL-13 in splenocytes were detected by ELISA. Our results displayed that the livers of C. sinensis-infected mice had serious chronic inflammation and collagen deposition. The transcriptional levels of collagen-I, collagen-III, α-SMA, and TIMP-1 in the livers of C. sinensis-infected mice were obviously increased. Splenocytes from both C. sinensis-infected and CsRNASET2-immunized mice expressed high levels of IL-13. Moreover, rIL-13 treatment markedly promoted the transcriptional levels of collagen-I, collagen-III, α-SMA, and TIMP-1. These data implied that hepatic fibrosis was formed in the livers of C. sinensis-infected mice, and IL-13 induced by C. sinensis infection and CsRNASET2 immunization might favor this progression.

  4. Infection prevention and control in deployed military medical treatment facilities.

    Science.gov (United States)

    Hospenthal, Duane R; Green, Andrew D; Crouch, Helen K; English, Judith F; Pool, Jane; Yun, Heather C; Murray, Clinton K

    2011-08-01

    Infections have complicated the care of combat casualties throughout history and were at one time considered part of the natural history of combat trauma. Personnel who survived to reach medical care were expected to develop and possibly succumb to infections during their care in military hospitals. Initial care of war wounds continues to focus on rapid surgical care with debridement and irrigation, aimed at preventing local infection and sepsis with bacteria from the environment (e.g., clostridial gangrene) or the casualty's own flora. Over the past 150 years, with the revelation that pathogens can be spread from patient to patient and from healthcare providers to patients (including via unwashed hands of healthcare workers, the hospital environment and fomites), a focus on infection prevention and control aimed at decreasing transmission of pathogens and prevention of these infections has developed. Infections associated with combat-related injuries in the recent operations in Iraq and Afghanistan have predominantly been secondary to multidrug-resistant pathogens, likely acquired within the military healthcare system. These healthcare-associated infections seem to originate throughout the system, from deployed medical treatment facilities through the chain of care outside of the combat zone. Emphasis on infection prevention and control, including hand hygiene, isolation, cohorting, and antibiotic control measures, in deployed medical treatment facilities is essential to reducing these healthcare-associated infections. This review was produced to support the Guidelines for the Prevention of Infections Associated With Combat-Related Injuries: 2011 Update contained in this supplement of Journal of Trauma.

  5. Cranberries for preventing urinary tract infections

    Directory of Open Access Journals (Sweden)

    Ruth G. Jepson

    Full Text Available BACKGROUND: Cranberries have been used widely for several decades for the prevention and treatment of urinary tract infections (UTIs. This is the third update of our review first published in 1998 and updated in 2004 and 2008. OBJECTIVES: To assess the effectiveness of cranberry products in preventing UTIs in susceptible populations. METHODS: Search methods: We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL in The Cochrane Library and the Internet. We contacted companies involved with the promotion and distribution of cranberry preparations and checked reference lists of review articles and relevant studies. Date of search: July 2012. Selection criteria: All randomised controlled trials (RCTs or quasi-RCTs of cranberry products for the prevention of UTIs. Data collection and analysis: Two authors independently assessed and extracted data. Information was collected on methods, participants, interventions and outcomes (incidence of symptomatic UTIs, positive culture results, side effects, adherence to therapy. Risk ratios (RR were calculated where appropriate, otherwise a narrative synthesis was undertaken. Quality was assessed using the Cochrane risk of bias assessment tool. MAIN RESULTS: This updated review includes a total of 24 studies (six cross-over studies, 11 parallel group studies with two arms; five with three arms, and two studies with a factorial design with a total of 4473 participants. Ten studies were included in the 2008 update, and 14 studies have been added to this update. Thirteen studies (2380 participants evaluated only cranberry juice/concentrate; nine studies (1032 participants evaluated only cranberry tablets/capsules; one study compared cranberry juice and tablets; and one study compared cranberry capsules and tablets. The comparison/control arms were placebo, no treatment, water, methenamine hippurate, antibiotics, or lactobacillus. Eleven studies were not included in the meta

  6. A framework for preventing healthcare-associated infection in ...

    African Journals Online (AJOL)

    To ensure safe healthcare delivery to children, a co-ordinated HAI prevention strategy should promote development of infection prevention norms and policies, education, patient safety advocacy, healthcare infrastructure, surveillance and research. We present a framework for SA to develop and expand HAI prevention in ...

  7. PREDICTION AND PREVENTION OF LIVER FAILURE AFTER MAJOR LIVER PRIMARY AND METASTATIC TUMORS RESECTION

    Directory of Open Access Journals (Sweden)

    A. D. Kaprin

    2016-01-01

    Full Text Available Abstract Purpose of the study. Improvement of results of treatment in patients with primary and metastatic liver cancer by decreasing the risk of post-resection liver failure on the basis of the evaluation of the functional reserves of the liver.Materials and Methods. The study included two independent samples of patients operated about primary or metastatic lesions of the liver at the Department of abdominal Oncology, P. A. Hertsen MORI. The first group included 53 patients who carried out 13C-breath test metallimovie and dynamic scintigraphy of the liver in the preoperative stage in addition to the standard algorithm of examination. Patients of the 2nd group (n=35 had a standard clinical and laboratory examination, the patients were not performed the preoperative evaluation of the functional reserve of the liver, the incidences of total bilirubin, albumin and prothrombin time did not reveal a reduction of liver function. Post-resection liver failure have been established on the basis of the 50/50 criterion in the evaluation on day 5 after surgery.Results. Analysis of operating characteristics of the functional tests showed the absolute methacin breath test sensitivity (SE≥100%, high specificity (SP≥67% of scintigraphy of the liver and the negative predictive value of outcome (VP≥100% at complex use of two diagnostic methods. The incidence of PROPS in the study group was significantly 2 times higher in the control group –15,1% and 26.8%, respectively (p<0.001.Conclusion. The combination of preoperative dynamic scintigraphy of the liver with carrying out 13C-breath methacin test allows you to conduct a comprehensive evaluation of the liver functional reserve and can significantly improve preoperative evaluation and postoperative results of anatomic resection in patients with primary and metastatic liver lesions.

  8. Prevention of catheter-related blood stream infection.

    Science.gov (United States)

    Byrnes, Matthew C; Coopersmith, Craig M

    2007-08-01

    Catheter-related blood stream infections are a morbid complication of central venous catheters. This review will highlight a comprehensive approach demonstrated to prevent catheter-related blood stream infections. Elements of prevention important to inserting a central venous catheter include proper hand hygiene, use of full barrier precautions, appropriate skin preparation with 2% chlorhexidine, and using the subclavian vein as the preferred anatomic site. Rigorous attention needs to be given to dressing care, and there should be daily assessment of the need for central venous catheters, with prompt removal as soon as is practicable. Healthcare workers should be educated routinely on methods to prevent catheter-related blood stream infections. If rates remain higher than benchmark levels despite proper bedside practice, antiseptic or antibiotic-impregnated catheters can also prevent infections effectively. A recent program utilizing these practices in 103 ICUs in Michigan resulted in a 66% decrease in infection rates. There is increasing recognition that a comprehensive strategy to prevent catheter-related blood stream infections can prevent most infections, if not all. This suggests that thousands of infections can potentially be averted if the simple practices outlined herein are followed.

  9. Organizational culture and its implications on infection prevention and control

    Directory of Open Access Journals (Sweden)

    R Baral

    2015-09-01

    Full Text Available The hospital acquired infections are becoming common in our hospitals lately. These infections are difficult to treat and maybe life threatening. Hospital acquired infection  can be minimized or eradicated by good Infection Prevention and Control guidelines and good hand hygiene practices. The success of Infection Prevention and Control guidelines program in any hospital is largely impacted by the organizational culture.  In any health care setting the management is challenged by the organizational culture to change of any kind. Where implementation of Infection Prevention and Control guidelines program is easily implemented in some hospitals it is very difficult in others. Moreover, hand hygiene is not only biomedical practice but also has more behavioral factors. 

  10. Transient elastography for predicting liver-related events in cirrhotic HIV-infected patients

    OpenAIRE

    Montes-Ramírez, M. L.; Berenguer, Juan; Miró, J. M.; Quereda, Carmen; Hernando Jeréz, María Asunción; Sanz, J.; Ortega, E.; Tural, Cristina; Wichmann, M. A.; Zamora, F. X.; González García, J. J.

    2017-01-01

    We assessed liver stiffness measurement (LSM) for the prediction of mortality and decompensation in HIVinfected patients with compensated liver cirrhosis. A prospective cohort study of HIV-infected patients with confirmed liver cirrhosis from 9 hospitals in Spain. LSM was undertaken for each patient; clinical events were collected prospectively after the baseline visit, and patients were followed until death or the censoring date. We used univariate/multivariate Cox proportional haz...

  11. Inflammatory pseudotumor of the liver in a patient with congenital granulocytopenia and HCV infection

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, G. E-mail: ragsne@uniklink-saarland.de; Fries, P.; Samaras, P.; Remberger, K.; Uder, M.; Kramann, B

    2003-12-01

    Inflammatory pseudotumor (IPT) of the liver is a rare pathologic lesion. Although IPTs within the liver shows spontaneous regression, these lesions are frequently misdiagnosed as malignant on the basis of the clinical manifestation and the results of diagnostic imaging. With special regard to magnetic resonance imaging (MRI), differential diagnosis such as hepatocellular or cholangiocellular carcinoma (HCC/CCC) as well as regenerative liver lesions are discussed in a case of IPT with concomitant hepatitis C virus (HCV) infection and congenital granulocytopenia.

  12. Hepatitis E virus genotype three infection of human liver chimeric mice as a model for chronic HEV infection

    NARCIS (Netherlands)

    M.D.B. van de Garde (Martijn D.B.); S.D. Pas (Suzan); G. van der Net (Guido); R.A. de Man (Robert); A.D.M.E. Osterhaus (Albert); B.L. Haagmans (Bart); A. Boonstra (Andre); T. Vanwolleghem (Thomas)

    2016-01-01

    textabstractGenotype (gt) 3 hepatitis E virus (HEV) infections are emerging in Western countries. Immunosuppressed patients are at risk of chronic HEV infection and progressive liver damage, but no adequate model system currently mimics this disease course. Here we explore the possibilities of in

  13. Hepatitis E virus (HEV) genotype 3 infection of human liver chimeric mice as a model for chronic HEV infection

    NARCIS (Netherlands)

    M.D.B. van de Garde (Martijn D.B.); S.D. Pas (Suzan); Van Der Net, G. (Guido); R.A. de Man (Robert); A.D.M.E. Osterhaus (Albert); B.L. Haagmans (Bart); P.A. Boonstra (André); T. Vanwolleghem (Thomas)

    2016-01-01

    textabstractGenotype 3 (gt3) hepatitis E virus (HEV) infections are emerging in Western countries. Immunosuppressed patients are at risk of chronic HEV infection and progressive liver damage, but no adequate model system currently mimics this disease course. Here we explore the possibilities of in

  14. Marijuana Use in Hepatitis C Infection does not Affect Liver Biopsy Histology or Treatment Outcomes

    Directory of Open Access Journals (Sweden)

    Theresa Liu

    2014-01-01

    Full Text Available BACKGROUND: Marijuana smoking is prevalent among hepatitis C virus-infected patients. The literature assessing the influence of marijuana on liver disease progression and hepatitis C virus antiviral treatment outcomes is conflicting.

  15. Evolving issues in the prevention of surgical site infections.

    LENUS (Irish Health Repository)

    Quinn, A

    2009-06-01

    Surgical site infection is one of the more common causes of post-operative morbidity. Such infections contribute to prolonged recovery, delayed discharge and increasing costs to both patients and the health service. In the current climate increased emphasis is being placed on minimising the risks of acquiring or transmitting these nosocomial infections. This article reviews the current literature obtained from a Pubmed database search in relation to three specific aspects of surgical site infection: compliance with prophylactic antibiotics, post-discharge surveillance and novel methods for preventing surgical site infections. These topics represent areas where many institutions will find room for improvement in the prevention of surgical site infections. Tight adherence to prophylactic antibiotic guidelines, close followup of surgical wounds during and after hospital discharge, and attention to oxygenation status and the body temperature of patients may all prove to be useful adjuncts in significantly decreasing surgical site infections.

  16. Prevalence, risk factors and spatial analysis of infections with liver flukes in Danish cattle herds

    DEFF Research Database (Denmark)

    Hisham Beshara Halasa, Tariq; Frankena, K.; Olsen, A.

    Liver fluke infection, also known as fasciolosis, is a world-wide prevalent zoonotic parasitic disease infecting a wide range of host species and is caused by Fasciola hepatica. Despite of the substantial economic and animal welfare effects of the disease, knowledge on its prevalence and the fact......Liver fluke infection, also known as fasciolosis, is a world-wide prevalent zoonotic parasitic disease infecting a wide range of host species and is caused by Fasciola hepatica. Despite of the substantial economic and animal welfare effects of the disease, knowledge on its prevalence...

  17. Occult hepatitis B infection in children with chronic liver disease.

    Science.gov (United States)

    Srivastava, Anshu; Mathias, Amrita; Yachha, Surender K; Aggarwal, Rakesh

    2015-04-01

    Occult hepatitis B infection (OBI) may adversely affect the outcome of patients with chronic liver disease (CLD). There are no data on OBI and CLD in children. This study determined the prevalence and effect of OBI in HBsAg-negative CLD children. CLD children were prospectively evaluated with a demographic, clinical, and investigative proforma. All HBsAg-negative CLD cases were tested for exposure to hepatitis B (total anti-HBc, anti-HBs). Serum hepatitis B virus DNA was measured in exposed (total anti-HBc positive) patients. A total of 115 HBsAg-negative CLD children (59 boys, age 9.0±3.6 years) were enrolled. The etiology of CLD was known in 94 cases and 21 children had cryptogenic CLD. Of these, 45 (39.1%) had evidence of HBV exposure (23 total anti-HBc positive, 17 total anti-HBc and anti-HBs positive, five only anti-HBs positive without previous vaccination). The anti-HBc-positive children had a higher Child's score than the anti-HBc-negative children [11 (5-13) vs. 7 (5-13); P=0.00]. A total of 4/45 children had seropositive OBI with serum HBV DNA of 8, 36, 133, and 156 IU/ml, respectively. The proportion of total anti-HBc positivity (8/21 vs. 32/94; P=0.8) and OBI (2/21 vs. 2/94; P=0.1) was similar in cryptogenic CLD and known cause CLD. Seropositive OBI is infrequent in Indian children with CLD. The prevalence is similar in cryptogenic and CLD of known etiology.

  18. Co-ordinate but disproportionate activation of apoptotic, regenerative and inflammatory pathways characterizes the liver response to acute amebic infection.

    Science.gov (United States)

    Pelosof, Lorraine C; Davis, Paul H; Zhang, Zhi; Zhang, Xiaochun; Stanley, Samuel L

    2006-03-01

    The liver has the remarkable ability to respond to injury with repair and regeneration. The protozoan parasite Entamoeba histolytica is the major cause of liver abscess worldwide. We report a transcriptional analysis of the response of mouse liver to E. histolytica infection, the first study looking at acute liver infection by a non-viral pathogen. Focusing on early time points, we identified 764 genes with altered transcriptional levels in amebic liver abscess. The response to infection is rapid and complex, with concurrent increased expression of genes linked to host defence through IL-1, TLR2, or interferon-induced pathways, liver regeneration via activation of IL-6 pathways, and genes associated with programmed cell death possibly through TNFalpha or Fas pathways. A comparison of amebic liver infection with the liver response to partial hepatectomy or toxins reveals striking similarities between amebic liver abscess and non-infectious injury in key components of the liver regeneration pathways. However, the response in amebic liver abscess is biased towards apoptosis when compared with acute liver injury from hepatectomy, toxins, or other forms of liver infection. E. histolytica infection of the liver simultaneously activates inflammatory, regenerative and apoptotic pathways, but the sum of these early responses is biased towards programmed cell death.

  19. Adult Catheter Care and Infection Prevention Guide

    Science.gov (United States)

    ... and go to an emergency room or clinic. Bring your repair kit because, unfortunately, many emergency rooms do not have them. • Ask your clinician about a sutureless securement device to reduce the risk of infection and accidental ...

  20. Adaptive Architecture and the Prevention of Infections in Hospitals

    Directory of Open Access Journals (Sweden)

    Khai Tran van

    2016-12-01

    Full Text Available Researches has shown that climate change may spark global epidemics. The objectives of hospital design consistent with a high standard of sustainable architecture must not only be the tropicalization of buildings but also a system to confront the impact of infectious diseases which arise from climate change. Infection control is the discipline concerned with preventing nosocomial or healthcare-associated infection. Infection control addresses factors related to the spread of infections within the hospital building, including prevention, monitoring and management measures. As the application of new technologies such as the Heating, ventilation and air conditioning system (HVAC with high-efficiency particulate arrestance (HEPA has application range within stamina, the study suggests the need to adopt an integrated adaptive hospital design strategy to prevent infection.

  1. Knowledge and attitudes of infection prevention and control among ...

    African Journals Online (AJOL)

    EB

    infection prevention and control is imparted early before they are introduced to the wards. ... professional nurses in Namibia instead of depending .... Table 3: ANOVA results for overall IPC Knowledge Score for gender, student area, high ...

  2. Future Research Opportunities in Peri-Prosthetic Joint Infection Prevention.

    Science.gov (United States)

    Berbari, Elie; Segreti, John; Parvizi, Javad; Berríos-Torres, Sandra I

    Peri-prosthetic joint infection (PJI) is a serious complication of prosthetic joint arthroplasty. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSI). Recently, the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) published the Guideline for Prevention of Surgical Site Infection. This targeted update applies evidence-based methodology in drafting recommendations for potential strategies to reduce the risk of SSI both across surgical procedures and specifically in prosthetic joint arthroplasty. A panel of PJI content experts identified nine PJI prevention research opportunities based on both evidence gaps identified through the guideline development process (transfusion, immunosuppressive therapy, anticoagulation, orthopedic space suit, and biofilm) and expert opinion (anesthesia, operative room environment, glycemic control, and Staphylococcus aureus nasal screening and decolonization. This article offers a road map for PJI prevention research.

  3. diagnosing multiple opportunistic infections: the value of a liver ...

    African Journals Online (AJOL)

    THE SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE Spring 2008. 51 ... standard TB therapy. The initial HIV diagnosis ... with elevated transaminases and canalicular enzymes, ... pattern of liver enzyme abnormalities was unchanged. Of note ... This case illustrates the diagnostic value of liver biopsy in our local patient.

  4. Parvovirus B19 Infection in a Fatal Case of Acute Liver Failure.

    Science.gov (United States)

    Leon, Luciane Almeida Amado; Alves, Arthur Daniel Rocha; Garcia, Rita de Cássia Nasser Cubel; Melgaço, Juliana Gil; de Paula, Vanessa Salete; Pinto, Marcelo Alves

    2017-12-01

    B19V has been proposed as an etiologic agent for hepatitis, mainly in children, but this is a rare clinical occurrence. In this article, we report a case of non-A-E acute liver failure in an immunocompetent child with B19 infection. The clinical findings of severe anemia and pancytopenia combined with the detection of anti-B19 Immunoglobulin G (IgG), B19 DNA and B19 mRNA in liver indicate a persistent infection and suggest a diagnosis of parvovirus B19-associated acute liver failure.

  5. 20-years of population-based cancer registration in hepatitis B and liver cancer prevention in the Gambia, West Africa.

    Directory of Open Access Journals (Sweden)

    Ebrima Bah

    Full Text Available The Gambia Hepatitis Intervention Study (GHIS was designed as a randomised control trial of infant hepatitis B vaccination applied to public health policy, with the main goal of preventing primary liver cancer later in adult life in The Gambia. To that effect, the National Cancer Registry of The Gambia (NCR, a population-based cancer registry (PBCR, was established in 1986 to actively collect data on all cancer diagnosis nation-wide. We extracted 20-years (1990-2009 of data to assess for the first time, the evolution of the most common cancers, also describe and demonstrate the role of the PBCR in a hepatitis B and liver cancer prevention programme in this population.We estimated Age-Standardised Incidence Rates (ASR (W of the most common cancers registered during the period by gender. The registration period was divided into four 5-year intervals and incidence rates were estimated for each interval. The most common cancers in males were liver, prostate, lung plus bronchus, non-Hodgkin lymphoma (NHL and stomach, accounting for 60%, 5%, 4%, 5% and 3%, respectively. Similarly, cancers of the cervix uteri, liver, breast and NHL, were the most common in females, accounting for 33%, 24%, 11% and 4% of the female cancers, respectively.Cancer incidence has remained relatively stable over time, but as shown elsewhere in sub-Saharan Africa the disease is a threat in The Gambia. The infection related cancers which are mostly preventable (HBV in men and HPV/HIV in women were the most common. At the moment the data is not enough to detect an effect of hepatitis B vaccination on liver cancer incidence in The Gambia. However, we observed that monitoring case occurrence through PBCR is a key public health pre-requisite for rational planning and implementation of targeted interventions for improving the health of the population.

  6. 20-Years of Population-Based Cancer Registration in Hepatitis B and Liver Cancer Prevention in The Gambia, West Africa

    Science.gov (United States)

    Bah, Ebrima; Carrieri, Maria Patrizia; Hainaut, Pierre; Bah, Yusupha; Nyan, Ousman; Taal, Makie

    2013-01-01

    Background The Gambia Hepatitis Intervention Study (GHIS) was designed as a randomised control trial of infant hepatitis B vaccination applied to public health policy, with the main goal of preventing primary liver cancer later in adult life in The Gambia. To that effect, the National Cancer Registry of The Gambia (NCR), a population-based cancer registry (PBCR), was established in 1986 to actively collect data on all cancer diagnosis nation-wide. We extracted 20-years (1990-2009) of data to assess for the first time, the evolution of the most common cancers, also describe and demonstrate the role of the PBCR in a hepatitis B and liver cancer prevention programme in this population. Methods and Findings We estimated Age-Standardised Incidence Rates (ASR (W)) of the most common cancers registered during the period by gender. The registration period was divided into four 5-year intervals and incidence rates were estimated for each interval. The most common cancers in males were liver, prostate, lung plus bronchus, non-Hodgkin lymphoma (NHL) and stomach, accounting for 60%, 5%, 4%, 5% and 3%, respectively. Similarly, cancers of the cervix uteri, liver, breast and NHL, were the most common in females, accounting for 33%, 24%, 11% and 4% of the female cancers, respectively. Conclusions Cancer incidence has remained relatively stable over time, but as shown elsewhere in sub-Saharan Africa the disease is a threat in The Gambia. The infection related cancers which are mostly preventable (HBV in men and HPV/HIV in women) were the most common. At the moment the data is not enough to detect an effect of hepatitis B vaccination on liver cancer incidence in The Gambia. However, we observed that monitoring case occurrence through PBCR is a key public health pre-requisite for rational planning and implementation of targeted interventions for improving the health of the population. PMID:24098724

  7. Value of serum PCT in early diagnosis of bacterial infection in patients with liver failure

    Directory of Open Access Journals (Sweden)

    WANG Chuanmin

    2017-06-01

    Full Text Available ObjectiveTo investigate the value of serum procalcitonin (PCT in early diagnosis of bacterial infection in patients with liver failure. MethodsA total of 463 patients with hepatitis B were selected from January to December, 2014, in the Department of Infectious Diseases, Taihe Hospital. According to the degree of liver injury, the patients were divided into four groups: mild liver injury group (n=120, moderate liver injury group (n=222, sever liver injury group (n=53, and liver failure group (n=68. Serum PCT was measured for all patients, and the white blood cell count (WBC and high-sensitivity C-reactive protein (hsCRP were measured for patients with liver failure. The clinical manifestations were observed and recorded. The t test was used for comparison of normally distributed continuous data, while the Kruskal-Wallis H test was used for non-normally distributed continuous data; the Mann-Whitney U test was used for pairwise comparison of continuous data. The chi-square test was used for comparison of categorical data. The receiver operating characteristic (ROC curve was used for the analysis of predictive value. ResultsThe liver failure group had a significantly higher PCT level than the severe liver injury group, moderate liver injury group, and mild liver injury group (0.81[0.34-2.15] vs 0.53[0.21-1.59], 0.35[010-1.18], and 0.17[0.10-0.60], χ2=25.091, P<0.05. The liver failure patients with PCT levels of <0.25 ng/ml (n=10, 0.25-0.5 ng/ml (n=10, and >0.5 ng/ml (n=48 had infection rates of 20%, 30%, and 66.7%, respectively, with a significant difference between the patients with a PCT level of >0.5 ng/ml and those with PCT levels of <0.25 ng/ml and 0.25-0.5 ng/ml (χ2=5631,4650,P=0018,0031. Among the liver failure patients, the infection cases had significantly higher PCT, WBC, and hsCRP than the non-infection cases (PCT: 3.72±1.33 ng/ml vs 0.34±0.12 ng/ml, t=-2.547, P=0.015; hsCRP: 16.70±7.03 mg

  8. Gene Expression Profile in the Liver of BALB/c Mice Infected with Fasciola hepatica.

    Science.gov (United States)

    Rojas-Caraballo, Jose; López-Abán, Julio; Fernández-Soto, Pedro; Vicente, Belén; Collía, Francisco; Muro, Antonio

    2015-01-01

    Fasciola hepatica infection still remains one of the helminthic neglected tropical diseases (NTDs). It has a huge worldwide distribution, affecting mainly cattle and, sometimes, human beings. In addition to data reported about the immunological response induced by helminthic infections and that induced by Fasciola hepatica, little is known about the gene expression profile in its organ target, the liver, which is where adult worms are established and live for long periods of time, causing its characteristic pathology. In the present work, we study both the early and late gene expression profiles in the livers of mice infected with F. hepatica metacercariae using a microarray-based methodology. A total of 9 female-6-week-old BALB/c mice (Charles River Laboratories, Barcelona, Spain) weighing 20 to 35 g were used for the experiments. Two groups of BALB/c mice were orally infected with seven F. hepatica metacercariae, and the other group remained untreated and served as a control. Mice were humanely euthanized and necropsied for liver recovery, histological assessment of hepatic damage, RNA isolation, microarray design and gene expression analysis on the day of infection (t0), seven days post-infection (t7) and twenty-one days post-infection (t21). We found that F. hepatica infection induces the differential expression of 128 genes in the liver in the early stage of infection and 308 genes in the late stage, and most of them are up-regulated. The Ingenuity Pathway Analysis revealed significant changes in the pathways related to metabolism, biosynthesis and signaling as well as genes implicated in inducing liver-toxicity, injury and death. The present study provides us insights at the molecular level about the underlying mechanisms used by F. hepatica, leading to liver damage and its subsequent pathophysiology. The expression pattern obtained here could also be used to explain the lack of association between infection with F. hepatica and cholangiocarcinoma. However

  9. Antibiotic therapy for preventing infections in people with acute stroke

    NARCIS (Netherlands)

    Vermeij, Jan-Dirk; Westendorp, Willeke F.; Dippel, Diederik Wj; van de Beek, Diederik; Nederkoorn, Paul J.

    2018-01-01

    Stroke is the main cause of disability in high-income countries and ranks second as a cause of death worldwide. Infections occur frequently after stroke and may adversely affect outcome. Preventive antibiotic therapy in the acute phase of stroke may reduce the incidence of infections and improve

  10. Antibiotic therapy for preventing infections in patients with acute stroke

    NARCIS (Netherlands)

    Westendorp, Willeke F.; Vermeij, Jan-Dirk; Vermeij, Frederique; den Hertog, Heleen M.; Dippel, Diederik W. J.; van de Beek, Diederik; Nederkoorn, Paul J.

    2012-01-01

    Background Stroke is the main cause of disability in high income countries and ranks second as a cause of death worldwide. Infections occur frequently after stroke and may adversely affect outcome. Preventive antibiotic therapy in the acute phase of stroke may reduce infections and improve outcome.

  11. Patients Receiving Prebiotics and Probiotics Before Liver Transplantation Develop Fewer Infections Than Controls: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Sawas, Tarek; Al Halabi, Shadi; Hernaez, Ruben; Carey, William D; Cho, Won Kyoo

    2015-09-01

    Among patients who have received liver transplants, infections increase morbidity and mortality and prolong hospital stays. Administration of antibiotics and surgical trauma create intestinal barrier dysfunction and microbial imbalances that allow enteric bacteria to translocate to the blood. Probiotics are believed to prevent bacterial translocation by stabilizing the intestinal barrier and stimulating proliferation of the intestinal epithelium, mucus secretion, and motility. We performed a meta-analysis to determine the effects of probiotics on infections in patients receiving liver transplants. We searched PubMed and EMBASE for controlled trials that evaluated the effects of prebiotics and probiotics on infections in patients who underwent liver transplantation. Heterogeneity was analyzed by the Cochran Q statistic. Pooled Mantel-Haenszel relative risks were calculated with a fixed-effects model. We identified 4 controlled studies, comprising 246 participants (123 received probiotics, 123 served as controls), for inclusion in the meta-analysis. In these studies, the intervention groups received enteric nutrition and fiber (prebiotics) with probiotics, and the control groups received only enteric nutrition and fiber without probiotics. The infection rate was 7% in groups that received probiotics vs 35% in control groups (relative risk [RR], 0.21; 95% confidence interval [CI], 0.11-0.41; P = .001). The number needed to treat to prevent 1 infection was 3.6. In subgroup analyses, only 2% of subjects in the probiotic groups developed urinary tract infections, compared with 16% of controls (RR, 0.14; 95% CI, 0.04-0.47; P probiotic groups developed intra-abdominal infections, compared with 11% of controls (RR, 0.27; 95% CI, 0.09-0.78; P = .02). Subjects receiving probiotics also had shorter stays in the hospital than controls (mean difference, 1.41 d; P probiotics and prebiotics before, or on the day of, liver transplantation reduces the rate of infection after

  12. Cranberry in prevention of urinary tract Infections in pregnancy

    OpenAIRE

    Miranda-Machado Pablo Andrés

    2011-01-01

    The urinary infection tract is the most common infectious complication in pregnancy.The aim was to conduct a literature review of the evidence on effectiveness, safetyand cost effectiveness of cranberry products in preventing urinary tract infection inpregnancy. Studies suggest a potential protective effect of cranberry products againsturinary tract infection in pregnancy and there is no documented evidence of danger orcontraindication in pregnancy or lactation. The cost effectiveness of cran...

  13. A retrospective 15-year review: survival advantage after switching to sirolimus in hepatitis C virus infected liver graft recipients.

    Science.gov (United States)

    Shah, M; Shankar, A; Gee, I; Nash, K; Hoare, M; Gibbs, P; Davies, S; Alexander, G J M

    2015-02-01

    The use of sirolimus-based immune suppression in liver transplantation, particularly in hepatitis C virus (HCV)-infected recipients, remains contentious. There is some evidence that sirolimus retards hepatic fibrosis, is renal sparing and may be of benefit in preventing hepatocellular carcinoma (HCC) recurrence. Sirolimus has not been adopted by many transplant centres because of persistent concerns regarding an increased risk of hepatic artery thrombosis, graft loss and death with de novo sirolimus. To review the impact of switching to sirolimus monotherapy in HCV-infected liver recipients with respect to survival, graft loss and hepatic fibrosis. A retrospective review of 190 patients from a single centre undergoing first liver transplantation for HCV over 15 years. 113 patients were switched from calcineurin inhibitor (CNI)-based therapy to low-dose sirolimus monotherapy at a median of 15 months after transplantation for HCV-related fibrosis (72%), renal impairment (14%) or high-risk HCC (5%). Patients switched to sirolimus had improved survival (P diabetes (P = 0.03). These data suggest selective switching to low-dose sirolimus monotherapy in HCV-positive liver recipients improves clinical outcome. © 2014 John Wiley & Sons Ltd.

  14. Comparison of rapid diagnostic tests to detect Mycobacterium avium subsp. paratuberculosis disseminated infection in bovine liver.

    Science.gov (United States)

    Zarei, Mehdi; Ghorbanpour, Masoud; Tajbakhsh, Samaneh; Mosavari, Nader

    2017-08-01

    Mycobacterium avium subsp. paratuberculosis (MAP) causes Johne's disease, a chronic enteritis in cattle and other domestic and wild ruminants. The presence of MAP in tissues other than intestines and associated lymph nodes, such as meat and liver, is a potential public health concern. In the present study, the relationship between the results of rapid diagnostic tests of the Johne's disease, such as serum ELISA, rectal scraping PCR, and acid-fast staining, and the presence of MAP in liver was evaluated. Blood, liver, and rectal scraping samples were collected from 200 slaughtered cattle with unknown Johne's disease status. ELISA was performed to determine the MAP antibody activity in the serum. Acid-fast staining was performed on rectal scraping samples, and PCR was performed on rectal scraping and liver samples. PCR-positive liver samples were used for mycobacterial culture. Overall, the results of this study demonstrated that MAP can be detected and cultured from liver of slaughtered cattle and rapid diagnostic tests of Johne's disease have limited value in detecting cattle with MAP infection in liver. These findings show that the presence of MAP in liver tissue may occur in cows with negative results for rapid diagnostic tests and vice versa. Hence, liver might represent another possible risk of human exposure to MAP. Given concerns about a potential zoonotic role for MAP, these results show the necessity to find new methods for detecting cattle with MAP disseminated infection.

  15. CT features of liver abscesses caused by the fasciola hepatica infection

    International Nuclear Information System (INIS)

    Fan Dong; Li Peng; Sun Hua; Wang Zhihua; She Bo

    2006-01-01

    Objective: To study CT features of liver abscesses caused by the fasciola hepatica infection, and discuss its pathologic basis. Methods: CT images of 15 Patients were collected. All patients underwent both unenhanced and biphasic enhanced CT scanning, then its CT performances were analyzed. Results: round and nodular lesions were observed in 15 cases, branching and stripping lesions like dilated bile duct in 9 cases. The density of lesions was inhomogeneous, and the lesions were multifocal and multiform. The liver abscesses caused by the fasciola hepatica infection had no 'rim sign' or 'target' sign, Liver abscesses were less than 3.0 cm in diameter, and the dilation of the bile duct were not observed. Conclusion: Liver abscessed caused by the fasciola hepatica infection have characteristic CT features. Combined with clinical examination and laboratory test, the reliability of diagnosis will be considerably increased. (authors)

  16. Immunological and pathophysiological studies on the infection of animals with liver specific trichocephalid Capillaris hepatica. Part a coordinated programme on isotopes and radiation in animal parasitology and immunology

    International Nuclear Information System (INIS)

    Zahner, H.

    1976-07-01

    The effect of X-ray radiation on the infection of animal liver with Capillaria hepatica was investigated. A dose of 70 Krd could not prevent an invasion of the liver with the parasite, and no differences in the number of lesions was found to occur between normal and irradiated parasite eggs. With regard to the fertility of the eggs, reproductivity was found to decrease after X-ray irradiation. Studies on cross- and histopathology were performed after infections with normal and irradiated (2 Krd and 5 Krd) eggs. Alterations of serum-enzyme activities were followed and the development of antibodies was demonstrated using an extract of non-embryonated C. hepatica eggs. Immunization experiments ascertained the immunizing capacity of a vaccine (as irradiated embryonated eggs) in comparison to normal infections and to intraperitoneal injections of nonembryonated eggs. The effect was determined with regard to the egg production of sublethal challenge infections and to the mortality after normally lethal challenge infections

  17. Achievement of interventions on HIV infection prevention among ...

    African Journals Online (AJOL)

    In China, migrants with acquired immunodeficiency syndrome (AIDS) have become a serious problem in the field of AIDS prevention. This study aimed to evaluate the efficacy of interventions for human immunodeficiency virus (HIV) infection prevention for migrants in China and to identify factors associated with intervention ...

  18. An analysis of content in comprehensive cancer control plans that address chronic hepatitis B and C virus infections as major risk factors for liver cancer.

    Science.gov (United States)

    Momin, Behnoosh; Richardson, Lisa

    2012-08-01

    Chronic hepatitis B and hepatitis C virus (HBV and HCV) infections are among the leading causes of preventable death worldwide. Chronic viral hepatitis is the cause of most primary liver cancer, which is the third leading cause of cancer deaths globally and the ninth leading cause of cancer deaths in the United States. The extent to which comprehensive cancer control (CCC) programs in states, tribal governments and organizations, territories, and Pacific Island jurisdictions address chronic hepatitis B and/or hepatitis C infections as risk factors for liver cancer or recommend interventions for liver cancer prevention in their CCC plans remains unknown. We searched CCC plans for this information using the search tool at http://www.cdc.gov/cancer/ncccp/ to access the content of plans for this information. A combination of key search terms including "liver cancer", "hepatitis", "chronic alcohol", and "alcohol abuse" were used to identify potential content regarding liver cancer risk factors and prevention. Relevant content was abstracted for further review and classification. Of 66 (Although CDC funds 65 programs, one of the Pacific Island Jurisdiction grantees is the Federated States of Micronesia (FSM). This national program supports four FSM states, each of which submits a cancer plan to CDC for a total of 69 plans. During this time period, 66 plans were available on the website.) CCC plans, 27% (n = 18) addressed liver cancer using the above-mentioned search terms. In the 23 plans that addressed HBV and/or HCV, there were 25 goals, objectives, strategies, and outcomes aimed at reducing the incidence or prevalence of HBV and/or HCV infection. While nearly a third of CCC programs identify at least one goal, objective, strategy, outcome, or prevention program to reduce cancer burden in their CCC plans, few plans discuss specific actions needed to reduce the burden of liver cancer.

  19. Changes in epidemiological patterns of HCV infection and their impact on liver disease over the last 20 years in Greece.

    Science.gov (United States)

    Savvas, S P; Koskinas, J; Sinani, C; Hadziyannis, A; Spanou, F; Hadziyannis, S J

    2005-09-01

    The aim of this study was to investigate the relative frequency of hepatitis C virus (HCV) genotypes in Greek patients with chronic infection as well as possible secular changes in their distribution in relation to modes of transmission, age and time at acquisition of the infection and other variables. We evaluated 434 unselected patients, 241 males and 193 females with a median age of 46.2 years (18-75), with chronic HCV infection presenting during the period 1996-2000. HCV infection was confirmed by the detection of HCV-RNA by polymerase chain reaction (PCR), while HCV genotyping was performed by the Inno-LiPA assay. Liver biopsies were evaluated according to Ishak's scoring system. Of 434 patients, 167 had a history of blood transfusion [post-transfusion hepatitis (PTH)], 80 were i.v. drug users and in 187 the route of infection remained unknown. The overall distribution of HCV genotypes 1, 2, 3 and 4 was 47, 8.3, 27 and 15.2%, respectively. Genotype 3 was common in younger adults and i.v. drug users, whereas genotype 1 predominated in older people and PTH patients (P duration of infection (P = 0.013). Our study revealed a change of HCV genotype distribution in the last 20 years among Greek patients with chronic HCV infection as a result of epidemiological changes in HCV transmission. The presence of cirrhosis was associated only with the duration of infection. These observations have impact both on prevention and treatment.

  20. Monitoring of nosocomial infections as an element of prevention

    Directory of Open Access Journals (Sweden)

    Izabela Gąska

    2017-10-01

    Full Text Available Introduction. Hospital infections are one of the most serious threats to the hospitalised patient and their monitoring is recognised as one of the most important criteria of care quality for modern hospitals. The aim of the work was to present the problem of nosocomial infections and desired behaviours and activities in the field of infection prophylaxis. Material and method. The analysis of the current scientific literature was carried out with particular attention to the prevention of infections in treatment wards and the need to monitor the patient's condition and the environment in the case of an infection. Results. The lack of developed and implemented programmes for the control of nosocomial infections is a fundamental element that increases the risk of nosocomial infections. This disrupts the proper functioning of the hospital and causes additional health problems for the patient and the ward staff. In addition, the hospital suffers losses instead of savings, which is a priority aim in the current funding system. Conclusions. The basis for eliminating or minimising the incidence of nosocomial infections is a well-developed and implemented programme of hospital infection control based on the education of medical personnel in the field of infection prevention. Constant, comprehensive assessment of the procedures used and the standards of conduct, epidemiological data as well as microbiological data can ensure quick identification and elimination of the threat.

  1. A Modern Approach to Preventing Prosthetic Joint Infections.

    Science.gov (United States)

    Papas, Paraskevi Vivian; Congiusta, Dominick; Scuderi, Giles R; Cushner, Fred D

    2018-02-28

    Total knee arthroplasty (TKA) is recognized as one of the most successful surgical procedures performed today. One of the most common and dreaded complications of TKA is postoperative infection. To prevent infections, it is critical to identify patients at high risk through analyzing their risk factors, and help in addressing them prior to surgery. The effort to prevent infection must be carried through every step of the surgical process, from preoperative counseling to intraoperative measures and postoperative protocols. Hair removal, the application of antiseptics, the utilization of antibiotics, barbed sutures, smart dressings, and antibacterial washes are some of the avenues surgeons may explore to help prevent infection. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  2. [Infection prevention and control in neonatal intensive care unit].

    Science.gov (United States)

    Lorenzini, Elisiane; Lorenzini, Elisiane; da Costa, Tatiane Costa; da Silva, Eveline Franco

    2013-12-01

    This study was aimed to identify the knowledge of the nursing team of a Neonatal Intensive Care Unit (NICU) on infection control, identijfying the factors that facilitate or hinder the prevention and control of Healthcare Associated Infections (HICAI). A descriptive study using a qualitative research method conducted with three nurses and 15 nurse technicians, who work in a NICU of a charitable organization, in southern Brazil. It became evident that the nursing staff had great knowledge about the factors that facilitate the prevention and control of HCAI in NICU, the most important factor being proper hand hygiene. Among the factors that hinder infection prevention and control are to overcrowding and excessive workload. The efficient performance of the nursing staff is an important part of the strategy for prevention and control of HCAI.

  3. HIV INFECTION AND AIDS: EPIDEMIOLOGY AND PREVENTION

    Directory of Open Access Journals (Sweden)

    Mustafa Alparslan BABAYIÐIT

    Full Text Available Human Immune-deficiency Virus (HIV was first discovered in 1981 in the United States of America and the day of December 1, was announced as ?World AIDS Day? by WHO (World Health Organization. In Turkey, the first announcement of the people living with HIV was made in 1985. HIV/AIDS has killed more than 20 millions people and more than 16,000 people become newly infected each day since the first cases were diagnosed in 1981. It is estimated that 39.4 million people would have been infected with HIV at the end of 2004, with 4.9 million new cases that year. Sub-Saharan Africa is the worst-hit region, with 70 percent of all people living with HIV. In Africa alone, 10,000 people become infected each day. This year?s main theme is ?Women, Girls, HIV and AIDS,? which reflects a focus on how the effects of HIV/AIDS have significantly increased among women. Women now make up half of all people living with HIV worldwide with the number of 17,6 million. [TAF Prev Med Bull 2004; 3(11.000: 280-290

  4. Group B Strep Infection: Prevention in Newborns

    Science.gov (United States)

    ... Prevención en los recién nacidos Preventing Early-Onset Group B Strep Disease The two most important ways ... occurs in babies younger than 1 week old) group B strep disease include: Testing all pregnant women ...

  5. Pathological Lesions and Inducible Nitric Oxide Synthase Expressions in the Liver of Mice Experimentally Infected with Clonorchis sinensis.

    Science.gov (United States)

    Yang, Qing-Li; Shen, Ji-Qing; Xue, Yan; Cheng, Xiao-Bing; Jiang, Zhi-Hua; Yang, Yi-Chao; Chen, Ying-Dan; Zhou, Xiao-Nong

    2015-12-01

    The nitric oxide (NO) formation and intrinsic nitrosation may be involved in the possible mechanisms of liver fluke-associated carcinogenesis. We still do not know much about the responses of inducible NO synthase (iNOS) induced by Clonorchis sinensis infection. This study was conducted to explore the pathological lesions and iNOS expressions in the liver of mice with different infection intensity levels of C. sinensis. Extensive periductal inflammatory cell infiltration, bile duct hyperplasia, and fibrosis were commonly observed during the infection. The different pathological responses in liver tissues strongly correlated with the infection intensity of C. sinensis. Massive acute spotty necrosis occurred in the liver parenchyma after a severe infection. The iNOS activity in liver tissues increased, and iNOS-expressing cells with morphological differences were observed after a moderate or severe infection. The iNOS-expressing cells in liver tissues had multiple origins.

  6. Atypical oral presentation of herpes simplex virus infection in a patient after orthotopic liver transplantation.

    Science.gov (United States)

    Burke, E M; Karp, D L; Wu, T C; Corio, R L

    1994-01-01

    An atypical oral presentation of herpes simplex virus infection in a 49-year-old woman after orthotopic liver transplantation is reported. Clinically, the differential diagnosis included chronic hyperplastic candidiasis, nodular leukoplakia of undetermined etiology, and malignant neoplasm. An excisional biopsy revealed herpesvirus infection, and immunoperoxidase staining confirmed herpes simplex virus infection. This report describes the clinical and histologic appearance of these lesions and the course and treatment of the patient.

  7. Liver damage caused by hepatitis C viral infection and ethyl alcohol consumption

    Directory of Open Access Journals (Sweden)

    Kostić Velimir

    2006-01-01

    Full Text Available Background/Aim. Hepatitis C virus infection (HCV is a complex disease, most commonly chronicle (80-85%. The aim of this research was to determinate the level of the liver damage in the patients cansed by HCV in conjunction with consuming ethyl alcohol. Methods. The research included 15 patients with chronic HCV infection supported by the misuse of ethyl alcohol, as well. The diagnosis of C infection hepatitis was proved using the ELISA test and PCR method. Results. The results of the study showed the liver damage by both HCV infection and ethyl alcohol, which was verified by the presence of biochemical changes and patohystological processing of the patients (liver biopsy and prosection. Patohystological changes were at the level of liver cirrhosis and carcinoma (2 patients. There was a signficant difference between the two subgroups (p < 0.001 regarding the examined values γ-GT, PLT and PTV. The basic therapeutic procedure was to introduce this category of patients into alcohol abstinence, and, in a few patients, to apply the antivirus therapy, as well. Conclusion. Based on the number of the examined patients (n = 15, we could conclude that a prolonged ethyl alcohol misuse with the presence of HCV infection was in a correlation with the liver disease progression.

  8. Staffing and structure of infection prevention and control programs.

    Science.gov (United States)

    Stone, Patricia W; Dick, Andrew; Pogorzelska, Monika; Horan, Teresa C; Furuya, E Yoko; Larson, Elaine

    2009-06-01

    The nature of infection prevention and control is changing; however, little is known about current staffing and structure of infection prevention and control programs. Our objectives were to provide a snapshot of the staffing and structure of hospital-based infection prevention and control programs in the United States. A Web-based survey was sent to 441 hospitals that participate in the National Healthcare Safety Network. The response rate was 66% (n = 289); data were examined on 821 professionals. Infection preventionist (IP) staffing was significantly negatively related to bed size, with higher staffing in smaller hospitals (P hospital epidemiologists were reported to have authority to close beds for outbreaks always or most of the time (n = 225, 78%). Only 32% (n = 92) reported using an electronic surveillance system to track infections. This study is the first to provide a comprehensive description of current infection prevention and control staffing, organization, and support in a select group of hospitals across the nation. Further research is needed to identify effective staffing levels for various hospital types as well as examine how the IP role is changing over time.

  9. Host AMPK Is a Modulator of Plasmodium Liver Infection

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    Margarida T. Grilo Ruivo

    2016-09-01

    Full Text Available Manipulation of the master regulator of energy homeostasis AMP-activated protein kinase (AMPK activity is a strategy used by many intracellular pathogens for successful replication. Infection by most pathogens leads to an activation of host AMPK activity due to the energetic demands placed on the infected cell. Here, we demonstrate that the opposite is observed in cells infected with rodent malaria parasites. Indeed, AMPK activity upon the infection of hepatic cells is suppressed and dispensable for successful infection. By contrast, an overactive AMPK is deleterious to intracellular growth and replication of different Plasmodium spp., including the human malaria parasite, P. falciparum. The negative impact of host AMPK activity on infection was further confirmed in mice under conditions that activate its function. Overall, this work establishes the role of host AMPK signaling as a suppressive pathway of Plasmodium hepatic infection and as a potential target for host-based antimalarial interventions.

  10. Preventing surgical site infection. Where now?

    LENUS (Irish Health Repository)

    Humphreys, H

    2009-12-01

    Surgical site infection (SSI) is increasingly recognised as a measure of the quality of patient care by surgeons, infection control practitioners, health planners and the public. There is increasing pressure to compare SSI rates between surgeons, institutions and countries. For this to be meaningful, data must be standardised and must include post-discharge surveillance (PDS) as many superficial SSIs do not present to the original institution. Further work is required to determine the best method of conducting PDS. In 2008 two important documents on SSI were published from the Society for Healthcare Epidemiology of America\\/The Infectious Disease Society of America and the National Institute for Health and Clincal Excellence, UK. Both emphasise key aspects during the preoperative, operative and postoperative phases of patient care. In addition to effective interventions known to be important for some time, e.g. not shaving the surgical site until the day of the procedure, there is increasing emphasis on physiological parameters, e.g. blood glucose concentrations, oxygen tensions and body temperature. Laparoscopic procedures are increasingly associated with reduced SSI rates, and the screening and decontamination of meticillin-resistant Staphylococcus aureus carriers is effective for certain surgical procedures but has to be balanced by cost and the risk of mupirocin resistance. Finally, there is a need to convert theory into practice by the rigorous application of SSI healthcare bundles. Recent studies suggest that, with a multidisciplinary approach, simple measures can be effective in reducing SSI rates.

  11. SIRT7 Represses Myc Activity to Suppress ER Stress and Prevent Fatty Liver Disease

    Directory of Open Access Journals (Sweden)

    Jiyung Shin

    2013-11-01

    Full Text Available Nonalcoholic fatty liver disease is the most common chronic liver disorder in developed countries. Its pathogenesis is poorly understood, and therapeutic options are limited. Here, we show that SIRT7, an NAD+-dependent H3K18Ac deacetylase, functions at chromatin to suppress ER stress and prevent the development of fatty liver disease. SIRT7 is induced upon ER stress and is stabilized at the promoters of ribosomal proteins through its interaction with the transcription factor Myc to silence gene expression and to relieve ER stress. SIRT7-deficient mice develop chronic hepatosteatosis resembling human fatty liver disease. Myc inactivation or pharmacological suppression of ER stress alleviates fatty liver caused by SIRT7 deficiency. Importantly, SIRT7 suppresses ER stress and reverts the fatty liver disease in diet-induced obese mice. Our study identifies SIRT7 as a cofactor of Myc for transcriptional repression and delineates a druggable regulatory branch of the ER stress response that prevents and reverts fatty liver disease.

  12. Infection Prevention and Control in Pediatric Ambulatory Settings.

    Science.gov (United States)

    Rathore, Mobeen H; Jackson, Mary Anne

    2017-11-01

    Since the American Academy of Pediatrics published its statement titled "Infection Prevention and Control in Pediatric Ambulatory Settings" in 2007, there have been significant changes that prompted this updated statement. Infection prevention and control is an integral part of pediatric practice in ambulatory medical settings as well as in hospitals. Infection prevention and control practices should begin at the time the ambulatory visit is scheduled. All health care personnel should be educated regarding the routes of transmission and techniques used to prevent the transmission of infectious agents. Policies for infection prevention and control should be written, readily available, updated every 2 years, and enforced. Many of the recommendations for infection control and prevention from the Centers for Disease Control and Prevention for hospitalized patients are also applicable in the ambulatory setting. These recommendations include requirements for pediatricians to take precautions to identify and protect employees likely to be exposed to blood or other potentially infectious materials while on the job. In addition to emphasizing the key principles of infection prevention and control in this policy, we update those that are relevant to the ambulatory care patient. These guidelines emphasize the role of hand hygiene and the implementation of diagnosis- and syndrome-specific isolation precautions, with the exemption of the use of gloves for routine diaper changes and wiping a well child's nose or tears for most patient encounters. Additional topics include respiratory hygiene and cough etiquette strategies for patients with a respiratory tract infection, including those relevant for special populations like patients with cystic fibrosis or those in short-term residential facilities; separation of infected, contagious children from uninfected children when feasible; safe handling and disposal of needles and other sharp medical devices; appropriate use of personal

  13. Involvement of Pro-Inflammatory Macrophages in Liver Pathology of Pirital Virus-Infected Syrian Hamsters

    Directory of Open Access Journals (Sweden)

    Corey L. Campbell

    2018-05-01

    Full Text Available New World arenaviruses cause fatal hemorrhagic disease in South America. Pirital virus (PIRV, a mammarenavirus hosted by Alston’s cotton rat (Sigmodon alstoni, causes a disease in Syrian golden hamsters (Mesocricetus auratus (biosafety level-3, BSL-3 that has many pathologic similarities to the South American hemorrhagic fevers (BSL-4 and, thus, is considered among the best small-animal models for human arenavirus disease. Here, we extend in greater detail previously described clinical and pathological findings in Syrian hamsters and provide evidence for a pro-inflammatory macrophage response during PIRV infection. The liver was the principal target organ of the disease, and signs of Kupffer cell involvement were identified in mortally infected hamster histopathology data. Differential expression analysis of liver mRNA revealed signatures of the pro-inflammatory response, hematologic dysregulation, interferon pathway and other host response pathways, including 17 key transcripts that were also reported in two non-human primate (NHP arenavirus liver-infection models, representing both Old and New World mammarenavirus infections. Although antigen presentation may differ among rodent and NHP species, key hemostatic and innate immune-response components showed expression parallels. Signatures of pro-inflammatory macrophage involvement in PIRV-infected livers included enrichment of Ifng, Nfkb2, Stat1, Irf1, Klf6, Il1b, Cxcl10, and Cxcl11 transcripts. Together, these data indicate that pro-inflammatory macrophage M1 responses likely contribute to the pathogenesis of acute PIRV infection.

  14. New horizon for infection prevention technology and implantable device

    Directory of Open Access Journals (Sweden)

    Yusuke Kondo, MD, PhD

    2016-08-01

    Full Text Available There has been a significant increase in the number of patients receiving cardiovascular implantable electronic devices (CIED over the last two decades. CIED infection represents a serious complication after CIED implantation and is associated with significant morbidity and mortality. Recently, newly advanced technologies have offered attractive and suitable therapeutic alternatives. Notably, the leadless pacemaker and anti-bacterial envelope decrease the potential risk of CIED infection and the resulting mortality, when it does occur. A completely subcutaneous implantable cardioverter defibrillator is also an alternative to the transvenous implantable cardioverter defibrillator (ICD, as it does not require implantation of any transvenous or epicardial leads. Among the patients who require ICD removal and subsequent antibiotics secondary to infection, the wearable cardioverter defibrillator represents an alternative approach to inpatient monitoring for the prevention of sudden cardiac death. In this review paper, we aimed to introduce the advanced technologies and devices for prevention of CIED infection.

  15. Anti-soluble liver antigen (SLA) antibodies in chronic HCV infection.

    Science.gov (United States)

    Vitozzi, Susana; Lapierre, Pascal; Djilali-Saiah, Idriss; Marceau, Gabriel; Beland, Kathie; Alvarez, Fernando

    2004-05-01

    Hepatitis C infection is associated with autoimmune disorders, such as the production of autoantibodies. Anti-LKM1 and anti-LC1, immunomarkers of type 2 autoimmune hepatitis, have been previously associated with a HCV infection. Anti-Soluble-Liver-Antigen autoantibodies (SLA) are specifically associated with type 1 and type 2 autoimmune hepatitis and more closely related to patients who relapse after steroid therapy. The recent molecular cloning of the soluble liver antigen provides the opportunity to develop more specific tests for the detection of antibodies against it. The aim of this work is to characterize anti-soluble-liver autoantibodies in sera from patients chronically infected by HCV. A recombinant cDNA from activated Jurkat cells coding for the full length tRNP(Ser)Sec/SLA antigen was obtained. ELISA, Western Blot and immunoprecipitation tests were developed and used to search for linear and conformational epitopes recognized by anti-SLA antibodies in sera from patients chronically infected by HCV. Anti-soluble liver antigen antibodies were found in sera from 10.4% of HCV-infected patients. The prevalence was significantly increased to 27% when anti-LKM1 was also present. Most anti-SLA reactivity was directed against conformational epitopes on the antigen. The means titers by ELISA were lower than those obtained in type 2 AIH. The result of autoantibody isotyping showed a subclass restriction to IgG1 and also IgG4. This study shows the presence of anti-SLA antibodies in approximately 10% of HCV infected patients. The prevalence of SLA autoantibodies in HCV infected patients increases when LKM1 autoantibodies are also present. The relationship between the prevalence of this characteristic autoimmune hepatitis autoantibody and the implication of an autoimmune phenomenon in the liver injury of patients chronically infected by HCV needs further investigation.

  16. Necrotizing Encephalitis Caused by Disseminated Aspergillus Infection after Orthotopic Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Luis E. Barrera-Herrera

    2015-01-01

    Full Text Available Liver transplantation is the only available treatment for some patients with end-stage liver disease. Despite reduction in mortality rates due to advances related to surgical techniques, intensive medical management and immunosuppressive therapy, invasive fungal infections remain a serious complication in orthotopic liver transplantation. We report the case of an 18-year-old male diagnosed with autoimmune cirrhosis in 2009 who was assessed and listed for liver transplantation for massive variceal hemorrhage. One year after listing a successful orthotopic liver transplantation was performed. Uneventful early recovery was achieved; however, he developed pulmonary and neurological Aspergillus infection 23 and 40 days after surgery, respectively. Antibiotic therapy with voriconazole and amphotericin was started early, with no major response. Neuroimaging revealed multiple right frontal and right parietal lesions with perilesional edema; surgical management of the brain abscesses was performed. A biopsy with periodic acid-Schiff and Gomori stains revealed areas with mycotic microorganisms morphologically consistent with Aspergillus, later confirmed by culture. The patient developed necrotizing encephalitis secondary to aspergillosis and died. Necrotizing encephalitis as a clinical presentation of Aspergillus infection in an orthotopic liver transplant is not common, and even with adequate management, early diagnosis and prompt antifungal treatment, mortality rates remain high.

  17. Development of quality metrics for ambulatory pediatric cardiology: Infection prevention.

    Science.gov (United States)

    Johnson, Jonathan N; Barrett, Cindy S; Franklin, Wayne H; Graham, Eric M; Halnon, Nancy J; Hattendorf, Brandy A; Krawczeski, Catherine D; McGovern, James J; O'Connor, Matthew J; Schultz, Amy H; Vinocur, Jeffrey M; Chowdhury, Devyani; Anderson, Jeffrey B

    2017-12-01

    In 2012, the American College of Cardiology's (ACC) Adult Congenital and Pediatric Cardiology Council established a program to develop quality metrics to guide ambulatory practices for pediatric cardiology. The council chose five areas on which to focus their efforts; chest pain, Kawasaki Disease, tetralogy of Fallot, transposition of the great arteries after arterial switch, and infection prevention. Here, we sought to describe the process, evaluation, and results of the Infection Prevention Committee's metric design process. The infection prevention metrics team consisted of 12 members from 11 institutions in North America. The group agreed to work on specific infection prevention topics including antibiotic prophylaxis for endocarditis, rheumatic fever, and asplenia/hyposplenism; influenza vaccination and respiratory syncytial virus prophylaxis (palivizumab); preoperative methods to reduce intraoperative infections; vaccinations after cardiopulmonary bypass; hand hygiene; and testing to identify splenic function in patients with heterotaxy. An extensive literature review was performed. When available, previously published guidelines were used fully in determining metrics. The committee chose eight metrics to submit to the ACC Quality Metric Expert Panel for review. Ultimately, metrics regarding hand hygiene and influenza vaccination recommendation for patients did not pass the RAND analysis. Both endocarditis prophylaxis metrics and the RSV/palivizumab metric passed the RAND analysis but fell out during the open comment period. Three metrics passed all analyses, including those for antibiotic prophylaxis in patients with heterotaxy/asplenia, for influenza vaccination compliance in healthcare personnel, and for adherence to recommended regimens of secondary prevention of rheumatic fever. The lack of convincing data to guide quality improvement initiatives in pediatric cardiology is widespread, particularly in infection prevention. Despite this, three metrics were

  18. [A case of liver abscess due to Streptococcus anginosus infection secondary to a dental extraction].

    Science.gov (United States)

    Iwashita, Hideyuki; Matsui, Noriaki; Tsukamoto, Shinji; Funakoshi, Sadahiro; Yamaguchi, Masashi; Kabemura, Teppei; Sohda, Tetsuro; Sakisaka, Shotaro

    2015-08-01

    A 74-year-old man was referred to our hospital because of a high fever. He had undergone a dental extraction about 1 month prior to admission because of apical periodontitis. Imaging study revealed liver abscess lesions. Infection with Streptococcus anginosus was confirmed using both stab and blood culture. An adequate selection of antibiotics was administered, and a good outcome was obtained. There have been no case reports of liver abscess caused by intraoral commensal flora related to dental extraction in healthy adults. This case shows that liver abscesses can occur secondary to dental extractions, even in healthy adults.

  19. Role of disinfection in the Infection Prevention Multibarrier System

    OpenAIRE

    Kramer, Axel

    2007-01-01

    The role of disinfection in infection prevention has been analyzed over the past 50 years both in the form of benefit-risk evaluations as well as in an epidemiological sense. This has served as the basis for not only national and international guidelines and recommendations, but has also created the legal and normative framework for regulation of infection control (and hence of disinfection) in numerous and acts and ordinances. Likewise, today the efficacy of disinfection measures, user safet...

  20. Antibiotic prophylaxis for surgical site infection in people undergoing liver transplantation.

    Science.gov (United States)

    Almeida, Ricardo A M B; Hasimoto, Claudia N; Kim, Anna; Hasimoto, Erica N; El Dib, Regina

    2015-12-05

    Surgical site infection is more frequent in liver transplantation than in other types of solid organ transplantation with different antibiotics. Studies have shown that the rate of surgical site infection varies from 8.8% to 37.5% after liver transplantation. Therefore, antimicrobial prophylaxis is likely an essential tool for reducing these infections. However, the literature lacks evidence indicating the best prophylactic antibiotic regimen that can be used for liver transplantation. To assess the benefits and harms of antibiotic prophylactic regimens for surgical site infection in people undergoing liver transplantation. We searched the Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Science Citation Index Expanded and Latin American Caribbean Health Sciences Literature (LILACS). The most recent search was performed on 11 September 2015. All eligible randomised clinical trials comparing any antibiotic regimen versus placebo, versus no intervention or versus another antibiotic regimen for surgical site infection in liver transplant recipients, regardless of age, sex and reason for transplantation. Quasi-randomised studies and other observational studies were considered for data on harm if retrieved with search results for randomised clinical trials. Two review authors selected relevant trials, assessed risk of bias of studies and extracted data. The electronic search identified 786 publications after removal of duplicates. From this search, only one seemingly randomised clinical trial, published in abstract form, fulfilled the inclusion criteria of this review. This trial was conducted at Shiraz Transplant Centre, Shiraz, Iran, where investigators randomly assigned a total of 180 consecutive liver transplant recipients. We judged the overall risk of bias of the trial published in abstract form as high. Researchers reported no numerical data but mentioned that 163 participants

  1. PRE-EXPOSURE PROPHYLAXIS FOR PREVENTION OF HIV INFECTION

    Directory of Open Access Journals (Sweden)

    Ana Rita Diniz

    2015-04-01

    Full Text Available Objectives: To review existing data on Pre-Exposure Prophylaxis (PrEP for prevention of HIV infection, including the role of medical male circumcision, oral administration of antiretroviral drugs and topical microbicides. Data Sources: PubMed and www.clinicaltrials.gov. Review Methods: Comprehensive review. Results: Medical male circumcision has been shown to prevent 48-60% of new HIV-1 infections. The efficacy rate of antiretroviral drugs given per os to prevent HIV infection varies in direct association with the adherence rate (62.2% in TDF2 study with 84% adherence; 44% in iPrEx study with <50% adherence; 48% in Bangkok study with 67% adherence; 67-75% in Partners PrEP study with 82% adherence; and 6% in FEM-PrEP study with 40% adherence. As for the use of topic microbicides, the CAPRISA 004 study showed 39% reduction in HIV infection using a 1% tenofovir gel. On the other hand, PRO2000 gel showed a modest reduction of 30% which was not statistically significant. Conclusions: The studies suggest that medical male circumcision is highly cost-effective at preventing HIV infection but requires careful communication strategies to be successful. PrEP using antiretroviral drugs is also very effective but it is highly dependent on the adherence rate. As for topical microbicides, 1% tenofovir gel is currently the only promising option.

  2. Infection Control and Prevention: A Review of Hospital-Acquired Infections and the Economic Implications

    OpenAIRE

    Reed, Deoine; Kemmerly, Sandra A.

    2009-01-01

    The Centers for Disease Control and Prevention estimates that 2 million patients suffer from hospital-acquired infections every year and nearly 100,000 of them die. Most of these medical errors are preventable. Hospital-acquired infections result in up to $4.5 billion in additional healthcare expenses annually. The U.S. government has responded to this financial loss by focusing on healthcare quality report cards and by taking strong action to curb healthcare spending. The Medicare Program ha...

  3. Follicular helper T cells promote liver pathology in mice during Schistosoma japonicum infection.

    Directory of Open Access Journals (Sweden)

    Xiaojun Chen

    2014-05-01

    Full Text Available Following Schistosoma japonicum (S. japonicum infection, granulomatous responses are induced by parasite eggs trapped in host organs, particular in the liver, during the acute stage of disease. While excessive liver granulomatous responses can lead to more severe fibrosis and circulatory impairment in chronically infected host. However, the exact mechanism of hepatic granuloma formation has remained obscure. In this study, we for the first time showed that follicular helper T (Tfh cells are recruited to the liver to upregulate hepatic granuloma formation and liver injury in S. japonicum-infected mice, and identified a novel function of macrophages in Tfh cell induction. In addition, our results showed that the generation of Tfh cells driven by macrophages is dependent on cell-cell contact and the level of inducible costimulator ligand (ICOSL on macrophages which is regulated by CD40-CD40L signaling. Our findings uncovered a previously unappreciated role for Tfh cells in liver pathology caused by S. japonicum infection in mice.

  4. The impact of economic recession on infection prevention and control.

    Science.gov (United States)

    O'Riordan, M; Fitzpatrick, F

    2015-04-01

    The economic recession that began in 2007 led to austerity measures and public sector cutbacks in many European countries. Reduced resource allocation to infection prevention and control (IPC) programmes is impeding prevention and control of tuberculosis, HIV and vaccine-preventable infections. In addition, higher rates of infectious disease in the community have a significant impact on hospital services, although the extent of this has not been studied. With a focus on quick deficit reduction, preventive services such IPC may be regarded as non-essential. Where a prevention programme succeeds in reducing disease burden to a low level, its very success can undermine the perceived need for the programme. To mitigate the negative effects of recession, we need to: educate our political leaders about the economic benefits of IPC; better quantify the costs of healthcare-associated infection; and evaluate the effects of budget cuts on healthcare outcomes and IPC activities. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  5. Prevalence of hepatitis E virus infection in liver transplant recipients

    NARCIS (Netherlands)

    Haagsma, Elizabeth B; Niesters, Hubert G M; van den Berg, Arie P; Riezebos-Brilman, Annelies; Porte, Robert J; Vennema, Harry; Reimerink, Johan H J; Koopmans, Marion P G

    2009-01-01

    Hepatitis E virus (HEV) infection is known to run a self-limited course. Recently, chronic hepatitis E has been described in several immunosuppressed patients after solid organ transplantation. The prevalence of HEV infection after transplantation, however, is unknown. We studied HEV parameters [HEV

  6. Lassa virus infection in experimentally infected marmosets: liver pathology and immunophenotypic alterations in target tissues.

    Science.gov (United States)

    Carrion, Ricardo; Brasky, Kathleen; Mansfield, Keith; Johnson, Curtis; Gonzales, Monica; Ticer, Anysha; Lukashevich, Igor; Tardif, Suzette; Patterson, Jean

    2007-06-01

    Lassa virus causes thousands of deaths annually in western Africa and is considered a potential biological weapon. In an attempt to develop a small nonhuman primate model of Lassa fever, common marmosets were subcutaneously inoculated with Lassa virus strain Josiah. This inoculation resulted in a systemic disease with clinical and morphological features mirroring those in fatal human Lassa infection: fever, weight loss, high viremia and viral RNA load in tissues, elevated liver enzymes, and severe morbidity between days 15 and 20. The most prominent histopathology findings included multifocal hepatic necrosis with mild inflammation and hepatocyte proliferation, lymphoid depletion, and interstitial nephritis. Cellular aggregates in regions of hepatocellular necrosis were largely composed of HAM56-positive macrophages, devoid of CD3-positive and CD20-positive cells, and characterized by marked reductions in the intensity of HLA-DP, DQ, DR staining. A marked reduction in the major histocompatibility complex class II expression was also observed in the lymph nodes. Immunophenotypic alterations in spleen included reductions in overall numbers of CD20-positive and CD3-positive cells and the disruption of lymphoid follicular architecture. These findings identify the common marmoset as an appropriate model of human Lassa fever and present the first experimental evidence that replication of Lassa virus in tissues is associated with alterations that would be expected to impair adaptive immunity.

  7. Prevention of Clostridium difficile infection in rural hospitals.

    Science.gov (United States)

    Haun, Nicholas; Hofer, Adam; Greene, M Todd; Borlaug, Gwen; Pritchett, Jenny; Scallon, Tina; Safdar, Nasia

    2014-03-01

    Prevention of Clostridium difficile infection (CDI) remains challenging across the spectrum of health care. There are limited data on prevention practices for CDI in the rural health care setting. An electronic survey was administered to 21 rural facilities in Wisconsin, part of the Rural Wisconsin Health Cooperative. Data were collected on hospital characteristics and practices to prevent endemic CDI. Fifteen facilities responded (71%). Nearly all respondent facilities reported regular use of dedicated patient care items, use of gown and gloves, private patient rooms, hand hygiene, and room cleaning. Facilities in which the infection preventionist thought the support of his/her leadership to be "Very good" or "Excellent" employed significantly more CDI practices (13.3 ± 2.4 [standard deviation]) compared with infection preventionists who thought there was less support from leadership (9.8 ± 3.0, P = .033). Surveillance for CDI was highly variable. The most frequent barriers to implementation of CDI prevention practices included lack of adequate resources, lack of a physician champion, and difficulty keeping up with new recommendations. Although most rural facilities in our survey reported using evidence-based practices for prevention of CDI, surveillance practices were highly variable, and data regarding the impact of these practices on CDI rates were limited. Future efforts that correlate CDI prevention initiatives and CDI incidence will help develop evidence-based practices in these resource-limited settings. Published by Mosby, Inc.

  8. Anti-CD25 mAb administration prevents spontaneous liver transplant tolerance.

    Science.gov (United States)

    Li, W; Carper, K; Liang, Y; Zheng, X X; Kuhr, C S; Reyes, J D; Perkins, D L; Thomson, A W; Perkins, J D

    2006-12-01

    Liver allografts are accepted spontaneously in all mouse strain combinations without immunosuppressive therapy. The mechanisms underlying this phenomenon remain largely undefined. In this study, we examined the effect of CD4+ CD25+ T regulatory cells (Treg) on the induction of mouse liver transplant tolerance. Orthotopic liver transplantation was performed from B10 (H2b) to C3H (H2k) mice. Depleting rat anti-mouse CD25 mAb (PC61) was given to the donors or recipients (250 microg/d IP) pretransplant or to the recipients postoperatively. At day 5 posttransplantation, both effector T cells (mainly CD8) and CD4+ CD25+ Treg were increased in the liver allografts and host spleens compared to naïve mice. Anti-CD25 mAb administration, either pretransplantation or posttransplantation, reduced the ratio of CD4+ CD25+ Treg to the CD3 T cells of liver grafts and recipient spleens and induced liver allograft acute rejection compared to IgG treatment. Anti-CD25 mAb administration elevated anti-donor T-cell proliferative responses and CTL and NK activities of graft infiltrates and host splenocytes; reduced CTLA4, Foxp3, and IDO mRNA levels; increased IL-10 and IFN-gamma; and decreased IL-4 mRNA levels in the livers or host spleens. The number of apoptotic T cells was reduced significantly in the liver grafts and treated host spleens. Therefore, anti-CD25 mAb administration changed the balance of CD4+ CD25+ Treg to activated T cells of liver graft recipients, preventing liver transplant tolerance. This was associated with enhanced anti-donor immune reactivity, downregulated Treg gene expression, and reduced T cell apoptosis in the grafts and host spleens.

  9. Initial prevalence of anal human papilloma virus infection in liver transplant recipients.

    Science.gov (United States)

    Grąt, Michał; Grąt, Karolina; Hołówko, Wacław; Malejczyk, Magdalena; Walter de Walthoffen, Szymon; Lewandowski, Zbigniew; Kobryń, Konrad; Patkowski, Waldemar; Majewski, Sławomir; Młynarczyk, Grażyna; Krawczyk, Marek

    2014-08-01

    Although liver transplant recipients are at increased risk of human papilloma virus (HPV)-related anal cancer, limited data are available regarding the initial prevalence of anal HPV infection in this population. Anal swabs collected from 50 liver transplant recipients within the first three postoperative weeks were subjected to real-time polymerase chain reaction for detection of the four HPV genotypes: 6, 11, 16, and 18. Predictors of any, low-risk, and high-risk anal HPV infection were evaluated. Overall, the prevalence of any anal HPV infection was 18.0%, with the corresponding rates for high- and low-risk HPV genotypes being 8.0% and 10.0%, respectively. Infection with any type of anal HPV was higher in patients with hepatitis B virus (HBV) infection (P = 0.027), ≥3 sexual partners (P = 0.031), and alcoholic liver disease (P = 0.063). HBV infection was the only factor significantly associated with high-risk HPV infection (P = 0.038). Male sex (P = 0.050), age ≥52 years (P = 0.016), ≥30 sexual partners (P = 0.003), age at first intercourse ≤18 years (P = 0.045), and time since first intercourse ≥38 years (P = 0.012) were identified as predictors of low-risk HPV infection. These results indicate that HPV vaccination of liver transplant candidates and screening for anal HPV infection in high-risk groups should be considered. © 2014 Steunstichting ESOT.

  10. Prevention of nosocomial infection in the ICU setting.

    Science.gov (United States)

    Corona, A; Raimondi, F

    2004-05-01

    The aim of this review is to focus the epidemiology and preventing measures of nosocomial infections that affect the critically ill patients. Most of them (over 80%) are related to the device utilization needed for patient life support but responsible for such complications as ventilator-associated pneumonia (VAP), catheter-related bloodstream infections (CRBSI), surgical site infections (SSI) and urinary tract infections (UTI). General recommendations include staff education and use of a surveillance program with a restrictive antibiotic policy. Adequate time must be allowed for hand washing and barrier precautions must always be used during device manipulation. The routine changing of central catheters is not necessary and increases costs; it is necessary to decrease the handling of administration sets, to use a more careful insertion technique and less frequent set replacement. Specific measures for VAP prevention are: 1). use of multi-use, closed-system suction catheters; 2). no routine change of the breathing circuit; 3). lubrication of the the endotracheal tube cuff with a water-soluble gel; 4). maintenance of patient in semi-recumbent position to improve chest physiotherapy. Specific measures for UTI prevention include: 1). use of a catheter-valve instead of a standard drainage system; 2). use of a silver-alloy, hydro gel-coated latex urinary catheter instead of uncoated catheters. By implementing effective preventive measures and maintaining strict surveillance of ICU infections, we hope to affect the associated morbidity, mortality, and cost that our patients and society bare. More clinical trials are needed to verify the efficacy of prevention measures of ICU infections.

  11. Pharmacological manipulation of the chronic granulomatous reactions in the livers of mice infected with schistosomiasis.

    Science.gov (United States)

    Rainsford, K D

    1985-01-01

    The severe granulomatous reactions in the liver which occur following infestation by adult Schistosoma mansonii are largely initiated by invading eosinophils and monocytes. The present studies were designed to investigate the possibility that (a) anti-inflammatory drugs could be employed beneficially to attenuate the liver granulomatous reactions in schistosomiasis, and (b) that part of the therapeutic effects of anti-schistosomal (AS) drugs might be due to possible influences on arachidonate metabolism. Therefore the effects were determined of (a) AS as compared with NSAI drugs on eicosanoid metabolism in isolated human peripheral leucocyte populations, and (b) electron-microscopic changes in the livers of mice infected with Schistosoma mansoni in response to AS and/or NSAI drugs. Of the AS drugs only praziquantel (10-100 microM) inhibited 5-HETE production by the 5-lipoxygenase pathway. No effects were observed of this or the other AS drugs on prostaglandin production. In S. mansoni infected mice, praziquantel (250 mg/kg/d), given orally with indomethacin (5 mg/kg/d) for 5 days did not improve the inflammatory reactions around worms or eggs of schistosomes. Furthermore, both indomethacin (5 mg/kg/d) alone and benoxaprofen (20 mg/kg/d for 5 days) elicited liver changes suggestive of specific liver damage by these drugs. These results suggest that liver pathology may be enhanced by NSAI drugs perhaps as a consequence of the liver metabolism of these drugs being compromised. Their use to modify inflammatory reactions at the peak of liver schistosome infections may thus be contraindicated.

  12. Evaluation of TNF-α, IL-4, and IL-10 and parasite density in spleen and liver of L. (L.) chagasi naturally infected dogs.

    Science.gov (United States)

    DE F Michelin, A; Perri, S H V; De Lima, V M F

    2011-07-01

    Dogs are the main domestic reservoirs of L. (L.) chagasi. Once in the vertebrate host, the parasite can cause visceral leishmaniasis, which can also be transmitted to humans. Cytokines are key elements of the host immune response against Leishmania spp. To investigate whether tumor necrosis factor (TNF)-α, interleukin (IL)-4 and IL-10 are associated with pattern infection in dogs, these cytokines were quantified in the spleen and liver of dogs naturally infected with L. (L.) chagasi, with or without clinical manifestations, and their levels were correlated with the parasite load verified in these organs. A total of 40 adult dogs naturally infected with L. (L.) chagasi were assessed, together with 12 uninfected control dogs. Samples from spleen and liver were used to determine the cytokine levels by capture ELISA and for quantifying parasite load by real-time PCR. Statistical analysis was performed using the minimum Chi square method and group means were compared using the Tukey test. TNF-α, IL-4 and IL-10 levels in infected dogs were higher than in control groups; the liver was the main cytokine-producing organ during infection. The level of splenic TNF-α showed correlation with parasite load and may represent an important marker for infection process evolution, with the participation of IL-10. These results may contribute to a clearer understanding of the immune response in dogs infected with L. (L.) chagasi, which may lead to the development of prophylactic or preventive measures for these animals.

  13. Prevention of nosocomial infections in developing countries, a systematic review.

    Science.gov (United States)

    Murni, Indah; Duke, Trevor; Triasih, Rina; Kinney, Sharon; Daley, Andrew J; Soenarto, Yati

    2013-05-01

    Prevention of nosocomial infection is key to providing good quality, safe healthcare. Infection control programmes (hand-hygiene campaigns and antibiotic stewardship) are effective in reducing nosocomial infections in developed countries. However, the effectiveness of these programmes in developing countries is uncertain. To evaluate the effectiveness of interventions for preventing nosocomial infections in developing countries. A systematic search for studies which evaluated interventions to prevent nosocomial infection in both adults and children in developing countries was undertaken using PubMed. Only intervention trials with a randomized controlled, quasi-experimental or sequential design were included. Where there was adequate homogeneity, a meta-analysis of specific interventions was performed using the Mantel-Haenzel fixed effects method to estimate the pooled risk difference. Thirty-four studies were found. Most studies were from South America and Asia. Most were before-and-after intervention studies from tertiary urban hospitals. Hand-hygiene campaigns that were a major component of multifaceted interventions (18 studies) showed the strongest effectiveness for reducing nosocomial infection rates (median effect 49%, effect range 12.7-100%). Hand-hygiene campaigns alone and studies of antibiotic stewardship to improve rational antibiotic use reduced nosocomial infection rates in three studies [risk difference (RD) of -0.09 (95%CI -0.12 to -0.07) and RD of -0.02 (95% CI -0.02 to -0.01), respectively]. Multifaceted interventions including hand-hygiene campaigns, antibiotic stewardship and other elementary infection control practices are effective in developing countries. The modest effect size of hand-hygiene campaigns alone and negligible effect size of antibiotic stewardship reflect the limited number of studies with sufficient homogeneity to conduct meta-analyses.

  14. Quercetin prevents pyrrolizidine alkaloid clivorine-induced liver injury in mice by elevating body defense capacity.

    Directory of Open Access Journals (Sweden)

    Lili Ji

    Full Text Available Quercetin is a plant-derived flavonoid that is widely distributed in nature. The present study is designed to analyze the underlying mechanism in the protection of quercetin against pyrrolizidine alkaloid clivorine-induced acute liver injury in vivo. Serum transaminases, total bilirubin analysis, and liver histological evaluation demonstrated the protection of quercetin against clivorine-induced liver injury. Terminal dUTP nick end-labeling assay demonstrated that quercetin reduced the increased amount of liver apoptotic cells induced by clivorine. Western-blot analysis of caspase-3 showed that quercetin inhibited the cleaved activation of caspase-3 induced by clivorine. Results also showed that quercetin reduced the increase in liver glutathione and lipid peroxidative product malondialdehyde induced by clivorine. Quercetin reduced the enhanced liver immunohistochemical staining for 4-hydroxynonenal induced by clivorine. Results of the Mouse Stress and Toxicity PathwayFinder RT2 Profiler PCR Array demonstrated that the expression of genes related with oxidative or metabolic stress and heat shock was obviously altered after quercetin treatment. Some of the alterations were confirmed by real-time PCR. Our results demonstrated that quercetin prevents clivorine-induced acute liver injury in vivo by inhibiting apoptotic cell death and ameliorating oxidative stress injury. This protection may be caused by the elevation of the body defense capacity induced by quercetin.

  15. Quercetin Prevents Pyrrolizidine Alkaloid Clivorine-Induced Liver Injury in Mice by Elevating Body Defense Capacity

    Science.gov (United States)

    Ji, Lili; Ma, Yibo; Wang, Zaiyong; Cai, Zhunxiu; Pang, Chun; Wang, Zhengtao

    2014-01-01

    Quercetin is a plant-derived flavonoid that is widely distributed in nature. The present study is designed to analyze the underlying mechanism in the protection of quercetin against pyrrolizidine alkaloid clivorine-induced acute liver injury in vivo. Serum transaminases, total bilirubin analysis, and liver histological evaluation demonstrated the protection of quercetin against clivorine-induced liver injury. Terminal dUTP nick end-labeling assay demonstrated that quercetin reduced the increased amount of liver apoptotic cells induced by clivorine. Western-blot analysis of caspase-3 showed that quercetin inhibited the cleaved activation of caspase-3 induced by clivorine. Results also showed that quercetin reduced the increase in liver glutathione and lipid peroxidative product malondialdehyde induced by clivorine. Quercetin reduced the enhanced liver immunohistochemical staining for 4-hydroxynonenal induced by clivorine. Results of the Mouse Stress and Toxicity PathwayFinder RT2 Profiler PCR Array demonstrated that the expression of genes related with oxidative or metabolic stress and heat shock was obviously altered after quercetin treatment. Some of the alterations were confirmed by real-time PCR. Our results demonstrated that quercetin prevents clivorine-induced acute liver injury in vivo by inhibiting apoptotic cell death and ameliorating oxidative stress injury. This protection may be caused by the elevation of the body defense capacity induced by quercetin. PMID:24905073

  16. Interaction of vinyl chloride monomer exposure and hepatitis B viral infection on liver cancer.

    Science.gov (United States)

    Wong, Ruey-Hong; Chen, Pau-Chung; Wang, Jung-Der; Du, Chung-Li; Cheng, Tsun-Jen

    2003-04-01

    Vinyl-chloride monomer (VCM), a human carcinogen, has caused angiosarcoma of the liver. Recent studies have shown that VCM exposure is associated with hepatocellular cancer. In Taiwanese studies, the majority of VCM-exposed workers with liver cancer had history of hepatitis B virus (HBV) infection. To determine the role of HBV on the development of liver cancer in the VCM-exposed workers, we conducted a case-control study from a previously established polyvinyl chloride (PVC) cohort consisting of 4096 male workers from six PVC polymerization plants. A total of 18 patients with liver cancer, and 68 control subjects matched for age and specific plant of employment were selected. Detailed history of the participants that included alcohol consumption status, cigarette use, occupation, and family history of chronic liver disease were obtained using an interviewer-administered questionnaire. When the HBV surface antigen (HBsAg)-negative subjects without history of tank-cleaning were used as the reference, the HBsAg-negative subjects with history of tank-cleaning demonstrated a 4.0-fold greater risk of liver cancer (95% confidence interval: 95% CI = 0.2-69.1). The HBsAg carriers without history of tank-cleaning revealed a 25.7-fold greater risk of liver cancer (95% CI = 2.9-229.4). Whereas the HBsAg carriers with history of tank-cleaning revealed the greatest risk (matched odds ratio (ORm) 396.0, 95% CI = 22.6 -infinity) of developing liver cancer among subjects with different VCM-exposure status and HBsAg status categories. Further analysis showed the interaction term was significant (P < .01). Therefore, our results suggest an interaction between occupational VCM exposure and HBV infection for the development of liver cancer.

  17. Epidemiology, surveillance, and prevention of bloodstream infections in hemodialysis patients.

    Science.gov (United States)

    Patel, Priti R; Kallen, Alexander J; Arduino, Matthew J

    2010-09-01

    Infections cause significant morbidity and mortality in patients undergoing hemodialysis. Bloodstream infections (BSIs) are particularly problematic, accounting for a substantial number of hospitalizations in these patients. Hospitalizations for BSI and other vascular access infections appear to have increased dramatically in hemodialysis patients since 1993. These infections frequently are related to central venous catheter (CVC) use for dialysis access. Regional initiatives that have shown successful decreases in catheter-related BSIs in hospitalized patients have generated interest in replicating this success in outpatient hemodialysis populations. Several interventions have been effective in preventing BSIs in the hemodialysis setting. Avoiding the use of CVCs in favor of access types with lower associated BSI risk is among the most important. When CVCs are used, adherence to evidence-based catheter insertion and maintenance practices can positively influence BSI rates. In addition, facility-level surveillance to detect BSIs and stimulate examination of vascular access use and care practices is essential to a comprehensive approach to prevention. This article describes the current epidemiology of BSIs in hemodialysis patients and effective prevention strategies to decrease the incidence of these devastating infections.

  18. Nurses infection prevention practices in handling injections: A case ...

    African Journals Online (AJOL)

    The adherence to basic infection prevention procedures/aseptic techniques in handling of injections by health workers is still a concern. The adherence to aseptic techniques in handling injections is significantly associated with the nurses to patients ratios. Therefore, it is imperative to improve nurse to patient ratio in public ...

  19. Compliance With Infection Prevention Guidelines By Health Care ...

    African Journals Online (AJOL)

    revealed varied levels of compliance on different components of infection prevention. The highest level of compliance (100%) was with single use of needles and syringes while the lowest (35.1) was with decontamination of needles and syringes with 0.5% chlorine solution prior to disposal. Compliance with hand hygiene ...

  20. Interventions for preventing recurrent urinary tract infection during pregnancy

    NARCIS (Netherlands)

    Schneeberger, Caroline; Geerlings, Suzanne E.; Middleton, Philippa; Crowther, Caroline A.

    2015-01-01

    Recurrent urinary tract infections (RUTI) are common in women who are pregnant and may cause serious adverse pregnancy outcomes for both mother and child including preterm birth and small-for-gestational-age babies. Interventions used to prevent RUTI in women who are pregnant can be pharmacological

  1. Interventions for preventing recurrent urinary tract infection during pregnancy

    NARCIS (Netherlands)

    Schneeberger, Caroline; Geerlings, Suzanne E.; Middleton, Philippa; Crowther, Caroline A.

    2015-01-01

    Background Recurrent urinary tract infections (RUTI) are common in women who are pregnant and may cause serious adverse pregnancy outcomes for both mother and child including preterm birth and small-for-gestational-age babies. Interventions used to prevent RUTI in women who are pregnant can be

  2. Interventions for preventing recurrent urinary tract infection during pregnancy

    NARCIS (Netherlands)

    Schneeberger, Caroline; Geerlings, Suzanne E.; Middleton, Philippa; Crowther, Caroline A.

    2012-01-01

    Background Recurrent urinary tract infections (RUTI) are common in women who are pregnant and may cause serious adverse pregnancy outcomes for both mother and child including preterm birth and small-for-gestational-age babies. Interventions used to prevent RUTI in women who are pregnant can be

  3. Prevention of common healthcare-associated infections in humanitarian hospitals.

    Science.gov (United States)

    Murphy, Richard A; Chua, Arlene C

    2016-08-01

    Humanitarian medical organizations focus on vulnerable patients with increased risk for healthcare-associated infections (HAIs) and are obligated to minimize them in inpatient departments (IPDs). However, in doing so humanitarian groups face considerable obstacles. This report will focus on approaches to reducing common HAIs that the authors have found to be helpful in humanitarian settings. HAIs are common in humanitarian contexts but there are few interventions or guidelines adapted for use in poor and conflict-affected settings to improve prevention and guide surveillance. Based on existing recommendations and studies, it appears prudent that all humanitarian IPDs introduce a basic infection prevention infrastructure, assure high adherence to hand hygiene with wide accessibility to alcohol-based hand rub, and develop pragmatic surveillance based on clinically evident nosocomial infection. Although microbiology remains out of reach for most humanitarian hospitals, rapid tests offer the possibility of improving the diagnosis of HAIs in humanitarian hospitals in the decade ahead. There is a dearth of new studies that can direct efforts to prevent HAIs in IPDs in poor and conflict-affected areas and there is a need for practical, field-adapted guidelines from professional societies, and international bodies to guide infection prevention efforts in humanitarian environments.

  4. State of Infection Prevention in US Hospitals Enrolled in NHSN

    Science.gov (United States)

    Pogorzelska-Maziarz, Monika; Herzig, Carolyn T. A.; Weiner, Lindsey M.; Furuya, E. Yoko; Dick, Andrew; Larson, Elaine

    2014-01-01

    Background This report provides a national cross-sectional snapshot of infection prevention and control programs and clinician compliance with the implementation of processes to prevent healthcare associated infections (HAI) in intensive care units (ICUs). Methods All hospitals, except for Veterans Affairs hospitals, enrolled in the National Healthcare Safety Network (NHSN) were eligible to participate. Participation included: 1) completion of a survey that assessed presence of evidence-based prevention policies and clinician adherence, and 2) joining our NHSN research group. Descriptive statistics were computed. Facility characteristics and HAI rates by ICU type were compared between respondents and non-respondents. Results Of the 3,374 eligible hospitals, 975 hospitals provided data (29% response rate) on 1,653 ICUs; and, there were complete data on the presence of policies in 1,534 ICUs. The average number of infection preventionists (IPs) per 100 beds was 1.2. Certification of IP staff varied across institutions and the average hours per week of data management and secretarial support were generally low. There was variation in the presence of policies and clinician adherence to these policies. There were no differences in HAI rates between respondents and non-respondents. Conclusions Guidelines around IP staffing in acute care hospitals should be updated. In future publications we will analyze the associations between HAI rates and infection prevention and control program characteristics, presence of and clinician adherence to evidence-based policies. PMID:24485365

  5. Urinary Tract Infections in Pregnancy - Diagnosis, Treatment and Prevention

    OpenAIRE

    Figueiredo, A; Gomes, G; Campos, A

    2012-01-01

    Objectives: Literature review of classification, epidemiology, pathophysiology, microbiology, clinical presentation, diagnosis, complications, treatment and prevention of urinary tract infections (UTI) in pregnancy. Data Sources and Review Methods: Bibliographic research in Medline, through PubMed and Medscape, of systematic reviews, observational studies, clinical guidelines, meta-analyses and randomized controlled trials published between January 1992 and December 2010. Results: Asymp...

  6. Prevention of perioperative wound infections | Buteera | East and ...

    African Journals Online (AJOL)

    Aiming at short preoperative stay in hospital, and pre-washing of the area concerned before cleaning with antiseptic are also imperative in reducing SSI. Preoperative skin preparation is an important element in prevention of infection, but removes only up to 80% of skin flora. Standard surgical antisepsis is an accepted ...

  7. JTP-103237, a monoacylglycerol acyltransferase inhibitor, prevents fatty liver and suppresses both triglyceride synthesis and de novo lipogenesis

    Directory of Open Access Journals (Sweden)

    Chihiro Okuma

    2015-07-01

    Conclusion: In the present study, JTP-103237 prevented carbohydrate-induced fatty liver and suppressed both TG synthesis and de novo lipogenesis, suggesting MGAT inhibitor may prevent carbohydrate-induced metabolic disorders, including NAFLD, obesity and diabetes.

  8. Prevention and treatment of opportunistic infections and other coinfections in HIV-infected patients: May 2015.

    Science.gov (United States)

    Iribarren, José Antonio; Rubio, Rafael; Aguirrebengoa, Koldo; Arribas, Jose Ramón; Baraia-Etxaburu, Josu; Gutiérrez, Félix; Lopez Bernaldo de Quirós, Juan Carlos; Losa, Juan Emilio; Miró, José Ma; Moreno, Santiago; Pérez Molina, José; Podzamczer, Daniel; Pulido, Federico; Riera, Melchor; Rivero, Antonio; Sanz Moreno, José; Amador, Concha; Antela, Antonio; Arazo, Piedad; Arrizabalaga, Julio; Bachiller, Pablo; Barros, Carlos; Berenguer, Juan; Caylá, Joan; Domingo, Pere; Estrada, Vicente; Knobel, Hernando; Locutura, Jaime; López Aldeguer, José; Llibre, Josep Ma; Lozano, Fernando; Mallolas, Josep; Malmierca, Eduardo; Miralles, Celia; Miralles, Pilar; Muñoz, Agustín; Ocampo, Agustín; Olalla, Julián; Pérez, Inés; Pérez Elías, Ma Jesús; Pérez Arellano, José Luis; Portilla, Joaquín; Ribera, Esteban; Rodríguez, Francisco; Santín, Miguel; Sanz Sanz, Jesús; Téllez, Ma Jesús; Torralba, Miguel; Valencia, Eulalia; Von Wichmann, Miguel Angel

    2016-10-01

    Despite the huge advance that antiretroviral therapy represents for the prognosis of infection by the human immunodeficiency virus (HIV), opportunistic infections (OIs) continue to be a cause of morbidity and mortality in HIV-infected patients. OIs often arise because of severe immunosuppression resulting from poor adherence to antiretroviral therapy, failure of antiretroviral therapy, or unawareness of HIV infection by patients whose first clinical manifestation of AIDS is an OI. The present article updates our previous guidelines on the prevention and treatment of various OIs in HIV-infected patients, namely, infections by parasites, fungi, viruses, mycobacteria, and bacteria, as well as imported infections. The article also addresses immune reconstitution inflammatory syndrome. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  9. Gene Expression Profile in the Liver of BALB/c Mice Infected with Fasciola hepatica.

    Directory of Open Access Journals (Sweden)

    Jose Rojas-Caraballo

    Full Text Available Fasciola hepatica infection still remains one of the helminthic neglected tropical diseases (NTDs. It has a huge worldwide distribution, affecting mainly cattle and, sometimes, human beings. In addition to data reported about the immunological response induced by helminthic infections and that induced by Fasciola hepatica, little is known about the gene expression profile in its organ target, the liver, which is where adult worms are established and live for long periods of time, causing its characteristic pathology. In the present work, we study both the early and late gene expression profiles in the livers of mice infected with F. hepatica metacercariae using a microarray-based methodology.A total of 9 female-6-week-old BALB/c mice (Charles River Laboratories, Barcelona, Spain weighing 20 to 35 g were used for the experiments. Two groups of BALB/c mice were orally infected with seven F. hepatica metacercariae, and the other group remained untreated and served as a control. Mice were humanely euthanized and necropsied for liver recovery, histological assessment of hepatic damage, RNA isolation, microarray design and gene expression analysis on the day of infection (t0, seven days post-infection (t7 and twenty-one days post-infection (t21.We found that F. hepatica infection induces the differential expression of 128 genes in the liver in the early stage of infection and 308 genes in the late stage, and most of them are up-regulated. The Ingenuity Pathway Analysis revealed significant changes in the pathways related to metabolism, biosynthesis and signaling as well as genes implicated in inducing liver-toxicity, injury and death.The present study provides us insights at the molecular level about the underlying mechanisms used by F. hepatica, leading to liver damage and its subsequent pathophysiology. The expression pattern obtained here could also be used to explain the lack of association between infection with F. hepatica and cholangiocarcinoma

  10. Procalcitonin Identifies Cell Injury, Not Bacterial Infection, in Acute Liver Failure.

    Directory of Open Access Journals (Sweden)

    Jody A Rule

    Full Text Available Because acute liver failure (ALF patients share many clinical features with severe sepsis and septic shock, identifying bacterial infection clinically in ALF patients is challenging. Procalcitonin (PCT has proven to be a useful marker in detecting bacterial infection. We sought to determine whether PCT discriminated between presence and absence of infection in patients with ALF.Retrospective analysis of data and samples of 115 ALF patients from the United States Acute Liver Failure Study Group randomly selected from 1863 patients were classified for disease severity and ALF etiology. Twenty uninfected chronic liver disease (CLD subjects served as controls.Procalcitonin concentrations in most samples were elevated, with median values for all ALF groups near or above a 2.0 ng/mL cut-off that generally indicates severe sepsis. While PCT concentrations increased somewhat with apparent liver injury severity, there were no differences in PCT levels between the pre-defined severity groups-non-SIRS and SIRS groups with no documented infections and Severe Sepsis and Septic Shock groups with documented infections, (p = 0.169. PCT values from CLD patients differed from all ALF groups (median CLD PCT value 0.104 ng/mL, (p ≤0.001. Subjects with acetaminophen (APAP toxicity, many without evidence of infection, demonstrated median PCT >2.0 ng/mL, regardless of SIRS features, while some culture positive subjects had PCT values <2.0 ng/mL.While PCT appears to be a robust assay for detecting bacterial infection in the general population, there was poor discrimination between ALF patients with or without bacterial infection presumably because of the massive inflammation observed. Severe hepatocyte necrosis with inflammation results in elevated PCT levels, rendering this biomarker unreliable in the ALF setting.

  11. Chlamydia pneumoniae acute liver infection affects hepatic cholesterol and triglyceride metabolism in mice.

    Science.gov (United States)

    Marangoni, Antonella; Fiorino, Erika; Gilardi, Federica; Aldini, Rita; Scotti, Elena; Nardini, Paola; Foschi, Claudio; Donati, Manuela; Montagnani, Marco; Cevenini, Monica; Franco, Placido; Roda, Aldo; Crestani, Maurizio; Cevenini, Roberto

    2015-08-01

    Chlamydia pneumoniae has been linked to atherosclerosis, strictly associated with hyperlipidemia. The liver plays a central role in the regulation of lipid metabolism. Since in animal models C. pneumoniae can be found at hepatic level, this study aims to elucidate whether C. pneumoniae infection accelerates atherosclerosis by affecting lipid metabolism. Thirty Balb/c mice were challenged intra-peritoneally with C. pneumoniae elementary bodies and thirty with Chlamydia trachomatis, serovar D. Thirty mice were injected with sucrose-phosphate-glutamate buffer, as negative controls. Seven days after infection, liver samples were examined both for presence of chlamydia and expression of genes involved in inflammation and lipid metabolism. C. pneumoniae was isolated from 26 liver homogenates, whereas C. trachomatis was never re-cultivated (P triglycerides levels compared both with negative controls (P metabolism. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. MOLECULAR MECHANISMS THAT LEAD TO CHOLANGIOCARCINOMA, DURING CHRONIC INFECTION OF LIVER FLUKES

    Directory of Open Access Journals (Sweden)

    A. O. Bogdanov

    2015-01-01

    Full Text Available Cholangiocarcinoma is a malignant tumor, characterized by poor prognosis and a low five-year survival rate. There is a clear correlation between the incidence of opisthorchiasis and high incidence of cholangiocarcinoma in South-East Asia. Liver flukes Clonorchis sinensis and Opisthorchis viverrini are I class carcinogens. There are some endemic regions of opisthorchiasis In the Russian Federation. The most important factor that leads to carcinogenesis during liver fluke infection is chronic inflammation. This review article focuses on the communication of chronic inflammation caused by invasion of liver flukes and cholangiocarcinoma. This paper summarizes the current knowledge about the risk factors for cholangiocarcinoma, as well as knowledge about the molecular aspects of the induction of carcinogenesis by liver flukes.

  13. Inflammatory bowel disease after liver transplantation : a role for cytomegalovirus infection

    NARCIS (Netherlands)

    Verdonk, Robert C; Haagsma, Elizabeth B; Van Den Berg, Aad P; Karrenbeld, Arend; Slooff, Maarten J H; Kleibeuker, Jan H; Dijkstra, Gerard

    OBJECTIVE: Despite the use of immunosuppressive drugs, recurrent and de novo inflammatory bowel disease (IBD) can develop after orthotopic liver transplantation (OLT). Cytomegalovirus (CMV) infection has been suggested to play a role in the pathogenesis of IBD. The aim of this study was to

  14. Inflammatory bowel disease after liver transplantation : A role for cytomegalovirus infection

    NARCIS (Netherlands)

    Verdonk, RC; Haagsma, EB; Van Den Berg, AP; Karrenbeld, A; Slooff, MJH; Kleibeuker, JH; Dijkstra, G

    Objective. Despite the use of immunosuppressive drugs, recurrent and de novo inflammatory bowel disease (IBD) can develop after orthotopic liver transplantation (OLT). Cytomegalovirus (CMV) infection has been suggested to play a role in the pathogenesis of IBD. The aim of this study was to

  15. Frequency of hepatitis B and C co-infection in chronic liver disease ...

    African Journals Online (AJOL)

    Hepatitis B (HBsAg) and C (HCV) virus are becoming a significant causative factors in the aetiology of chronic liver disease (CLD) worldwide. However, the information on the frequency of HBsAg and HCV virus co-infection in CLD is sparsely reported in Nigeria. In this study, we assessed the frequency of HBsAg and HCV ...

  16. Frequency of Hepatitis B and C Co-Infection in Chronic Liver ...

    African Journals Online (AJOL)

    olayemitoyin

    Summary: Hepatitis B (HBsAg) and C (HCV) virus are becoming a significant causative factors in the aetiology of chronic liver disease (CLD) worldwide. However, the information on the frequency of HBsAg and HCV virus co-infection in CLD is sparsely reported in Nigeria. In this study, we assessed the frequency of HBsAg ...

  17. Fish oil prevents sucrose-induced fatty liver but exacerbates high-safflower oil-induced fatty liver in ddy mice.

    Science.gov (United States)

    Yamazaki, Tomomi; Nakamori, Akiko; Sasaki, Eriko; Wada, Satoshi; Ezaki, Osamu

    2007-12-01

    Diets high in sucrose/fructose or fat can result in hepatic steatosis (fatty liver). We analyzed the effects of dietary fish oil on fatty liver induced by sucrose, safflower oil, and butter in ddY mice. In experiment I, mice were fed a high-starch diet [70 energy% (en%) starch] plus 20% (wt/wt) sucrose in the drinking water or fed a high-safflower oil diet (60 en%) for 11 weeks. As a control, mice were fed a high-starch diet with drinking water. Fish oil (10 en%) was either supplemented or not. Mice supplemented with sucrose or fed safflower oil showed a 1.7-fold or 2.2-fold increased liver triglyceride content, respectively, compared with that of control mice. Fish oil completely prevented sucrose-induced fatty liver, whereas it exacerbated safflower oil-induced fatty liver. Sucrose increased SREBP-1c and target gene messenger RNAs (mRNAs), and fish oil completely inhibited these increases. In experiment II, mice were fed a high-safflower oil or a high-butter diet, with or without fish oil supplementation. Fish oil exacerbated safflower oil-induced fatty liver but did not affect butter-induced fatty liver. Fish oil increased expression of peroxisome proliferator-activated receptor gamma (PPARgamma) and target CD36 mRNA in safflower oil-fed mice. These increases were not observed in sucrose-supplemented or butter-fed mice. The effects of dietary fish oil on fatty liver differ according to the cause of fatty liver; fish oil prevents sucrose-induced fatty liver but exacerbates safflower oil-induced fatty liver. The exacerbation of fatty liver may be due, at least in part, to increased expression of liver PPARgamma.

  18. Bacterial infections in alcoholic and nonalcoholic liver cirrhosis

    DEFF Research Database (Denmark)

    Sargenti, Konstantina; Prytz, Hanne; Bertilsson, Sara

    2015-01-01

    .001), this relationship was not significant after adjustment for confounders in Cox regression analysis (P=0.056). Resistance to piperacilin-tazobactam and carbapenems was more common in infections occurring in alcoholic versus nonalcoholic cirrhosis (13 vs. 5%, P=0.057 and 12 vs. 2%, P=0.009). Alcoholic etiology...

  19. Sorafenib prevents liver fibrosis in a non-alcoholic steatohepatitis (NASH) rodent model

    Energy Technology Data Exchange (ETDEWEB)

    Stefano, J.T.; Pereira, I.V.A.; Torres, M.M.; Bida, P.M. [Disciplina de Gastroenterologia Clínica (LIM-07), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Coelho, A.M.M. [Disciplina de Transplante de Órgãos do Aparelho Digestivo (LIM-37), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Xerfan, M.P. [Disciplina de Gastroenterologia Clínica (LIM-07), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Cogliati, B. [Departamento de Patologia, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP (Brazil); Barbeiro, D.F. [Disciplina de Emergências Clínicas (LIM-51), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Mazo, D.F.C. [Disciplina de Gastroenterologia Clínica (LIM-07), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Kubrusly, M.S.; D' Albuquerque, L.A.C. [Disciplina de Transplante de Órgãos do Aparelho Digestivo (LIM-37), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Souza, H.P. [Disciplina de Emergências Clínicas (LIM-51), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil); Carrilho, F.J.; Oliveira, C.P. [Disciplina de Gastroenterologia Clínica (LIM-07), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil)

    2015-02-24

    Liver fibrosis occurring as an outcome of non-alcoholic steatohepatitis (NASH) can precede the development of cirrhosis. We investigated the effects of sorafenib in preventing liver fibrosis in a rodent model of NASH. Adult Sprague-Dawley rats were fed a choline-deficient high-fat diet and exposed to diethylnitrosamine for 6 weeks. The NASH group (n=10) received vehicle and the sorafenib group (n=10) received 2.5 mg·kg{sup -1}·day{sup -1} by gavage. A control group (n=4) received only standard diet and vehicle. Following treatment, animals were sacrificed and liver tissue was collected for histologic examination, mRNA isolation, and analysis of mitochondrial function. Genes related to fibrosis (MMP9, TIMP1, TIMP2), oxidative stress (HSP60, HSP90, GST), and mitochondrial biogenesis (PGC1α) were evaluated by real-time quantitative polymerase chain reaction (RT-qPCR). Liver mitochondrial oxidation activity was measured by a polarographic method, and cytokines by enzyme-linked immunosorbent assay (ELISA). Sorafenib treatment restored mitochondrial function and reduced collagen deposition by nearly 63% compared to the NASH group. Sorafenib upregulated PGC1α and MMP9 and reduced TIMP1 and TIMP2 mRNA and IL-6 and IL-10 protein expression. There were no differences in HSP60, HSP90 and GST expression. Sorafenib modulated PGC1α expression, improved mitochondrial respiration and prevented collagen deposition. It may, therefore, be useful in the treatment of liver fibrosis in NASH.

  20. TREATMENT AND VACCINE PREVENTION OF ROTAVIRAL INFECTION AMONG CHILDREN

    Directory of Open Access Journals (Sweden)

    T.V. Kulichenko

    2007-01-01

    Full Text Available Irrespective of the level of healthcare system development rotaviral infection is a serious medical, social and economic problem at all times. Any infant has to undergo rotaviral gastroenteritis. The run of the disease among infants is mostly often aggravated by dehydration and needs intense treatment of exicosis. The standard of treatment is an oral rehydration, which is in most cases contributes to a quicker improvement of the children’s status. In the meantime, according to the metaphor put forward by the who experts «the best solution» to prevent acute rotaviral diarrhea today may become a rotaviral vaccine. Nowadays, in different countries of the world, two vaccines, which showed high efficiency and safety in clinical research, have been registered. Application of these vaccines may contribute to the significant reduction of the acute forms of rotaviral infection among infants, hospitalizations and mortality caused by rotaviral gastroenteritis. This article highlights the principles of treatment and possibility for vaccine prevention of rotaviral infection among children.Key words: rotaviral infection, gastroenteritis, diarrhea, children, rehydration, vaccine prevention, rotaviral vaccine.

  1. Optimal diagnosis, prevention, and management of periprosthetic joint infection

    Directory of Open Access Journals (Sweden)

    Tafer N

    2015-01-01

    Full Text Available Nathalie Tafer,1 Wilson Belaieff,1 Céline Cuérel,1 Matthieu Zingg,1 Pierre Hoffmeyer,1 Ilker Uçkay1,2 1Orthopedic Surgery Department, 2Division of Infectious Diseases, University of Geneva Hospitals and Medical School, Geneva, Switzerland Abstract: The pace of the aging population is steadily rising worldwide with a parallel increase in the demand for joint replacement procedures. With the increasing number of patients undergoing arthroplasty, there is also an increased risk for arthroplasty infection that may lead to severe complications, poorer outcome, and substantial extra costs for health care systems. Current rates of prosthetic joint infection are not dramatically different from the 1960s or 1970s, but some general principles are now better defined, and their management has been studied extensively during the past decades, thus resulting in a change in clinical practice. The purpose of this review is to summarize important principles of prosthetic joint infection to guide the clinician and to contribute to the optimal diagnosis, prevention, and management of periprosthetic joint infections. Keywords: arthroplasty infection, antibiotic therapy, biofilm, surgery, prevention

  2. PNEUMOCOCCAL INFECTION: MODERN VIEW ON THE ISSUE AND PREVENTION

    Directory of Open Access Journals (Sweden)

    V.К. Tatochenko

    2007-01-01

    Full Text Available Pneumococci are spread everywhere and they are very often a component of the microflora of the upper respiratory tracts. The level of the pneumococcus carriage is correlated with age. Among children the highest frequency is observed at the age of 4,5 years (up to 90% of cases, among adults it is 5–10%. According to international and Russian data, pneumococcal infection causes up to 76% of all the aetiologically deciphered cases of community cacquired pneumonia among adults and up to 94% (aggravated cases among children. The most frequent clinical forms of pneumococcal infection among children are acute otitis media (over 30%, pneumonia and meningitis (about 5–20% of all purulent bacterial meningitis, among adults — meningitis and sepsis. In 1998, in Russia was registered the first and still the only vaccine for the prevention of pneumococcal infection — Pneumo 23 (Sanofi Pasteur. The vaccine consists of 23 antic gens of the most dangerous pneumococcus serotypes and is used for the prevention of all the forms of pneumococcal infection. The composition of Pneumo 23 corresponds to 85% of pneumococcus serotypes circulating across Europe and to 90% serotypes resistant to penicillin. According to Russian data Pneumo 23 consists of about 80% of pneumococcus serotypes isolated in healthy carriers and ill with acute respiratory diseases and of 92% of serotypes in those suffering from acute bronchitis and pneumonia. The results of the clinical studies allow us to recommend the use of the given vaccine in a complex therapy of children, suffering from latent TB infection, often recurrent episodes of bronchopulmonary pathologies, ENT diseases, bronchial asthma and other chronic diseases.Key words: therapy, pediatrics, pneumonia, bronchial asthma, chronic obstructive lungs disease, prevention, treatment, pneumococcal infection.

  3. [The Importance of Vector Management for Prevention of Hospital Infections].

    Science.gov (United States)

    Çetin, Hüseyin

    2015-09-01

    Many researches show that cockroaches, ants, some other arthropods and also rodents in hospitals, can act as potential vectors of medically important bacteria, fungi and parasites. The results of microbiological studies show that these animals play a significant role in the epidemiology of hospital infections. These vectors may be found inside of the kitchens, patient rooms, toilets, medicine stores, canteen and wards in health care environments. The importance of vector control in order to prevent the spread of nosocomial infections in healthcare facilities was discussed in this paper. This study also gives information on integrated control methods for vectors in hospitals.

  4. [The features in preventing recurrent lower urinary tract infection].

    Science.gov (United States)

    Gadzhieva, Z K; Kazilov, Yu B

    2016-08-01

    This review outlines characteristics of medications most commonly used for preventing recurrent lower urinary tract infection (UTI). It shows that the treatment and prophylaxis of UTI should be comprehensive and include the restoration of the normal urogenital tract anatomy and use in addition to antibacterial and anti-inflammatory drugs, agents, normalizing the function of the lower urinary tract, as well as drugs for local and systemic immunoprophylaxis, protection of the urothelium from recurrent infection, local hormone replacement therapy in menopause, and dietary supplements to acidify the urine.

  5. Prevention and treatment of surgical site infection in HIV-infected patients

    Directory of Open Access Journals (Sweden)

    Zhang Lei

    2012-05-01

    Full Text Available Abstract Background Surgical site infection (SSI are the third most frequently reported nosocomial infection, and the most common on surgical wards. HIV-infected patients may increase the possibility of developing SSI after surgery. There are few reported date on incidence and the preventive measures of SSI in HIV-infected patients. This study was to determine the incidence and the associated risk factors for SSI in HIV-infected patients. And we also explored the preventive measures. Methods A retrospective study of SSI was conducted in 242 HIV-infected patients including 17 patients who combined with hemophilia from October 2008 to September 2011 in Shanghai Public Health Clinical Center. SSI were classified according to Centers for Disease Control and Prevention (CDC criteria and identified by bedside surveillance and post-discharge follow-up. Data were analyzed using SPSS 16.0 statistical software (SPSS Inc., Chicago, IL. Results The SSI incidence rate was 47.5% (115 of 242; 38.4% incisional SSIs, 5.4% deep incisional SSIs and 3.7% organ/space SSIs. The SSI incidence rate was 37.9% in HIV-infected patients undergoing abdominal operation. Patients undergoing abdominal surgery with lower preoperative CD4 counts were more likely to develop SSIs. The incidence increased from 2.6% in clean wounds to 100% in dirty wounds. In the HIV-infected patients combined with hemophilia, the mean preoperative albumin and postoperative hemoglobin were found significantly lower than those in no-SSIs group (P Conclusions SSI is frequent in HIV-infected patients. And suitable perioperative management may decrease the SSIs incidence rate of HIV-infected patients.

  6. Prevalence, risk factors and spatial analysis of liver fluke infections in Danish cattle herds

    DEFF Research Database (Denmark)

    Olsen, Abbey; Frankena, Klaas; Bødker, Rene

    2015-01-01

    Background: Fasciola hepatica, a trematode parasite (liver fluke), infects a wide range of host species causing fasciolosis. The disease is prevalent world-wide and causes considerable economic losses to the livestock industry. Fasciolosis is regarded as an emerging food-borne zoonosis. To promote...... awareness among farmers and to implement strategies to control the infection, this study examined the prevalence, spatial distribution and risk factors for Fasciola hepatica infection in Danish cattle herds. Methods: A retrospective population based study was performed using meat inspection data...... of approximately 1.5 million cattle slaughtered in the period 2011 to 2013. Annual cumulative prevalence of recorded liver fluke findings was calculated for each year. Global and local spatial cluster analysis was used to identify and map spatial patterns of Fasciola hepatica positive and negative herds to explore...

  7. Hepatitis virus infection and chronic liver disease among atomic-bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Fujiwara, Saeko; Cologne, John; Akahoshi, Masazumi [Radiation Effects Research Foundation, Hiroshima (Japan); Kusumi, Shizuyo [Institute of Radiation Epidemiology, Radiation Effects Association, Tokyo (Japan); Kodama, Kazunori; Yoshizawa, Hiroshi [Hiroshima University School of Medicine, Hiroshima (Japan)

    2000-05-01

    Hepatitis C and B virus (HCV, HBV) infection plays a crucial role in the etiology of chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma, which have been reported to increase with radiation dose among the atomic bomb survivors. The purpose of this study is to investigate whether radiation exposure altered the prevalence of hepatitis virus infection or accelerated the progress toward chronic hepatitis after hepatitis virus infection. Levels of serum antibody to hepatitis C virus (anti-HCV), HBs antigen (HBsAg), and anti-HBs antibody (anti-HBs) were measured for 6,121 participants in the Adult Health Study of atomic bomb survivors in Hiroshima and Nagasaki. No relationship was found between anti-HCV prevalence and radiation dose, after adjusting for age, sex, city, history of blood transfusion, acupuncture, and family history, but prevalence of anti-HCV was significantly lower overall among the radiation-exposed people (relative prevalence 0.84, p=0.022) compared to people with estimated radiation dose 0 Gy. No significant interaction was found between any of the above mentioned risk factors and radiation dose. People with anti-HCV positive had 13 times higher prevalence of chronic liver disease than those without anti-HCV. However, the radiation dose response for chronic liver disease among anti-HCV positive survivors may be greater than that among anti-HCV negative survivors (slope ratio 20), but the difference was marginally significant (p=0.097). Prevalence of HBsAg increased with whole-body kerma. However, no trend with radiation dose was found in the anti-HBs prevalence. In the background, prevalence of chronic liver disease in people with HBsAg-positive was approximately three times higher that in those without HBsAg. No difference in slope of the dose was found among HBsAg positive and negative individuals (slope: HBsAg positive 0.91/Gy, HBsAg negative 0.11/Gy, difference p=0.66). In conclusion, no dose-response relationship was found between

  8. Hepatitis virus infection and chronic liver disease among atomic-bomb survivors

    International Nuclear Information System (INIS)

    Fujiwara, Saeko; Cologne, John; Akahoshi, Masazumi; Kusumi, Shizuyo; Kodama, Kazunori; Yoshizawa, Hiroshi

    2000-01-01

    Hepatitis C and B virus (HCV, HBV) infection plays a crucial role in the etiology of chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma, which have been reported to increase with radiation dose among the atomic bomb survivors. The purpose of this study is to investigate whether radiation exposure altered the prevalence of hepatitis virus infection or accelerated the progress toward chronic hepatitis after hepatitis virus infection. Levels of serum antibody to hepatitis C virus (anti-HCV), HBs antigen (HBsAg), and anti-HBs antibody (anti-HBs) were measured for 6,121 participants in the Adult Health Study of atomic bomb survivors in Hiroshima and Nagasaki. No relationship was found between anti-HCV prevalence and radiation dose, after adjusting for age, sex, city, history of blood transfusion, acupuncture, and family history, but prevalence of anti-HCV was significantly lower overall among the radiation-exposed people (relative prevalence 0.84, p=0.022) compared to people with estimated radiation dose 0 Gy. No significant interaction was found between any of the above mentioned risk factors and radiation dose. People with anti-HCV positive had 13 times higher prevalence of chronic liver disease than those without anti-HCV. However, the radiation dose response for chronic liver disease among anti-HCV positive survivors may be greater than that among anti-HCV negative survivors (slope ratio 20), but the difference was marginally significant (p=0.097). Prevalence of HBsAg increased with whole-body kerma. However, no trend with radiation dose was found in the anti-HBs prevalence. In the background, prevalence of chronic liver disease in people with HBsAg-positive was approximately three times higher that in those without HBsAg. No difference in slope of the dose was found among HBsAg positive and negative individuals (slope: HBsAg positive 0.91/Gy, HBsAg negative 0.11/Gy, difference p=0.66). In conclusion, no dose-response relationship was found between

  9. Tuberculosis and hepatic steatosis are prevalent liver pathology findings among HIV-infected patients in South Africa.

    Directory of Open Access Journals (Sweden)

    Christopher J Hoffmann

    Full Text Available Liver disease epidemiology in sub-Saharan Africa has shifted as a result of HIV and the increased use of antiretroviral therapy leading to a need for updated data on common causes of liver disease. We retrospectively reviewed records from all hospitalized patients who had liver biopsy at a single hospital in South Africa from 2001 to 2009 and compared diagnosis by HIV status. During the period of study 262 patients had liver biopsy, 108 (41% were HIV-infected, 25 (10% were HIV-sero-negative, and 129 (49% had unknown or unrecorded HIV status. Overall 81% of biopsies provided additional diagnostic data. Malignancy was the most common finding reported on 56 (21% biopsies followed by granuloma or TB, hepatic steatosis, and fibrosis or cirrhosis. HIV-infected patients were more likely to have granulomas and steatosis. Half of patients with granulomas were already on TB treatment, suggesting paradoxical reactions or drug induced liver injury may have been important causes of liver inflammation among these patients. We note that TB, paradoxical reactions during TB treatment, possible drug induced liver injury, and hepatic steatosis are important causes of liver pathology among HIV-infected hospitalized patients with unclear etiology of liver disease after initial assessment. Among HIV sero-negative patients, malignancy was the major cause of liver disease. Our findings re-enforce the importance of TB as a diagnosis among HIV-infected individuals.

  10. Performance of diagnostic biomarkers in predicting liver fibrosis among hepatitis C virus-infected Egyptian children

    Directory of Open Access Journals (Sweden)

    Yasser E Nassef

    2013-11-01

    Full Text Available The aim of the present study was to identify specific markers that mirror liver fibrosis progression as an alternative to biopsy when biopsy is contraindicated, especially in children. After liver biopsies were performed, serum samples from 30 hepatitis C virus (HCV paediatric patients (8-14 years were analysed and compared with samples from 30 healthy subjects. All subjects were tested for the presence of serum anti-HCV antibodies. Direct biomarkers for liver fibrosis, including transforming growth factor-β1, tissue inhibitor of matrix metalloproteinase-1 (TIMP-1, hyaluronic acid (HA, procollagen type III amino-terminal peptide (PIIINP and osteopontin (OPN, were measured. The indirect biomarkers aspartate and alanine aminotransferases, albumin and bilirubin were also tested. The results revealed a significant increase in the serum marker levels in HCV-infected children compared with the healthy group, whereas albumin levels exhibited a significant decrease. Significantly higher levels of PIIINP, TIMP-1, OPN and HA were detected in HCV-infected children with moderate to severe fibrosis compared with children with mild fibrosis (p < 0.05. The diagnostic accuracy of these direct biomarkers, represented by sensitivity, specificity and positive predictive value, emphasises the utility of PIIINP, TIMP-1, OPN and HA as indicators of liver fibrosis among HCV-infected children.

  11. Enterobius vermicularis (pinworm) infection of the liver mimicking malignancy: Presentation of a new case and review of current literature.

    Science.gov (United States)

    Arkoulis, Nikolaos; Zerbinis, Helen; Simatos, Georgios; Nisiotis, Athanasios

    2012-01-01

    Enterobius vermicularis or "pinworm" infection of the liver is an extremely rare condition with only five cases previously reported in literature. It is characterized by the presence of granulomas in the liver with a necrotic core, containing adult helminthes or their ova. Because of the relatively mild symptomatology associated with this disease, prior to the arrival of modern imaging methods hepatic enterobiasis was an incidental intra-operative finding during abdominal surgery for other conditions. In recent years however, with high-resolution abdominal imaging readily available and the improved safety of hepatic resection, a lower threshold for treating suspicious hepatic nodules aggressively with surgery is being adopted. We present the second case in international literature, where E. vermicularis of the liver was mistaken for malignancy and led to hepatic resection and perform a literature review of the five previously documented cases of hepatic enterobiasis. Our report identifies certain trends in this condition's aetiology and clinical behaviour, but due to its rarity definitive answers cannot yet be established. We do not advocate a change in the current approach of suspicious hepatic nodules, but we do feel that better understanding of the mechanisms involved with hepatic enterobiasis could, in the future, prevent unnecessary surgery.

  12. Condoms for sexually transmissible infection prevention: politics versus science.

    Science.gov (United States)

    Mindel, Adrian; Sawleshwarkar, Shailendra

    2008-03-01

    The present review assesses the protection that condoms offer against sexually transmissible infections (STI) and the impact that social, political and religious opinion in the USA has had in the past 8 years on promoting condoms for safer sex. Condoms offer protection against most STI. However, the degree of protection depends on correct and consistent use, the type of sexual activity and the biological characteristics of different infections. Cross-sectional and case-control studies and other observational data provide the majority of evidence for STI prevention. Condoms provide a high level of protection against those infections that are transmitted mainly via infected secretions, including HIV, gonorrhoea, chlamydia and trichomoniasis. Protection against those infections transmitted via skin and mucous membrane contact, including Herpes simplex virus infection and human papilloma virus, appears to be less. The Bush administration, driven by conservative political, social and religious elements in the USA, has mounted a concerted campaign to undermine the role of the condom in health-promotion activities in the USA and overseas by undervaluing and misrepresenting scientific data, and through a sustained and well-funded promotion of abstinence-only education. However, this has lead to considerable controversy and disillusionment with abstinence-only education, both at home and abroad, and there is now incontrovertible evidence that abstinence-only programs are ineffectual.

  13. Prevention of recurrent urinary tract infections in women.

    Science.gov (United States)

    2013-06-01

    Around 40-50% of women experience at least one urinary tract infection (UTI) during their lifetime and 20-30% of these have a recurrence within 3-4 months of the initial infection.¹ Recurrent UTI (usually defined as three episodes in the last 12 months or two episodes in the last 6 months) can have a considerable impact on a woman's quality of life. Each episode of acute UTI in young women is typically associated with about 6 days of symptoms, 2.4 days of restricted activities and 0.4 days of bed rest.¹ Antibacterial prophylaxis is effective in preventing recurrent episodes, but at the expense of unwanted effects and a risk of promoting bacterial resistance. Here we assess the efficacy of different antibacterial regimens and non-antibacterial alternatives (cranberry, probiotics, oestrogens, immunostimulation, hyaluronic acid and chondroitin, acupuncture and herbs) in the prevention of recurrent uncomplicated UTIs in women.

  14. Multistate outbreak of Campylobacter jejuni infections associated with undercooked chicken livers--northeastern United States, 2012.

    Science.gov (United States)

    2013-11-08

    In October 2012 the Vermont Department of Health (VDH) identified three cases of laboratory-confirmed Campylobacter jejuni infection in Vermont residents; the isolates had indistinguishable pulsed-field gel electrophoresis (PFGE) patterns. A query of PulseNet, the national molecular subtyping network for foodborne disease surveillance, led to the identification of one additional case each from New Hampshire, New York, and Vermont that had been reported in the preceding 6 months. An investigation led by VDH found that all six patients had been exposed to raw or lightly cooked chicken livers that had been produced at the same Vermont poultry establishment (establishment A). Livers collected from this establishment yielded the outbreak strain of C. jejuni. In response, establishment A voluntarily ceased the sale of chicken livers on November 9. A food safety assessment conducted by the U.S. Department of Agriculture's Food Safety and Inspection Service (USDA-FSIS) found no major violations at the establishment. This is the first reported multistate outbreak of campylobacteriosis associated with chicken liver in the United States. Public health professionals, members of the food industry, and consumers should be aware that chicken livers often are contaminated with Campylobacter and that fully cooking products made with chicken liver is the only way to prepare them so they are safe to eat.

  15. Complications of radiofrequency ablation for liver cancer in high-risk locations and their prevention

    Directory of Open Access Journals (Sweden)

    ZHANG Junchao

    2017-05-01

    Full Text Available Radiofrequency ablation (RFA is one of the most important methods for the treatment of liver cancer and has the advantages of small trauma, simple operation, and repeatability. However, for tumors in high-risk locations within 5 mm of the first and second branches of the hepatic portal vein, near the hepatic vein, the inferior vena cava, or the gallbladder, within 5 mm of the intestinal tract, under the Glisson’s capsule, and in the diaphragm, RFA has the issues of a low complete ablation rate, a high local recurrence rate, and serious complications. This article introduces the complications of RFA for liver cancer in high-risk locations and their prevention and points out that with the promotion of individualized and standardized RFA, liver cancer in these high-risk locations is no longer a contradiction for RFA.

  16. Nutraceutical Approach for Preventing Obesity-Related Colorectal and Liver Carcinogenesis

    Directory of Open Access Journals (Sweden)

    Hisataka Moriwaki

    2012-01-01

    Full Text Available Obesity and its related metabolic abnormalities, including insulin resistance, alterations in the insulin-like growth factor-1 (IGF-1/IGF-1 receptor (IGF-1R axis, and the state of chronic inflammation, increase the risk of colorectal cancer (CRC and hepatocellular carcinoma (HCC. However, these findings also indicate that the metabolic disorders caused by obesity might be effective targets to prevent the development of CRC and HCC in obese individuals. Green tea catechins (GTCs possess anticancer and chemopreventive properties against cancer in various organs, including the colorectum and liver. GTCs have also been known to exert anti-obesity, antidiabetic, and anti-inflammatory effects, indicating that GTCs might be useful for the prevention of obesity-associated colorectal and liver carcinogenesis. Further, branched-chain amino acids (BCAA, which improve protein malnutrition and prevent progressive hepatic failure in patients with chronic liver diseases, might be also effective for the suppression of obesity-related carcinogenesis because oral supplementation with BCAA reduces the risk of HCC in obese cirrhotic patients. BCAA shows these beneficial effects because they can improve insulin resistance. Here, we review the detailed relationship between metabolic abnormalities and the development of CRC and HCC. We also review evidence, especially that based on our basic and clinical research using GTCs and BCAA, which indicates that targeting metabolic abnormalities by either pharmaceutical or nutritional intervention may be an effective strategy to prevent the development of CRC and HCC in obese individuals.

  17. Therapeutic and prevention strategies against human enterovirus 71 infection

    Science.gov (United States)

    Kok, Chee Choy

    2015-01-01

    Human enterovirus 71 (HEV71) is the cause of hand, foot and mouth disease and associated neurological complications in children under five years of age. There has been an increase in HEV71 epidemic activity throughout the Asia-Pacific region in the past decade, and it is predicted to replace poliovirus as the extant neurotropic enterovirus of highest global public health significance. To date there is no effective antiviral treatment and no vaccine is available to prevent HEV71 infection. The increase in prevalence, virulence and geographic spread of HEV71 infection over the past decade provides increasing incentive for the development of new therapeutic and prevention strategies against this emerging viral infection. The current review focuses on the potential, advantages and disadvantages of these strategies. Since the explosion of outbreaks leading to large epidemics in China, research in natural therapeutic products has identified several groups of compounds with anti-HEV71 activities. Concurrently, the search for effective synthetic antivirals has produced promising results. Other therapeutic strategies including immunotherapy and the use of oligonucleotides have also been explored. A sound prevention strategy is crucial in order to control the spread of HEV71. To this end the ultimate goal is the rapid development, regulatory approval and widespread implementation of a safe and effective vaccine. The various forms of HEV71 vaccine designs are highlighted in this review. Given the rapid progress of research in this area, eradication of the virus is likely to be achieved. PMID:25964873

  18. MicroRNA-gene expression network in murine liver during Schistosoma japonicum infection.

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    Pengfei Cai

    Full Text Available BACKGROUND: Schistosomiasis japonica remains a significant public health problem in China and Southeast Asian countries. The most typical and serious outcome of the chronic oriental schistosomiasis is the progressive granuloma and fibrosis in the host liver, which has been a major medical challenge. However, the molecular mechanism underling the hepatic pathogenesis is still not clear. METHODOLOGY AND PRINCIPAL FINDINGS: Using microarrays, we quantified the temporal gene expression profiles in the liver of Schistosoma japonicum-infected BALB/c mice at 15, 30, and 45 day post infection (dpi with that from uninfected mice as controls. Gene expression alternation associated with liver damage was observed in the initial phase of infection (dpi 15, which became more magnificent with the onset of egg-laying. Up-regulated genes were dominantly associated with inflammatory infiltration, whereas down-regulated genes primarily led to the hepatic functional disorders. Simultaneously, microRNA profiles from the same samples were decoded by Solexa sequencing. More than 130 miRNAs were differentially expressed in murine liver during S. japonicum infection. MiRNAs significantly dysregulated in the mid-phase of infection (dpi 30, such as mmu-miR-146b and mmu-miR-155, may relate to the regulation of hepatic inflammatory responses, whereas miRNAs exhibiting a peak expression in the late phase of infection (dpi 45, such as mmu-miR-223, mmu-miR-146a/b, mmu-miR-155, mmu-miR-34c, mmu-miR-199, and mmu-miR-134, may represent a molecular signature of the development of schistosomal hepatopathy. Further, a dynamic miRNA-gene co-expression network in the progression of infection was constructed. CONCLUSIONS AND SIGNIFICANCE: This study presents a global view of dynamic expression of both mRNA and miRNA transcripts in murine liver during S. japonicum infection, and highlights that miRNAs may play a variety of regulatory roles in balancing the immune responses during the

  19. Congenital Cytomegalovirus Infection: New Prospects for Prevention and Therapy

    Science.gov (United States)

    Swanson, Elizabeth C.; Schleiss, Mark R.

    2013-01-01

    SYNOPSIS Cytomegalovirus (CMV) is the most common congenital viral infection in the developed world, with an overall birth prevalence of approximately 0.6%. Approximately 10% of congenitally infected infants have signs and symptoms of disease at birth, and these symptomatic infants have a high risk for demonstration of subsequent neurologic sequelae, including sensorineural hearing loss (SNHL), mental retardation, microcephaly, development delay, seizure disorders, and cerebral palsy. Antiviral therapy of children with symptomatic central nervous system (CNS) congenital CMV infection is effective at reducing the risk of long-term disabilities and should be offered to families with affected newborns. An effective pre-conceptual vaccine against CMV could, by preventing congenital infection, protect against long-term neurological sequelae and other disabilities. A variety of active and passive immunization strategies are in clinical trials and are likely to be licensed in the next few years. Until a vaccine is licensed, preventive strategies aimed at reducing transmission should be emphasized and public awareness increased, particularly among women of child-bearing age. PMID:23481104

  20. INFECTION PREVENTION IN PEDIATRIC HOSPITAL ADMISSION: A LITERATURE REVIEW

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    Patrícia de Menezes Castilhos Azevedo

    2017-01-01

    Full Text Available The objective of this study was to characterize and evaluate the measures of prevention and control of HI in pediatric hospitalization units. It was adopted as the method literature review. The following databases were consulted: Scielo, LILACS, PubMed and Google Scholar, as well as text books and legislation on the subject. The research was carried out from May to December 2015. Inclusion criteria were publications in the period between 1996 and 2015 that were available in the Portuguese or Spanish language. Nineteen publications were eligible, among them: 14 articles, 3 book chapters, 1 final graduation paper and 1 doctoral thesis. Data was consulted in existing legislation with regard to infection control. The results showed as key measures for proper prevention and Hospital Infection control in pediatric inpatient units: the proper use of insulation and precautions, the guidance and education of relatives and companions of hospitalized children and continuing education of staff nursing, highlighting the importance of hand washing in hospital infection control. It is important that the nursing professional has adequate knowledge of the country's legislation on the infection control in the hospital environment, so you can require that guidelines and regulations described in this are met by health care facilities, thereby helping to quality care to hospitalized children.

  1. Measures to prevent nosocomial infections during mechanical ventilation.

    Science.gov (United States)

    Ramirez, Paula; Bassi, Gianluigi L; Torres, Antonio

    2012-02-01

    Endotracheal intubation and mechanical ventilation are lifesaving measures in critically ill patients. However, these interventions increase the risk of respiratory infections, particularly ventilator-associated pneumonia (VAP). VAP constitutes a serious burden for the healthcare system and worsens the patient's outcomes; thus, several preventive strategies have been implemented. This communication reviews the current knowledge on VAP pathogenesis and the latest preventive measures. Pathogen-laden oropharyngeal secretions leak across the endotracheal tube (ETT) cuff; thus, a continuous control of the internal cuff pressure and cuffs made of polyurethane improve sealing effectiveness and associated risks of infections. Subglottic secretions aspiration prevents VAP, and the latest evidence demonstrated a reduction in the incidence of late-onset VAP. The role of ETT biofilm in the pathogenesis of VAP is not fully elucidated. Nevertheless, antimicrobial-coated ETTs have showed beneficial effects in VAP incidence. Recent experimental evidence has challenged the benefits associated with the use of the semirecumbent position; yet, these findings need to be corroborated in clinical trials. The latest results from trials testing the effects of selective digestive decontamination (SDD) showed beneficial effects on patients' outcomes, but concerns remain regarding the emergence of bacterial resistance, specifically upon digestive tract re-colonization. The use of oropharyngeal decontamination with antiseptics and the use of probiotics are potential alternatives to SDD. There is consistent evidence that strategies affecting the primary mechanisms of VAP pathogenesis efficiently reduce the occurrence of the disease. Preventive measures should be implemented grouped into bundles to improve overall efficacy.

  2. Liver mortality attributable to chronic hepatitis C virus infection in Denmark and Scotland - using spontaneous resolvers as the benchmark comparator

    DEFF Research Database (Denmark)

    Innes, H; Hutchinson, S J; Obel, N

    2016-01-01

    Liver mortality among individuals with chronic hepatitis C (CHC) infection is common, but the relative contribution of CHC per se versus adverse health behaviours is uncertain. We explored data on spontaneous resolvers of hepatitis C virus (HCV) as a benchmark group, to uncover the independent...... contribution of CHC on liver mortality. Using national HCV diagnosis and mortality registers from Denmark and Scotland, we calculated the liver mortality rate (LMR) for persons diagnosed with CHC infection (LMRchronic ) and spontaneously resolved infection (LMRresolved ), according to subgroups defined by: age...

  3. Hepatic steatosis progresses faster in HIV mono-infected than HIV/HCV co-infected patients and is associated with liver fibrosis.

    Science.gov (United States)

    Pembroke, Thomas; Deschenes, Marc; Lebouché, Bertrand; Benmassaoud, Amine; Sewitch, Maida; Ghali, Peter; Wong, Philip; Halme, Alex; Vuille-Lessard, Elise; Pexos, Costa; Klein, Marina B; Sebastiani, Giada

    2017-10-01

    Hepatic steatosis (HS) seems common in patients infected with human immunodeficiency virus (HIV). However, the relative effect of HIV, as well as hepatitis C virus (HCV) in those co-infected, and the influence of HS on liver fibrosis progression are unclear. The LIVEr disease in HIV (LIVEHIV) is a Canadian prospective cohort study using transient elastography and associated controlled attenuation parameter (CAP) to screen for HS and liver fibrosis, in unselected HIV-infected adults. HS progression was defined as development of any grade HS (CAP ⩾248dB/m), or transition to severe HS (CAP >292dB/m), for those with any grade HS at baseline. Fibrosis progression was defined as development of significant liver fibrosis (liver stiffness measurement [LSM] >7.1kPa), or transition to cirrhosis (LSM >12.5kPa) for those with significant liver fibrosis at baseline. Cox regression analysis was used to assess predictors of HS and fibrosis progression. A prospective cohort study was conducted, which included 726 HIV-infected patients (22.7% HCV co-infected). Prevalence of any grade HS did not differ between HIV mono-infected and HIV/HCV co-infected patients (36.1% vs. 38.6%, respectively). 313 patients were followed for a median of 15.4 (interquartile range 8.5-23.0) months. The rate of HS progression was 37.8 (95% confidence interval [CI] 29.2-49.0) and 21.9 (95% CI 15.6-30.7) per 100 person-years in HIV mono-infection and HIV/HCV co-infection, respectively. HCV co-infection was an independent negative predictor of HS progression (adjusted hazard ratio [aHR] 0.50, 95% CI 0.28-0.89). HS predicted liver fibrosis progression in HIV mono-infection (aHR 4.18, 95% CI 1.21-14.5), but not in HIV/HCV co-infection. HS progresses faster and is associated with liver fibrosis progression in HIV mono-infection but not in HIV/HCV co-infection. Lay summary: Fatty liver is the most frequent liver disease in Western countries. People living with HIV seem at high risk of fatty liver due to

  4. Infection prevention workforce: Potential benefits to educational diversity.

    Science.gov (United States)

    Reese, Sara M; Gilmartin, Heather M

    2017-06-01

    Nurses have historically occupied the infection preventionist (IP) role. As the knowledge and skills needed to advance the field expand, professionals from public health and the laboratory sciences have become IPs. Our study describes the characteristics of current IPs and assesses for relationships between background, certification, experience, and type of work performed. The data were drawn from an existing dataset collected in the conduct of the Association for Professionals in Infection Control and Epidemiology (APIC) MegaSurvey. Descriptive statistics were computed. Associations were calculated using χ 2 or Cochran-Mantel-Haenszel tests. Characteristics of IPs were stratified by work-related activities to allow for comparisons between groups. Of the 13,050 active APIC members, 4,079 participated in the survey (31% response rate). The primary job activity for nurses (97.9%; n = 2,434) was preventing and controlling the transmission of infectious agents or health care-associated infections, for laboratory scientists (97.5%; n = 307) it was the interpretation of surveillance data, and for public health professionals (96.1%; n = 136) it was management and communication: feedback. Infection control departments would benefit from hiring IPs with diverse education and training to address the expanding roles and responsibilities of IPs. This may facilitate the implementation of novel and innovative processes that will impact patient care. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  5. Implications of Helicobacter pylori infection for stomach cancer prevention

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    Goodman Karen J.

    1997-01-01

    Full Text Available Accumulating evidence has implicated Helicobacter pylori, an established cause of chronic gastritis and peptic ulcer, in the etiology of gastric cancer. Control of this infection would reduce the occurrence of chronic gastritis and peptic ulcer and might substantially lower the risk of stomach cancer as well. The public health impact of this infectious agent warrants efforts to identify preventive measures. This paper reviews the evidence linking H. pylori infection to gastric cancer and evaluates the potential for control in high-risk populations. Current obstacles to H. pylori control are discussed, including the link to poor socioeconomic conditions, difficulty in identifying incident cases, lack of natural immunity to reinfection, limited effectiveness of antibiotic therapy in high-prevalence populations, and incomplete knowledge regarding the reservoir of infection, mode of transmission, host susceptibility factors, and the potential for developing an effective vaccine. Worthwhile avenues of research include studies designed to identify modifiable risk factors for acquisition of the infection, modifiable host factors that may increase resistance to chronic infection, more effective antibiotic therapies, and effective vaccines.

  6. Schistosoma mansoni infection suppresses the growth of Plasmodium yoelii parasites in the liver and reduces gametocyte infectivity to mosquitoes.

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    Taeko Moriyasu

    2018-01-01

    Full Text Available Malaria and schistosomiasis are major parasitic diseases causing morbidity and mortality in the tropics. Epidemiological surveys have revealed coinfection rates of up to 30% among children in Sub-Saharan Africa. To investigate the impact of coinfection of these two parasites on disease epidemiology and pathology, we carried out coinfection studies using Plasmodium yoelii and Schistosoma mansoni in mice. Malaria parasite growth in the liver following sporozoite inoculation is significantly inhibited in mice infected with S. mansoni, so that when low numbers of sporozoites are inoculated, there is a large reduction in the percentage of mice that go on to develop blood stage malaria. Furthermore, gametocyte infectivity is much reduced in mice with S. mansoni infections. These results have profound implications for understanding the interactions between Plasmodium and Schistosoma species, and have implications for the control of malaria in schistosome endemic areas.

  7. Targeted induction of interferon-λ in humanized chimeric mouse liver abrogates hepatotropic virus infection.

    Science.gov (United States)

    Nakagawa, Shin-ichiro; Hirata, Yuichi; Kameyama, Takeshi; Tokunaga, Yuko; Nishito, Yasumasa; Hirabayashi, Kazuko; Yano, Junichi; Ochiya, Takahiro; Tateno, Chise; Tanaka, Yasuhito; Mizokami, Masashi; Tsukiyama-Kohara, Kyoko; Inoue, Kazuaki; Yoshiba, Makoto; Takaoka, Akinori; Kohara, Michinori

    2013-01-01

    The interferon (IFN) system plays a critical role in innate antiviral response. We presume that targeted induction of IFN in human liver shows robust antiviral effects on hepatitis C virus (HCV) and hepatitis B virus (HBV). This study used chimeric mice harboring humanized livers and infected with HCV or HBV. This mouse model permitted simultaneous analysis of immune responses by human and mouse hepatocytes in the same liver and exploration of the mechanism of antiviral effect against these viruses. Targeted expression of IFN was induced by treating the animals with a complex comprising a hepatotropic cationic liposome and a synthetic double-stranded RNA analog, pIC (LIC-pIC). Viral replication, IFN gene expression, IFN protein production, and IFN antiviral activity were analyzed (for type I, II and III IFNs) in the livers and sera of these humanized chimeric mice. Following treatment with LIC-pIC, the humanized livers of chimeric mice exhibited increased expression (at the mRNA and protein level) of human IFN-λs, resulting in strong antiviral effect on HBV and HCV. Similar increases were not seen for human IFN-α or IFN-β in these animals. Strong induction of IFN-λs by LIC-pIC occurred only in human hepatocytes, and not in mouse hepatocytes nor in human cell lines derived from other (non-hepatic) tissues. LIC-pIC-induced IFN-λ production was mediated by the immune sensor adaptor molecules mitochondrial antiviral signaling protein (MAVS) and Toll/IL-1R domain-containing adaptor molecule-1 (TICAM-1), suggesting dual recognition of LIC-pIC by both sensor adaptor pathways. These findings demonstrate that the expression and function of various IFNs differ depending on the animal species and tissues under investigation. Chimeric mice harboring humanized livers demonstrate that IFN-λs play an important role in the defense against human hepatic virus infection.

  8. Targeted induction of interferon-λ in humanized chimeric mouse liver abrogates hepatotropic virus infection.

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    Shin-ichiro Nakagawa

    Full Text Available BACKGROUND & AIMS: The interferon (IFN system plays a critical role in innate antiviral response. We presume that targeted induction of IFN in human liver shows robust antiviral effects on hepatitis C virus (HCV and hepatitis B virus (HBV. METHODS: This study used chimeric mice harboring humanized livers and infected with HCV or HBV. This mouse model permitted simultaneous analysis of immune responses by human and mouse hepatocytes in the same liver and exploration of the mechanism of antiviral effect against these viruses. Targeted expression of IFN was induced by treating the animals with a complex comprising a hepatotropic cationic liposome and a synthetic double-stranded RNA analog, pIC (LIC-pIC. Viral replication, IFN gene expression, IFN protein production, and IFN antiviral activity were analyzed (for type I, II and III IFNs in the livers and sera of these humanized chimeric mice. RESULTS: Following treatment with LIC-pIC, the humanized livers of chimeric mice exhibited increased expression (at the mRNA and protein level of human IFN-λs, resulting in strong antiviral effect on HBV and HCV. Similar increases were not seen for human IFN-α or IFN-β in these animals. Strong induction of IFN-λs by LIC-pIC occurred only in human hepatocytes, and not in mouse hepatocytes nor in human cell lines derived from other (non-hepatic tissues. LIC-pIC-induced IFN-λ production was mediated by the immune sensor adaptor molecules mitochondrial antiviral signaling protein (MAVS and Toll/IL-1R domain-containing adaptor molecule-1 (TICAM-1, suggesting dual recognition of LIC-pIC by both sensor adaptor pathways. CONCLUSIONS: These findings demonstrate that the expression and function of various IFNs differ depending on the animal species and tissues under investigation. Chimeric mice harboring humanized livers demonstrate that IFN-λs play an important role in the defense against human hepatic virus infection.

  9. The role of surface disinfection in infection prevention

    Science.gov (United States)

    Gebel, Jürgen; Exner, Martin; French, Gary; Chartier, Yves; Christiansen, Bärbel; Gemein, Stefanie; Goroncy-Bermes, Peter; Hartemann, Philippe; Heudorf, Ursel; Kramer, Axel; Maillard, Jean-Yves; Oltmanns, Peter; Rotter, Manfred; Sonntag, Hans-Günther

    2013-01-01

    Background: The Rudolf Schuelke Foundation addresses topics related to hygiene, infection prevention and public health. In this context a panel of scientists from various European countries discussed “The Role of Surface Disinfection in Infection Prevention”. The most important findings and conclusions of this meeting are summarised in the present consensus paper. Aim: Although the relevance of surface disinfection is increasingly being accepted, there are still a number of issues which remain controversial. In particular, the following topics were addressed: Transferral of microbes from surface to patients as a cause of infection, requirements for surface disinfectants, biocidal resistance and toxicity, future challenges. Methods and findings: After discussion and review of current scientific literature the authors agreed that contaminated surfaces contribute to the transmission of pathogens and may thus pose an infection hazard. Targeted surface disinfection based on a risk profile is seen as an indispensable constituent in a multibarrier approach of universal infection control precautions. Resistance and cross-resistance depend on the disinfectant agent as well as on the microbial species. Prudent implementation of surface disinfection regimens tested to be effective can prevent or minimize adverse effects. Conclusions: Disinfection must be viewed as a holistic process. There is a need for defining standard principles for cleaning and disinfection, for ensuring compliance with these principles by measures such as written standard operating procedures, adequate training and suitable audit systems. Also, test procedures must be set up in order to demonstrate the efficacy of disinfectants including new application methods such as pre-soaked wipes for surface disinfection. PMID:23967396

  10. The role of surface disinfection in infection prevention

    Directory of Open Access Journals (Sweden)

    Gebel, Jürgen

    2013-04-01

    Full Text Available [english] Background: The Rudolf Schuelke Foundation addresses topics related to hygiene, infection prevention and public health. In this context a panel of scientists from various European countries discussed “The Role of Surface Disinfection in Infection Prevention”. The most important findings and conclusions of this meeting are summarised in the present consensus paper.Aim: Although the relevance of surface disinfection is increasingly being accepted, there are still a number of issues which remain controversial. In particular, the following topics were addressed: Transferral of microbes from surface to patients as a cause of infection, requirements for surface disinfectants, biocidal resistance and toxicity, future challenges.Methods and findings: After discussion and review of current scientific literature the authors agreed that contaminated surfaces contribute to the transmission of pathogens and may thus pose an infection hazard. Targeted surface disinfection based on a risk profile is seen as an indispensable constituent in a multibarrier approach of universal infection control precautions. Resistance and cross-resistance depend on the disinfectant agent as well as on the microbial species. Prudent implementation of surface disinfection regimens tested to be effective can prevent or minimize adverse effects.Conclusions: Disinfection must be viewed as a holistic process. There is a need for defining standard principles for cleaning and disinfection, for ensuring compliance with these principles by measures such as written standard operating procedures, adequate training and suitable audit systems. Also, test procedures must be set up in order to demonstrate the efficacy of disinfectants including new application methods such as pre-soaked wipes for surface disinfection.

  11. National survey of practices to prevent health care-associated infections in Thailand: The role of prevention bundles.

    Science.gov (United States)

    Apisarnthanarak, Anucha; Ratz, David; Greene, M Todd; Khawcharoenporn, Thana; Weber, David J; Saint, Sanjay

    2017-07-01

    We evaluated the practices used in Thai hospitals to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated pneumonia (VAP). From January 1, 2014-November 30, 2014, we surveyed all Thai hospitals with an intensive care unit and at least 250 beds. The use of prevention practices for CAUTI, CLABSI, and VAP was assessed. High compliance (≥75%) with all components of the CLABSI and VAP prevention bundles were determined. CAUTI, CLABSI, and VAP infection rates before and after implementing infection control practices are reported. Multivariable regression was used to examine associations between infection prevention bundle compliance and infection rate changes. Out of 245 eligible hospitals, 212 (86.5%) responded. A total of 120 (56.6%) and 115 hospitals (54.2%) reported ≥75% compliance for all components of the CLABSI and VAP prevention bundles, respectively, and 91 hospitals (42.9%) reported using ≥ 4 recommended CAUTI-prevention practices. High compliance with all of the CLABSI and VAP bundle components was associated with significant infection rate reductions (CLABSI, 38.3%; P Hospitals regularly using ≥ 4 CAUTI-prevention practices did not have greater reductions in CAUTI (0.02%; P = .99). Compliance with practices to prevent hospital infections was suboptimal. Policies and interventions promoting bundled approaches may help reduce hospital infections for Thai hospitals. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  12. Impact of Infection Prevention and Control Initiatives on Acute Respiratory Infections in a Pediatric Long-Term Care Facility.

    Science.gov (United States)

    Murray, Meghan T; Jackson, Olivia; Cohen, Bevin; Hutcheon, Gordon; Saiman, Lisa; Larson, Elaine; Neu, Natalie

    2016-07-01

    We evaluated the collective impact of several infection prevention and control initiatives aimed at reducing acute respiratory infections (ARIs) in a pediatric long-term care facility. ARIs did not decrease overall, though the proportion of infections associated with outbreaks and average number of cases per outbreak decreased. Influenza rates decreased significantly. Infect Control Hosp Epidemiol 2016;37:859-862.

  13. Marijuana use in hepatitis C infection does not affect liver biopsy histology or treatment outcomes

    OpenAIRE

    Liu, Theresa; Howell, Glen T; Turner, Lucy; Corace, Kimberley; Garber, Gary; Cooper, Curtis

    2014-01-01

    BACKGROUND: Marijuana smoking is prevalent among hepatitis C virus-infected patients. The literature assessing the influence of marijuana on liver disease progression and hepatitis C virus antiviral treatment outcomes is conflicting.METHODS: The authors evaluated hepatitis C virus RNA-positive patients followed at The Ottawa Hospital Viral Hepatitis Clinic (Ottawa, Ontario) from 2000 to 2009. Using The Ottawa Hospital Viral Hepatitis Clinic database and charts, information regarding demograph...

  14. The Possible Role of Helicobacter pylori Infection in Non-alcoholic Fatty Liver Disease

    Directory of Open Access Journals (Sweden)

    Dan-dan Cheng

    2017-05-01

    Full Text Available Helicobacter pylori (H. pylori which colonizes the stomach can cause a wide array of gastric disorders, including chronic gastritis, peptic ulcer, and gastric cancer. Recently, accumulating evidence has implicated H. pylori infection in extragastrointestinal diseases such as cardiovascular diseases, neurological disorders, and metabolic diseases. At the same time, many scholars have noted the relationship between H. pylori infection and non-alcoholic fatty liver disease (NAFLD. Despite the positive association between H. pylori and NAFLD reported in some researches, there are opposite perspectives denying their relationship. Due to high prevalence, unclear etiology and difficult treatment of NAFLD, confirming the pathogenicity of H. pylori infection in NAFLD will undoubtedly provide insights for novel treatment strategies for NAFLD. This paper will review the relationship between H. pylori infection and NAFLD and the possible pathogenic mechanisms.

  15. Deletion of nardilysin prevents the development of steatohepatitis and liver fibrotic changes.

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    Shoko Ishizu-Higashi

    Full Text Available Nonalcoholic steatohepatitis (NASH is an inflammatory form of nonalcoholic fatty liver disease that progresses to liver cirrhosis. It is still unknown how only limited patients with fatty liver develop NASH. Tumor necrosis factor (TNF-α is one of the key molecules in initiating the vicious circle of inflammations. Nardilysin (N-arginine dibasic convertase; Nrd1, a zinc metalloendopeptidase of the M16 family, enhances ectodomain shedding of TNF-α, resulting in the activation of inflammatory responses. In this study, we aimed to examine the role of Nrd1 in the development of NASH. Nrd1+/+ and Nrd1-/- mice were fed a control choline-supplemented amino acid-defined (CSAA diet or a choline-deficient amino acid-defined (CDAA diet. Fatty deposits were accumulated in the livers of both Nrd1+/+ and Nrd1-/- mice by the administration of the CSAA or CDAA diets, although the amount of liver triglyceride in Nrd1-/- mice was lower than that in Nrd1+/+ mice. Serum alanine aminotransferase levels were increased in Nrd1+/+ mice but not in Nrd1-/- mice fed the CDAA diet. mRNA expression of inflammatory cytokines were decreased in Nrd1-/- mice than in Nrd1+/+ mice fed the CDAA diet. While TNF-α protein was detected in both Nrd1+/+ and Nrd1-/- mouse livers fed the CDAA diet, secretion of TNF-α in Nrd1-/- mice was significantly less than that in Nrd1+/+ mice, indicating the decreased TNF-α shedding in Nrd1-/- mouse liver. Notably, fibrotic changes of the liver, accompanied by the increase of fibrogenic markers, were observed in Nrd1+/+ mice but not in Nrd1-/- mice fed the CDAA diet. Similar to the CDAA diet, fibrotic changes were not observed in Nrd1-/- mice fed a high-fat diet. Thus, deletion of nardilysin prevents the development of diet-induced steatohepatitis and liver fibrogenesis. Nardilysin could be an attractive target for anti-inflammatory therapy against NASH.

  16. National infection prevention and control programmes: Endorsing quality of care.

    Science.gov (United States)

    Stempliuk, Valeska; Ramon-Pardo, Pilar; Holder, Reynaldo

    2014-01-01

    Core components Health care-associated infections (HAIs) are a major cause of morbidity and mortality. In addition to pain and suffering, HAIs increase the cost of health care and generates indirect costs from loss of productivity for patients and society as a whole. Since 2005, the Pan American Health Organization has provided support to countries for the assessment of their capacities in infection prevention and control (IPC). More than 130 hospitals in 18 countries were found to have poor IPC programmes. However, in the midst of many competing health priorities, IPC programmes are not high on the agenda of ministries of health, and the sustainability of national programmes is not viewed as a key point in making health care systems more consistent and trustworthy. Comprehensive IPC programmes will enable countries to reduce the mobility, mortality and cost of HAIs and improve quality of care. This paper addresses the relevance of national infection prevention and control (NIPC) programmes in promoting, supporting and reinforcing IPC interventions at the level of hospitals. A strong commitment from national health authorities in support of national IPC programmes is crucial to obtaining a steady decrease of HAIs, lowering health costs due to HAIs and ensuring safer care.

  17. Consensus document for the prevention of respiratory infections in adults

    Directory of Open Access Journals (Sweden)

    F. Froes

    2014-03-01

    Full Text Available Infectious diseases are one of the principle causes of morbidity, mortality and drain on health resources worldwide. In recent years there has been an increase in the impact of respiratory infections, particularly in the Portuguese population. It is for this reason that the Portuguese Respiratory Society has presented a series of recommendations for the prevention of respiratory infections in adults. These recommendations include both general measures and vaccinations for flu and pneumococcal pneumonia. Resumo: As infeções respiratórias são uma das principais causas de morbilidade, mortalidade e consumo de recursos de saúde a nível global. Nos últimos anos tem-se assistido a um crescente impacto das infeções respiratórias, nomeadamente na população portuguesa. Assim, a Sociedade Portuguesa de Pneumologia apresenta um conjunto de recomendações para a prevenção das infeções respiratórias no adulto. Estas recomendações englobam medidas gerais e de vacinação antigripal e antipneumocócica. Keywords: Prevention, Respiratory infections, Pneumonia, Flu vaccination, Pneumococcal vaccination, Palavras-chave: Prevenção, Infeções respiratórias, Pneumonia, Vacina da gripe, Vacina pneumocócica

  18. Oxidative stress-mediated mouse liver lesions caused by Clonorchis sinensis infection.

    Science.gov (United States)

    Maeng, Sejung; Lee, Hye Won; Bashir, Qudsia; Kim, Tae Im; Hong, Sung-Jong; Lee, Tae Jin; Sohn, Woon-Mok; Na, Byoung-Kuk; Kim, Tong-Soo; Pak, Jhang Ho

    2016-03-01

    Clonorchis sinensis is a high-risk pathogenic helminth that strongly provokes inflammation, epithelial hyperplasia, periductal fibrosis, and even cholangiocarcinoma in chronically infected individuals. Chronic inflammation is associated with an increased risk of various cancers due to the disruption of redox homeostasis. Accordingly, the present study was conducted to examine the time course relationship between histopathological changes and the appearance of oxidative stress markers, including lipid peroxidation, enzymes involved in lipid peroxidation, and mutagenic DNA adducts in the livers of mice infected with C. sinensis, as well as proinflammatory cytokines in infected mouse sera. Histopathological phenotypes such as bile duct epithelial hyperplasia, periductal fibrosis, edema and inflammatory infiltration increased in infected livers in a time-dependent manner. Intense immunoreactivity of lipid peroxidation products (4-hydroxy-2-nonenal; malondialdehyde), cyclooxygenase-2, 5-lipoxygenase and 8-oxo-7,8-dihydro-2'-deoxyguanosine were concomitantly observed in these injured regions. We also found elevated expressions of cyclooxygenase-2 and 5-lipoxygenase in C. sinensis excretory-secretory product-treated cholangiocarcinoma cells. Moreover, the levels of proinflammatory cytokines such as TNF-α, ILβ-1 and IL-6 were differentially upregulated in infected sera. With regard to oxidative stress-mediated carcinogenesis, our findings suggest that C. sinensis infestation may disrupt host redox homeostasis, creating a damaging environment that favors the development of advanced hepatobiliary diseases such as clonorchiasis-associated cholangiocarcinoma. Copyright © 2015 Australian Society for Parasitology Inc. Published by Elsevier Ltd. All rights reserved.

  19. Antibiotic therapy for preventing infections in people with acute stroke.

    Science.gov (United States)

    Vermeij, Jan-Dirk; Westendorp, Willeke F; Dippel, Diederik Wj; van de Beek, Diederik; Nederkoorn, Paul J

    2018-01-22

    Stroke is the main cause of disability in high-income countries and ranks second as a cause of death worldwide. Infections occur frequently after stroke and may adversely affect outcome. Preventive antibiotic therapy in the acute phase of stroke may reduce the incidence of infections and improve outcome. In the previous version of this Cochrane Review, published in 2012, we found that antibiotics did reduce the risk of infection but did not reduce the number of dependent or deceased patients. However, included studies were small and heterogeneous. In 2015, two large clinical trials were published, warranting an update of this Review. To assess the effectiveness and safety of preventive antibiotic therapy in people with ischaemic or haemorrhagic stroke. We wished to determine whether preventive antibiotic therapy in people with acute stroke:• reduces the risk of a poor functional outcome (dependency and/or death) at follow-up;• reduces the occurrence of infections in the acute phase of stroke;• reduces the occurrence of elevated body temperature (temperature ≥ 38° C) in the acute phase of stroke;• reduces length of hospital stay; or• leads to an increased rate of serious adverse events, such as anaphylactic shock, skin rash, or colonisation with antibiotic-resistant micro-organisms. We searched the Cochrane Stroke Group Trials Register (25 June 2017); the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 5; 25 June 2017) in the Cochrane Library; MEDLINE Ovid (1950 to 11 May 2017), and Embase Ovid (1980 to 11 May 2017). In an effort to identify further published, unpublished, and ongoing trials, we searched trials and research registers, scanned reference lists, and contacted trial authors, colleagues, and researchers in the field. Randomised controlled trials (RCTs) of preventive antibiotic therapy versus control (placebo or open control) in people with acute ischaemic or haemorrhagic stroke. Two review authors independently selected

  20. Hepatitis C virus liver disease in women infected with contaminated anti-D immunoglobulin.

    LENUS (Irish Health Repository)

    Sheehan, M M

    2012-02-03

    Screening for hepatitis C virus (HCV) infection is carried out by detection of antibodies to the virus (enzyme-linked immunosorbent assay (ELISA) and recombinant immunoblot assay (RIBA)) with confirmation by identification of HCV RNA genome in serum (polymerase chain reaction (PCR)). We describe the histological features on liver biopsy in 88 women with chronic HCV infection (serum positive on ELISA, RIBA and PCR) acquired from virus contaminated anti-D immunoglobulin. For the majority of these patients the time interval from virus infection to presentation was between 17 and 18 years. We separately assessed necroinflammatory disease activity and architectural features on liver biopsy and applied a scoring system which permitted semi-quantitative documentation of abnormal features. Only three women showed liver biopsies within normal limits (+\\/-focal steatosis). The remaining 85 cases showed a predominantly mild or moderate degree of disease activity with interface hepatitis (56.8% of cases), spotty necrosis, apoptosis and focal inflammation (88.6% of cases) and portal inflammation (90.9% of cases). Confluent necrosis was an uncommon finding (2.3% of cases). Assessment of architectural features showed normal appearance in 35.2% of biopsies. The predominant architectural abnormality noted was portal tract fibrosis. Ten per cent of cases, however, showed significant fibrous band and\\/or nodule formation.

  1. Pneumoconiosis and liver cirrhosis are not risk factors for tuberculosis in patients with pulmonary infection

    Energy Technology Data Exchange (ETDEWEB)

    Wu, H.P.; Pan, Y.H.; Hua, C.C.; Shieh, H.B.; Jiang, B.Y.; Yu, T.J. [Chang Gung Memorial Hospital, Chilung (Taiwan)

    2007-05-15

    It is unclear whether patients with liver cirrhosis and coal miners with pneumoconiosis are at increased risk of developing pulmonary tuberculosis (TB). Furthermore, little is known of the likelihood of pneumonia in patients with bronchiectasis, haemodialysis, diabetes mellitus or advanced lung cancer being due to TB. To answer these questions, patients with these clinical comorbidities were analysed. The study was retrospective and included 264 TB patients, 478 non-TB pneumonia patients, and as negative controls, 438 subjects without pneumonia. The parameters analysed were age, gender and the presence of pneumoconiosis, bronchiectasis, liver cirrhosis, haemodialysis, diabetes mellitus and advanced lung cancer. Male gender was the only significant factor increasing the risk of pulmonary TB. When compared with non-TB pneumonia and control patients, the odds ratios were 1.862 and 2.182, respectively. Patients with liver cirrhosis did not show an increased risk of pulmonary TB after regression analysis. Pneumoconiosis resulted in a 2.260 (P = 0.003) odds ratio for pulmonary TB, compared with the controls. However, there was no difference in pneurmoconiosis between TB and non-TB pneumonia patients. Patients with bronchiectasis, lung cancer and those receiving haemodialysis had a lower risk for pulmonary TB in lower respiratory tract infection, with odds ratios of 0.342, 0.311 and 0.182, respectively. Physicians should first consider non-TB bacterial infection rather than Mycobacterium tuberculosis infection in pneumonia in patients with bronchiectasis, lung cancer or those receiving haemodialysis.

  2. Prone position for the prevention of lung infection.

    Science.gov (United States)

    Beuret, P

    2002-04-01

    Pulmonary infection is frequent in brain injured patients. It has been identified as an independent predictor of unfavorable neurological outcome, calling for attempts of prevention. We recently evaluated intermittent prone positioning for the prevention of ventilator-associated pneumonia (VAP) in comatose brain injured patients, in a randomized study. 25 patients were included in the prone position (PP) group: they were positioned on prone four hours once daily until they could get up to sit in an armchair; 26 patients were included in the supine position (SP) group. The main characteristics of the patients from the two groups were similar at randomization. The primary end-point was the incidence of lung worsening, defined by an increase in the Lung Injury Score by at least one point since the time of randomization. The incidence of lung worsening was lower in the PP group (12%) than in the SP group (50%) (p=0.003). The incidence of VAP was 38.4% in the SP group and 20% in the PP group (p=0.14). There was no serious complication attributable to prone positioning. In conclusion, the beneficial effect of prone positioning for prevention of lung infection in brain injured patients is not well established. However, in those patients, prone positioning is able to avoid the worsening of pulmonary function, especially in oxygenation.

  3. Prevention of pin tract infection with titanium-copper alloys.

    Science.gov (United States)

    Shirai, Toshiharu; Tsuchiya, Hiroyuki; Shimizu, Tohru; Ohtani, Kaori; Zen, Yo; Tomita, Katsuro

    2009-10-01

    The most frequent complication in external fixation is pin tract infection. To reduce the incidence of implant-associated infection, many published reports have looked at preventing bacterial adhesion by treating the pin surface. This study aimed to evaluate the antibacterial activity of a Titanium-Copper (Ti-Cu) alloy on implant infection, and to determine the potential use of the Ti-Cu alloy as a biomaterial. Two forms of Ti-Cu alloys were synthesized: one with 1% Cu and the other with 5% Cu. For analyzing infectious behavior, the implants were exposed to Staphylococcus aureus and Escherichia coli. The reaction of pathogens to the Ti-Cu alloys was compared with their reaction to stainless steel and pure titanium as controls. Both Ti-Cu alloys evidently inhibited colonization by both bacteria. Conversely, cytocompatibility studies were performed using fibroblasts and colony formation on the metals was assessed by counting the number of colonies. Ti-1% Cu alloy showed no difference in the number of colonies compared with the control. External fixator pins made of Ti-Cu alloys were evaluated in a rabbit model. The tissue-implant interactions were analyzed for the presence of infection, inflammatory changes and osteoid-formation. Ti-1% Cu alloy significantly inhibited inflammation and infection, and had excellent osteoid-formation. Copper blood levels were measured before surgery and at 14 days postoperatively. Preoperative and postoperative blood copper values were not statistically different. Overall, it was concluded that Ti-Cu alloys have antimicrobial activity and substantially reduce the incidence of pin tract infection. Ti-1% Cu alloy shows particular promise as a biomaterial. (c) 2009 Wiley Periodicals, Inc.

  4. Mannose-binding lectin and Ficolin-2 gene polymorphisms predispose to cytomegalovirus (re)infection after orthotopic liver transplantation

    NARCIS (Netherlands)

    de Rooij, Bert-Jan F.; van der Beek, Martha T.; van Hoek, Bart; Vossen, Ann C. T. M.; ten Hove, W. Rogier; Roos, Anja; Schaapherder, Alexander F.; Porte, Robert J.; van der Reijden, Johan J.; Coenraad, Minneke J.; Hommes, Daniel W.; Verspaget, Hein W.

    2011-01-01

    Background & Aims: The lectin pathway of complement activation is a crucial effector cascade of the innate immune response to pathogens. Cytomegalovirus (CMV) infection occurs frequently in immunocompromised patients after orthotopic liver transplantation (OLT). Single-nucleotide polymorphisms

  5. Liver-related deaths in persons infected with the human immunodeficiency virus: the D:A:D study

    NARCIS (Netherlands)

    Weber, Rainer; Sabin, Caroline A.; Friis-Møller, Nina; Reiss, Peter; El-Sadr, Wafaa M.; Kirk, Ole; Dabis, Francois; Law, Matthew G.; Pradier, Christian; de Wit, Stephane; Akerlund, Börje; Calvo, Gonzalo; D'Arminio Monforte, Antonella; Rickenbach, Martin; Ledergerber, Bruno; Phillips, Andrew N.; Lundgren, Jens D.

    2006-01-01

    BACKGROUND: An increasing proportion of deaths among human immunodeficiency virus (HIV)-infected persons with access to combination antiretroviral therapy (cART) are due to complications of liver diseases. METHODS: We investigated the frequency of and risk factors associated with liver-related

  6. Molecular profiling of early stage liver fibrosis in patients with chronic hepatitis C virus infection

    International Nuclear Information System (INIS)

    Bieche, Ivan; Asselah, Tarik; Laurendeau, Ingrid; Vidaud, Dominique; Degot, Claude; Paradis, Valerie; Bedossa, Pierre; Valla, Dominique-Charles; Marcellin, Patrick; Vidaud, Michel

    2005-01-01

    The molecular mechanisms of acute hepatitis C virus (HCV) infection, end-stage hepatitis (cirrhosis), and hepatocellular carcinoma have been extensively studied, but little is known of the changes in liver gene expression during the early stages of liver fibrosis associated with chronic HCV infection, that is, the transition from normal liver (NL) of uninfected patients to the first stage of liver fibrosis (F1-CH-C). To obtain insight into the molecular pathogenesis of F1-CH-C, we used real-time quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) to study the mRNA expression of 240 selected genes in liver tissue with F1-CH-C, in comparison with NL. The expression of 54 (22.5%) of the 240 genes was significantly different between F1-CH-C and NL; 46 genes were upregulated and 8 were downregulated in F1-CH-C. The most noteworthy changes in gene expression mainly affected the transcriptional network regulated by interferons (IFNs), including both IFN-α/β-inducible genes (STAT1, STAT2, ISGF3G/IRF9, IFI27, G1P3, G1P2, OAS2, MX1) and IFN-γ-inducible genes (CXCL9, CXCL10, CXCL11). Interesting, upregulation of IFN-α/β-inducible genes (but not IFN-γ-inducible genes) was independent of histological scores (grade and stage of fibrosis) and HCV characteristics (hepatic HCV mRNA levels and the HCV genotype), and was specific to HCV (as compared to hepatitis B virus (HBV)). Other genes dysregulated in F1-CH-C, albeit less markedly than IFN-α/β- and IFN-γ-inducible genes, were mainly involved in the activation of lymphocytes infiltrating the liver (IFNG, TNF, CXCL6, IL6, CCL8, CXCR3, CXCR4, CCR2), cell proliferation (p16/CDKN2A, MKI67, p14/ARF), extracellular matrix remodeling (MMP9, ITGA2), lymphangiogenesis (XLKD1/LYVE), oxidative stress (CYP2E1), and cytoskeleton microtubule organization (STMN2/SCG10). Thus, a limited number of signaling pathways, and particularly the transcriptional network regulated by interferons, are dysregulated in the first

  7. Enterobacteriaceae infection – diagnosis, antibiotic resistance and prevention

    Directory of Open Access Journals (Sweden)

    Anna Jarząb

    2011-01-01

    Full Text Available Intestinal infections caused by rod-shaped bacteria of the [i]Enterobacteriaceae[/i] genus are one of the major health hazards in countries where sanitation standards are low. [i]Strains[/i] of [i]Shigella,[/i] [i]Salmonella, Escherichia[/i] and [i]Yersinia [/i]are responsible for diarrhea, severe bacillary dysentery, typhoid, other intestinal diseases, as well as genitourinary tract and blood infections. According to the WHO there are 4.5 billion cases every year, of which 1.9 million end in death. This makes intestinal infections third in terms of human disease mortality. In this work we discuss methods of pathogen identification, the mechanism of host-pathogen interaction, and the nature of the ¬host’s immunological response. Due to rising drug resistance we discuss the importance of better pathogen detection, vaccine design and the use of vaccines as a preventive measure against intestinal infections. Special attention is paid to OMP38, a protein isolated from [i]S. flexneri[/i] 3a outer membrane. Since it is known that this protein has good immunogenic properties, it can be used as an antigen or carrier for conjugate vaccines.

  8. Oral Valganciclovir as a Preemptive Treatment for Cytomegalovirus (CMV Infection in CMV-Seropositive Liver Transplant Recipients.

    Directory of Open Access Journals (Sweden)

    Jong Man Kim

    Full Text Available Cytomegalovirus (CMV infections in liver transplant recipients are common and result in significant morbidity and mortality. Intravenous ganciclovir or oral valganciclovir are the standard treatment for CMV infection. The present study investigates the efficacy of oral valganciclovir in CMV infection as a preemptive treatment after liver transplantation.Between 2012 and 2013, 161 patients underwent liver transplantation at Samsung Medical Center. All patients received tacrolimus, steroids, and mycophenolate mofetil. Patients with CMV infection were administered oral valganciclovir (VGCV 900mg/day daily or intravenous ganciclovir (GCV 5mg/kg twice daily as preemptive treatment. Stable liver transplant recipients received VGCV.Eighty-three patients (51.6% received antiviral therapy as a preemptive treatment because of CMV infection. The model for end-stage liver disease (MELD score and the proportions of Child-Pugh class C, hepatorenal syndrome, and deceased donor liver transplantation in the CMV infection group were higher than in the no CMV infection group. Sixty-one patients received GCV and 22 patients received VGCV. The MELD scores in the GCV group were higher than in the VGCV group, but there were no statistical differences in the pretransplant variables between the two groups. AST, ALT, and total bilirubin levels in the GCV group were higher than in the VGCV group when CMV infection occurred. The incidences of recurrent CMV infection in the GCV and VGCV groups were 14.8% and 4.5%, respectively (P=0.277.Oral valganciclovir is feasible as a preemptive treatment for CMV infection in liver transplant recipients with stable graft function.

  9. Diagnostic Usefulness of APRI and FIB-4 for the Prediction of Liver Fibrosis After Liver Transplantation in Patients Infected with Hepatitis C Virus.

    Science.gov (United States)

    Imai, H; Kamei, H; Onishi, Y; Ishizu, Y; Ishigami, M; Goto, H; Ogura, Y

    2018-06-01

    Aspartate transaminase-to-platelet ratio index (APRI) and fibrosis-4 (FIB-4) are well known as representative indirect serum biomarkers related to liver fibrosis. The usefulness of these markers for the diagnosis of liver fibrosis after liver transplantation (LT) in hepatitis C virus (HCV)-infected patients and the influence of splenectomy were investigated. From June 2003 to May 2014, 31 HCV-infected patients who underwent LT and postoperative follow-up liver biopsies were included in this study. The association between liver fibrosis and serum biomarkers and the influence of splenectomy on APRI and FIB-4 were also investigated. A total of 195 biopsy specimens were collected, and liver fibrosis was identified as: F0, 59.7%; F1, 34.1%; and F2, 6.3%. Both APRI and FIB-4 were significantly higher in patients who showed F1 and F2 in liver biopsy specimen than F0 (P values, .009 and .022, respectively); sensitivity and specificity of APRI were, respectively, 63.4% and 66.7%, and those of FIB-4 were 57.7% and 69.6%. In 11 patients (35.5%) who underwent splenectomy at the time of LT, the cutoff values for APRI and FIB-4 were 0.61 and 1.41, which were significantly lower than the corresponding values (1.00 and 3.64) of patients without splenectomy. APRI and FIB-4 could effectively estimate liver fibrosis after LT for HCV-related liver disease. For LT patients with splenectomy, APRI and FIB-4 were also useful to estimate liver fibrosis, but the standard values should be adjusted lower than those for patients without splenectomy. Copyright © 2018 Elsevier Inc. All rights reserved.

  10. Differential metabonomic profiles of primary hepatocellular carcinoma tumors from alcoholic liver disease, HBV-infected, and HCV-infected cirrhotic patients

    OpenAIRE

    Cao, Ding; Cai, Can; Ye, Mingxin; Gong, Junhua; Wang, Menghao; Li, Jinzheng; Gong, Jianping

    2017-01-01

    Our objective was to comparatively profile the metabolite composition of primary hepatocellular carcinoma (HCC) tumors from alcoholic liver disease (ALD), hepatitis B virus (HBV)-infected, and hepatitis C virus (HCV)-infected cirrhotic patients. Primary HCC tumors were collected from ALD, HBV-infected, and HCV-infected cirrhotic patients (n=20 each). High-resolution magic-angle spinning proton nuclear magnetic resonance spectroscopy and metabonomic data analysis were performed to compare HCC ...

  11. Hospital infection prevention and control issues relevant to extensive floods.

    Science.gov (United States)

    Apisarnthanarak, Anucha; Mundy, Linda M; Khawcharoenporn, Thana; Glen Mayhall, C

    2013-02-01

    The devastating clinical and economic implications of floods exemplify the need for effective global infection prevention and control (IPC) strategies for natural disasters. Reopening of hospitals after excessive flooding requires a balance between meeting the medical needs of the surrounding communities and restoration of a safe hospital environment. Postflood hospital preparedness plans are a key issue for infection control epidemiologists, healthcare providers, patients, and hospital administrators. We provide recent IPC experiences related to reopening of a hospital after extensive black-water floods necessitated hospital closures in Thailand and the United States. These experiences provide a foundation for the future design, execution, and analysis of black-water flood preparedness plans by IPC stakeholders.

  12. Preventing Bacterial Infections using Metal Oxides Nanocoatings on Bone Implant

    Science.gov (United States)

    Duceac, L. D.; Straticiuc, S.; Hanganu, E.; Stafie, L.; Calin, G.; Gavrilescu, S. L.

    2017-06-01

    Nowadays bone implant removal is caused by infection that occurs around it possibly acquired after surgery or during hospitalization. The purpose of this study was to reveal some metal oxides applied as coatings on bone implant thus limiting the usual antibiotics-resistant bacteria colonization. Therefore ZnO, TiO2 and CuO were synthesized and structurally and morphologically analized in order to use them as an alternative antimicrobial agents deposited on bone implant. XRD, SEM, and FTIR characterization techniques were used to identify structure and texture of these nanoscaled metal oxides. These metal oxides nanocoatings on implant surface play a big role in preventing bacterial infection and reducing surgical complications.

  13. Hand hygiene for the prevention of nosocomial infections.

    Science.gov (United States)

    Kampf, Günter; Löffler, Harald; Gastmeier, Petra

    2009-10-01

    The WHO regards hand hygiene as an essential tool for the prevention of nosocomial infection, but compliance in clinical practice is often low. The relevant scientific literature and national and international evidence-based recommendations (Robert Koch Institute [Germany], WHO) were evaluated. Hygienic hand disinfection has better antimicrobial efficacy than hand-washing and is the procedure of choice to be performed before and after manual contact with patients. The hands should be washed, rather than disinfected, only when they are visibly soiled. Skin irritation is quite common among healthcare workers and is mainly caused by water, soap, and prolonged wearing of gloves. Compliance can be improved by training, by placing hand-rub dispensers at the sites where they are needed, and by physicians setting a good example for others. Improved compliance in hand hygiene, with proper use of alcohol-based hand rubs, can reduce the nosocomial infection rate by as much as 40%.

  14. The Epidemiology and Clinical Features of Clostridium difficile Infection in Liver Transplant Recipients.

    Science.gov (United States)

    Sullivan, Timothy; Weinberg, Alan; Rana, Meenakshi; Patel, Gopi; Huprikar, Shirish

    2016-09-01

    Clostridium difficile infection (CDI) is common after liver transplantation (LT); however, few studies have examined the risk factors, clinical manifestations, and outcomes of CDI in this population. A retrospective study of adults who underwent LT between January 1, 2011, and April 4, 2013, at The Mount Sinai Hospital was conducted. Potential risk factors were evaluated via univariate and multivariable analysis to determine predictors of CDI in this population. The clinical manifestations of CDI and patient outcomes were also reviewed. Clostridium difficile infection occurred in 27 (14%) of 192 patients after LT. In multivariable analysis, CDI was associated with having a model for end-stage liver disease score of 20 or greater (hazards ratio, 2.90; 95% confidence interval, 1.29-6.52; P = 0.010), and receiving a LT from a living donor (hazards ratio, 3.77; 95% confidence interval, 1.47-9.67; P = 0.006). Forty-one percent of CDI cases occurred within 1 week of LT. Seven percent of patients with CDI had a serum white blood cell count greater than 12 000 cells per μL, and 26% had a temperature greater than 38.0°C. After treatment 6 (22%) patients developed CDI relapse, and all were successfully treated. No patients died of CDI after a mean follow-up time of 1.8 years; however, overall survival was significantly lower among those with CDI (78% vs 92%; P = 0.033). Clostridium difficile infection after LT was associated with higher model for end-stage liver disease scores and receiving a LT from a living donor. Clostridium difficile infection often occurred soon after LT and was infrequently associated with leukocytosis or fever. Clostridium difficile infection in LT recipients was associated with lower overall survival.

  15. Treating High-grade Lesions to Prevent Anal Cancer in HIV-infected People

    Science.gov (United States)

    This study, called the ANCHOR trial, will investigate whether screening and prevention methods similar to those used to prevent cervical cancer can help prevent anal cancer in HIV-infected men and women.

  16. Medium chain triglycerides dose-dependently prevent liver pathology in a rat model of nonalcoholic fatty liver disease

    Science.gov (United States)

    Obesity is often associated with a cluster of increased health risks collectively known as "Metabolic Syndrome" (MS). MS is often accompanied by development of fatty liver. Sometimes fatty liver results in damage leading to reduced liver function, and need for a transplant. This condition is known...

  17. Decolonization in Prevention of Health Care-Associated Infections

    Science.gov (United States)

    Schweizer, Marin L.

    2016-01-01

    SUMMARY Colonization with health care-associated pathogens such as Staphylococcus aureus, enterococci, Gram-negative organisms, and Clostridium difficile is associated with increased risk of infection. Decolonization is an evidence-based intervention that can be used to prevent health care-associated infections (HAIs). This review evaluates agents used for nasal topical decolonization, topical (e.g., skin) decolonization, oral decolonization, and selective digestive or oropharyngeal decontamination. Although the majority of studies performed to date have focused on S. aureus decolonization, there is increasing interest in how to apply decolonization strategies to reduce infections due to Gram-negative organisms, especially those that are multidrug resistant. Nasal topical decolonization agents reviewed include mupirocin, bacitracin, retapamulin, povidone-iodine, alcohol-based nasal antiseptic, tea tree oil, photodynamic therapy, omiganan pentahydrochloride, and lysostaphin. Mupirocin is still the gold standard agent for S. aureus nasal decolonization, but there is concern about mupirocin resistance, and alternative agents are needed. Of the other nasal decolonization agents, large clinical trials are still needed to evaluate the effectiveness of retapamulin, povidone-iodine, alcohol-based nasal antiseptic, tea tree oil, omiganan pentahydrochloride, and lysostaphin. Given inferior outcomes and increased risk of allergic dermatitis, the use of bacitracin-containing compounds cannot be recommended as a decolonization strategy. Topical decolonization agents reviewed included chlorhexidine gluconate (CHG), hexachlorophane, povidone-iodine, triclosan, and sodium hypochlorite. Of these, CHG is the skin decolonization agent that has the strongest evidence base, and sodium hypochlorite can also be recommended. CHG is associated with prevention of infections due to Gram-positive and Gram-negative organisms as well as Candida. Conversely, triclosan use is discouraged, and

  18. Dendrobium huoshanense polysaccharide prevents ethanol-induced liver injury in mice by metabolomic analysis.

    Science.gov (United States)

    Wang, Xiao-Yu; Luo, Jian-Ping; Chen, Rui; Zha, Xue-Qiang; Pan, Li-Hua

    2015-01-01

    The prevalence of alcohol consumption has increased in modern dietary life and alcoholic liver injury can follow. Dendrobium huoshanense polysaccharide (DHP) is a homogeneous polysaccharide isolated from Dendrobium huoshanense, which possesses hepatoprotection function. In this study, we investigated the metabolic profiles of serum and liver tissues extracts from control, ethanol-treated and DHP\\ethanol-treated mice using a UHPLC/LTQ Orbitrap XL MS-based metabolomics approach. Our results indicated that DHP alleviated early steatosis and inflammation in liver histology and the metabolomic analysis of serum and hepatic tissue revealed that first, ethanol treatment mainly altered phosphatidylcholines (PCs) including PC (13:0) and phosphocholine, arachidonic acid metabolites including 20-ethyl PGF2α and amino acids including L-Proline; Second, DHP supplementation ameliorated the altered metabolic levels particularly involved in phosphocholine and L-Proline. These data suggested that DHP might restore the perturbed metabolism pathways by ethanol exposure to prevent the progression of alcoholic liver injury. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Liver

    International Nuclear Information System (INIS)

    Bernardino, M.E.; Sones, P.J. Jr.; Barton Price, R.; Berkman, W.A.

    1984-01-01

    Evaluation of the liver for focal lesions is extremely important because the liver is one of the most common sites for metastatic disease. Most patients with metastatic deposits to the liver have a survival rate of about 6 months. Thus, metastatic disease to the liver has an extremely grave prognosis. In the past patients with hepatic lesions had no therapeutic recourse. However, with recent aggressive surgical advances (such as partial hepatectomies) and hepatic artery embolization, survival of patients with hepatic metastases has increased. Thus it is important for noninvasive imaging not only to detect lesions early in their course, but also to give their true hepatic involvement and the extent of the neoplastic process elsewhere in the body. Recent advances in imaging have been rapidly changing over the past 5 years. These changes have been more rapid in computed tomography (CT) and ultrasound than in radionuclide imaging. Thus, the question addressed in this chapter is: What is the relationship of hepatic ultrasound to the other current diagnostic modalities in detecting metastatic liver disease and other focal liver lesions? Also, what is its possible future relationship to nuclear magnetic resonance?

  20. Predictors of certification in infection prevention and control among infection preventionists: APIC MegaSurvey findings.

    Science.gov (United States)

    Kalp, Ericka L; Harris, Jeanette J; Zawistowski, Grace

    2018-06-06

    The 2015 APIC MegaSurvey was completed by 4,078 members to assess infection prevention practices. This study's purpose was to examine MegaSurvey results to relate infection preventionist (IP) certification status with demographic characteristics, organizational structure, compensation benefits, and practice and competency factors. Descriptive statistics were used to examine population characteristics and certification status. Bivariate logistic regression was performed to evaluate relationships between independent variables and certification status. Variables demonstrating statistical significance (P Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  1. Pyogenic liver abscess

    Science.gov (United States)

    Liver abscess; Bacterial liver abscess ... There are many possible causes of liver abscesses, including: Abdominal infection, such as appendicitis , diverticulitis , or a perforated bowel Infection in the blood Infection of the bile draining tubes ...

  2. Prevention and Control Strategies to Counter Dengue Virus Infection.

    Science.gov (United States)

    Rather, Irfan A; Parray, Hilal A; Lone, Jameel B; Paek, Woon K; Lim, Jeongheui; Bajpai, Vivek K; Park, Yong-Ha

    2017-01-01

    Dengue is currently the highest and rapidly spreading vector-borne viral disease, which can lead to mortality in its severe form. The globally endemic dengue poses as a public health and economic challenge that has been attempted to suppress though application of various prevention and control techniques. Therefore, broad spectrum techniques, that are efficient, cost-effective, and environmentally sustainable, are proposed and practiced in dengue-endemic regions. The development of vaccines and immunotherapies have introduced a new dimension for effective dengue control and prevention. Thus, the present study focuses on the preventive and control strategies that are currently employed to counter dengue. While traditional control strategies bring temporary sustainability alone, implementation of novel biotechnological interventions, such as sterile insect technique, paratransgenesis, and production of genetically modified vectors, has improved the efficacy of the traditional strategies. Although a large-scale vector control strategy can be limited, innovative vaccine candidates have provided evidence for promising dengue prevention measures. The use of tetravalent dengue vaccine (CYD-TDV) has been the most effective so far in treating dengue infections. Nonetheless, challenges and limitation hinder the progress of developing integrated intervention methods and vaccines; while the improvement in the latest techniques and vaccine formulation continues, one can hope for a future without the threat of dengue virus.

  3. Prevention and Control Strategies to Counter Dengue Virus Infection

    Directory of Open Access Journals (Sweden)

    Irfan A. Rather

    2017-07-01

    Full Text Available Dengue is currently the highest and rapidly spreading vector-borne viral disease, which can lead to mortality in its severe form. The globally endemic dengue poses as a public health and economic challenge that has been attempted to suppress though application of various prevention and control techniques. Therefore, broad spectrum techniques, that are efficient, cost-effective, and environmentally sustainable, are proposed and practiced in dengue-endemic regions. The development of vaccines and immunotherapies have introduced a new dimension for effective dengue control and prevention. Thus, the present study focuses on the preventive and control strategies that are currently employed to counter dengue. While traditional control strategies bring temporary sustainability alone, implementation of novel biotechnological interventions, such as sterile insect technique, paratransgenesis, and production of genetically modified vectors, has improved the efficacy of the traditional strategies. Although a large-scale vector control strategy can be limited, innovative vaccine candidates have provided evidence for promising dengue prevention measures. The use of tetravalent dengue vaccine (CYD-TDV has been the most effective so far in treating dengue infections. Nonetheless, challenges and limitation hinder the progress of developing integrated intervention methods and vaccines; while the improvement in the latest techniques and vaccine formulation continues, one can hope for a future without the threat of dengue virus.

  4. Liver-related death among HIV/hepatitis C virus-co-infected individuals

    DEFF Research Database (Denmark)

    Grint, Daniel; Peters, Lars; Rockstroh, Juergen K

    2015-01-01

    BACKGROUND: Potent, less toxic, directly acting antivirals (DAAs) for treatment of hepatitis C virus (HCV) infection promise to improve HCV cure rates among HIV/HCV-co-infected individuals. However, the costs of treatment will necessitate prioritization of those at greatest risk of liver-related ......BACKGROUND: Potent, less toxic, directly acting antivirals (DAAs) for treatment of hepatitis C virus (HCV) infection promise to improve HCV cure rates among HIV/HCV-co-infected individuals. However, the costs of treatment will necessitate prioritization of those at greatest risk of liver.......7-2.9), but substantial in those with F2/F3 and F4 fibrosis (sHR 10.3%, 95% CI 7.6-13.5; and sHR 14.0%, 95% CI 10.3-18.3, respectively). CONCLUSION: Treatment with DAAs should be prioritized for those with at least F2 fibrosis. Early initiation of cART with the aim of avoiding low CD4 cell counts should be considered...

  5. Long-term outcomes of liver transplant patients with human immunodeficiency virus infection and end-stage-liver-disease: single center experience

    Directory of Open Access Journals (Sweden)

    Vernadakis S

    2011-08-01

    Full Text Available Abstract Objective Orthotopic-liver-transplantation (OLT in patients with Human-Immunodeficiency-Virus infection (HIV and end-stage-liver-disease (ESDL is rarely reported. The purpose of this study is to describe our institutional experience on OLT for HIV positive patients. Material and methods This is a retrospective study of all HIV-infected patients who underwent OLT at the University Hospital of Essen, from January 1996 to December 2009. Age, sex, HIV transmission-way, CDC-stage, etiology of ESDL, concomitant liver disease, last CD4cell count and HIV-viral load prior to OLT were collected and analysed. Standard calcineurin-inhibitors-based immunosuppression was applied. All patients received anti-fungal and anti-pneumocystis carinii pneumonia prophylaxis post-OLT. Results Eight transplanted HIV-infected patients with a median age of 46 years (range 35-61 years were included. OLT indications were HCV (n = 5, HBV (n = 2, HCV/HBV/HDV-related cirrhosis (n = 1 and acute liver-failure (n = 1. At OLT, CD4 cell-counts ranged from 113-621 cells/μl, and HIV viral-loads from Conclusions OLT in HIV-infected patients and ESLD is an acceptable therapeutic option in selected patients. Long-term survival can be achieved without HIV disease-progression under antiretroviral therapy and management of the viral hepatitis co-infection.

  6. Prevention of Postoperative Bile Leak in Partial Cystectomy for Hydatid Liver Disease: Tricks of the Trade.

    Science.gov (United States)

    Peker, Kivanc Derya; Gumusoglu, Alpen Yahya; Seyit, Hakan; Kabuli, Hamit Ahmet; Salik, Aysun Erbahceci; Gonenc, Murat; Kapan, Selin; Alis, Halil

    2015-12-01

    The presence of postoperative bile leak is the major outcome measure for the assessment of operative success in partial cystectomy for hydatid liver disease. However, the optimal operative strategy to reduce the postoperative bile leak rate is yet to be defined. Medical records of patients who underwent partial cystectomy for hydatid liver disease between January 2013 and January 2015 were reviewed in this retrospective analysis. All patients were managed with a specific operative protocol. The primary outcome measure was the rate of persistent postoperative bile leak. The secondary outcome measures were the morbidity and mortality rate, and the length of hospital stay. Twenty-eight patients were included in the study. Only one patient (3.6 %) developed persistent postoperative bile leak. The overall morbidity and mortality rate was 17.8 and 0 %, respectively. The median length of hospital stay was 5 days. Aggressive preventative surgical measures have led to low persistent bile leak rates with low morbidity and mortality.

  7. Preventing healthcare-associated infections through human factors engineering.

    Science.gov (United States)

    Jacob, Jesse T; Herwaldt, Loreen A; Durso, Francis T

    2018-05-24

    Human factors engineering (HFE) approaches are increasingly being used in healthcare, but have been applied in relatively limited ways to infection prevention and control (IPC). Previous studies have focused on using selected HFE tools, but newer literature supports a system-based HFE approach to IPC. Cross-contamination and the existence of workarounds suggest that healthcare workers need better support to reduce and simplify steps in delivering care. Simplifying workflow can lead to better understanding of why a process fails and allow for improvements to reduce errors and increase efficiency. Hand hygiene can be improved using visual cues and nudges based on room layout. Using personal protective equipment appropriately appears simple, but exists in a complex interaction with workload, behavior, emotion, and environmental variables including product placement. HFE can help prevent the pathogen transmission through improving environmental cleaning and appropriate use of medical devices. Emerging evidence suggests that HFE can be applied in IPC to reduce healthcare-associated infections. HFE and IPC collaboration can help improve many of the basic best practices including use of hand hygiene and personal protective equipment by healthcare workers during patient care.

  8. Preventing urinary tract infections after menopause without antibiotics.

    Science.gov (United States)

    Caretto, Marta; Giannini, Andrea; Russo, Eleonora; Simoncini, Tommaso

    2017-05-01

    Urinary tract infections (UTIs) are the most common bacterial infections in women, and increase in incidence after the menopause. It is important to uncover underlying abnormalities or modifiable risk factors. Several risk factors for recurrent UTIs have been identified, including the frequency of sexual intercourse, spermicide use and abnormal pelvic anatomy. In postmenopausal women UTIs often accompany the symptoms and signs of the genitourinary syndrome of menopause (GSM). Antimicrobial prophylaxis has been demonstrated to be effective in reducing the risk of recurrent UTIs in women, but this may lead to drug resistance of both the causative microorganisms and the indigenous flora. The increasing prevalence of Escherichia coli (the most prevalent uropathogen) that is resistant to antimicrobial agents has stimulated interest in novel non-antibiotic methods for the prevention of UTIs. Evidence shows that topical estrogens normalize vaginal flora and greatly reduce the risk of UTIs. The use of intravaginal estrogens may be reasonable in postmenopausal women not taking oral estrogens. A number of other strategies have been used to prevent recurrent UTIs: probiotics, cranberry juice and d-mannose have been studied. Oral immunostimulants, vaginal vaccines and bladder instillations with hyaluronic acid and chondroitin sulfate are newer strategies proposed to improve urinary symptoms and quality of life. This review provides an overview of UTIs' prophylaxis without antibiotics, focusing on a practical clinical approach to women with UTIs. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Prevention of recurrent urinary tract infection in children.

    Science.gov (United States)

    Williams, Gabrielle; Craig, Jonathan C

    2009-02-01

    Urinary tract infection (UTI) in children is common (5-10%) and recurs in 10-30%. UTI causes an unpleasant, usually febrile illness in children. This review focuses on studies evaluating interventions to prevent UTI in children and published between January 2007 and June 2008. Three relevant updated Cochrane reviews, six randomized trials and an evidence-based guideline were published in the study period. Five of the six trials and one of the three Cochrane updates included data on the effects of relevant interventions in children. Three of the six trials investigated the efficacy of long-term, low-dose antibiotics as prophylaxis, and the other trials and both Cochrane updates evaluated complementary therapies such as vitamin A, probiotics and herbal supplements. The benefit of prophylactic antibiotics for the prevention of recurrent UTI in children remains unclear because of underpowered and suboptimally designed trials, but these studies suggest that any benefit is likely to be small, and clinical significance may be limited. The trials of complementary interventions (vitamin A, probiotics, cranberry, nasturtium and horseradish) generally gave favourable results but were not conclusive. Children and families who use these products should be aware that further infections are possible despite their use.

  10. Research progress on influencing factors of hospital infection and prevention and control measures

    Directory of Open Access Journals (Sweden)

    He Wenlong

    2015-03-01

    Full Text Available Hospital infections are associated with the emergence of hospitals. As the understanding of hospital infections deepen and prevention and control measures improve, hospital infections have become manageable. In recent years, affected by the increase in invasive treatment technology, antimicrobial abuse, and other factors, the control of hospital infection has encountered new problems. This paper reviews the influencing factors of hospital infections and their prevention and control measures.

  11. Risk Factors for Bloodstream Infection After Living-donor Liver Transplantation in Children.

    Science.gov (United States)

    Shoji, Kensuke; Funaki, Takanori; Kasahara, Mureo; Sakamoto, Seisuke; Fukuda, Akinari; Vaida, Florin; Ito, Kenta; Miyairi, Isao; Saitoh, Akihiko

    2015-10-01

    Postoperative bloodstream infection (BSI) is the most important determinant of recipient morbidity and mortality after liver transplantation (LT). Children who underwent LT are at the highest risk of developing BSI because of the significant surgical intervention, use of multiple devices, and administration of immunosuppressive agents. However, information regarding the risk factors for BSI in children after LT is limited. We retrospectively reviewed 210 children who underwent living-donor LT at the largest pediatric LT center in Japan. Patients' characteristics, blood culture results and clinical outcomes were extracted from electronic medical records. Univariate and multivariate analyses were performed to identify the risk factors for BSI. Among the 210 LT recipients, 53 (25%) recipients experienced 86 episodes of BSI during the observational period. The source of the BSI was identified only in 38%: catheter-related BSI (27%) peritonitis (7%), urinary tract infection (2%), pneumonia (1%) and infectious endocarditis (1%). A multivariate analysis demonstrated that body weight (P = 0.03), volume of blood loss during LT (P 24 months), blood loss and pediatric end-stage liver disease/model for end-stage liver disease versus positive CMV antigenemia. The volume of blood loss, postoperative CMV antigenemia positivity and body weight were associated with the development of BSI after LT in pediatric living-donor recipients. To identify the age-specific predictors of BSI in children who underwent LT, age-specific analyses are crucial.

  12. Interventions for preventing recurrent urinary tract infection during pregnancy.

    Science.gov (United States)

    Schneeberger, Caroline; Geerlings, Suzanne E; Middleton, Philippa; Crowther, Caroline A

    2012-11-14

    Recurrent urinary tract infections (RUTI) are common in women who are pregnant and may cause serious adverse pregnancy outcomes for both mother and child including preterm birth and small-for-gestational-age babies. Interventions used to prevent RUTI in women who are pregnant can be pharmacological (antibiotics) or non-pharmacological (cranberry products, acupuncture, probiotics and behavioural modifications). So far little is known about the best way to prevent RUTI in pregnant women. To assess the effects of interventions for preventing recurrent urinary tract infections in pregnant women.The primary maternal outcomes were RUTI before birth (variously defined) and preterm birth (before 37 weeks). The primary infant outcomes were small-for-gestational age and total mortality. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (8 June 2012) and reference lists of retrieved articles. Published, unpublished and ongoing randomised controlled trials (RCTs), quasi-RCTs, clustered-randomised trials and abstracts of any intervention (pharmacological and non-pharmacological) for preventing RUTI during pregnancy (compared with another intervention, placebo or with usual care). Two review authors independently evaluated the one identified trial for inclusion and assessed trial quality. Two review authors extracted data. Data were checked for accuracy. The review included one trial involving 200 women. The trial compared a daily dose of nitrofurantoin and close surveillance (regular clinic visit, urine cultures and antibiotics when a positive culture was found) with close surveillance only. No significant differences were found for the primary outcomes: recurrent pyelonephritis (risk ratio (RR) 0.89, 95% confidence interval (CI) 0.31 to 2.53, one study, 167 women), recurrent urinary tract infection before birth (RR 0.30, 95% CI 0.06 to 1.38; one study 167 women) and preterm birth (before 37 weeks) (RR 1.18, 95% CI 0.42 to 3.35; one study 147 women). The

  13. [Clinical guidelines for the prevention of infective endocarditis].

    Science.gov (United States)

    Pérez-Lescure Picarzo, J; Crespo Marcos, D; Centeno Malfaz, F

    2014-03-01

    This article sets out the recommendations for the prevention of infective endocarditis (IE), contained in the guidelines developed by the American Heart Association (AHA) and the European Society of Cardiology (ESC), from which the recommendations of the Spanish Society of Paediatric Cardiology and Congenital Heart Disease have been agreed. In recent years, there has been a considerable change in the recommendations for the prevention of IE, mainly due to the lack of evidence on the effectiveness of antibiotic prophylaxis in prevention, and the risk of the development of antibiotic resistance. The main change is a reduction of the indications for antibiotic prophylaxis, both in terms of patients and procedures considered at risk. Clinical practice guidelines and recommendations should assist health professionals in making clinical decisions in their daily practice. However, the ultimate judgment regarding the care of a particular patient must be taken by the physician responsible. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  14. Action of mechanism of traditional Chinese medicine in prevention and treatment of nonalcoholic fatty liver disease

    Directory of Open Access Journals (Sweden)

    HOU Yixin

    2016-04-01

    Full Text Available In recent years, extensive studies have been conducted on the pathogenesis of nonalcoholic fatty liver disease (NAFLD, and the action of mechanism of traditional Chinese medicine (TCM in NAFLD has become a new research topic. TCM has achieved good clinical efficacy in the treatment of NAFLD, with the advantages of specific, flexible, multilevel, and multi-target treatment. This article introduces the role of TCM in improving insulin, regulating lipid metabolism, preventing lipid peroxidation, regulating cytokines, regulating and maintaining the dynamic balance of factors involved in lipid metabolism, and maintaining the balance of intestinal microflora, and analyzes the major problems in TCM research.

  15. Liver (Hepatocellular) Cancer Screening

    Science.gov (United States)

    ... Treatment Liver Cancer Prevention Liver Cancer Screening Research Liver (Hepatocellular) Cancer Screening (PDQ®)–Patient Version What is ... These are called diagnostic tests . General Information About Liver (Hepatocellular) Cancer Key Points Liver cancer is a ...

  16. Host scavenger receptor SR-BI plays a dual role in the establishment of malaria parasite liver infection

    NARCIS (Netherlands)

    Rodrigues, Cristina D.; Hannus, Michael; Prudencio, Miguel; Martin, Cecilie; Goncalves, Ligia A.; Portugal, Silvia; Epiphanio, Sabrina; Akinc, Akin; Hadwiger, Philipp; Jahn-Hofmann, Kerstin; Roehl, Ingo; van Gemert, Geert-Jan; Franetich, Jean-Francois; Luty, Adrian J. F.; Sauerwein, Robert; Mazier, Dominique; Koteliansky, Victor; Vornlocher, Hans-Peter; Echeverri, Christophe J.; Mota, Maria M.

    2008-01-01

    An obligatory step of malaria parasite infection is Plasmodium sporozoite invasion of host hepatocytes, and host lipoprotein clearance pathways have been linked to Plasmodium liver infection. By using RNA interference to screen lipoprotein-related host factors, we show here that the class B, type I

  17. 'Surprise': Outbreak of Campylobacter infection associated with chicken liver pâté at a surprise birthday party, Adelaide, Australia, 2012.

    Science.gov (United States)

    Parry, Amy; Fearnley, Emily; Denehy, Emma

    2012-10-01

    In July 2012, an outbreak of Campylobacter infection was investigated by the South Australian Communicable Disease Control Branch and Food Policy and Programs Branch. The initial notification identified illness at a surprise birthday party held at a restaurant on 14 July 2012. The objective of the investigation was to identify the potential source of infection and institute appropriate intervention strategies to prevent further illness. A guest list was obtained and a retrospective cohort study undertaken. A combination of paper-based and telephone questionnaires were used to collect exposure and outcome information. An environmental investigation was conducted by Food Policy and Programs Branch at the implicated premises. All 57 guests completed the questionnaire (100% response rate), and 15 met the case definition. Analysis showed a significant association between illness and consumption of chicken liver pâté (relative risk: 16.7, 95% confidence interval: 2.4-118.6). No other food or beverage served at the party was associated with illness. Three guests submitted stool samples; all were positive for Campylobacter. The environmental investigation identified that the cooking process used in the preparation of chicken liver pâté may have been inconsistent, resulting in some portions not cooked adequately to inactivate potential Campylobacter contamination. Chicken liver products are a known source of Campylobacter infection; therefore, education of food handlers remains a high priority. To better identify outbreaks among the large number of Campylobacter notifications, routine typing of Campylobacter isolates is recommended.

  18. ‘Surprise’: Outbreak of Campylobacter infection associated with chicken liver pâté at a surprise birthday party, Adelaide, Australia, 2012

    Science.gov (United States)

    Fearnley, Emily; Denehy, Emma

    2012-01-01

    Objective In July 2012, an outbreak of Campylobacter infection was investigated by the South Australian Communicable Disease Control Branch and Food Policy and Programs Branch. The initial notification identified illness at a surprise birthday party held at a restaurant on 14 July 2012. The objective of the investigation was to identify the potential source of infection and institute appropriate intervention strategies to prevent further illness. Methods A guest list was obtained and a retrospective cohort study undertaken. A combination of paper-based and telephone questionnaires were used to collect exposure and outcome information. An environmental investigation was conducted by Food Policy and Programs Branch at the implicated premises. Results All 57 guests completed the questionnaire (100% response rate), and 15 met the case definition. Analysis showed a significant association between illness and consumption of chicken liver pâté (relative risk: 16.7, 95% confidence interval: 2.4–118.6). No other food or beverage served at the party was associated with illness. Three guests submitted stool samples; all were positive for Campylobacter. The environmental investigation identified that the cooking process used in the preparation of chicken liver pâté may have been inconsistent, resulting in some portions not cooked adequately to inactivate potential Campylobacter contamination. Discussion Chicken liver products are a known source of Campylobacter infection; therefore, education of food handlers remains a high priority. To better identify outbreaks among the large number of Campylobacter notifications, routine typing of Campylobacter isolates is recommended. PMID:23908933

  19. Immunoexpression of intermediate filaments and morphological changes in the liver and bile duct of rats infected with Fasciola hepatica.

    Science.gov (United States)

    Kolodziejczyk, L; Laszczyńska, M; Masiuk, M; Grabowska, M; Skrzydlewska, E

    2015-01-01

    We investigated the immunoexpression of the intermediate filament proteins, cytokeratin and desmin, and the morphological changes in the liver of rats during experimental fasciolosis at 4, 7 and 10 weeks post-infection. Rats were infected with 30 Fasciola hepatica metacercariae. Paraffin sections of the liver were stained using H & E, PAS and azan stains. Immunohistochemical reactions were performed using antibodies against cytokeratin and desmin. The experimental F. hepatica infection led to fibrosis and cirrhosis of the liver, and to inflammation of the common bile ducts. The expression of cytokeratin was increased in the epithelial cells of both the liver bile ductules at 4, 7 and 10 weeks post-infection and in the common bile ducts at 7 and 10 weeks post-infection compared to uninfected rats; expression in the common bile ducts was more intense. The myofibroblasts of the liver and smooth myocytes of the interlobular bile ducts and common bile ducts, showed a slight increase in desmin expression compared to the uninfected rats. The increased expression of cytokeratins in the hyperplastic rat common bile duct epithelium during the biliary phase of fasciolosis at 7 and 10 weeks post-infection may be explained by mechanical irritation by the parasite and an inflammatory reaction in the bile duct epithelium and in periductal fibrous tissue.

  20. The national response for preventing healthcare-associated infections: research and adoption of prevention practices.

    Science.gov (United States)

    Kahn, Katherine L; Mendel, Peter; Leuschner, Kristin J; Hiatt, Liisa; Gall, Elizabeth M; Siegel, Sari; Weinberg, Daniel A

    2014-02-01

    Healthcare-associated infections (HAIs) have long been the subject of research and prevention practice. When findings show potential to significantly impact outcomes, clinicians, policymakers, safety experts, and stakeholders seek to bridge the gap between research and practice by identifying mechanisms and assigning responsibility for translating research to practice. This paper describes progress and challenges in HAI research and prevention practices, as explained through an examination of Health and Human Services (HHS) Action Plan's goals, inputs, and implementation in each area. We used the Context-Input-Process-Product evaluation model, together with an HAI prevention system framework, to assess the transformative processes associated with HAI research and adoption of prevention practices. Since the introduction of the Action Plan, HHS has made substantial progress in prioritizing research projects, translating findings from those projects into practice, and designing and implementing research projects in multisite practice settings. Research has emphasized the basic science and epidemiology of HAIs, the identification of gaps in research, and implementation science. The basic, epidemiological, and implementation science communities have joined forces to better define mechanisms and responsibilities for translating HAI research into practice. Challenges include the ongoing need for better evidence about intervention effectiveness, the growing implementation burden on healthcare providers and organizations, and challenges implementing certain practices. Although these HAI research and prevention practice activities are complex spanning multiple system functions and properties, HHS is making progress so that the right methods for addressing complex HAI problems at the interface of patient safety and clinical practice can emerge.

  1. Time course of gene expression profiling in the liver of experimental mice infected with Echinococcus multilocularis.

    Directory of Open Access Journals (Sweden)

    Renyong Lin

    Full Text Available BACKGROUND: Alveolar echinococcosis (AE is a severe chronic parasitic disease which behaves like a slow-growing liver cancer. Clinical observations suggest that the parasite, Echinococcus multilocularis (E. multilocularis influences liver homeostasis and hepatic cell metabolism. However, this has never been analyzed during the time course of infection in the common model of secondary echinococcosis in experimental mice. METHODOLOGY/PRINCIPAL FINDINGS: Gene expression profiles were assessed using DNA microarray analysis, 1, 2, 3 and 6 months after injection of E. multilocularis metacestode in the liver of susceptible mice. Data were collected at different time points to monitor the dynamic behavior of gene expression. 557 differentially expressed genes were identified at one or more time points, including 351 up-regulated and 228 down-regulated genes. Time-course analysis indicated, at the initial stage of E. multilocularis infection (month 1-2, that most of up-regulated pathways were related to immune processes and cell trafficking such as chemokine-, mitogen-activated protein kinase (MAPK signaling, and down-regulated pathways were related to xenobiotic metabolism; at the middle stage (month 3, MAPK signaling pathway was maintained and peroxisome proliferator-activated receptor (PPAR signaling pathway emerged; at the late stage (month 6, most of up-regulated pathways were related to PPAR signaling pathway, complement and coagulation cascades, while down-regulated pathways were related to metabolism of xenobiotics by cytochrome P450. Quantitative RT-PCR analysis of a random selection of 19 genes confirmed the reliability of the microarray data. Immunohistochemistry analysis showed that proliferating cell nuclear antigen (PCNA was increased in the liver of E. multilocularis infected mice from 2 months to 6 months. CONCLUSIONS: E. multilocularis metacestode definitely exerts a deep influence on liver homeostasis, by modifying a number of gene

  2. Alpha-fetoprotein and hepatitis B virus infection in chronic liver disease

    International Nuclear Information System (INIS)

    Solina, A.

    1987-01-01

    Among 177 patients with chronic non-malignant liver disease, the prevalence of raised levels of alpha-fetoprotein (AFP) was 11.2 percent. A close association between the severity of the liver disease and AFP concentrations was observed. The most frequent pattern of hepatitis B virus (HBV) infection in these patients was the presence of antibodies to hepatitis B surface antigen (anti-HBs) and hepatitis B core antigen (anti-HBc), whilst only 5 cases were positive for hepatitis B surface antigen (HBsAg). Sixty seven patients, 18 of whom with high AFP, were longitudinally studied over a period ranging from 1 to 6 years. The evaluation of AFP was transient in 6 cases and persistent in 12 cases. The patients in the former group had high activity of liver disease and none of them developed primary liver cell cancer during the follow-up. In contrast, only two patients in the latter group had high activity, and 3 developed PLC. Active HBV replication was significantly more frequent among those with transient elevation of AFP, whereas anti-HBs and anti-HBc positive cases were significantly more frequent among those with persistent elevation of AFP. It is concluded that the severity of the liver disease is the major factor of elevation of AFP. Transiently raised levels of AFP are not related with PLC, whereas persistently high levels represent a premalignant condition. At variance with data obtained in areas with high prevalence of PLC, HBsAg seems not to be related with persistent elevation of AFP. The high rate positive for anti-HBs and anti-HBc in this group remains to be clarified

  3. Cochrane Commentary: Probiotics For Prevention of Acute Upper Respiratory Infection.

    Science.gov (United States)

    Quick, Melissa

    2015-01-01

    Probiotics may improve a person's health by regulating their immune function. Some trials have shown that probiotic strains can prevent respiratory infections. Even though the previous version of our review showed benefits of probiotics for acute upper respiratory tract infections (URTIs), several new studies have been published. To assess the effectiveness and safety of probiotics (any specified strain or dose), compared with placebo, in the prevention of acute URTIs in people of all ages, who are at risk of acute URTIs. We searched CENTRAL (2014, Issue 6), MEDLINE (1950 to July week 3, 2014), EMBASE (1974 to July 2014), Web of Science (1900 to July 2014), the Chinese Biomedical Literature Database, which includes the China Biological Medicine Database (from 1978 to July 2014), the Chinese Medicine Popular Science Literature Database (from 2000 to July 2014) and the Masters Degree Dissertation of Beijing Union Medical College Database (from 1981 to July 2014). We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov for completed and ongoing trials on 31 July 2014. Randomised controlled trials (RCTs) comparing probiotics with placebo to prevent acute URTIs. Two review authors independently assessed the eligibility and quality of trials, and extracted data using the standard methodological procedures expected by The Cochrane Collaboration. We included 13 RCTs, although we could only extract data to meta-analyze 12 trials, which involved 3720 participants including children, adults (aged around 40 years) and older people. We found that probiotics were better than placebo when measuring the number of participants experiencing episodes of acute URTI [at least one episode: odds ratio (OR): 0.53; 95% CI = 0.37-0.76, P school absence (OR: 0.10; 95% CI = 0.02-0.47, very low quality evidence). Probiotics and placebo were similar when measuring the rate ratio of episodes of acute URTI (rate ratio: 0

  4. Probiotics to prevent urinary tract infections: the rationale and evidence.

    Science.gov (United States)

    Reid, Gregor; Bruce, Andrew W

    2006-02-01

    For over 30 years, urologists have recognized in females, that urinary pathogens almost always infect the host through ascension from the rectum, vagina to the urethra and bladder. Likewise, the Lactobacillus organisms that predominate in the vagina of healthy women, spread from the rectum and perineum and form a barrier in the vagina to bladder entry by uropathogens. The concept of artificially boosting the lactobacilli numbers through probiotic instillation has long been conceived, but only in recent years shown to be possible. Not all lactobacilli are effective, and to date clinical efficacy only exists for Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri B-54 and RC-14. These strains are only commercially available in Austria, and therefore for most urologists, while some probiotic organisms may reduce the recurrences of bladder cancer or oxaluria, no probiotics can be recommended widely to prevent UTI at present.

  5. Nanosized Selenium: A Novel Platform Technology to Prevent Bacterial Infections

    Science.gov (United States)

    Wang, Qi

    As an important category of bacterial infections, healthcare-associated infections (HAIs) are considered an increasing threat to the safety and health of patients worldwide. HAIs lead to extended hospital stays, contribute to increased medical costs, and are a significant cause of morbidity and mortality. In the United States, infections encountered in the hospital or a health care facility affect more than 1.7 million patients, cost 35.7 billion to 45 billion, and contribute to 88,000 deaths in hospitals annually. The most conventional and widely accepted method to fight against bacterial infections is using antibiotics. However, because of the widespread and sometimes inappropriate use of antibiotics, many strains of bacteria have rapidly developed antibiotic resistance. Those new, stronger bacteria pose serious, worldwide threats to public health and welfare. In 2014, the World Health Organization (WHO) reported antibiotic resistance as a global serious threat that is no longer a prediction for the future but is now reality. It has the potential to affect anyone, of any age, in any country. The most effective strategy to prevent antibiotic resistance is minimizing the use of antibiotics. In recent years, nanomaterials have been investigated as one of the potential substitutes of antibiotics. As a result of their vastly increased ratio of surface area to volume, nanomaterials will likely exert a stronger interaction with bacteria which may affect bacterial growth and propagation. A major concern of most existing antibacterial nanomaterials, like silver nanoparticles, is their potential toxicity. But selenium is a non-metallic material and a required nutrition for the human body, which is recommended by the FDA at a 53 to 60 μg daily intake. Nanosized selenium is considered to be healthier and less toxic compared with many metal-based nanomaterials due to the generation of reactive oxygen species from metals, especially heavy metals. Therefore, the objectives of

  6. Clinical Predictors of Liver Fibrosis in Patients With Chronic Hepatitis B Virus Infection From Children to Adults.

    Science.gov (United States)

    Wu, Jia-Feng; Song, Shih-Hsi; Lee, Chee-Seng; Chen, Huey-Ling; Ni, Yen-Hsuan; Hsu, Hong-Yuan; Wu, Tzee-Chung; Chang, Mei-Hwei

    2018-04-11

    This study aimed to elucidate predictors of liver fibrosis in patients with chronic hepatitis B virus (HBV) infection. Transient elastography was performed to define liver stiffness in 533 patients with chronic HBV infection (mean age ± standard deviation, 30.72 ± 0.57 years). Protein array was performed on serum samples and lysates of Huh7 cells transfected with HBV mutants; the results were confirmed by enzyme-linked immunosorbent assay. Single-nucleotide polymorphisms in the gene encoding interleukin 1β (IL-1β) were examined in patients with chronic HBV infection with and without liver fibrosis. Male sex, age ≥18 years, and serum α-fetoprotein level >3.6 ng/mL were independent predictors of a liver stiffness measurement of ≥7 kPa (P = .005, .019, and rs16944 and the CC genotype at rs1143627 in the gene encoding IL-1β were associated with higher serum IL-1β levels and liver fibrosis. Male sex, age ≥18 years, elevated α-fetoprotein level, and HBeAg-negative hepatitis are risk factors for liver fibrosis. IL-1β is involved in the progression of liver fibrosis in subjects with HBeAg-negative hepatitis.

  7. Non-invasive index of liver fibrosis induced by alcohol, thioacetamide and schistosomal infection in mice

    Directory of Open Access Journals (Sweden)

    El-Beltagy Doha M

    2010-06-01

    Full Text Available Abstract Background Non invasive approaches will likely be increasing utilized to assess liver fibrosis. This work provides a new non invasive index to predict liver fibrosis induced in mice. Methods Fibrosis was generated by thioacetamide (TAA, chronic intake of ethanol, or infection with S. mansoni in 240 mice. Both progression and regression of fibrosis (after treatment with silymarin and/or praziquantel were monitored. The following methods were employed: (i The METAVIR system was utilized to grade and stage liver inflammation and fibosis; (ii Determination of hepatic hydroxyproline and collagen; and (iii Derivation of a new hepatic fibrosis index from the induced changes, and its prospective validation in a group of 70 mice. Results The index is composed of 4 serum variable including total proteins, γ-GT, bilirubin and reduced glutathione (GSH, measured in diseased, treated and normal mice. These parameters were highly correlated with both the histological stage and the grade. They were combined in a logarithmic formula, which non-invasively scores the severity of liver fibrosis through a range (0 to 2, starting with healthy liver (corresponding to stage 0 to advanced fibrosis (corresponding stage 3.Receiver operating characteristic curves (ROC for the accuracy of the index to predict the histological stages demonstrated that the areas under the curve (AUC were 0.954, 0.979 and 0.99 for index values corresponding to histological stages 1, 2 and 3, respectively. Also, the index was correlated with stage and grade, (0.947 and 0.859, respectively. The cut off values that cover the range between stages 0-1, 1-2 and 2-3 are 0.4, 1.12 and 1.79, respectively. The results in the validation group confirmed the accuracy of the test. The AUROC was 0.869 and there was good correlation with the stage of fibrosis and grade of inflammation. Conclusion The index fulfils the basic criteria of non-invasive marker of liver fibrosis since it is liver

  8. Curcumin Prevents Aflatoxin B1 Hepatoxicity by Inhibition of Cytochrome P450 Isozymes in Chick Liver

    Directory of Open Access Journals (Sweden)

    Ni-Ya Zhang

    2016-11-01

    Full Text Available This study was designed to establish if Curcumin (CM alleviates Aflatoxin B1 (AFB1-induced hepatotoxic effects and to determine whether alteration of the expression of cytochrome P450 (CYP450 isozymes is involved in the regulation of these effects in chick liver. One-day-old male broilers (n = 120 were divided into four groups and used in a two by two factorial trial in which the main factors included supplementing AFB1 (< 5 vs. 100 μg/kg and CM (0 vs. 150 mg/kg in a corn/soybean-based diet. Administration of AFB1 induced liver injury, significantly decreasing albumin and total protein concentrations and increasing alanine aminotransferase and aspartate aminotransferase activities in serum, and induced hepatic histological lesions at week 2. AFB1 also significantly decreased hepatic glutathione peroxidase, catalase, and glutathione levels, while increasing malondialdehyde, 8-hydroxydeoxyguanosine, and exo-AFB1-8,9-epoxide (AFBO-DNA concentrations. In addition, the mRNA and/or activity of enzymes responsible for the bioactivation of AFB1 into AFBO—including CYP1A1, CYP1A2, CYP2A6, and CYP3A4—were significantly induced in liver microsomes after 2-week exposure to AFB1. These alterations induced by AFB1 were prevented by CM supplementation. Conclusively, dietary CM protected chicks from AFB1-induced liver injury, potentially through the synergistic actions of increased antioxidant capacities and inhibition of the pivotal CYP450 isozyme-mediated activation of AFB1 to toxic AFBO.

  9. Fenofibrate, a peroxisome proliferator-activated receptor α ligand, prevents abnormal liver function induced by a fasting–refeeding process

    International Nuclear Information System (INIS)

    Lee, Joon No; Dutta, Raghbendra Kumar; Kim, Seul-Gi; Lim, Jae-Young; Kim, Se-Jin; Choe, Seong-Kyu; Yoo, Kyeong-Won; Song, Seung Ryel; Park, Do-Sim; So, Hong-Seob; Park, Raekil

    2013-01-01

    Highlights: •A fasting–refeeding high fat diet (HDF) model mimics irregular eating habit. •A fasting–refeeding HFD induces liver ballooning injury. •A fasting–refeeding HDF process elicits hepatic triglyceride accumulation. •Fenofibrate, PPARα ligand, prevents liver damage induced by refeeding HFD. -- Abstract: Fenofibrate, a peroxisome proliferator-activated receptor α (PPARα) agonist, is an anti-hyperlipidemic agent that has been widely used in the treatment of dyslipidemia. In this study, we examined the effect of fenofibrate on liver damage caused by refeeding a high-fat diet (HFD) in mice after 24 h fasting. Here, we showed that refeeding HFD after fasting causes liver damage in mice determined by liver morphology and liver cell death. A detailed analysis revealed that hepatic lipid droplet formation is enhanced and triglyceride levels in liver are increased by refeeding HFD after starvation for 24 h. Also, NF-κB is activated and consequently induces the expression of TNF-α, IL1-β, COX-2, and NOS2. However, treating with fenofibrate attenuates the liver damage and triglyceride accumulation caused by the fasting–refeeding HFD process. Fenofibrate reduces the expression of NF-κB target genes but induces genes for peroxisomal fatty acid oxidation, peroxisome biogenesis and mitochondrial fatty acid oxidation. These results strongly suggest that the treatment of fenofibrate ameliorates the liver damage induced by fasting–refeeding HFD, possibly through the activation of fatty acid oxidation

  10. Fenofibrate, a peroxisome proliferator-activated receptor α ligand, prevents abnormal liver function induced by a fasting–refeeding process

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Joon No; Dutta, Raghbendra Kumar; Kim, Seul-Gi; Lim, Jae-Young; Kim, Se-Jin; Choe, Seong-Kyu [Center for Metabolic Function Regulation, and Department of Microbiology, School of Medicine, Wonkwang University, Iksan (Korea, Republic of); Yoo, Kyeong-Won [Center for Metabolic Function Regulation, and Department of Microbiology, School of Medicine, Wonkwang University, Iksan (Korea, Republic of); Immune-network Pioneer Research Center, Department of Biochemistry, College of Medicine, Dong-A University, Busan (Korea, Republic of); Song, Seung Ryel [Center for Metabolic Function Regulation, and Department of Microbiology, School of Medicine, Wonkwang University, Iksan (Korea, Republic of); Park, Do-Sim [Center for Metabolic Function Regulation, and Department of Microbiology, School of Medicine, Wonkwang University, Iksan (Korea, Republic of); Department of Laboratory of Medicine, School of Medicine, Wonkwang University, Iksan (Korea, Republic of); So, Hong-Seob [Center for Metabolic Function Regulation, and Department of Microbiology, School of Medicine, Wonkwang University, Iksan (Korea, Republic of); Park, Raekil [Center for Metabolic Function Regulation, and Department of Microbiology, School of Medicine, Wonkwang University, Iksan (Korea, Republic of)

    2013-12-06

    Highlights: •A fasting–refeeding high fat diet (HDF) model mimics irregular eating habit. •A fasting–refeeding HFD induces liver ballooning injury. •A fasting–refeeding HDF process elicits hepatic triglyceride accumulation. •Fenofibrate, PPARα ligand, prevents liver damage induced by refeeding HFD. -- Abstract: Fenofibrate, a peroxisome proliferator-activated receptor α (PPARα) agonist, is an anti-hyperlipidemic agent that has been widely used in the treatment of dyslipidemia. In this study, we examined the effect of fenofibrate on liver damage caused by refeeding a high-fat diet (HFD) in mice after 24 h fasting. Here, we showed that refeeding HFD after fasting causes liver damage in mice determined by liver morphology and liver cell death. A detailed analysis revealed that hepatic lipid droplet formation is enhanced and triglyceride levels in liver are increased by refeeding HFD after starvation for 24 h. Also, NF-κB is activated and consequently induces the expression of TNF-α, IL1-β, COX-2, and NOS2. However, treating with fenofibrate attenuates the liver damage and triglyceride accumulation caused by the fasting–refeeding HFD process. Fenofibrate reduces the expression of NF-κB target genes but induces genes for peroxisomal fatty acid oxidation, peroxisome biogenesis and mitochondrial fatty acid oxidation. These results strongly suggest that the treatment of fenofibrate ameliorates the liver damage induced by fasting–refeeding HFD, possibly through the activation of fatty acid oxidation.

  11. Pyogenic liver abscess in a child with concomitant infections – Staphylococcus aureus, Echinococcus multilocularis and Mycobacterium tuberculosis

    Directory of Open Access Journals (Sweden)

    Antolová D.

    2016-09-01

    Full Text Available Pyogenic liver abscess is an uncommon but important and potentially life-threatening disease that occurs whenever there is failure of clearance of an infection in the liver. Work presents a rare case of pyogenic liver abscess with confirmed bacterial aetiology of Staphylococcus aureus, subsequently confirmed Echinococcus multilocularis and suspected Mycobacterium tuberculosis liver infection in 6 years old child. Moreover, several other parasitic diseases were recorded. According to clinical presentation of diseases, it could be supposed that liver impairment caused by alveolar echinococcosis and potentially also by M. tuberculosis could be the predisposition site for the capture of Staphylococcus aureus in altered liver tissues during its haematogenous spreading, and thus contributed to the development and subsequent clinical presentation of pyogenic liver abscess. The presence of three different aetiological agents complicated the diagnostic process as well as the therapy of the patient and made her prognosis uncertain. Proper diagnosis of multiloculated liver abscesses, with echinococcosis and hepatic tuberculosis considered in the differential diagnosis, is therefore crucial to administration of early and appropriate treatment.

  12. [Primary and secondary prevention of urinary tract infections].

    Science.gov (United States)

    Wagenlehner, F M E; Vahlensieck, W; Bauer, H W; Weidner, W; Naber, K G; Piechota, H J

    2011-10-01

    Urinary tract infections (UTI) are among the most frequent bacterial infections in the community and health care setting. Mostly young and, to some extent, postmenopausal women are affected by recurrent UTI (rUTI) defined as ≥3 UTI/year. On the other hand rUTI are frequently found in patients with complicating urological factors, e.g. urinary catheters. Modifiable predisposing factors in uncomplicated rUTI in women are rare. Continuous antibiotic prophylaxis or postcoital prophylaxis, if there is close correlation with sexual intercourse, are most effective to prevent rUTI. Nitrofurantoin, trimethoprim (or cotrimoxazole), and fosfomycin trometamol are available as first-line drugs. Oral cephalosporins and quinolones should be restricted to specific indications. Antibiotic prophylaxis reduces the number of uropathogens in the gut and/or vaginal flora and reduces bacterial"fitness". Given the correct indication, the recurrence rate of rUTI can be reduced by about 90%. In postmenopausal patients vaginal substitution of oestriol should be started first. Oral or parenteral immunoprophylaxis is another option in patients with rUTI. Other possibilities with varying scientific evidence are prophylaxis with cranberries or probiotics. The prophylaxis of catheter-associated UTI or asymptomatic bacteriuria should employ strategies which result in a reduction of frequency and duration of catheter drainage of the urinary tract. The currently available catheter materials have only little influence on reducing catheter-associated rUTI.

  13. Food restriction prevents an age-associated increase in rat liver beta-adrenergic receptors

    Energy Technology Data Exchange (ETDEWEB)

    Dax, E.M.; Ingram, D.K.; Partilla, J.S.; Gregerman, R.I.

    1989-05-01

    In male Wistar rats fed ad libitum (24% protein, 4.5 Kcal/gm), the (/sup 125/I)iodopindolol binding capacity of the beta-adrenergic receptors in liver of 24-month-old animals is 3-4 times greater than that of 6-month-old counterparts. In rats fed the same diet, on alternate days from weaning, the receptor capacity did not increase significantly between 6 and 24 months (10.20 +/- 0.55 vs 9.20 +/- 0.72 fmol/mg) or between 24 and 30 months. This was not due to acute dietary deprivation, as rats food-restricted for only 2 weeks, at 23.5 months of age, also showed elevated receptor capacities compared to 6-month-old ad libitum fed animals. Moreover, intermittent feeding produced no significant effects among 6-month-old animals, whether restricted since weaning or for two weeks prior to sacrifice. Many biochemical parameters that decrease with aging in rats fed ad libitum are prevented by dietary restriction. Our results demonstrate that a reproducible biochemical process that increases with aging is also prevented with dietary restriction. The age-related, liver beta-receptor increase may be a potentially reliable marker for studying biochemical perturbations that modify life span.

  14. Food restriction prevents an age-associated increase in rat liver beta-adrenergic receptors

    International Nuclear Information System (INIS)

    Dax, E.M.; Ingram, D.K.; Partilla, J.S.; Gregerman, R.I.

    1989-01-01

    In male Wistar rats fed ad libitum (24% protein, 4.5 Kcal/gm), the [ 125 I]iodopindolol binding capacity of the beta-adrenergic receptors in liver of 24-month-old animals is 3-4 times greater than that of 6-month-old counterparts. In rats fed the same diet, on alternate days from weaning, the receptor capacity did not increase significantly between 6 and 24 months (10.20 +/- 0.55 vs 9.20 +/- 0.72 fmol/mg) or between 24 and 30 months. This was not due to acute dietary deprivation, as rats food-restricted for only 2 weeks, at 23.5 months of age, also showed elevated receptor capacities compared to 6-month-old ad libitum fed animals. Moreover, intermittent feeding produced no significant effects among 6-month-old animals, whether restricted since weaning or for two weeks prior to sacrifice. Many biochemical parameters that decrease with aging in rats fed ad libitum are prevented by dietary restriction. Our results demonstrate that a reproducible biochemical process that increases with aging is also prevented with dietary restriction. The age-related, liver beta-receptor increase may be a potentially reliable marker for studying biochemical perturbations that modify life span

  15. [Hepatitis A and E enterically transmitted virus infections of the liver].

    Science.gov (United States)

    Siegl, G

    2004-08-01

    Hepatitis A virus (a picornavirus) and hepatitis E virus (so far unclassified) are small, non-enveloped and relatively stable RNA viruses with many similar, yet, not identical characteristics. Both viruses are transmitted preferentially by the fecal-oral route. Consequently, their spread is favoured by poor personal hygiene and inappropriate sanitary conditions. Infection can pass subclinically, take an acute and self limiting course, and can also manifest as fulminant hepatitis with liver failure. True chronic disease is unknown. Laboratory diagnosis is preferentially performed by serology, but can also be complemented by assay for viral RNA in stool or serum. Resolution of infection leads to immunity which, in the case of hepatitis A, is known to be fully protective and most likely lifelong. Available hepatitis A vaccines are able to induce a similar state of protection. Vaccines for hepatitis E are under development. Specific antiviral treatment is not yet available, neither for hepatitis A nor for hepatitis E.

  16. Successful Fecal Microbiota Transplantation in a Patient with Severe Complicated Clostridium difficile Infection after Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Kai Markus Schneider

    2018-02-01

    Full Text Available Clostridium difficile infection (CDI represents one of the most common healthcare-associated infections. Due to increasing numbers of recurrences and therapy failures, CDI has become a major disease burden. Studies have shown that fecal microbiota transplantation (FMT can both be a safe and highly efficacious therapy for patients with therapy-refractory CDI. However, patients undergoing solid organ transplantation are at high risk for CDI due to long-term immunosuppression, previous antibiotic therapy, and proton pump inhibitor use. Additionally, these patients may be especially prone to adverse events related to FMT. Here, we report a successful FMT in a patient with severe therapy-refractory CDI after liver transplantation.

  17. Novel Electron Spin Resonance-Enzyme Immunosorbent Assay for Detecting Occult Hepatitis B Infection in HCV Chronic Liver Disease

    Directory of Open Access Journals (Sweden)

    Hala Badawi

    2017-11-01

    diagnosing OHB in patients with CLD who are negative for conventional HBV-related serological markers. Moreover, investigation of chronic infection with a low HBV load and its clinical significance is considered to make a significant contribution to prevention and treatment. Detection of OHB would limit its nosocomial spread particularly in hemodialysis units and liver transplant recipients.

  18. Bezlotoxumab: A Review in Preventing Clostridium difficile Infection Recurrence.

    Science.gov (United States)

    Deeks, Emma D

    2017-10-01

    Bezlotoxumab (Zinplava™) is a fully human monoclonal antibody against Clostridium difficile toxin B indicated for the prevention of C. difficile infection (CDI) recurrence in patients with a high recurrence risk. It is the first agent approved for recurrence prevention and is administered as a single intravenous infusion in conjunction with standard-of-care (SoC) antibacterial treatment for CDI. In well-designed, placebo-controlled, phase 3 trials (MODIFY 1 and 2), a single infusion of bezlotoxumab, given in combination with SoC antibacterial therapy for CDI in adults, was effective in reducing CDI recurrence in the 12 weeks post-treatment, with this benefit being seen mainly in the patients at high recurrence risk. Bezlotoxumab did not impact the efficacy of the antibacterials being used to treat the CDI and, consistent with its benefits on CDI recurrence, appeared to reduce the need for subsequent antibacterials, thus minimizing further gut microbiota disruption. Longer term, there were no further CDI recurrences over 12 months' follow-up among patients who had received bezlotoxumab in MODIFY 2 and entered an extension substudy. Bezlotoxumab has low immunogenicity and is generally well tolerated, although the potential for heart failure in some patients requires consideration; cost-effectiveness data for bezlotoxumab are awaited with interest. Thus, a single intravenous infusion of bezlotoxumab during SoC antibacterial treatment for CDI is an emerging option for reducing CDI recurrence in adults at high risk of recurrence.

  19. CAPABILITY OF PAPILLOMAVIRUS INFECTION PREVENTION IN GIRLS AND WOMEN OF VARIOUS AGES

    Directory of Open Access Journals (Sweden)

    F.Ch. Shakhtakhtinskaya

    2009-01-01

    Full Text Available The article looks at one of the critical issues in modern medicine — human papilloma virus infection. The prevalence of this infection in the world and the possibility of primary prevention in females of various age groups are highlighted in details. It provides the results of vaccine prevention against the human papilloma virus in Russian in girls and women aged 9 to 26 years.Key words: papilloma virus infection, cervical cancer, women, girls, vaccinal prevention.

  20. Simulating the Risk of Liver Fluke Infection using a Mechanistic Hydro-epidemiological Model

    Science.gov (United States)

    Beltrame, Ludovica; Dunne, Toby; Rose, Hannah; Walker, Josephine; Morgan, Eric; Vickerman, Peter; Wagener, Thorsten

    2016-04-01

    Liver Fluke (Fasciola hepatica) is a common parasite found in livestock and responsible for considerable economic losses throughout the world. Risk of infection is strongly influenced by climatic and hydrological conditions, which characterise the host environment for parasite development and transmission. Despite on-going control efforts, increases in fluke outbreaks have been reported in recent years in the UK, and have been often attributed to climate change. Currently used fluke risk models are based on empirical relationships derived between historical climate and incidence data. However, hydro-climate conditions are becoming increasingly non-stationary due to climate change and direct anthropogenic impacts such as land use change, making empirical models unsuitable for simulating future risk. In this study we introduce a mechanistic hydro-epidemiological model for Liver Fluke, which explicitly simulates habitat suitability for disease development in space and time, representing the parasite life cycle in connection with key environmental conditions. The model is used to assess patterns of Liver Fluke risk for two catchments in the UK under current and potential future climate conditions. Comparisons are made with a widely used empirical model employing different datasets, including data from regional veterinary laboratories. Results suggest that mechanistic models can achieve adequate predictive ability and support adaptive fluke control strategies under climate change scenarios.

  1. The surgical care improvement project and prevention of post-operative infection, including surgical site infection.

    Science.gov (United States)

    Rosenberger, Laura H; Politano, Amani D; Sawyer, Robert G

    2011-06-01

    In response to inconsistent compliance with infection prevention measures, the Centers for Medicare & Medicaid Services collaborated with the U.S. Centers for Disease Control and Prevention on the Surgical Infection Prevention (SIP) project, introduced in 2002. Quality improvement measures were developed to standardize processes to increase compliance. In 2006, the Surgical Care Improvement Project (SCIP) developed out of the SIP project and its process measures. These initiatives, published in the Specifications Manual for National Inpatient Quality Measures, outline process and outcome measures. This continually evolving manual is intended to provide standard quality measures to unify documentation and track standards of care. Seven of the SCIP initiatives apply to the peri-operative period: Prophylactic antibiotics should be received within 1 h prior to surgical incision (1), be selected for activity against the most probable antimicrobial contaminants (2), and be discontinued within 24 h after the surgery end-time (3); (4) euglycemia should be maintained, with well-controlled morning blood glucose concentrations on the first two post-operative days, especially in cardiac surgery patients; (6) hair at the surgical site should be removed with clippers or by depilatory methods, not with a blade; (9) urinary catheters are to be removed within the first two post-operative days; and (10) normothermia should be maintained peri-operatively. There is strong evidence that implementation of protocols that standardize practices reduce the risk of surgical infection. The SCIP initiative targets complications that account for a significant portion of preventable morbidity as well as cost. One of the goals of the SCIP guidelines was a 25% reduction in the incidence of surgical site infections from implementation through 2010. Process measures are becoming routine, and as we practice more evidence-based medicine, it falls to us, the surgeons and scientists, to be active

  2. Liver Fluke Infection and Fish Consumption in Khon Kaen, Thailand: A Case Study on Negotiating the Middle Ground between Western Science and Eastern Culture

    Science.gov (United States)

    Samiphak, Sara

    This research investigates why typical strategies for promoting health, prolonging life, and preventing disease do not work in many communities. I use the liver fluke infection endemic in Khon Kaen, Thailand to explore the middle ground between Western science and Eastern culture. Prior work on the O.viverrini infection in Khon Kaen, Thailand has focused almost exclusively on developing effective medical treatment for the liver fluke infection. This dissertation employs a case study designed to explore the conditions that created and perpetuate the problem in the first place. In concrete terms, I analyze how the worldviews of local villagers shape their attitudes toward life (and death), which in turn determine if they engage in the high-risk behavior -- eating undercooked fish -- that makes them vulnerable to the infection. My research focuses on these people in-situ over a three-month period, and includes data from participant-observation, interviews, and video-recordings. This work seeks to illuminate how people's thinking and reasoning skills, and personal/cultural identities affect their abilities to learn and act on new health concepts. This potentially provides a window into future educational strategies in a complex world.

  3. Chronic hepatitis C infection and liver disease in HIV-coinfected patients in Asia.

    Science.gov (United States)

    Durier, N; Yunihastuti, E; Ruxrungtham, K; Kinh, N V; Kamarulzaman, A; Boettiger, D; Widhani, A; Avihingsanon, A; Huy, B V; Syed Omar, S F B; Sanityoso, A; Chittmittrapap, S; Dung, N T H; Pillai, V; Suwan-Ampai, T; Law, M; Sohn, A H; Matthews, G

    2017-03-01

    Data on markers of hepatitis C virus (HCV) disease in HIV-HCV-coinfected patients in resource-limited settings are scarce. We assessed HCV RNA, HCV genotype (GT), IL28B GT and liver fibrosis (FibroScan ® ) in 480 HIV-infected patients with positive HCV antibody in four HIV treatment centres in South-East Asia. We enrolled 165 (34.4%) patients in Jakarta, 158 (32.9%) in Bangkok, 110 (22.9%) in Hanoi and 47 (9.8%) in Kuala Lumpur. Overall, 426 (88.8%) were male, the median (IQR) age was 38.1 (34.7-42.5) years, 365 (76.0%) reported HCV exposure through injecting drug use, and 453 (94.4%) were on combination antiretroviral therapy. The median (IQR) CD4 count was 446 (325-614) cells/mm 3 and 208 (94.1%) of 221 patients tested had HIV-1 RNA F4). One patient (0.3%) had FibroScan ® failure. In conclusion, a high proportion of HIV-HCV-coinfected patients had chronic HCV infection. HCV GT1 was predominant, and 62% of patients had liver disease warranting prompt treatment (≥F2). © 2016 John Wiley & Sons Ltd.

  4. Infection of the left sided gallbladder simulating liver abscess and gastric antral tumor

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Woo; Ahn, Jae Sung [St Mary' s Hospital Catholic Medical College, Seoul (Korea, Republic of)

    1972-12-15

    The left sided gallbladder, being a rare occurrence, may create diagnostic problem especially when it becomes infected. Recently, we have experienced 2 cases of infection of left sided gallbladder at the Department of Radiology, St Mary's Hospital, Catholic Medical College. Case I was a 32-year-old housewife with dyspepsia, epigastric pain and recurring bouts of high fever of 2 months duration. Under the provisional diagnosis of liver abscess liver scan was performed which revealed well defined cold area in the left lobe supporting the provisional diagnosis. Tender cystic mass was aspirated and pus was drained. The injected air at the occasion of aspiration outlined well defined cystic structure. Because aspiration failed to control the symptoms, laparotomy was performed. Surgeon found a left sided gallbladder which was empyematous. Case II was a 38 year old business man admitted to the hospital because of tender ill defined mass in mid epigastrium. The patient was febrile (39.4 .deg. C) and anemic. An upper GI series disclosed an irregular filling defect involving the antrum of the stomach. The mass was primarily extrinsic but was closely fixed to the gastric wall. Surgical intervention revealed chronic cholecystitis and pericholecystitis with thick adhesion to the distal stomach.

  5. Algorithm of Golgi protein 73 and liver stiffness accurately diagnoses significant fibrosis in chronic HBV infection.

    Science.gov (United States)

    Cao, Zhujun; Li, Ziqiang; Wang, Hui; Liu, Yuhan; Xu, Yumin; Mo, Ruidong; Ren, Peipei; Chen, Lichang; Lu, Jie; Li, Hong; Zhuang, Yan; Liu, Yunye; Wang, Xiaolin; Zhao, Gangde; Tang, Weiliang; Xiang, Xiaogang; Cai, Wei; Liu, Longgen; Bao, Shisan; Xie, Qing

    2017-11-01

    Serum Golgi protein 73 (GP73) is a potential biomarker for fibrosis assessment. We aimed to develop an algorithm based on GP73 and liver stiffness (LS) for further improvement of accuracy for significant fibrosis in patients with antiviral-naïve chronic hepatitis B virus (HBV) infection. Diagnostic accuracy evaluation of GP73 and development of GP73-LS algorithm was performed in training cohort (n = 267) with an independent cohort (n = 133) for validation. A stepwise increasing pattern of serum GP73 was observed across fibrosis stages in patients with antiviral-naïve chronic HBV infection. Serum GP73 significantly correlated (rho = 0.48, P 73, accuracy: 63.6%). Using GP73-LS algorithm, GP73 < 63 in agreement with LS < 8.5 provided accuracy of 81.7% to excluded significant fibrosis. GP73 ≥ 63 in agreement with LS ≥ 8.5 provided accuracy of 93.3% to confirm significant fibrosis. Almost 64% or 68% of patients in the training or validation cohort could be accurately classified. Serum GP73 is a robust biomarker for significant fibrosis diagnosis. GP73-LS algorithm provided better diagnostic accuracy than currently available approaches. More than 60% antiviral naïve CHB patients could use this algorithm without resorting to liver biopsy. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Executive summary: Prevention and treatment of opportunistic infections and other coinfections in HIV-infected patients: May 2015.

    Science.gov (United States)

    Iribarren, José Antonio; Rubio, Rafael; Aguirrebengoa, Koldo; Arribas, Jose Ramón; Baraia-Etxaburu, Josu; Gutiérrez, Félix; Lopez Bernaldo de Quirós, Juan Carlos; Losa, Juan Emilio; Miró, José Ma; Moreno, Santiago; Pérez Molina, José; Podzamczer, Daniel; Pulido, Federico; Riera, Melchor; Rivero, Antonio; Sanz Moreno, José; Amador, Concha; Antela, Antonio; Arazo, Piedad; Arrizabalaga, Julio; Bachiller, Pablo; Barros, Carlos; Berenguer, Juan; Caylá, Joan; Domingo, Pere; Estrada, Vicente; Knobel, Hernando; Locutura, Jaime; López Aldeguer, José; Llibre, Josep Ma; Lozano, Fernando; Mallolas, Josep; Malmierca, Eduardo; Miralles, Celia; Miralles, Pilar; Muñoz, Agustín; Ocampo, Agustín; Olalla, Julián; Pérez, Inés; Pérez Elías, Ma Jesús; Pérez Arellano, José Luis; Portilla, Joaquín; Ribera, Esteban; Rodríguez, Francisco; Santín, Miguel; Sanz Sanz, Jesús; Téllez, Ma Jesús; Torralba, Miguel; Valencia, Eulalia; Von Wichmann, Miguel Angel

    2016-10-01

    Opportunistic infections continue to be a cause of morbidity and mortality in HIV-infected patients. They often arise because of severe immunosuppression resulting from poor adherence to antiretroviral therapy, failure of antiretroviral therapy, or unawareness of HIV infection by patients whose first clinical manifestation of AIDS is an opportunistic infection. The present article is an executive summary of the document that updates the previous recommendations on the prevention and treatment of opportunistic infections in HIV-infected patients, namely, infections by parasites, fungi, viruses, mycobacteria, and bacteria, as well as imported infections. The article also addresses immune reconstitution inflammatory syndrome. This document is intended for all professionals who work in clinical practice in the field of HIV infection. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  7. Prediction of occult hepatitis B virus infection in liver transplant donors through hepatitis B virus blood markers.

    Science.gov (United States)

    Tandoi, Francesco; Caviglia, Gian Paolo; Pittaluga, Fabrizia; Abate, Maria Lorena; Smedile, Antonina; Romagnoli, Renato; Salizzoni, Mauro

    2014-11-01

    Occult hepatitis B virus infection is defined as detectable HBV-DNA in liver of HBsAg-negative individuals, with or without detectable serum HBV-DNA. In deceased liver donors, results of tissue analysis cannot be obtained prior to allocation for liver transplantation. we investigated prevalence and predictability of occult hepatitis B using blood markers of viral exposure/infection in deceased liver donors. In 50 consecutive HBsAg-negative/anti-HBc-positive and 20 age-matched HBsAg-negative/anti-HBc-negative donors, a nested-PCR assay was employed in liver biopsies for diagnosis of occult hepatitis B according to Taormina criteria. All donors were characterized for plasma HBV-DNA and serum anti-HBs/anti-HBe. In liver tissue, occult hepatitis B was present in 30/50 anti-HBc-positive (60%) and in 0/20 anti-HBc-negative donors (pdonors with detectable HBV-DNA in plasma (n=5) or anti-HBs>1,000 mIU/mL (n=5) eventually showed occult infection, i.e, 10/30 occult hepatitis B-positive donors which could have been identified prior to transplantation. In the remaining 40 anti-HBc-positive donors, probability of occult infection was 62% for anti-HBe-positive and/or anti-HBs ≥ 58 mIU/mL; 29% for anti-HBe-negative and anti-HBsdonors, combining anti-HBc with other blood markers of hepatitis B exposure/infection allows to predict occult hepatitis B with certainty and speed in one third of cases. These findings might help refine the allocation of livers from anti-HBc-positive donors. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  8. Effect of host-related factors on the intensity of liver fibrosis in patients with chronic hepatitis C virus infection

    Directory of Open Access Journals (Sweden)

    Costa Luciano Bello

    2002-01-01

    Full Text Available There is increasing interest in the identification of factors associated with liver disease progression in patients infected with hepatitis C virus (HCV. We assessed host-related factors associated with a histologically advanced stage of this disease and determined the rate of liver fibrosis progression in HCV-infected patients. We included patients submitted to liver biopsy, who were anti-HCV and HCV RNA positive, who showed a parenteral risk factor (blood transfusion or intravenous drug use, and who gave information about alcohol consumption.Patients were divided into two groups for analysis: group 1 - grades 0 to 2; group 2 - grades 3 to 4. The groups were compared in terms of sex, age at the time of infection, estimated duration of infection and alcoholism. The rate of fibrosis progression (index of fibrosis was determined based on the relationship between disease stage and duration of infection (years. Logistic regression analysis revealed that age at the time of infection (P or = 40 years (median = 0.47. The main factors associated with a more rapid fibrosis progression were age at the time of infection and the estimated duration of infection. Patients who acquired HCV after 40 years of age showed a higher rate of fibrosis progression.

  9. Proteomic and transcriptomic studies of HBV-associated liver fibrosis of an AAV-HBV-infected mouse model.

    Science.gov (United States)

    Kan, Fangming; Ye, Lei; Yan, Tao; Cao, Jiaqi; Zheng, Jianhua; Li, Wuping

    2017-08-22

    Human hepatitis B virus (HBV) infection is an important public health issue in the Asia-Pacific region and is associated with chronic hepatitis, liver fibrosis, cirrhosis and even liver cancer. However, the underlying mechanisms of HBV-associated liver fibrosis remain incompletely understood. In the present study, proteomic and transcriptomic approaches as well as biological network analyses were performed to investigate the differentially expressed molecular signature and key regulatory networks that were associated with HBV-mediated liver fibrosis. RNA sequencing and 2DE-MALDI-TOF/TOF were performed on liver tissue samples obtained from HBV-infected C57BL/6 mouse generated via AAV8-HBV virus. The results showed that 322 genes and 173 proteins were differentially expressed, and 28 HBV-specific proteins were identified by comprehensive proteomic and transcriptomic analysis. GO analysis indicated that the differentially expressed proteins were predominantly involved in oxidative stress, which plays a key role in HBV-related liver fibrosis. Importantly, CAT, PRDX1, GSTP1, NXN and BLVRB were shown to be associated with oxidative stress among the differentially expressed proteins. The most striking results were validated by Western blot and RT-qPCR. The RIG-I like receptor signaling pathway was found to be the major signal pathway that changed during HBV-related fibrosis. This study provides novel insights into HBV-associated liver fibrosis and reveals the significant role of oxidative stress in liver fibrosis. Furthermore, CAT, BLVRB, NXN, PRDX1, and IDH1 may be candidates for detection of liver fibrosis or therapeutic targets for the treatment of liver fibrosis.

  10. Probiotics for preventing acute upper respiratory tract infections.

    Science.gov (United States)

    Hao, Qiukui; Dong, Bi Rong; Wu, Taixiang

    2015-02-03

    Probiotics may improve a person's health by regulating their immune function. Some trials have shown that probiotic strains can prevent respiratory infections. Even though the previous version of our review showed benefits of probiotics for acute upper respiratory tract infections (URTIs), several new studies have been published. To assess the effectiveness and safety of probiotics (any specified strain or dose), compared with placebo, in the prevention of acute URTIs in people of all ages, at risk of acute URTIs. We searched CENTRAL (2014, Issue 6), MEDLINE (1950 to July week 3, 2014), EMBASE (1974 to July 2014), Web of Science (1900 to July 2014), the Chinese Biomedical Literature Database, which includes the China Biological Medicine Database (from 1978 to July 2014), the Chinese Medicine Popular Science Literature Database (from 2000 to July 2014) and the Masters Degree Dissertation of Beijing Union Medical College Database (from 1981 to July 2014). We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov for completed and ongoing trials on 31 July 2014. Randomised controlled trials (RCTs) comparing probiotics with placebo to prevent acute URTIs. Two review authors independently assessed the eligibility and quality of trials, and extracted data using the standard methodological procedures expected by The Cochrane Collaboration. We included 13 RCTs, although we could only extract data to meta-analyse 12 trials, which involved 3720 participants including children, adults (aged around 40 years) and older people. We found that probiotics were better than placebo when measuring the number of participants experiencing episodes of acute URTI (at least one episode: odds ratio (OR) 0.53; 95% confidence interval (CI) 0.37 to 0.76, P value school absence (OR 0.10; 95% CI 0.02 to 0.47, very low quality evidence). Probiotics and placebo were similar when measuring the rate ratio of episodes of acute

  11. Practical Dietary Recommendations for the Prevention and Management of Nonalcoholic Fatty Liver Disease in Adults.

    Science.gov (United States)

    George, Elena S; Forsyth, Adrienne; Itsiopoulos, Catherine; Nicoll, Amanda J; Ryan, Marno; Sood, Siddharth; Roberts, Stuart K; Tierney, Audrey C

    2018-01-01

    Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. In the absence of effective pharmacotherapies, clinical guidelines focus primarily on weight loss to treat this condition. Established consensus, evidence-based, and clinical dietary recommendations for NAFLD are currently lacking. The aim of this paper is to provide evidence-based practical dietary recommendations for the prevention and management of NAFLD in adults. A literature review focusing on established principles for the development of clinical practice recommendations was employed using the following criteria: based on substantial evidence, ensures risk minimization, is flexible for an individual patient approach, and is open to further modification as evidence emerges. The Practice-based Evidence in Nutrition classification system was used to grade these principles. Five key dietary recommendations were developed: 1) follow traditional dietary patterns, such as the Mediterranean diet; 2) limit excess fructose consumption and avoid processed foods and beverages with added fructose; 3) PUFAs, especially long-chain omega-3 rich foods and MUFAs, should replace SFAs in the diet; 4) replace processed food, fast food, commercial bakery goods, and sweets with unprocessed foods high in fiber, including whole grains, vegetables, fruits, legumes, nuts, and seeds; and 5) avoid excess alcohol consumption. Improving diet quality may reduce the incidence and progression of NAFLD and associated risk factors. Many of the benefits are likely to result from the collective effect of dietary patterns. High-quality research-in particular, randomized clinical trials assessing dietary interventions that focus on liver-specific endpoints-are needed as a priority. © 2018 American Society for Nutrition. All rights reserved.

  12. Liver is the major source of elevated serum lipocalin-2 levels after bacterial infection or partial hepatectomy

    DEFF Research Database (Denmark)

    Xu, Ming-Jiang; Feng, Dechun; Wu, Hailong

    2015-01-01

    cell type responsible for LCN2 production after bacterial infection or PHx, and this response is dependent on IL-6 activation of the STAT3 signaling pathway. Thus, hepatocyte-derived LCN2 plays an important role in inhibiting bacterial infection and promoting liver regeneration....... or E. coli. These mice also had increased enteric bacterial translocation from the gut to the mesenteric lymph nodes and exhibited reduced liver regeneration after PHx. Treatment with interleukin (IL)-6 stimulated hepatocytes to produce LCN2 in vitro and in vivo. Hepatocyte-specific ablation of the IL...

  13. [Early detection, prevention and management of renal failure in liver transplantation].

    Science.gov (United States)

    Castells, Lluís; Baliellas, Carme; Bilbao, Itxarone; Cantarell, Carme; Cruzado, Josep Maria; Esforzado, Núria; García-Valdecasas, Juan Carlos; Lladó, Laura; Rimola, Antoni; Serón, Daniel; Oppenheimer, Federico

    2014-10-01

    Renal failure is a frequent complication in liver transplant recipients and is associated with increased morbidity and mortality. A variety of risk factors for the development of renal failure in the pre- and post-transplantation periods have been described, as well as at the time of surgery. To reduce the negative impact of renal failure in this population, an active approach is required for the identification of those patients with risk factors, the implementation of preventive strategies, and the early detection of progressive deterioration of renal function. Based on published evidence and on clinical experience, this document presents a series of recommendations on monitoring RF in LT recipients, as well as on the prevention and management of acute and chronic renal failure after LT and referral of these patients to the nephrologist. In addition, this document also provides an update of the various immunosuppressive regimens tested in this population for the prevention and control of post-transplantation deterioration of renal function. Copyright © 2013 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  14. Liver and Bile Duct Cancer—Patient Version

    Science.gov (United States)

    Liver cancer includes hepatocellular carcinoma and bile duct cancer (cholangiocarcinoma). Risk factors for HCC include chronic infection with hepatitis B or C and cirrhosis of the liver. Start here to find information on liver and bile duct cancer treatment, causes and prevention, screening, research, and statistics.

  15. [Risk of nosocomial infection in Intertropical Africa. Part 4: prevention].

    Science.gov (United States)

    Rebaudet, S; De Pina, J J; Rapp, C; Kraemer, P; Savini, H; Demortiere, E; Simon, F

    2008-02-01

    Nosocomial infections have long been neglected in Sub-Saharan Africa, even though their prevalence is higher than in developed countries. Recently, however, this major public health problem has been the focus of a growing number of recommendations not only from the World Health Organization but also from some national health ministries. Because of the numerous limitations especially in financial resources in these regions, priority must be given to the implementation of simple and cost-effective measures. Accordingly the greatest efforts must be devoted to educating healthcare workers and patients about the importance of handwashing, eliminating unnecessary injections and transfusions, performing the latter acts in aseptic conditions, isolating patients with communicable diseases, handling waste products safely, and using antimicrobials properly. Amid the daunting health issues facing Sub-Saharan Africa, implementing these inexpensive measures that could save the lives of thousands of patients and healthcare workers appears easy. However it will require a cultural revolution. The keys to success will be changing the organizational culture, developing a commitment to prevention and evaluating performance regularly.

  16. Prevention of primary vascular graft infection with silver-coated polyester graft in a porcine model

    DEFF Research Database (Denmark)

    Gao, H; Sandermann, J; Prag, J

    2010-01-01

    To evaluate the efficacy of a silver-coated vascular polyester graft in the prevention of graft infection after inoculation with Staphylococcus aureus in a porcine model.......To evaluate the efficacy of a silver-coated vascular polyester graft in the prevention of graft infection after inoculation with Staphylococcus aureus in a porcine model....

  17. The role of education in the prevention and control of infection: a review of the literature.

    Science.gov (United States)

    Ward, Deborah J

    2011-01-01

    This paper discusses a literature review which was undertaken prior to a research study about student nurses' and midwives' experiences of learning infection control in clinical practice. Its aim is to identify the role of education in the prevention and control of infection, with a specific focus on compliance with infection control precautions and reduction in infection rates. It also identifies the methods used for teaching infection control. The review concludes that there is no rigorous and convincing evidence that education improves compliance with infection control precautions or reduces rates of infection, particularly in the long-term. Areas for future research are identified. 2010 Elsevier Ltd. All rights reserved.

  18. Citrulline and Nonessential Amino Acids Prevent Fructose-Induced Nonalcoholic Fatty Liver Disease in Rats.

    Science.gov (United States)

    Jegatheesan, Prasanthi; Beutheu, Stéphanie; Ventura, Gabrielle; Nubret, Esther; Sarfati, Gilles; Bergheim, Ina; De Bandt, Jean-Pascal

    2015-10-01

    Fructose induces nonalcoholic fatty liver disease (NAFLD). Citrulline (Cit) may exert a beneficial effect on steatosis. We compared the effects of Cit and an isonitrogenous mixture of nonessential amino acids (NEAAs) on fructose-induced NAFLD. Twenty-two male Sprague Dawley rats were randomly assigned into 4 groups (n = 4-6) to receive for 8 wk a 60% fructose diet, either alone or supplemented with Cit (1 g · kg(-1) · d(-1)), or an isonitrogenous amount of NEAAs, or the same NEAA-supplemented diet with starch and maltodextrin instead of fructose (controls). Nutritional and metabolic status, liver function, and expression of genes of hepatic lipid metabolism were determined. Compared with controls, fructose led to NAFLD with significantly higher visceral fat mass (128%), lower lean body mass (-7%), insulin resistance (135%), increased plasma triglycerides (TGs; 67%), and altered plasma amino acid concentrations with decreased Arg bioavailability (-27%). This was corrected by both NEAA and Cit supplementation. Fructose caused a 2-fold increase in the gene expression of fatty acid synthase (Fas) and 70% and 90% decreases in that of carnitine palmitoyl-transferase 1a and microsomal TG transfer protein via a nearly 10-fold higher gene expression of sterol regulatory element-binding protein-1c (Srebp1c) and carbohydrate-responsive element-binding protein (Chrebp), and a 90% lower gene expression of peroxisome proliferator-activated receptor α (Ppara). NEAA or Cit supplementation led to a Ppara gene expression similar to controls and decreased those of Srebp1c and Chrebp in the liver by 50-60%. Only Cit led to Fas gene expression and Arg bioavailability similar to controls. In our rat model, Cit and NEAAs effectively prevented fructose-induced NAFLD. On the basis of literature data and our findings, we propose that NEAAs may exert their effects specifically on the liver, whereas Cit presumably acts at both the hepatic and whole-body level, in part via improved

  19. [Infection prevention in Dutch hospitals; results say more than process indicators].

    Science.gov (United States)

    Bonten, Marc J M; Friedrich, Alexander; Kluytmans, Jan A J W; Vandenbroucke-Grauls, Christina M J E; Voss, Andreas; Vos, Margreet C

    2014-01-01

    The Dutch Health Care Inspectorate investigated the preparedness of Dutch hospitals for the emergence of antibiotic resistance, and concluded that hospitals are not well prepared and are insufficiently aware that infection prevention is a prerequisite for patient safety. These conclusions are based on observations of process indicators of current practice guidelines, without including the available outcome indicators that demonstrate the persistently low incidence of infections with antibiotic resistant bacteria in Dutch hospitals. The conclusions may have negative effects on the quality of infection prevention in Dutch hospitals. Therefore, it is advisable to use outcome indicators rather than process indicators to evaluate the quality of infection prevention.

  20. Hyperimmune anti-HBs plasma as alternative to commercial immunoglobulins for prevention of HBV recurrence after liver transplantation

    Directory of Open Access Journals (Sweden)

    Majno Pietro

    2010-07-01

    Full Text Available Abstract Background Hepatitis B immune globulins (HBIG in combination with nucleos(tide analogues (NA are effectively used for the prevention of hepatitis B virus (HBV recurrence after liver transplantation (LT. However, associated treatment costs for HBIG are exceedingly high. Methods Fresh frozen plasma obtained from blood donors with high anti-HBs levels (hyperimmune plasma, HIP containing at least 4,500 IU anti-HBs was used as alternative treatment for HBV recurrence prophylaxis post-LT. Results Twenty-one HBV-related LT recipients received HIP starting at transplantation, followed by long-term combination treatment with NA. Mean follow-up time was 4.5 years (range 0.5-12.6 and each patient received on average 8.2 HIP per year (range 5.8-11.4. Anti-HBs terminal elimination kinetic after HIP administration was 20.6 days (range 13.8-30.9, which is comparable to values reported for commercial HBIG products. All 21 patients remained free of HBV recurrence during follow-up and no transfusion-transmitted infection or other serious complication was observed. Seven patients developed reversible mild transfusion reactions. The cost for one HIP unit was US$140; average yearly HBIG treatment cost was US$1,148 per patient, as compared to US$25,000-100,000 for treatment with commercial HBIG. Conclusion The results of this study suggest that the use of HIP may be a useful and economical approach for the prevention of HBV recurrence post-LT if used in combination with NA. Additional prospective controlled studies in larger populations are needed to confirm these results.

  1. Stevia Prevents Acute and Chronic Liver Injury Induced by Carbon Tetrachloride by Blocking Oxidative Stress through Nrf2 Upregulation

    Science.gov (United States)

    Ramos-Tovar, Erika; Hernández-Aquino, Erika; Casas-Grajales, Sael; Buendia-Montaño, Laura D.; Tsutsumi, Víctor

    2018-01-01

    The effect of stevia on liver cirrhosis has not been previously investigated. In the present study, the antioxidant and anti-inflammatory properties of stevia leaves were studied in male Wistar rats with carbon tetrachloride- (CCl4-) induced acute and chronic liver damage. Acute and chronic liver damage induced oxidative stress, necrosis, and cholestasis, which were significantly ameliorated by stevia. Chronic CCl4 treatment resulted in liver cirrhosis, as evidenced by nodules of hepatocytes surrounded by thick bands of collagen and distortion of the hepatic architecture, and stevia significantly prevented these alterations. Subsequently, the underlying mechanism of action of the plant was analyzed. Our study for the first time shows that stevia upregulated Nrf2, thereby counteracting oxidative stress, and prevented necrosis and cholestasis through modulation of the main proinflammatory cytokines via NF-κB inhibition. These multitarget mechanisms led to the prevention of experimental cirrhosis. Given the reasonable safety profile of stevia, our results indicated that it may be useful for the clinical treatment of acute and chronic liver diseases. PMID:29849889

  2. Infection prevention in the surgical intensive care unit using selective decontamination : epidemiology, bacteriology and clinical practice

    NARCIS (Netherlands)

    G.W.M. Tetteroo (Geert)

    1993-01-01

    textabstractIn Part A the extent of the problems in infection-prevention is described in Chapter 1 and nosocomial infections are defined in Chapter 2, in which also the difficulties of infection diagnosis in critically ill patients are reviewed. Chapter 3 describes the history of antibiotic

  3. PAPILLOMA VIRAL INFECTION AMONG BOYS AND YOUNG MEN PRIMARY PREVENTION

    OpenAIRE

    M.G. Galitskaya; M.I. Ivardava

    2009-01-01

    Young sexually active men may have anogenital HPV related infection, which can cause the genital penis verruca, penis cancer, perianal and anal cancer. Besides, men's HPV infection may cause an infection and subsequent diseases of cervix of the uterus and other organs among women. The available opportunity to inoculate boys and young men against HPV infection provides for 100% guaranteed protection from severe diseases not only for boys and young men but also for girls and women, who men may ...

  4. Vaccines for preventing infection with Pseudomonas aeruginosa in cystic fibrosis

    DEFF Research Database (Denmark)

    Johansen, Helle Krogh; Gøtzsche, Peter C

    2013-01-01

    Chronic pulmonary infection in cystic fibrosis results in progressive lung damage. Once colonisation of the lungs with Pseudomonas aeruginosa occurs, it is almost impossible to eradicate. Vaccines, aimed at reducing infection with Pseudomonas aeruginosa, have been developed.......Chronic pulmonary infection in cystic fibrosis results in progressive lung damage. Once colonisation of the lungs with Pseudomonas aeruginosa occurs, it is almost impossible to eradicate. Vaccines, aimed at reducing infection with Pseudomonas aeruginosa, have been developed....

  5. Korean clinical practice guidelines for preventing the transmission of infections in hemodialysis facilities

    Directory of Open Access Journals (Sweden)

    Hayne Cho Park

    2018-03-01

    Full Text Available Patients receiving hemodialysis are vulnerable to infectious diseases due to their impaired immunity and high risk of exposure to pathogens. To protect patients, staff, and visitors from potential infections, each hemodialysis unit should establish and follow standard infection control and prevention measures. Therefore, clinical practice guidelines were developed by a working group of nephrologists and infection control specialists to provide evidence-based guidance for dialysis physicians and nurses, with the aim of preventing infection transmission and controlling infection sources in hemodialysis facilities. The areas of infection control covered by these guidelines include standard precautions, isolation strategies, vascular access, water treatment, cleaning/disinfecting/sterilizing, and vaccination. This special report summarizes the key recommendations from the Korean clinical practice guidelines for preventing the transmission of infections in hemodialysis facilities.

  6. Perioperative management for the prevention of bacterial infection in cardiac implantable electronic device placement

    Directory of Open Access Journals (Sweden)

    Katsuhiko Imai

    2016-08-01

    Full Text Available Cardiac implantable electronic devices (CIEDs have become important in the treatment of cardiac disease and placement rates increased significantly in the last decade. However, despite the use of appropriate antimicrobial prophylaxis, CIED infection rates are increasing disproportionately to the implantation rate. CIED infection often requires explantation of all hardware, and at times results in death. Surgical site infection (SSI is the most common cause of CIED infection as a pocket infection. The best method of combating CIED infection is prevention. Prevention of CIED infections comprises three phases: before, during, and after device implantation. The most critical factors in the prevention of SSIs are detailed operative techniques including the practice of proper technique by the surgeon and surgical team.

  7. Systems Thinking and Leadership: How Nephrologists Can Transform Dialysis Safety to Prevent Infections.

    Science.gov (United States)

    Wong, Leslie P

    2018-04-06

    Infections are the second leading cause of death for patients with ESKD. Despite multiple efforts, nephrologists have been unable to prevent infections in dialysis facilities. The American Society of Nephrology and the Centers for Disease Control and Prevention have partnered to create Nephrologists Transforming Dialysis Safety to promote nephrologist leadership and engagement in efforts to "Target Zero" preventable dialysis infections. Because traditional approaches to infection control and prevention in dialysis facilities have had limited success, Nephrologists Transforming Dialysis Safety is reconceptualizing the problem in the context of the complexity of health care systems and organizational behavior. By identifying different parts of a problem and attempting to understand how these parts interact and produce a result, systems thinking has effectively tackled difficult problems in dynamic settings. The dialysis facility is composed of different physical and human elements that are interconnected and affect not only behavior but also, the existence of a culture of safety that promotes infection prevention. Because dialysis infections result from a complex system of interactions between caregivers, patients, dialysis organizations, and the environment, attempts to address infections by focusing on one element in isolation often fail. Creating a sense of urgency and commitment to eradicating dialysis infections requires leadership and motivational skills. These skills are not taught in the standard nephrology or medical director curriculum. Effective leadership by medical directors and engagement in infection prevention by nephrologists are required to create a culture of safety. It is imperative that nephrologists commit to leadership training and embrace their potential as change agents to prevent infections in dialysis facilities. This paper explores the systemic factors contributing to the ongoing dialysis infection crisis in the United States and the role

  8. Liver fibrosis in treatment-naïve HIV-infected and HIV/HBV co-infected patients: Zambia and Switzerland compared.

    Science.gov (United States)

    Wandeler, Gilles; Mulenga, Lloyd; Vinikoor, Michael J; Kovari, Helen; Battegay, Manuel; Calmy, Alexandra; Cavassini, Matthias; Bernasconi, Enos; Schmid, Patrick; Bolton-Moore, Carolyn; Sinkala, Edford; Chi, Benjamin H; Egger, Matthias; Rauch, Andri

    2016-10-01

    To examine the association between hepatitis B virus (HBV) infection and liver fibrosis in HIV-infected patients in Zambia and Switzerland. HIV-infected adults starting antiretroviral therapy in two clinics in Zambia and Switzerland were included. Liver fibrosis was evaluated using the aspartate aminotransferase-to-platelet-ratio index (APRI), with a ratio >1.5 defining significant fibrosis and a ratio >2.0 indicating cirrhosis. The association between hepatitis B surface antigen (HBsAg) positivity, HBV replication, and liver fibrosis was examined using logistic regression. In Zambia, 96 (13.0%) of 739 patients were HBsAg-positive compared to 93 (4.5%) of 2058 in Switzerland. HBsAg-positive patients were more likely to have significant liver fibrosis than HBsAg-negative ones: the adjusted odds ratio (aOR) was 3.25 (95% confidence interval (CI) 1.44-7.33) in Zambia and 2.50 (95% CI 1.19-5.25) in Switzerland. Patients with a high HBV viral load (≥20000 IU/ml) were more likely to have significant liver fibrosis compared to HBsAg-negative patients or patients with an undetectable viral load: aOR 3.85 (95% CI 1.29-11.44) in Zambia and 4.20 (95% CI 1.64-10.76) in Switzerland. In both settings, male sex was a strong risk factor for significant liver fibrosis. Despite the differences in HBV natural history between Sub-Saharan Africa and Europe, the degree of liver fibrosis and the association with important risk factors were similar. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  9. miRNA signatures can predict acute liver failure in hepatitis E infected pregnant females

    Directory of Open Access Journals (Sweden)

    Nirupma Trehanpati

    2017-04-01

    Full Text Available Background: Acute viral hepatitis E (AVH-E can often result in acute liver failure (ALF during pregnancy. microRNAs serve as mediators in drug induced liver failure. We investigated their role as a biomarker in predicting ALF due to HEV (ALF-E. Methods: We performed next generation sequencing and subsequent validation studies in PBMCs of pregnant (P self limiting AVH-E, ALF due to HEV (ALF-E and compared with AVH-E in non-pregnant (NP females and healthy controls. Findings: Eleven microRNAs were significantly expressed in response to HEV infection; importantly, miR- 431, 654, 1468 and 4435, were distinctly expressed in pregnant self-limiting AVH-E and healthy females (p = 0.0005, but not in ALF-E. Sixteen exclusive microRNAs differentiated ALF-E from self limiting AVH-E in pregnant females. miR-450b which affects cellular proliferation and metabolic processes through RNF20 and SECB was predominanlty upregulated and correlated with poor outcome (ROC 0.958, p = 0.001. Interpretation: Our results reveal that a specific microRNA profile can predict fatality in ALF-E in pregnancy. These microRNAs could be exploited as prognostic biomarkers and help in the development of new therapeutic interventions. Keywords: Health sciences, Virology

  10. Medium chain triglycerides dose-dependently prevent liver pathology in a rat model of non-alcoholic fatty liver disease

    Science.gov (United States)

    Metabolic syndrome is often accompanied by development of hepatic steatosis and less frequently by nonalcoholic fatty liver disease (NAFLD) leading to nonalcoholic steatohepatitis (NASH). Replacement of corn oil with medium chain triacylglycerols (MCT) in the diets of alcohol-fed rats has been show...

  11. Quality improvement collaborative: A novel approach to improve infection prevention and control. Perceptions of lead infection prevention nurses who participated.

    Science.gov (United States)

    Adams, Debra; Hine, Victoria; Bucior, Helen; Foster, Wendy; Mukombe, Nyarayi; Ryan, Jane; Smirthwaite, Sandra; Winfield, Jodie

    2018-03-01

    In response to the ongoing infection prevention (IP) challenges in England, a 90-day quality improvement (QI) collaborative programme was developed. The paper discusses the approach, benefits, challenges and evaluation of the programme. The objective of the collaborative was to develop new approaches to enable sustainable and effective IP. Six trusts in the region participated in the collaborative. Each defined their bespoke IP focus. There was no expectation that statistically significant measurable improvements would be identified during the short time frame. The experiences of the participants were sought both during the programme to facilitate its constant review and at the end of the programme to evaluate its effectiveness. The feedback focused on achievements, barriers to change and benefits of participating in a QI collaborative. To measure the potential success of the projects, participants completed the Model for Understanding Success in Quality framework. (MUSIQ; Kaplan et al., 2012). Since each trusts IP focus was bespoke commonalities of success were not evaluated. Participants identified a positive outcome from their QI interventions. The MUSIQ score identified the projects had the potential for success. The feedback from the participants demonstrated that it is worthy of further development.

  12. Liver fluke (Fasciola hepatica) infection in cattle in Northern Ireland: a large-scale epidemiological investigation utilising surveillance data.

    Science.gov (United States)

    Byrne, Andrew W; McBride, Stewart; Lahuerta-Marin, Angela; Guelbenzu, Maria; McNair, Jim; Skuce, Robin A; McDowell, Stanley W J

    2016-04-14

    Liver fluke (Fasciola hepatica) is a widespread parasite of ruminants which can have significant economic impact on cattle production. Fluke infection status at the animal-level is captured during meat inspection of all animals processed for human consumption within Northern Ireland. These national datasets have not been analysed to assess their utility in uncovering patterns in fluke infection at animal- and herd-levels in Northern Ireland. We utilised a dataset of 1.2 million animal records from ~18,000 herds across 3 years (2011-2013) to assess animal- and herd-level apparent prevalence and risk-factors associated with fluke infection. Animal-level apparent prevalence was measured as the proportion of animals exhibiting evidence of fluke infection at slaughter; between herd-level infection prevalence was measured by binary categorisation of herds (infected or not). "Within herd" infection prevalence was measured using the proportion of animals within a herd that showed evidence of fluke infection per year (ranging from 0-100%). "Within herd" infection prevalence at the herd level was investigated using multivariable modelling. At the animal level, the proportion of animals slaughtered that exhibited evidence of infection was 21-25% amongst years. Across herds, the proportion of herds with at least one infected animal, varied between 61 and 65%. However, there was a significant sampling effect at the herd-level; all herds where at least 105 animals slaughtered over the study period exhibited evidence of fluke infection (100%). There was significant variation in terms of within-herd infection prevalence. Risk factors included herd type, long-term weather variation, geographic location (region) and the abattoir. Liver fluke apparent prevalence was high at the herd-level across years. However, there was lower prevalence at the animal level, which may indicate significant variation in the exposure to fluke infection within herds. The proportion infected within

  13. Acyclic retinoid in chemoprevention of hepatocellular carcinoma: Targeting phosphorylated retinoid X receptor-α for prevention of liver carcinogenesis

    Directory of Open Access Journals (Sweden)

    Masahito Shimizu

    2012-01-01

    Full Text Available One of the key features of hepatocellular carcinoma (HCC is the high rate of intrahepatic recurrence that correlates with poor prognosis. Therefore, in order to improve the clinical outcome for patients with HCC, development of a chemopreventive agent that can decrease or delay the incidence of recurrence is a critical issue for urgent investigation. Acyclic retinoid (ACR, a synthetic retinoid, successfully improves HCC patient survival by preventing recurrence and the formation of secondary tumors. A malfunction of the retinoid X receptor-α (RXRα due to phosphorylation by the Ras-MAPK signaling pathway plays a critical role in liver carcinogenesis, and ACR exerts chemopreventive effects on HCC development by inhibiting RXRα phosphorylation. Here, we review the relationship between retinoid signaling abnormalities and liver disease, the mechanisms of how RXRα phosphorylation contributes to liver carcinogenesis, and the detailed effects of ACR on preventing HCC development, especially based on the results of our basic and clinical research. We also outline the concept of "clonal deletion and inhibition" therapy, which is defined as the removal and inhibition of latent malignant clones from the liver before they expand into clinically detectable HCC, because ACR prevents the development of HCC by implementing this concept. Looking toward the future, we discuss "combination chemoprevention" using ACR as a key drug since it can generate a synergistic effect, and may thus be an effective new strategy for the prevention of HCC.

  14. Prevalence and Clinical Correlates of Chronic Hepatitis E Infection in German Renal Transplant Recipients With Elevated Liver Enzymes

    Directory of Open Access Journals (Sweden)

    Mira Choi, MD

    2018-02-01

    Conclusions. This retrospective study showed that prevalence of chronic HEV infection was high in our renal transplant patient cohort and was associated with significant liver impairment and the occurrence of renal injury. Ribavirin treatment was effective and should be initiated early to avoid complications, but the risk of severe hemolytic anemia makes strict monitoring essential.

  15. Whole Blood Polymerase Chain Reaction in a Neonate with Disseminated Herpes Simplex Virus Infection and Liver Failure

    Directory of Open Access Journals (Sweden)

    Jennifer A. Scoble

    2013-10-01

    Full Text Available A late preterm neonate born by cesarean section with intact membranes presented at 9 days of life with shock and liver failure. Surface cultures were negative but whole blood polymerase chain reaction was positive for herpes simplex virus type 2, underscoring the value of this test in early diagnosis of perinatally acquired disseminated herpes simplex virus infection without skin lesions.

  16. Programs of the preventive interventions against sexually transmitted infections in the high-risk subpopulations

    OpenAIRE

    T. V. Krasnoselskikh; E. V. Sokolovskiy

    2017-01-01

    A review article highlights the practical issues of design, implementation and effectiveness estimation of STI prevention programs aimed to correct the behavior leading to infection. the importance of epidemiological modeling method for the organization of preventive interventions is discussed. the prospects of the multidisciplinary behavioral approach to STI prevention are demonstrated.

  17. Programs of the preventive interventions against sexually transmitted infections in the high-risk subpopulations

    Directory of Open Access Journals (Sweden)

    T. V. Krasnoselskikh

    2017-01-01

    Full Text Available A review article highlights the practical issues of design, implementation and effectiveness estimation of STI prevention programs aimed to correct the behavior leading to infection. the importance of epidemiological modeling method for the organization of preventive interventions is discussed. the prospects of the multidisciplinary behavioral approach to STI prevention are demonstrated.

  18. Primer for Teachers: Quick and Easy Liver Wellness, Hepatitis B and Substance Abuse Prevention Messages.

    Science.gov (United States)

    Thiel, Thelma King

    This guide provides information for teachers to use in teaching about liver wellness, hepatitis B, and substance abuse. The guide includes effective motivational techniques to help students understand how valuable their liver is to their health and well being. It also provides basic information to help students avoid liver damaging behaviors, such…

  19. The INCA trial (Impact of NOD2 genotype-guided antibiotic prevention on survival in patients with liver Cirrhosis and Ascites): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Casper, Markus; Mengel, Martin; Fuhrmann, Christine; Herrmann, Eva; Appenrodt, Beate; Schiedermaier, Peter; Reichert, Matthias; Bruns, Tony; Engelmann, Cornelius; Grünhage, Frank; Lammert, Frank

    2015-03-08

    Patients with liver cirrhosis have a highly elevated risk of developing bacterial infections that significantly decrease survival rates. One of the most relevant infections is spontaneous bacterial peritonitis (SBP). Recently, NOD2 germline variants were found to be potential predictors of the development of infectious complications and mortality in patients with cirrhosis. The aim of the INCA (Impact of NOD2 genotype-guided antibiotic prevention on survival in patients with liver Cirrhosis and Ascites) trial is to investigate whether survival of this genetically defined high-risk group of patients with cirrhosis defined by the presence of NOD2 variants is improved by primary antibiotic prophylaxis of SBP. The INCA trial is a double-blind, placebo-controlled clinical trial with two parallel treatment arms (arm 1: norfloxacin 400 mg once daily; arm 2: placebo once daily; 12-month treatment and observational period). Balanced randomization of 186 eligible patients with stratification for the protein content of the ascites (INCA trial is first in the field of hepatology aimed at rapidly transferring and validating information on individual genetic risk into clinical decision algorithms. German Clinical Trials Register DRKS00005616 . Registered 22 January 2014. EU Clinical Trials Register EudraCT 2013-001626-26 . Registered 26 January 2015.

  20. Novel Approaches to Preventing Urinary Tract Infection in Women

    Science.gov (United States)

    1998-09-01

    tract tissue (kidney). (4) Establishment of a collaboration with Drs. M. Juliana McElrath and Florian Hladik of the Fred Hutchison Cancer Research...liver, A. Hamers , W. Gaastra, 20. Levery, S. B., M. E. Salyan, S. J. Steele, R. Kannagi, S. Dasgupta, J. L. K.-A. Karlsson, and S. Normark. 1990

  1. Causes, prevention and treatment of Escherichia coli infections.

    Science.gov (United States)

    Gould, Dinah

    Escherichia coli is a normal inhabitant of the human gastrointestinal tract and can cause healthcare-associated infections. The organism is most frequently responsible for urinary tract infections and it is the bacterium most often implicated in the cause of diarrhoea in people travelling overseas. In recent years, a strain called Ecoli O157 has gained notoriety for causing foodborne infection, which can have severe health consequences, especially in young children. This article describes the range of different infections caused by Ecoli in healthcare settings and the community and discusses the characteristics of the different strains of the bacteria that explain variations in their pathogenicity.

  2. The Potential of Non-Provitamin A Carotenoids for the Prevention and Treatment of Non-Alcoholic Fatty Liver Disease

    Directory of Open Access Journals (Sweden)

    Ana Gabriela Murillo

    2016-11-01

    Full Text Available Non-alcoholic fatty liver disease (NAFLD is an obesity-associated spectrum of comorbidities defined by the presence of metabolic dysfunction, oxidative stress, inflammation, and fibrosis in the liver. If left untreated, NAFLD can progress to cirrhosis, liver failure, or hepatocellular carcinoma. NAFLD is recognized as the most common liver disease in the United States, affecting around 30% of the population. Identification of dietary components capable of reducing or preventing NAFLD is therefore essential to battle this condition. Dietary carotenoids including astaxanthin, lycopene, lutein, and zeaxanthin have been demonstrated to be potent antioxidants as well as to exhibit anti-inflammatory effects. Many studies report the protective effect(s of these carotenoids against different conditions such as atherosclerosis, diabetic complications, age-related macular degeneration, and liver diseases. In this review, we will focus on the effects of these carotenoids in the prevention or reduction of NAFLD as seen in epidemiological observations and clinical trials, as well as the suggested mechanism of action derived from animal and cell studies.

  3. Soluble CD163 predicts incident chronic lung, kidney and liver disease in HIV infection

    DEFF Research Database (Denmark)

    Kirkegaard-Klitbo, Ditte M; Mejer, Niels; Knudsen, Troels B

    2017-01-01

    OBJECTIVE: To examine if monocyte and macrophage activity may be on the mechanistic pathway to non-AIDS comorbidity by investigating the associations between plasma-soluble CD163 (sCD163) and incident non-AIDS comorbidities in well treated HIV-infected individuals. DESIGN: Prospective single...... was examined using multivariable Cox proportional hazards models adjusted for pertinent covariates. RESULTS: In HIV-1-infected individuals (n = 799), the highest quartile of plasma sCD163 was associated with incident chronic lung disease [adjusted hazard ratio (aHR), 3.2; 95% confidence interval (CI): 1.34; 7.......46] and incident chronic kidney disease (aHR, 10.94; 95% CI: 2.32; 51.35), when compared with lowest quartiles. Further, (every 1 mg) increase in plasma sCD163 was positively correlated with incident liver disease (aHR, 1.12; 95% CI: 1.05; 1.19). The sCD163 level was not associated with incident cancer...

  4. ‘Surprise’: Outbreak of Campylobacter infection associated with chicken liver pâté at a surprise birthday party, Adelaide, Australia, 2012

    Directory of Open Access Journals (Sweden)

    Emma Denehy

    2012-11-01

    Full Text Available Objective: In July 2012, an outbreak of Campylobacter infection was investigated by the South Australian Communicable Disease Control Branch and Food Policy and Programs Branch. The initial notification identified illness at a surprise birthday party held at a restaurant on 14 July 2012. The objective of the investigation was to identify the potential source of infection and institute appropriate intervention strategies to prevent further illness.Methods: A guest list was obtained and a retrospective cohort study undertaken. A combination of paper-based and telephone questionnaires were used to collect exposure and outcome information. An environmental investigation was conducted by Food Policy and Programs Branch at the implicated premises.Results: All 57 guests completed the questionnaire (100% response rate, and 15 met the case definition. Analysis showed a significant association between illness and consumption of chicken liver pâté (relative risk: 16.7, 95% confidence interval: 2.4–118.6. No other food or beverage served at the party was associated with illness. Three guests submitted stool samples; all were positive for Campylobacter. The environmental investigation identified that the cooking process used in the preparation of chicken liver pâté may have been inconsistent, resulting in some portions not cooked adequately to inactivate potential Campylobacter contamination.Discussion: Chicken liver products are a known source of Campylobacter infection; therefore, education of food handlers remains a high priority. To better identify outbreaks among the large number of Campylobacter notifications, routine typing of Campylobacter isolates is recommended.

  5. Therapeutic role of niacin in the prevention and regression of hepatic steatosis in rat model of nonalcoholic fatty liver disease.

    Science.gov (United States)

    Ganji, Shobha H; Kukes, Gary D; Lambrecht, Nils; Kashyap, Moti L; Kamanna, Vaijinath S

    2014-02-15

    Nonalcoholic fatty liver disease (NAFLD), a leading cause of liver damage, comprises a spectrum of liver abnormalities including the early fat deposition in the liver (hepatic steatosis) and advanced nonalcoholic steatohepatitis. Niacin decreases plasma triglycerides, but its effect on hepatic steatosis is elusive. To examine the effect of niacin on steatosis, rats were fed either a rodent normal chow, chow containing high fat (HF), or HF containing 0.5% or 1.0% niacin in the diet for 4 wk. For regression studies, rats were first fed the HF diet for 6 wk to induce hepatic steatosis and were then treated with niacin (0.5% in the diet) while on the HF diet for 6 wk. The findings indicated that inclusion of niacin at 0.5% and 1.0% doses in the HF diet significantly decreased liver fat content, liver weight, hepatic oxidative products, and prevented hepatic steatosis. Niacin treatment to rats with preexisting hepatic steatosis induced by the HF diet significantly regressed steatosis. Niacin had no effect on the mRNA expression of fatty acid synthesis or oxidation genes (including sterol-regulatory element-binding protein 1, acetyl-CoA carboxylase 1, fatty acid synthase, and carnitine palmitoyltransferase 1) but significantly inhibited mRNA levels, protein expression, and activity of diacylglycerol acyltrasferase 2, a key enzyme in triglyceride synthesis. These novel findings suggest that niacin effectively prevents and causes the regression of experimental hepatic steatosis. Approved niacin formulation(s) for other indications or niacin analogs may offer a very cost-effective opportunity for the clinical development of niacin for treating NAFLD and fatty liver disease.

  6. Health care-associated infection prevention in Japan: the role of safety culture.

    Science.gov (United States)

    Sakamoto, Fumie; Sakihama, Tomoko; Saint, Sanjay; Greene, M Todd; Ratz, David; Tokuda, Yasuharu

    2014-08-01

    Limited data exist on the use of infection prevention practices in Japan. We conducted a nationwide survey to examine the use of recommended infection prevention strategies and factors affecting their use in Japanese hospitals. Between April 1, 2012, and January 31, 2013, we surveyed 971 hospitals in Japan. The survey instrument assessed general hospital and infection prevention program characteristics and use of infection prevention practices, including practices specific to preventing catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated pneumonia (VAP). Logistic regression models were used to examine multivariable associations between hospital characteristics and the use of the various prevention practices. A total of 685 hospitals (71%) responded to the survey. Maintaining aseptic technique during catheter insertion and maintenance, avoiding routine central line changes, and using maximum sterile barrier precautions and semirecumbent positioning were the only practices regularly used by more than one-half of the hospitals to prevent CAUTI, CLABSI, and VAP, respectively. Higher safety-centeredness was associated with regular use of prevention practices across all infection types. Although certain practices were used commonly, the rate of regular use of many evidence-based prevention practices was low in Japanese hospitals. Our findings highlight the importance of fostering an organization-wide atmosphere that prioritizes patient safety. Such a commitment to patient safety should in turn promote the use of effective measures to reduce health care-associated infections in Japan. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  7. Probiotics for preventing urinary tract infections in adults and children.

    Science.gov (United States)

    Schwenger, Erin M; Tejani, Aaron M; Loewen, Peter S

    2015-12-23

    Urinary tract infection (UTI) is a common bacterial infection that can lead to significant morbidity including stricture, abscess formation, fistula, bacteraemia, sepsis, pyelonephritis and kidney dysfunction. Mortality rates are reported to be as high as 1% in men and 3% in women due to development of pyelonephritis. Because probiotic therapy is readily available without a prescription, a review of their efficacy in the prevention of UTI may aid consumers in making informed decisions about potential prophylactic therapy. Institutions and caregivers also need evidence-based synopses of current evidence to make informed patient care decisions. Compared to placebo or no therapy, did probiotics (any formulation) provide a therapeutic advantage in terms of morbidity and mortality, when used to prevent UTI in susceptible patient populations?Compared to other prophylactic interventions, including drug and non-drug measures (e.g. continuous antibiotic prophylaxis, topical oestrogen, cranberry juice), did probiotics (any formulation) provide a therapeutic advantage in terms of morbidity and mortality when used to prevent UTIs in susceptible patient populations? We searched the Cochrane Kidney and Transplant Specialised Register to 21 September 2015 through contact with the Trials' Search Co-ordinator using search terms relevant to this review. Randomised controlled trials (RCTs) of susceptible patients (e.g. past history of UTI) or healthy people in which any strain, formulation, dose or frequency of probiotic was compared to placebo or active comparators were included. All RCTs and quasi-RCTs (RCTs in which allocation to treatment was obtained by alternation, use of alternate medical records, date of birth or other predictable methods) looking at comparing probiotics to no therapy, placebo, or other prophylactic interventions were included. Summary estimates of effect were obtained using a random-effects model, and results were expressed as risk ratios (RR) and their 95

  8. Liver-related deaths among persons infected with the human immunodeficiency virus: The D:A:D Study

    DEFF Research Database (Denmark)

    Weber, R; Sabin, CA; Friis-Møller, Nina

    2006-01-01

    . RESULTS: There were 1246 deaths (5.3%; 1.6 per 100 person-years); 14.5% were from liver-related causes. Of these, 16.9% had active hepatitis B virus (HBV), 66.1% had hepatitis C virus (HCV), and 7.1% had dual viral hepatitis co-infections. Predictors of liver-related deaths were latest CD4 cell count...... (adjusted relative rate [RR], 16.1; 95% confidence interval [CI], 8.1-31.7 for or =500/microL), age (RR, 1.3; 95% CI, 1.2-1.4 per 5 years older), intravenous drug use (RR, 2.0; 95% CI, 1.2-3.4), HCV infection (RR, 6.7; 95% CI, 4.0-11.2), and active HBV infection (RR, 3.7; 95% CI, 2...

  9. Introduction to the Centers for Disease Control and Prevention and Healthcare Infection Control Practices Advisory Committee Guideline for Prevention of Surgical Site Infection: Prosthetic Joint Arthroplasty Section.

    Science.gov (United States)

    Segreti, John; Parvizi, Javad; Berbari, Elie; Ricks, Philip; Berríos-Torres, Sandra I

    Peri-prosthetic joint infection (PJI) is a severe complication of total joint arthroplasty that appears to be increasing as more of these procedures are performed. Numerous risk factors for incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSIs) have been identified. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional SSI and PJI. The Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) recently updated the national Guideline for Prevention of Surgical Site Infection. The updated guideline applies evidence-based methodology, presents recommendations for potential strategies to reduce the risk of SSI, and includes an arthroplasty-specific section. This article serves to introduce the guideline development process and to complement the Prosthetic Joint Arthroplasty section with background information on PJI-specific economic burden, epidemiology, pathogenesis and microbiology, and risk factor information.

  10. ICMR programme on Antibiotic Stewardship, Prevention of Infection & Control (ASPIC).

    Science.gov (United States)

    Chandy, Sujith J; Michael, Joy Sarojini; Veeraraghavan, Balaji; Abraham, O C; Bachhav, Sagar S; Kshirsagar, Nilima A

    2014-02-01

    Antimicrobial resistance and hospital infections have increased alarmingly in India. Antibiotic stewardship and hospital infection control are two broad strategies which have been employed globally to contain the problems of resistance and infections. For this to succeed, it is important to bring on board the various stakeholders in hospitals, especially the clinical pharmacologists. The discipline of clinical pharmacology needs to be involved in themes such as antimicrobial resistance and hospital infection which truly impact patient care. Clinical pharmacologists need to collaborate with faculty in other disciplines such as microbiology to achieve good outcomes for optimal patient care in the hospital setting. The ASPIC programme was initiated by the Indian Council of Medical Research (ICMR) in response to the above need and was designed to bring together faculty from clinical pharmacology, microbiology and other disciplines to collaborate on initiating and improving antibiotic stewardship and concurrently curbing hospital infections through feasible infection control practices. This programme involves the participation of 20 centres per year throughout the country which come together for a training workshop. Topics pertaining to the above areas are discussed in addition to planning a project which helps to improve antibiotic stewardship and infection control practices in the various centres. It is hoped that this programme would empower hospitals and institutions throughout the country to improve antibiotic stewardship and infection control and ultimately contain antimicrobial resistance.

  11. Infections in Neonatal Intensive Care: Prevalence, Prevention and Antibiotic use

    NARCIS (Netherlands)

    van den Hoogen, A.

    2009-01-01

    Neonatal infections are an important cause of morbidity in neonatal intensive care units (NICUs). Prematurity or very low birth weight is an important predisposing factor for neonatal infection. In addition, preterm infants have a compromized immune system and they often require invasive procedures

  12. Natural approaches to prevention and treatment of infections of the lower urinary tract.

    Science.gov (United States)

    Head, Kathleen A

    2008-09-01

    Infections of the lower urinary tract are common occurrences in young women, during pregnancy, and in peri- and postmenopausal women. Because of the chronic nature of urinary tract infections (UTIs) and the potential for antibiotic resistance, a natural approach to prevention and treatment is desirable. Clinical research suggests the best natural options for long-term prevention include cranberry, mannose, and probiotics. Botanicals that can be effective at the first sign of an infection and for short-term prophylaxis include berberine and uva ursi. Estriol cream and vitamins A and C have also been shown to prevent UTIs, while potassium salts can alkalinize the urine and reduce dysuria.

  13. Strategies for the prevention of hospital-acquired infections in the neonatal intensive care unit.

    Science.gov (United States)

    Borghesi, A; Stronati, M

    2008-04-01

    Nosocomial infections are among the leading causes of mortality and morbidity in neonatal intensive care units. Prevention of healthcare-associated infections is based on strategies that aim to limit susceptibility to infections by enhancing host defences, interrupting transmission of organisms by healthcare workers and by promoting the judicious use of antimicrobials. Several strategies are available and include: hand hygiene practices; prevention of central venous catheter-related bloodstream infections; judicious use of antimicrobials for therapy and prophylaxis; enhancement of host defences; skin care; and early enteral feeding with human milk.

  14. Nursing Care Model Based on Knowledge Management in Preventing Nosocomial Infection After Caesarean Section in Hospital

    Directory of Open Access Journals (Sweden)

    Ahsan Ahsan

    2016-09-01

    Full Text Available Introduction: Nosocomial infection is one indicator of the quality of health services in the community, which also determines the image of health care institutions becauseit was a major cause of morbidityand death rate (mortality in hospital. Nursing care based on knowledge management is established from identification knowledge which is required, prevention performance of nosocomial infections post section caesarea. Nosocomial infections component consists of wound culture result. Method: This study was an observational study with a quasi experimental design. The population was all of nursing staff who working in obstetrics installation in hospitals A and B as much as 46 people. Sample was the total population. Data was collected through questionnaire, observation sheets and examination of the wound culture. Data was analyzed using t test B 1.274 dan p=0.028 Result: The result showed that 1 there was difference in knowledge management implementation before and after training; 2 there was difference in nurse’s performance in preventing nosocomial infection before and after training; 3 there is significant relationship between nurse’s performance in preventing nosocomial infection and infection incidence; 4 there is no significant difference of nursing care impementation on nosocomial incidence. Discussion: In conclusion, the development of nursing care based on knowledge management as a synthesis or induction of findings directed at 1 nurses’ knowledge does not affect the performance of the prevention of nosocomial infections; 2 knowledge management has a positive effect on the performance of the prevention of nosocomial infections; 3 implementation of infection prevention is integrated capabilities between knowledge, skills and attitudes of nurses in implementing performance in care. Keywords: model prevention, nosocomial infections, nursing care, knowledge management, sectio Caesarea

  15. Prevention of nosocomial infections in intensive care unit and nursing practices

    Directory of Open Access Journals (Sweden)

    Sevilay Yüceer

    2009-01-01

    Full Text Available Nosocomial infections which are considered as the primary indicator of the quality of care in hospitals, cause to prolong hospitalization at intensive care unit and hospital, increase morbidity, mortality, and the cost of treatment. Although only 5-10% of the patients are treated in the intensive care units, 20-25% of all nosocomial infections are seen in these units. Preventing nosocomial infections in intensive care units is a process started at the patient acceptance to unit that requires an interdisciplinary team approach of intensive care staffs’ and Infection Control Committee members.Intensive care nurses who are in constant contact with patients have important responsibilities in preventing nosocomial infections. Intensive care nurses should be aware that the nosocomial infections can be prevented. They should have current knowledge about universal precautions related to prevention and control of infections, which are accepted by the entire world and they reinforce this knowledge by practice and should provide the most effective care to patients.In this article, nursing practices for prevention of nosocomial infections in intensive care units are discussed based on universal precautions.

  16. Targeted Assessment for Prevention of Healthcare-Associated Infections: A New Prioritization Metric.

    Science.gov (United States)

    Soe, Minn M; Gould, Carolyn V; Pollock, Daniel; Edwards, Jonathan

    2015-12-01

    To develop a method for calculating the number of healthcare-associated infections (HAIs) that must be prevented to reach a HAI reduction goal and identifying and prioritizing healthcare facilities where the largest reductions can be achieved. Acute care hospitals that report HAI data to the Centers for Disease Control and Prevention's National Healthcare Safety Network. METHODS :The cumulative attributable difference (CAD) is calculated by subtracting a numerical prevention target from an observed number of HAIs. The prevention target is the product of the predicted number of HAIs and a standardized infection ratio goal, which represents a HAI reduction goal. The CAD is a numeric value that if positive is the number of infections to prevent to reach the HAI reduction goal. We calculated the CAD for catheter-associated urinary tract infections for each of the 3,639 hospitals that reported such data to National Healthcare Safety Network in 2013 and ranked the hospitals by their CAD values in descending order. Of 1,578 hospitals with positive CAD values, preventing 10,040 catheter-associated urinary tract infections at 293 hospitals (19%) with the highest CAD would enable achievement of the national 25% catheter-associated urinary tract infection reduction goal. The CAD is a new metric that facilitates ranking of facilities, and locations within facilities, to prioritize HAI prevention efforts where the greatest impact can be achieved toward a HAI reduction goal.

  17. Liver transplantation may prevent neurodevelopmental deterioration in high-risk patients with urea cycle disorders.

    Science.gov (United States)

    Kido, Jun; Matsumoto, Shirou; Momosaki, Ken; Sakamoto, Rieko; Mitsubuchi, Hiroshi; Endo, Fumio; Nakamura, Kimitoshi

    2017-09-01

    UCDs are among the most common inherited metabolic diseases in Japan. We investigated the clinical manifestations, treatment, and prognoses of 177 patients with UCDs who were evaluated and treated from January 1999 to March 2009 in Japan, using a questionnaire survey. Among these 177 patients, 42 (seven with carbamoyl phosphate synthetase 1 deficiency, 27 with ornithine transcarbamylase deficiency, seven with argininosuccinate synthetase deficiency, and one with arginase 1 deficiency) underwent living-donor LT. Although this study was retrospective and included limited neurodevelopmental information before and after LT, we evaluated whether LT could improve neurodevelopmental outcomes in patients with UCDs. The neurodevelopmental outcomes of patients with a MAC of <300 μmol/L at the time of onset were not significantly different between the LT and non-LT groups (P=.222). LT may have prevented further neurodevelopmental complications in children with MAC ≥300 μmol/L (P=.008) compared with non-transplant management. Therefore, Liver transplant should be considered in patients with UCD with a MAC of ≥300 μmol/L at the time of disease onset. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Odontella aurita-enriched diet prevents high fat diet-induced liver insulin resistance.

    Science.gov (United States)

    Amine, Hamza; Benomar, Yacir; Haimeur, Adil; Messaouri, Hafida; Meskini, Nadia; Taouis, Mohammed

    2016-01-01

    The beneficial effect of polyunsaturated omega-3 fatty acid (w-3 FA) consumption regarding cardiovascular diseases, insulin resistance and inflammation has been widely reported. Fish oil is considered as the main source of commercialized w-3 FAs, and other alternative sources have been reported such as linseed or microalgae. However, despite numerous reports, the underlying mechanisms of action of w-3 FAs on insulin resistance are still not clearly established, especially those from microalgae. Here, we report that Odontella aurita, a microalga rich in w-3 FAs eicosapentaenoic acid, prevents high fat diet-induced insulin resistance and inflammation in the liver of Wistar rats. Indeed, a high fat diet (HFD) increased plasma insulin levels associated with the impairment of insulin receptor signaling and the up-regulation of toll-like receptor 4 (TLR4) expressions. Importantly, Odontella aurita-enriched HFD (HFOA) reduces body weight and plasma insulin levels and maintains normal insulin receptor expression and responsiveness. Furthermore, HFOA decreased TLR4 expression, JNK/p38 phosphorylation and pro-inflammatory factors. In conclusion, we demonstrate for the first time, to our knowledge, that diet supplementation with whole Ondontella aurita overcomes HFD-induced insulin resistance through the inhibition of TLR4/JNK/p38 MAP kinase signaling pathways. © 2016 Society for Endocrinology.

  19. Prevention of organ rejection in renal and liver transplantation with extended release tacrolimus

    Directory of Open Access Journals (Sweden)

    Reschen ME

    2014-09-01

    Full Text Available Michael E Reschen, Christopher A O’Callaghan Henry Wellcome Building, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom Abstract: Tacrolimus is the key immunosuppressant used to prevent allograft rejection in kidney and liver transplant recipients. Despite the efficacy of tacrolimus and adjunctive immunosuppressants, a substantial number of patients experience episodes of acute rejection and late graft loss. Nonadherence is an etiological factor in both acute rejection and graft loss. In 2007, a prolonged release version of tacrolimus became available that allows once daily administration, thus halving the pill burden compared to the standard twice-daily tacrolimus. An increasing number of studies in de novo transplantation and in treatment conversion have evaluated the pharmacokinetic profile, efficacy, and safety of prolonged-release tacrolimus. We have reviewed the literature on the use of prolonged-release tacrolimus and hope that this will be of value in the design of protocols for transplant immunosuppression.Keywords: immunosuppression, kidney, hepatic, allograft, adherence

  20. Efficacy of Rifaximin in Prevention of Recurrence of Hepatic Encephalopathy in Patients with Cirrhosis of Liver

    International Nuclear Information System (INIS)

    Ali, B.; Zaidi, Y. A.; Alam, A.; Anjum, H. S.

    2014-01-01

    Objective: To determine the efficacy of Rifaximin in prevention of repeated episodes of hepatic encephalopathy in patients with liver cirrhosis as compared to placebo. Study Design: Triple-blind, randomized placebo-controlled trial. Place and Duration of Study: Department of Gastroenterology-Hepatology, Shaikh Zayed Hospital, Lahore, from October 2012 to April 2013. Methodology: Patients in remission from recurrent hepatic encephalopathy resulting from cirrhosis were randomly assigned to receive either Rifaximin, at a dose of 550 mg twice daily (63 patients), or placebo (63 patients.) Patients were requested to take the drug orally twice daily for 6 months or until they developed a breakthrough episode of hepatic encephalopathy. Results: Mean age of patients in treatment and control group was 40.21 A +- 2.33 years and 42.87 A +- 4.54 years respectively. The most common etiology of cirrhosis was hepatitis C followed by hepatitis B. Patients who remained free of hepatic encephalopathy during study period were 40 out of 63 patients in control group and 35 patients out of 63 patients (p = 0.56). Most of the patients who developed breakthrough hepatic encephalopathy had a MELD score range of 21-25 in both groups. The number of deaths and adverse events was similar in both groups. Conclusion: Over a 6-month period, treatment with Rifaximin failed to maintain remission from hepatic encephalopathy more effectively than placebo in the studied group. (author)

  1. Starvation beneficially influences the liver physiology and nutrient metabolism in Edwardsiella tarda infected red sea bream (Pagrus major).

    Science.gov (United States)

    Mohapatra, Sipra; Chakraborty, Tapas; Shimizu, Sonoko; Urasaki, Shintaro; Matsubara, Takahiro; Nagahama, Yoshitaka; Ohta, Kohei

    2015-11-01

    Dietary compromises, especially food restrictions, possess species-specific effects on the health status and infection control in several organisms, including fish. To understand the starvation-mediated physiological responses in Edwardsiella tarda infected red sea bream, especially in the liver, we performed a 20-day starvation experiment using 4 treatment (2 fed and 2 starved) groups, namely, fed-placebo, starved-placebo, fed-infected, and starved-infected, wherein bacterial exposure was done on the 11th day. In the present study, the starved groups showed reduced hepatosomatic index and drastic depletion in glycogen storage and vacuole formation. The fed-infected fish showed significant (Pred sea bream. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Unhealthy alcohol use, HIV infection and risk of liver fibrosis in drug users with hepatitis C.

    Directory of Open Access Journals (Sweden)

    Roberto Muga

    Full Text Available AIM: To analyze alcohol use, clinical data and laboratory parameters that may affect FIB-4, an index for measuring liver fibrosis, in HCV-monoinfected and HCV/HIV-coinfected drug users. PATIENTS AND METHODS: Patients admitted for substance abuse treatment between 1994 and 2006 were studied. Socio-demographic data, alcohol and drug use characteristics and clinical variables were obtained through hospital records. Blood samples for biochemistry, liver function tests, CD4 cell count, and serology of HIV and HCV infection were collected at admission. Multivariate linear regression was used to analyze the predictors of FIB-4 increase. RESULTS: A total of 472 (83% M, 17% F patients were eligible. The median age at admission was 31 years (Interquartile range (IQR 27-35 years, and the median duration of drug use was 10 years (IQR 5.5-15 years. Unhealthy drinking (>50 grams/day was reported in 32% of the patients. The FIB-4 scores were significantly greater in the HCV/HIV-coinfected patients (1.14, IQR 0.76-1.87 than in the HCV-monoinfected patients (0.75, IQR 0.56-1.11 (p<0.001. In the multivariate analysis, unhealthy drinking (p = 0.034, lower total cholesterol (p = 0.042, serum albumin (p<0.001, higher GGT (p<0.001 and a longer duration of addiction (p = 0.005 were independently associated with higher FIB-4 scores in the HCV-monoinfected drug users. The effect of unhealthy drinking on FIB-4 scores disappeared in the HCV/HIV-coinfected patients, whereas lower serum albumin (p<0.001, a lower CD4 cell count (p = 0.006, higher total bilirubin (p<0.001 and a longer drug addiction duration (p<0.001 were significantly associated with higher FIB-4 values. CONCLUSIONS: Unhealthy alcohol use in the HCV-monoinfected patients and HIV-related immunodeficiency in the HCV/HIV-coinfected patients are important risk factors associated with liver fibrosis in the respective populations.

  3. Demonstration of Hepatitis C Virus RNA with In Situ Hybridization Employing a Locked Nucleic Acid Probe in Humanized Liver of Infected Chimeric Mice and in Needle-Biopsied Human Liver

    Directory of Open Access Journals (Sweden)

    Kazuya Shiogama

    2013-01-01

    Full Text Available Background. In situ hybridization (ISH with high sensitivity has been requested to demonstrate hepatitis C virus (HCV RNA in formalin-fixed, paraffin-embedded (FFPE sections of the liver. Methods. ISH employing a locked-nucleic-acid- (LNA-modified oligonucleotide probe and biotin-free catalyzed signal amplification system (CSAII was applied to HCV-RNA detection in the liver tissue. Nested reverse-transcription polymerase chain reaction (RT-PCR was performed for HCV genotyping using total RNA extracted from FFPE sections. The target tissues included FFPE tissue sections of humanized livers in HCV-infected chimeric mice (HCV genotypes 1a, 1b, and 2a and noninfected and of needle-biopsied livers from HCV-infected patients. Results. HCV-RNA was demonstrated with the ISH technique in HCV-infected liver tissues from both chimeric mice and 9 (82% of 11 patients with HCV infection. The HCV signals were sensitive to RNase. Nested RT-PCR confirmed the genotype in 8 (73% of 11 livers (type 1b: 6 lesions and type 2a: 2 lesions. HCV-RNA was not identified in chronic hepatitis B lesions, fatty liver, autoimmune hepatitis, and hepatocellular carcinoma. Conclusion. ISH using the LNA-modified oligonucleotide probe and CSAII was applicable to detecting HCV-RNA in routinely prepared FFPE liver specimens.

  4. Amebic liver abscess

    Science.gov (United States)

    Hepatic amebiasis; Extraintestinal amebiasis; Abscess - amebic liver ... Amebic liver abscess is caused by Entamoeba histolytica. This parasite causes amebiasis , an intestinal infection that is also called ...

  5. Maternal and fetal cytomegalovirus infection: diagnosis, management, and prevention [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Robert F. Pass

    2018-03-01

    Full Text Available Congenital cytomegalovirus infection is a major cause of central nervous system and sensory impairments that affect cognition, motor function, hearing, language development, vestibular function, and vision. Although the importance of congenital cytomegalovirus infection is readily evident, the vast majority of maternal and fetal infections are not identified, even in developed countries. Multiple studies of prenatal cytomegalovirus infections have produced a body of knowledge that can inform the clinical approach to suspected or proven maternal and fetal infection. Reliable diagnosis of cytomegalovirus infection during pregnancy and accurate diagnosis of fetal infection are a reality. Approaches to preventing the transmission of cytomegalovirus from mother to fetus and to the treatment of fetal infection are being studied. There is evidence that public health approaches based on hygiene can dramatically reduce the rate of primary maternal cytomegalovirus infections during pregnancy. This review will consider the epidemiology of congenital cytomegalovirus infection, the diagnosis and management of primary infection during pregnancy, and approaches to preventing maternal infection.

  6. A framework for preventing healthcare-associated infection in ...

    African Journals Online (AJOL)

    mented an HAI prevalence of 24%, with hospital-acquired pneumonia and ... Healthcare-associated infection (HAI) is a frequent and serious complication affecting 4 - 8% of ... The risk of pathogen transmission and hospital outbreaks after.

  7. Respiratory Syncytial Virus Infection (RSV): Transmission and Prevention

    Science.gov (United States)

    ... of Search Controls Search Form Controls Cancel Submit Respiratory Syncytial Virus Infection (RSV) Note: Javascript is disabled ... 2018 Content source: National Center for Immunization and Respiratory Diseases (NCIRD) , Division of Viral Diseases Email Recommend ...

  8. Bacterial infections in patients with liver cirrhosis: clinical characteristics and the role of C-reactive protein

    Science.gov (United States)

    Deutsch, Melanie; Manolakopoulos, Spilios; Andreadis, Ioannis; Giannaris, Markos; Kontos, George; Kranidioti, Hariklia; Pirounaki, Maria; Koskinas, John

    2018-01-01

    Background: The diagnosis of bacterial infection in cirrhotic patients may be difficult, because of the absence of classical signs such as fever and raised white blood cell count. The role of C-reactive protein (CRP) in this context has not been clearly defined. Methods: Clinical and laboratory characteristics of 210 consecutive cirrhotic patients with (n=100) or without (n=110) bacterial infection were compared with a control group of non-cirrhotic patients with infection (n=106). Results: Significantly fewer patients with cirrhosis had a body temperature ≥37°C when presenting with bacterial infection (56% cirrhotic vs. 85.5% non-cirrhotic patients, P=0.01). Mean leukocyte count was 6.92 × 103/mm3 in patients with cirrhosis and infection, 5.75 × 103/mm3 (P=0.02) in cirrhotic patients without infection, and 11.28 × 103/mm3 in non-cirrhotic patients with infection (P10 mg/L indicated the presence of infection with a sensitivity of 68%, a specificity of 84.5% and an area under the receiver operating characteristic curve of 0.8197. CRP cutoff level differed according to the severity of the liver disease: Child-Pugh score (CPS) A: 21.3 mg/L, B: 17 mg/L, and C: 5.78 mg/L. Conclusions: CRP at admission could help diagnose infection in cirrhotic patients. Since the severity of liver disease seems to affect the CRP values, lower CRP levels might indicate infection. Clinical suspicion is necessary to avoid delay in diagnosis and initiate antibiotic treatment. PMID:29333070

  9. Bacterial infections in patients with liver cirrhosis: clinical characteristics and the role of C-reactive protein.

    Science.gov (United States)

    Deutsch, Melanie; Manolakopoulos, Spilios; Andreadis, Ioannis; Giannaris, Markos; Kontos, George; Kranidioti, Hariklia; Pirounaki, Maria; Koskinas, John

    2018-01-01

    The diagnosis of bacterial infection in cirrhotic patients may be difficult, because of the absence of classical signs such as fever and raised white blood cell count. The role of C-reactive protein (CRP) in this context has not been clearly defined. Clinical and laboratory characteristics of 210 consecutive cirrhotic patients with (n=100) or without (n=110) bacterial infection were compared with a control group of non-cirrhotic patients with infection (n=106). Significantly fewer patients with cirrhosis had a body temperature ≥37°C when presenting with bacterial infection (56% cirrhotic vs. 85.5% non-cirrhotic patients, P=0.01). Mean leukocyte count was 6.92 × 10 3 /mm 3 in patients with cirrhosis and infection, 5.75 × 10 3 /mm 3 (P=0.02) in cirrhotic patients without infection, and 11.28 × 10 3 /mm 3 in non-cirrhotic patients with infection (P10 mg/L indicated the presence of infection with a sensitivity of 68%, a specificity of 84.5% and an area under the receiver operating characteristic curve of 0.8197. CRP cutoff level differed according to the severity of the liver disease: Child-Pugh score (CPS) A: 21.3 mg/L, B: 17 mg/L, and C: 5.78 mg/L. CRP at admission could help diagnose infection in cirrhotic patients. Since the severity of liver disease seems to affect the CRP values, lower CRP levels might indicate infection. Clinical suspicion is necessary to avoid delay in diagnosis and initiate antibiotic treatment.

  10. Novel Approaches to Preventing Urinary Tract Infection in Women

    Science.gov (United States)

    2001-09-01

    vaccines . In: Mobley HLT. 54. Johnson JR. Steil A. Delavari P. Canine feces as a reservoir ofextraintestinal Warren 1W, eds. Urinary tract infections...the material was subjected to analysis by Triple quadrupole ESI-MS/CID-MS experiments were electrospray ionization mass spectrometry in the positive ion...prophylaxis. Characteristic of prophylactic regimens development of vaccines against these infections, containing nitrofurantoin is the frequency of side

  11. Frequency and prevention of laparoscopic port site infection.

    Science.gov (United States)

    Taj, Muhammad Naeem; Iqbal, Yasmeen; Akbar, Zakia

    2012-01-01

    The present study was conducted to evaluate the usefulness and safety of the nonpowder surgical glove for extraction of the gallbladder in laparoscopic cholecystectomy. The study was carried out in Capital Hospital Islamabad and in a private hospital. The duration of study was from March 2009 to March 2012. This was an observational study carried out in 492 patients who underwent laparoscopic cholecystectomy using the surgical glove for extraction of the gallbladder and compared with the conventional method of gall bladder removal in two hospitals were analyzed. The operative findings, port site infection and co morbid conditions were evaluated. Postoperative wound infection was found in 27 (5.48%) of 492 cases. Umbilical port infection was found in 26 (5.28%) of cases in which gall bladder was removed without endogloves and only one case (0.2%) had infection when gall bladder was removed with the endogloves. Wound infection was more in acute cholecystitis (25.9%) and empyema of Gall Bladder (44.4%). Among the co morbid conditions, diabetes mellitus has got higher frequency of wound infection (44%). The use of the surgical glove for extraction of the gallbladder is safe, cheap, simple and potentially reduces significant morbidity. Its routine use at laparoscopic cholecystectomy is mandatory in all cases.

  12. Application of copper to prevent and control infection. Where are we now?

    LENUS (Irish Health Repository)

    O'Gorman, J

    2012-08-01

    The antimicrobial effect of copper has long been recognized and has a potential application in the healthcare setting as a mechanism to reduce environmental contamination and thus prevent healthcare-associated infection (HCAI).

  13. Probiotics in Preventing Recurrent Urinary Tract Infections in Women: A Literature Review.

    Science.gov (United States)

    Chisholm, Annie H

    2015-01-01

    Increasing antibiotic resistance and increasing resistance to commonly used antibiotics makes treatment and prevention of urinary tract infections difficult. Although more research is needed, probiotics should be considered a useful and safe alternative to antibiotics.

  14. Potential of RNA aptamers in the prevention of HIV-1 subtype C infections

    CSIR Research Space (South Africa)

    London, GM

    2014-10-01

    Full Text Available Compounds that have been used to prevent human immunodeficiency virus type-I (HIV-1) infections include synthetic chemicals, plant extras and monoclonal antibodies. Although most of these compounds have potent antiviral activity, they often fail...

  15. Risk factors for secondary transmission of Shigella infection within households: implications for current prevention policy

    NARCIS (Netherlands)

    Boveé, Lian; Whelan, Jane; Sonder, Gerard J. B.; van Dam, Alje P.; van den Hoek, Anneke

    2012-01-01

    Background: Internationally, guidelines to prevent secondary transmission of Shigella infection vary widely. Cases, their contacts with diarrhoea, and those in certain occupational groups are frequently excluded from work, school, or daycare. In the Netherlands, all contacts attending pre-school

  16. THE INFECTIVE ENDOCARDITIS (PREVENTION, DIAGNOSIS CRITERIA AND TREATMENT: KEY POINTS 2010

    Directory of Open Access Journals (Sweden)

    A. A. Demin

    2010-01-01

    Full Text Available Key positions of Guidelines on the prevention, diagnosis, and treatment of infective endocarditis issued by the Task Force of ESC in 2009 are explained in the comments. Recent opinions on these items are presented.

  17. Multiplicity of Plasmodium falciparum infection following intermittent preventive treatment in infants

    NARCIS (Netherlands)

    Buchholz, Ulrike; Kobbe, Robin; Danquah, Ina; Zanger, Philipp; Reither, Klaus; Abruquah, Harry H.; Grobusch, Martin P.; Ziniel, Peter; May, Jürgen; Mockenhaupt, Frank P.

    2010-01-01

    Intermittent preventive treatment in infants with sulphadoxine-pyrimethamine (IPTi-SP) reduces malaria morbidity by 20% to 33%. Potentially, however, this intervention may compromise the acquisition of immunity, including the tolerance towards multiple infections with Plasmodium falciparum.

  18. Multiplicity of Plasmodium falciparum infection following intermittent preventive treatment in infants

    NARCIS (Netherlands)

    Buchholz, U.; Kobbe, R.; Danquah, I.; Zanger, P.; Reither, K.; Abruquah, H.H.; Grobusch, M.P.; Ziniel, P.; May, J.; Mockenhaupt, F.P.

    2010-01-01

    Background: Intermittent preventive treatment in infants with sulphadoxine-pyrimethamine (IPTi-SP) reduces malaria morbidity by 20% to 33%. Potentially, however, this intervention may compromise the acquisition of immunity, including the tolerance towards multiple infections with Plasmodium

  19. Histopathological changes in the liver and stomach of Didelphis virginiana (Didelphimorphia: Didelphidae) during natural infection with Gnathostoma turgidum (Nematoda: Gnathostomidae).

    Science.gov (United States)

    Torres-Montoya, E H; Zazueta-Moreno, J M; Osuna-Martínez, L U; Castillo-Ureta, H; Silva-Hidalgo, G; López-Moreno, H S; Osuna-Ramírez, I; Noguera-Corona, E; Rendón-Maldonado, J G

    2017-11-06

    Gnathostoma turgidum is a nematode parasite that exploits the stomach of Virginian opossums, Didelphis virginiana, in Latin America. The opossum is the definitive host of G. turgidum in the wild. Intrahepatic growth and maturation of the parasite, subsequent migration to the stomach and spontaneous expulsion are common. However, the histopathological lesions caused by G. turgidum are poorly described. A better understanding of the life cycle of this parasite and the pathological changes in natural host-parasite interactions could help to clarify the progression of human infections caused by Gnathostoma binucleatum. The aim of this work was to study morphological changes in the liver and stomach of D. virginiana during natural infection and adult worm expulsion. Three opossums naturally infected with G. turgidum were captured from an endemic area of gnathostomosis. Three uninfected opossums captured from a non-endemic area were used as controls. The opossums were sacrificed at different stages of infection (March, May and December), and a histopathological study of their livers and stomachs was conducted. Injuries in livers were observed by histopathology - areas of necrosis and collagen septa were identified. Parasites caused nodules with necrosis on the periphery of lesions, and collagen fibres were also observed in stomachs. Collagen septa may be caused by antigenic remains of the parasite. Further immunological studies are necessary to verify that stimulation is caused by these factors.

  20. The protective effect of Moringa oleifera leaf extract on liver damage in mice infected with Plasmodium berghei ANKA

    Directory of Open Access Journals (Sweden)

    Kittiyaporn Dondee

    2016-09-01

    Full Text Available Objective: To investigate the protective effect of Moringa oleifera leaf extract on liver damage in mice infected with Plasmodium berghei ANKA (P. berghei Methods: For extraction of Moringa oleifera (M. oleifera leaves, microwave with hot water method was used and acute toxicity study was then be done. Standard Peters’ test was carried out to test the efficacy of M. oleifera extract in vivo. The ICR mice were inoculated with 1 × 107 red blood cells infected with P. berghei strain by intraperitoneal injection. They were subsequently given with 100, 500 and 1000 mg/kg of this extract by intragastric route once a day for 4 consecutive days. Parasitemia was estimated using microscopy and levels of aspartate aminotransferase, alanine aminotransferase and albumin were also measured. Results: The M. oleifera leaf extract showed the protective activity on liver damage in mice infected with P. berghei in a dose-dependent fashion. It can be indicated by normal levels of aspartate aminotransferase, alanine aminotransferase and albumin in mice treated with extract. The 1000 mg/kg of extract was observed to present the highest activity. Interestingly, the dosedependent antimalarial activity was also found in the mice treated with extract. Conclusions: The M. oleifera leaf extract presented protective effect on liver damage in mice infected with P. berghei.

  1. Hepatitis virus infection and chronic liver disease among atomic-bomb survivors

    Energy Technology Data Exchange (ETDEWEB)

    Fujiwara, S.; Cologne, J.; Akahoshi, M. [Radiation Effects Research Foundation, Hiroshima (Japan); Kusumi, S.; Kodama, K.; Yoshizawa, H.

    2000-05-01

    The purpose of this study is to analyze various laboratory indicators of inflammation measured in atomic bomb survivors. Subjects are 6304 survivors who underwent inflammatory tests at RERF between 1998 and 1992 and whose radiation doses (DS86) are available. Inflammatory tests include leukocyte counts, neutrophil counts, erythrocyte sedimentation rate, corrected erythrocyte sedimentation rate, alpha 1 globulin, alpha 2 globulin, and sialic acid. Adjusting for age, sex, smoking, and city of residence, regression analysis was conducted. Regression analysis, adjusted for age, sex, smoking, and city of residence showed statistically significant associations with radiation dose for leukocyte counts (71.0 /mm{sup 3}/Gy, p=0.00151), erythrocyte sedimentation rate (1.58 mm/hour/Gy, p=0.0001), corrected erythrocyte sedimentation rate (1.14 mm/hour/Gy, p=0.0001), alpha 1 globulin (0.0057 g/dl/Gy, p=0.0001), alpha 2 globulin (0.0128 g/dl/Gy, p=0.0001), and sialic acid (1.2711 mg/dl/Gy, p=0.0001), but not for neutrophil counts (29.9 /mm{sup 3}/Gy, p=0.1729). Standardized scores combining results from these seven inflammatory tests showed significant associations with radiation dose both for persons with and without inflammatory disease, and for two inflammatory conditions in particular, chronic thyroiditis and chronic liver disease. In analyses of data from 403 AHS patients, in whom both inflammation indicators and T-cell ratios were measured, increased inflammation correlates with decreases in CD4 T-cells. Since the laboratory indicators of inflammation that we studied are not specific for particular clinical diseases, the implication of their dose-response-pattern is hard to interpret. The general occurrence of infectious diseases in survivors is not related to radiation dose. Such a relationship does exist, however, for other diseases in which infection may play an etiologic role. Virologic studies in A-bomb survivors have suggested dose-response alterations in immune

  2. Device-related infections in critically ill patients. Part II: Prevention of ventilator-associated pneumonia and urinary tract infections.

    Science.gov (United States)

    Di Filippo, A; De Gaudio, A R

    2003-12-01

    Device utilization in critically ill patients is responsible for a high risk of complications such as catheter-related bloodstream infections (CRBSI), ventilator-associated pneumonia (VAP) and urinary tract infections (UTI). In this article we will review the current status of data regarding the prevention of VAP and UTI. The results of the more recent (5 years) randomized controlled trials are reviewed and discussed. General recommendations include staff education and use of a surveillance program with a restrictive antibiotic policy. Adequate time must be allowed for hand washing and barrier precautions must always be used during device manipulation. Specific measures for VAP prevention are: 1) use of multi-use, closed-system suction catheters; 2) no routine change of the breathing circuit; 3) lubrication of the cuff of the endotracheal tube (ET) with a water-soluble gel; 4) maintenance of patient in semi-recumbent position to improve chest physiotherapy in intubated patients. Specific measures for UTI prevention include: 1) use of a catheter-valve instead of a standard drainage system; 2) use of a silver-alloy, hydro gel-coated latex urinary catheter instead of uncoated catheters. Biofilm represents a new variable: the capacity of bacteria to organize a biofilm on a device surface can explain the difficulty in preventing and eradicating an infection in a critically ill patient. More clinical trials are needed to verify the efficacy of prevention measures of ICU infections.

  3. IFNγ and perforin cooperate to control infection and prevent fatal pathology during persistent gammaherpesvirus infection in mice

    DEFF Research Database (Denmark)

    Bartholdy, Christina; Høgh-Petersen, Mette; Storm, Pernille

    2014-01-01

    herpes virus infection, we infected IFNγ/perforin double deficient C57BL/6 mice and followed the outcome of infection. While absence of perforin prevented the splenic atrophy in IFNγ deficient mice, fibrosis did not disappear. Moreover, double deficient mice developed extreme splenomegaly, were unable...... in double deficient mice, other aspects are exaggerated, and the normal architecture of the spleen is completely destroyed. Thus, IFNγ and perforin work in concert to minimize pathology and control the viral load. In the absence of both effector molecules, the balancing race between the virus and the host...

  4. Performance, egg quality, and liver lipid reserves of free-range laying hens naturally infected with Ascaridia galli.

    Science.gov (United States)

    Sharma, N; Hunt, P W; Hine, B C; Sharma, N K; Chung, A; Swick, R A; Ruhnke, I

    2018-03-16

    A study was conducted to determine the performance, egg quality, and liver lipid reserves of laying hens exposed to ranges contaminated with Ascaridia galli. Sixteen-week-old Lohmann Brown laying hens (n = 200) were divided into 4 treatments with 5 replicates containing 10 hens per pen. Hens of treatment 1 [negative control (NC)] ranged on a decontaminated area, and hens of treatments 2 (low infection) and 3 (medium infection) ranged on areas previously contaminated by hens artificially infected with 250 and 1,000 embryonated A. galli eggs, respectively. The hens of treatment 4 [positive control (PC)] ranged on areas previously contaminated by hens artificially infected with 2,500 embryonated A. galli eggs, and in addition these hens were orally inoculated with 1,000 embryonated eggs. Results indicated that hens of the medium infection group had a higher number of intestinal A. galli worms and A. galli eggs in the coprodeum excreta (43.9 ± 4.0 and 3,437 ± 459 eggs/g) compared to hens of the low infection group (23.8 ± 4.0 and 1,820 ± 450 eggs/g) (P  0.05). Egg production, egg mass, feed intake, and feed conversion ratio (FCR) were not affected by A. galli infection (P > 0.05). Egg quality parameters (egg weight, shell reflectivity, shell weight, shell thickness, shell percentage, shell breaking strength, deformation, albumen height, Haugh unit, and yolk score) were not affected by A. galli infection (P > 0.05). Highly infected hens had lower liver lipid content (2.72 ± 0.51 g) compared to uninfected hens (4.46 ± 0.58 g, P ranges contaminated with A. galli resulted in infection of the ranging hens, but this did not affect egg production or egg quality. Infection with A. galli lowered the liver lipid reserves of the host significantly, suggesting infected hens use more energy reserves for maintenance and production.

  5. Effects of a catheter-associated urinary tract infection prevention campaign on infection rate, catheter utilization, and health care workers' perspective at a community safety net hospital.

    Science.gov (United States)

    Gray, Dorinne; Nussle, Richard; Cruz, Abner; Kane, Gail; Toomey, Michael; Bay, Curtis; Ostovar, Gholamabbas Amin

    2016-01-01

    Preventing catheter-associated urinary tract infections is in the forefront of health care quality. However, nurse and physician engagement is a common barrier in infection prevention efforts. After implementation of a multidisciplinary catheter-associated urinary tract infection (CAUTI) prevention campaign, we studied the impact of our campaign and showed its association with reducing the CAUTI rate and catheter utilization and the positive effect on health care workers' engagement and perspectives. CAUTI prevention campaigns can lead to lower infection rates and change health care workers' perspective. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  6. Guidelines for the Prevention of Infections Associated With Combat-Related Injuries: 2011 Update (Executive Summary)

    Science.gov (United States)

    2011-08-01

    employed at all deployed medical treatment facilities (MTF). These should include hand hygiene . with compli- ance monitoring. Infection control and...established infections where nosocomial pathogens, including multidrug~resistant. may be the in~ fecting agents (Table 3). 7. Selected agents should be dosed...REVIEW ARTICLE Executive Summary: Guidelines for the Prevention of Infections Associated With Combat-Related Injuries: 2011 Update Endorsed by the

  7. Discussion on the Relevant Factors of General Surgery Incision Infection and Prevention Methods

    Directory of Open Access Journals (Sweden)

    Jin Baotao

    2017-01-01

    Full Text Available There are many reasons that can lead to incision infection of general surgical patients. The main reasons include weight, age, body albumin level, surgical time, observation ward, etc. This paper analyzes the clinic data of patients with incision infection after general surgery based on clinic practice and study on the reasons that have impact on general surgical incision infection and gives relevant prevention countermeasures.

  8. Preclinical Efficacy of Clumping Factor A in Prevention of Staphylococcus aureus Infection

    OpenAIRE

    Li, Xue; Wang, Xiaogang; Thompson, Christopher D.; Park, Saeyoung; Park, Wan Beom; Lee, Jean C.

    2016-01-01

    ABSTRACT Treatment of Staphylococcus aureus infections has become increasingly difficult because of the emergence of multidrug-resistant isolates. Development of a vaccine to prevent staphylococcal infections remains a priority. To determine whether clumping factor A (ClfA) is a good target protein for inclusion in a multivalent vaccine, we evaluated its efficacy in a variety of relevant staphylococcal infection models, challenging with different S. aureus strains. ClfA adsorbed to Alhydrogel...

  9. Introduction to the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infections.

    Science.gov (United States)

    Solomkin, Joseph S; Mazuski, John; Blanchard, Joan C; Itani, Kamal M F; Ricks, Philip; Dellinger, E Patchen; Allen, George; Kelz, Rachel; Reinke, Caroline E; Berríos-Torres, Sandra I

    Surgical site infection (SSI) is a common type of health-care-associated infection (HAI) and adds considerably to the individual, social, and economic costs of surgical treatment. This document serves to introduce the updated Guideline for the Prevention of SSI from the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC). The Core section of the guideline addresses issues relevant to multiple surgical specialties and procedures. The second procedure-specific section focuses on a high-volume, high-burden procedure: Prosthetic joint arthroplasty. While many elements of the 1999 guideline remain current, others warrant updating to incorporate new knowledge and changes in the patient population, operative techniques, emerging pathogens, and guideline development methodology.

  10. Are probiotics effective in preventing urinary tract infection?

    Science.gov (United States)

    Canales, Juan; Rada, Gabriel

    2018-04-04

    Urinary tract infection is the most common bacterial infection and recurrences are common. Probiotics have been proposed as an alternative to decrease this risk. However, it is not clear if they are really effective. To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We identified six systematic reviews including nine studies overall, of which seven were randomized trials. We concluded it is not clear whether probiotics decrease the risk of symptomatic urinary tract infection, because the certainty of the evidence is very low.

  11. Outcomes associated with Clostridium difficile infection in patients with chronic liver disease.

    Science.gov (United States)

    Dotson, Kierra M; Aitken, Samuel L; Sofjan, Amelia K; Shah, Dhara N; Aparasu, Rajender R; Garey, Kevin W

    2018-05-09

    Patients with chronic liver disease (CLD) have frequent exposure to Clostridium difficile infection (CDI) risk factors but the incidence and aetiology of CDI on this population is poorly understood. The aim of this study was to assess the incidence, disease presentation and outcomes of CDI in patients with underlying CLD. The Health Care and Utilization Project National Inpatient Sample (HCUP-NIS) 2009 dataset was used to identify patients with CLD who developed CDI along with matched non-CLD patients with CDI. Using the NIS dataset, the incidence rate of CDI was 189.4/10 000 discharges in CLD patients vs. 83.7/10 000 discharges in the non-CLD matched cohort (P CLD, comorbidity-matched controls with CDI, CLD patients with CDI had higher likelihood of in-hospital mortality (8.8% vs. 18.6%, P CLD and CDI (n = 41) compared with patients with CDI but not CLD (n = 111), CLD patients had significantly higher Charlson comorbidity index (P CLD patients. In conclusion, CDI-related risk factors were almost universally present in the CLD population. CDI resulted in worse outcomes in this population.

  12. Molecular characterization of occult hepatitis B virus infection in patients with end-stage liver disease in Colombia.

    Directory of Open Access Journals (Sweden)

    Julio Cesar Rendon

    Full Text Available Hepatitis B virus (HBV occult infection (OBI is a risk factor to be taken into account in transfusion, hemodialysis and organ transplantation. The aim of this study was to identify and characterize at the molecular level OBI cases in patients with end-stage liver disease.Sixty-six liver samples were obtained from patients with diagnosis of end-stage liver disease submitted to liver transplantation in Medellin (North West, Colombia. Samples obtained from patients who were negative for the surface antigen of HBV (n = 50 were tested for viral DNA detection by nested PCR for ORFs S, C, and X and confirmed by Southern-Blot. OBI cases were analyzed by sequencing the viral genome to determine the genotype and mutations; additionally, viral genome integration events were examined by the Alu-PCR technique.In five cases out of 50 patients (10% the criteria for OBI was confirmed. HBV genotype F (subgenotypes F1 and F3, genotype A and genotype D were characterized in liver samples. Three integration events in chromosomes 5q14.1, 16p13 and 20q12 affecting Receptor-type tyrosine-protein phosphatase T, Ras Protein Specific Guanine Nucleotide Releasing Factor 2, and the zinc finger 263 genes were identified in two OBI cases. Sequence analysis of the viral genome of the 5 OBI cases showed several punctual missense and nonsense mutations affecting ORFs S, P, Core and X.This is the first characterization of OBI in patients with end-stage liver disease in Colombia. The OBI cases were identified in patients with HCV infection or cryptogenic cirrhosis. The integration events (5q14.1, 16p13 and 20q12 described in this study have not been previously reported. Further studies are required to validate the role of mutations and integration events in OBI pathogenesis.

  13. Advances in the Prevention of infection-Related Preterm Birth

    DEFF Research Database (Denmark)

    Lamont, R. F.

    2015-01-01

    Infection-related preterm birth (PTB) is more common at early gestational ages and is associated with major neonatal mortality and morbidity. Abnormal genital tract microflora in early pregnancy predicts late miscarriage and early PTB. Accordingly, it is logical to consider antibiotics as an inte......Infection-related preterm birth (PTB) is more common at early gestational ages and is associated with major neonatal mortality and morbidity. Abnormal genital tract microflora in early pregnancy predicts late miscarriage and early PTB. Accordingly, it is logical to consider antibiotics...

  14. First step to reducing infection risk as a system: evaluation of infection prevention processes for 71 hospitals.

    Science.gov (United States)

    Fakih, Mohamad G; Heavens, Michelle; Ratcliffe, Carol J; Hendrich, Ann

    2013-11-01

    Hospitals can better focus their efforts to prevent health care-associated infections (HAIs) if they identify specific areas for improvement. We administered a 96-question survey to infection preventionists at 71 Ascension Health hospitals to evaluate opportunities for the prevention of catheter-associated urinary tract infection, central line-associated bloodstream infection, ventilator-associated pneumonia, and surgical site infection. Seventy-one (100%) infection preventionists completed the survey. The majority of hospitals had established policies for urinary catheter placement and maintenance (55/70, 78.6%), central venous catheter maintenance (68/71, 95.8%), and care for the mechanically ventilated patient (62/66, 93.9%). However, there was variation in health care worker practice and evaluation of competencies and outcomes. When addressing device need, 55 of 71 (77.5%) hospitals used a nurse-driven evaluation of urinary catheter need, 26 of 71 (36.6%) had a team evaluation for central venous catheters on transfer out of intensive care, and 53 of 57 (93%) assessed daily ventilator support for continued need. Only 19 of 71 (26.8%) hospitals had annual nursing competencies for urinary catheter placement and maintenance, 29 of 71 (40.8%) for nursing venous catheter maintenance, and 38 of 66 (57.6%) for appropriate health care worker surgical scrubbing. We suggest evaluating infection prevention policies and practices as a first step to improvement efforts. The next steps include implementing spread of evidence-based practices, with focus on competencies and feedback on performance. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  15. Dietary sphingolipids lower plasma cholesterol and triacylglycerol and prevent liver steatosis in APOE*3Leiden mice

    NARCIS (Netherlands)

    Duivenvoorden, Ilse; Voshol, Peter J.; Rensen, Patrick C. N.; van Duyvenvoorde, Wim; Romijn, Johannes A.; Emeis, Jef J.; Havekes, Louis M.; Nieuwenhuizen, Willem F.

    2006-01-01

    The prevalence of dyslipidemia and obesity resulting from excess energy intake and physical inactivity is increasing. The liver plays a pivotal role in systemic lipid homeostasis. Effective, natural dietary interventions that lower plasma lipids and promote liver health are needed. Our goal was to

  16. Dietary sphingolipids lower plasma cholesterol and triacylglycerol and prevent liver steatosis in APOE*3Leiden mice

    NARCIS (Netherlands)

    Duivenvoorden, I.; Voshol, P.J.; Rensen, P.C.N.; Duyvenvoorde, W. van; Romijn, J.A.; Emeis, J.J.; Havekes, L.M.; Nieuwenhuizen, W.F.

    2006-01-01

    Background: The prevalence of dyslipidemia and obesity resulting from excess energy intake and physical inactivity is increasing. The liver plays a pivotal role in systemic lipid homeostasis. Effective, natural dietary interventions that lower plasma lipids and promote liver health are needed.

  17. Statins Increase Mitochondrial and Peroxisomal Fatty Acid Oxidation in the Liver and Prevent Non-Alcoholic Steatohepatitis in Mice

    Directory of Open Access Journals (Sweden)

    Han-Sol Park

    2016-04-01

    Full Text Available BackgroundNon-alcoholic fatty liver disease is the most common form of chronic liver disease in industrialized countries. Recent studies have highlighted the association between peroxisomal dysfunction and hepatic steatosis. Peroxisomes are intracellular organelles that contribute to several crucial metabolic processes, such as facilitation of mitochondrial fatty acid oxidation (FAO and removal of reactive oxygen species through catalase or plasmalogen synthesis. Statins are known to prevent hepatic steatosis and non-alcoholic steatohepatitis (NASH, but underlying mechanisms of this prevention are largely unknown.MethodsSeven-week-old C57BL/6J mice were given normal chow or a methionine- and choline-deficient diet (MCDD with or without various statins, fluvastatin, pravastatin, simvastatin, atorvastatin, and rosuvastatin (15 mg/kg/day, for 6 weeks. Histological lesions were analyzed by grading and staging systems of NASH. We also measured mitochondrial and peroxisomal FAO in the liver.ResultsStatin treatment prevented the development of MCDD-induced NASH. Both steatosis and inflammation or fibrosis grades were significantly improved by statins compared with MCDD-fed mice. Gene expression levels of peroxisomal proliferator-activated receptor α (PPARα were decreased by MCDD and recovered by statin treatment. MCDD-induced suppression of mitochondrial and peroxisomal FAO was restored by statins. Each statin's effect on increasing FAO and improving NASH was independent on its effect of decreasing cholesterol levels.ConclusionStatins prevented NASH and increased mitochondrial and peroxisomal FAO via induction of PPARα. The ability to increase hepatic FAO is likely the major determinant of NASH prevention by statins. Improvement of peroxisomal function by statins may contribute to the prevention of NASH.

  18. Review and analysis of existing mobile phone applications for health care-associated infection prevention.

    Science.gov (United States)

    Schnall, Rebecca; Iribarren, Sarah J

    2015-06-01

    The expanding number of mobile health applications (apps) holds potential to reduce and eliminate health care-associated infections (HAIs) in clinical practice. The purpose of this review was to identify and provide an overview of the apps available to support prevention of HAIs and to assess their functionality and potential uses in clinical care. We searched 3 online mobile app stores using the following terms: infection prevention, prevention, hand hygiene, hand washing, and specific HAI terms (catheter-associated urinary tract infection [CAUTI], central line-associated bloodstream infections, surgical site infection, and ventilator associated pneumonia [VAP]). Search queries yielded a total of 2,646 potentially relevant apps, of which 17 met our final inclusion criteria. The areas of focus were CAUTI (n = 1, 5.9%), VAP (n = 1, 5.9%), environmental monitoring (n = 2, 11.8%), and hand hygiene (n = 2, 11.8%); the remainder (n = 11, 64.7%) were focused on >1 area (eg, multiple infection prevention bundles, infection prevention guidelines). Almost all of the apps (70.6%) had a maximum of two functions. Mobile apps may help reduce HAI by providing easy access to guidelines, hand hygiene monitoring support, or step-by-step procedures aimed at reducing infections at the point of clinical care. Given the dearth of available apps and the lack of functionality with those that are available, there is a need for further development of mobile apps for HAI prevention at the point of care. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  19. Preventing device-associated infections in US hospitals: national surveys from 2005 to 2013.

    Science.gov (United States)

    Krein, Sarah L; Fowler, Karen E; Ratz, David; Meddings, Jennifer; Saint, Sanjay

    2015-06-01

    Numerous initiatives have focused on reducing device-associated infections, contributing to an overall decrease in infections nationwide. To better understand factors associated with this decline, we assessed the use of key practices to prevent device-associated infections by US acute care hospitals from 2005 to 2013. We mailed surveys to infection preventionists at a national random sample of ∼600 US acute care hospitals in 2005, 2009 and 2013. Our survey asked about the use of practices to prevent the 3 most common device-associated infections: central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP) and catheter-associated urinary tract infection (CAUTI). Using sample weights, we estimated the per cent of hospitals reporting regular use (a score of 4 or 5 on a scale from 1 (never use) to 5 (always use)) of prevention practices from 2005 to 2013. The response rate was about 70% in all 3 periods. Use of most recommended prevention practices increased significantly over time. Among those showing the greatest increase were use of an antimicrobial dressing for preventing CLABSI (25-78%, ppreventing VAP (41-79%, ppreventing CAUTI (9-53%, pinfections. Practices for which little change was observed included use of antimicrobial catheters to prevent either CLABSI or CAUTI. US hospitals have responded to the call to reduce infection by increasing use of key recommended practices. Vigilance is needed to ensure sustained improvement and additional strategies may still be required, given an apparent continuing lag in CAUTI prevention efforts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Occupational coke oven emissions exposure and risk of abnormal liver function: modifications of body mass index and hepatitis virus infection

    Energy Technology Data Exchange (ETDEWEB)

    Y. Hu; B. Chen; J. Qian; L. Jin; T. Jin; D. Lu [Fudan University, Shanghai (China). Department of Occupational and Environmental Health

    2010-03-15

    Occupational coke oven emissions (COEs) have been considered an important health issue. However, there are no conclusive data on human hepatic injury due to COE exposure. The association of COE exposure with liver function was explored and the effects of modification of potential non-occupational factors were assessed. 705 coke oven workers and 247 referents were investigated. Individual cumulative COE exposure was quantitatively estimated. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), {gamma}-glutamyl transferase, alkaline phosphatase, hepatitis B surface antigen and anti-hepatitis C antibody were measured. Among those with high COE exposure, the adjusted ORs of abnormal ALT and AST were 5.23 (95% CI 2.66 to 10.27) and 1.95 (95% CI 1.18 to 3.52), respectively. Overweight individuals (body mass index (BMI) {>=}25 kg/m{sup 2}) with high COE exposure had elevated risks of abnormal ALT (adjusted OR 23.93, 95% CI 8.73 to 65.62) and AST (adjusted OR 5.18, 95% CI 2.32 to 11.58). Risk of liver damage in hepatitis B virus- or hepatitis C virus-positive individuals with COE exposure was also elevated. Long-term exposure to COE increases the risk of liver dysfunction, which is more prominent among those with higher BMI and hepatitis virus infection. The risk assessment of liver damage associated with COE exposure should take BMI and hepatitis virus infection into consideration.

  1. Liver cytosolic 1 antigen-antibody system in type 2 autoimmune hepatitis and hepatitis C virus infection.

    Science.gov (United States)

    Lenzi, M; Manotti, P; Muratori, L; Cataleta, M; Ballardini, G; Cassani, F; Bianchi, F B

    1995-01-01

    Within the multiform liver/kidney microsomal (LKM) family, a subgroup of sera that reacts with a liver cytosolic (LC) protein has been isolated and the new antigen-antibody system is called LC1. Unlike LKM antibody type 1 (anti-LKM1), anti-LC1 is said to be unrelated to hepatitis C virus (HCV) infection and has therefore been proposed as a marker of 'true' autoimmune hepatitis type 2. Altogether 100 LKM1 positive sera were tested by immunodiffusion (ID). Twenty five gave a precipitation line with human liver cytosol; 17 of the 25 also reacted with rat liver cytosol. Thirteen of the 25 sera were anti-HCV positive by second generation ELISA: anti-HCV positive patients were significantly older (p LKM1, and that it is an additional marker of juvenile autoimmune hepatitis type 2. It does not, however, discriminate between patients with and without HCV infection. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 PMID:7797126

  2. Progression of Liver Fibrosis in HIV/HCV Co-Infection: A Comparison between Non-Invasive Assessment Methods and Liver Biopsy.

    Directory of Open Access Journals (Sweden)

    Patrick Schmid

    Full Text Available To evaluate the diagnostic performance of seven non-invasive tests (NITs of liver fibrosis and to assess fibrosis progression over time in HIV/HCV co-infected patients.Transient elastography (TE and six blood tests were compared to histopathological fibrosis stage (METAVIR. Participants were followed over three years with NITs at yearly intervals.Area under the receiver operating characteristic curve (AUROC for significant fibrosis (> = F2 in 105 participants was highest for TE (0.85, followed by FIB-4 (0.77, ELF-Test (0.77, APRI (0.76, Fibrotest (0.75, hyaluronic acid (0.70, and Hepascore (0.68. AUROC for cirrhosis (F4 was 0.97 for TE followed by FIB-4 (0.91, APRI (0.89, Fibrotest (0.84, Hepascore (0.82, ELF-Test (0.82, and hyaluronic acid (0.79. A three year follow-up was completed by 87 participants, all on antiretroviral therapy and in 20 patients who completed HCV treatment (9 with sustained virologic response. TE, APRI and Fibrotest did not significantly change during follow-up. There was weak evidence for an increase of FIB-4 (mean increase: 0.22, p = 0.07. 42 participants had a second liver biopsy: Among 38 participants with F0-F3 at baseline, 10 were progessors (1-stage increase in fibrosis, 8 participants; 2-stage, 1; 3-stage, 1. Among progressors, mean increase in TE was 3.35 kPa, in APRI 0.36, and in FIB-4 0.75. Fibrotest results did not change over 3 years.TE was the best NIT for liver fibrosis staging in HIV/HCV co-infected patients. APRI-Score, FIB-4 Index, Fibrotest, and ELF-Test were less reliable. Routinely available APRI and FIB-4 performed as good as more expensive tests. NITs did not change significantly during a follow-up of three years, suggesting slow liver disease progression in a majority of HIV/HCV co-infected persons on antiretroviral therapy.

  3. Progression of Liver Fibrosis in HIV/HCV Co-Infection: A Comparison between Non-Invasive Assessment Methods and Liver Biopsy.

    Science.gov (United States)

    Schmid, Patrick; Bregenzer, Andrea; Huber, Milo; Rauch, Andri; Jochum, Wolfram; Müllhaupt, Beat; Vernazza, Pietro; Opravil, Milos; Weber, Rainer

    2015-01-01

    To evaluate the diagnostic performance of seven non-invasive tests (NITs) of liver fibrosis and to assess fibrosis progression over time in HIV/HCV co-infected patients. Transient elastography (TE) and six blood tests were compared to histopathological fibrosis stage (METAVIR). Participants were followed over three years with NITs at yearly intervals. Area under the receiver operating characteristic curve (AUROC) for significant fibrosis (> = F2) in 105 participants was highest for TE (0.85), followed by FIB-4 (0.77), ELF-Test (0.77), APRI (0.76), Fibrotest (0.75), hyaluronic acid (0.70), and Hepascore (0.68). AUROC for cirrhosis (F4) was 0.97 for TE followed by FIB-4 (0.91), APRI (0.89), Fibrotest (0.84), Hepascore (0.82), ELF-Test (0.82), and hyaluronic acid (0.79). A three year follow-up was completed by 87 participants, all on antiretroviral therapy and in 20 patients who completed HCV treatment (9 with sustained virologic response). TE, APRI and Fibrotest did not significantly change during follow-up. There was weak evidence for an increase of FIB-4 (mean increase: 0.22, p = 0.07). 42 participants had a second liver biopsy: Among 38 participants with F0-F3 at baseline, 10 were progessors (1-stage increase in fibrosis, 8 participants; 2-stage, 1; 3-stage, 1). Among progressors, mean increase in TE was 3.35 kPa, in APRI 0.36, and in FIB-4 0.75. Fibrotest results did not change over 3 years. TE was the best NIT for liver fibrosis staging in HIV/HCV co-infected patients. APRI-Score, FIB-4 Index, Fibrotest, and ELF-Test were less reliable. Routinely available APRI and FIB-4 performed as good as more expensive tests. NITs did not change significantly during a follow-up of three years, suggesting slow liver disease progression in a majority of HIV/HCV co-infected persons on antiretroviral therapy.

  4. Antibiotic-Releasing Silk Biomaterials for Infection Prevention and Treatment

    OpenAIRE

    Pritchard, Eleanor M.; Valentin, Thomas; Panilaitis, Bruce; Omenetto, Fiorenzo; Kaplan, David L.

    2012-01-01

    Effective treatment of infections in avascular and necrotic tissues can be challenging due to limited penetration into the target tissue and systemic toxicities. Controlled release polymer implants have the potential to achieve the high local concentrations needed while also minimizing systemic exposure. Silk biomaterials possess unique characteristics for antibiotic delivery including biocompatibility, tunable biodegradation, stabilizing effects, water-based processing and diverse material f...

  5. Infection Prevention and Control in Deployed Military Medical Treatment Facilities

    Science.gov (United States)

    2011-08-01

    to surgery in 1867.31 Supported by the discoveries of Louis Pasteur (in the 1850s–1860s) that germs (bacteria) were the cause of putrification (pus...Kirkup BC Jr, et al. Surveillance, characterisation, and preservation of multidrug-resistant bacteria. Lancet Infect Dis. 2011;11: 8–10. 50. Lesho E

  6. [Social marketing: applying commercial strategies to the prevention of nosocomial infections].

    Science.gov (United States)

    Sax, Hugo; Longtin, Yves; Alvarez-Ceyssat, Raymonde; Bonfillon, Chantal; Cavallero, Sabrina; Dayer, Pierre; Ginet, Claude; Herrault, Pascale

    2009-04-01

    Although a large proportion of healthcare-associated infections are avoidable, healthcare workers do not always practice evidence-based preventive strategies. Marketing technologies might help to improve patient safety. This article presents the basic principles of marketing and its potential use to promote good infection control practices. The marketing mix (Product, Price, Place, and Promotion) should be taken into account to induce behaviour change. By placing the emphasis on the perceived "profits" for healthcare workers the approach might lose its moral aspect and gain in effectiveness. VigiGerme, a non-commercial registered trademark, applies social marketing techniques to infection control and prevention.

  7. Urinary Tract Infections Among Hospitalized Adults in the Early Post-Liver Transplant Period: Prevalence, Risk Factors, Causative Agents, and Microbial Susceptibility.

    Science.gov (United States)

    Pouladfar, Gholamreza; Jafarpour, Zahra; Firoozifar, Mohammad; Malek Hosseini, Seyed Ali; Rasekh, Razieh; Khosravifard, Leila; Janghorban, Parisa

    2017-02-01

    Urinary tract infections are among the most common infections after liver transplant, especially soon after surgery. This study analyzed urinary tract infections or bacteriuria, their causative agents, and related risk factors in the early period after liver transplant in hospitalized adult transplant recipients in the main liver transplant referral center in Iran. In this prospective study, 389 consecutive adult patients who underwent liver transplant at the Nemazee Teaching Hospital were enrolled between October 2014 and October 2015. Risk factors were compared for patients who developed urinary tract infections or bacteriuria ("infection group "; n = 63 [16.2% ]) and patients without evidence of infection ("control group "; n = 211 [54.2% ]). Patients with sites of infection other than the urinary tract were excluded. Antimicrobial sus ceptibility testing was performed using the Kirby-Bauer disk-diffusion method. Univariate and multivariate analyses compared variables between the 2 groups. Seventy-nine episodes of urinary tract infections or bacteriuria occurred in the infection group. Multiple logistic regression analysis showed that female sex, hospitalization 2 to 7 days before transplant, and frequency of abdominal exploration were 11.0, 5.9, and 3.0 times more common in the infection group than in the control group. The chance of infection rises 1.1 times with each one unit increase of body mass index. The most common infection causes were gram-negative bacteria (n = 50; 63.3%), predominantly Escherichia coli (n = 24; 30.4%); followed by gram-positive bacteria (n = 20; 25.3%), predominantly Enterococcus species (n = 14; 17.8%) that had a high incidence of vancomycin resistance (n = 10; 71.4%); and non-Candida albicans species isolates (n = 9; 11.4%). Urinary tract infections are a common infection in hospitalized adult patients soon after liver transplant. Female sex, hospitalization shortly before transplant, more frequent abdominal exploration, and higher

  8. Long-term Effects of Hepatitis B Immunization of Infants in Preventing Liver Cancer.

    Science.gov (United States)

    Chang, Mei-Hwei; You, San-Lin; Chen, Chien-Jen; Liu, Chun-Jen; Lai, Ming-Wei; Wu, Tzee-Chung; Wu, Shu-Fen; Lee, Chuan-Mo; Yang, Sheng-Shun; Chu, Heng-Cheng; Wang, Tsang-Eng; Chen, Bor-Wen; Chuang, Wan-Long; Soon, Maw-Soan; Lin, Ching-Yih; Chiou, Shu-Ti; Kuo, Hsu-Sung; Chen, Ding-Shinn

    2016-09-01

    The incidence of hepatocellular carcinoma (HCC) increases with age, but protective antibody responses decrease with time after infants are immunized against hepatitis B virus (HBV). We investigated whether immunization of infants against HBV prevents their developing HCC as adults. We also searched for strategies to maximize the cancer-preventive effects. We collected data from 2 Taiwan HCC registry systems on 1509 patients (6-26 years old) diagnosed with HCC from 1983 through 2011. Data on history of HBV immunization and prenatal maternal levels of HBV antigens of all HCC patients born after July 1984 were retrieved from the HBV immunization data bank of the Taiwan Center for Disease Control. We collected data on birth cohort-specific populations (6-26 years old) of Taiwan using the National Household Registry System. Rates of HCC incidence per 10(5) person-years were derived by dividing the number of patients with HCC by the person-years of the general population. Relative risks (RR) for HCC were estimated by Poisson regression analysis in vaccinated vs unvaccinated birth cohorts. We stratified patients by age group to evaluate the association of birth cohorts and HCC risks. Of the 1509 patients with HCC, 1343 were born before, and 166 were born after, the HBV vaccination program began. HCC incidence per 10(5) person-years was 0.92 in the unvaccinated cohort and 0.23 in the vaccinated birth cohorts. The RRs for HCC in patients 6-9 years old, 10-14 years old, 15-19 years old, and 20-26 years old who were vaccinated vs unvaccinated were 0.26 (95% confidence interval [CI], 0.17-0.40), 0.34 (95% CI, 0.25-0.48), 0.37 (95% CI, 0.25-0.51), and 0.42 (95% CI, 0.32-0.56), respectively. The RR for HCC in 6- to 26-year-olds was lower in the later vs the earlier cohorts (born in 1992-2005 vs 1986-1992; P Taiwan, immunization of infants against HBV reduces their risk of developing HCC as children and young adults. Improving HBV vaccination strategies and overcoming risk

  9. Hepatitis A infection in patients with chronic viral liver disease: a cross-sectional study in Jahrom, Iran.

    Science.gov (United States)

    Ahmadi Vasmehjani, A; Javeshghani, D; Baharlou, R; Shayestehpour, M; Mousavinasab, S D; Joharinia, N; Enderami, S E

    2015-02-01

    Infection with hepatitis A virus (HAV) in patient with chronic liver disease (CLD; due to hepatitis B or hepatitis C) may cause severe disease and fulminant liver failure. This study aimed to determine the seroprevalence of HAV antibodies in patients infected with HCV or HBV in Iran (Jahrom city). A total of 159 patients with underlying CLD were recruited between September 2012 and February 2013. Serum samples were collected from each patient and tested for anti-HAV using enzyme-linked immunosorbent assay (ELISA). The overall seroprevalence of total anti-HAV was 79·2%. Patients aged 20-30 years had the lowest (28·3%) anti-HAV seropositivity and those aged >50 years had the highest (95%) seropositivity. The overall prevalence of anti-HAV in patients with chronic HCV and HBV infection was 93·7% and 77·1%, respectively. The anti-HAV seropositivity in liver cirrhosis patients was 100% compared to CLD patients. Because of low HAV immunity in younger CLD patients, vaccination against HAV should be considered.

  10. Prevalence of liver flukes infections and hydatidosis in slaughtered sheep and goats in Nishapour, Khorasan Razavi, Iran

    Directory of Open Access Journals (Sweden)

    Majid Aminzare

    2018-02-01

    Full Text Available Background: Food-borne trematode infections and hydatidosis are endemic diseases caused by helminths in Iran that are responsible for great economic loss and getting public health at risk. Aim: Aim of this study was to determine the prevalence of fasciolosis, dicrocoeliasis, and hydatidosis infections in slaughtered sheep and goats in Nishapour, Khorasan Razavi province of Iran. Materials and Methods: A survey was implemented on 130,107 sheep and goats slaughtered at an abattoir in Nishapour (Neyshbur city, north central Khorasan Razavi Province, Iran, to determine the prevalence of fascioliasis, dicrocoeliosis and presence of hydatidosis. Results: During a 1-year period of study, among 130,107 of sheep and goats slaughtered at Nishapour abattoir, 1064 and 7124 livers were condemned totally and partially, respectively. A total of 255 (0.19%, 181 (0.12 %, and 7751 (5.95% of livers were condemned due to cysts of Echinococcus granulosus, flukes of Fasciola spp., and Dicrocoelium dendriticum, respectively. Totally, 1932 (1.48% lungs were condemned due to hydatidosis. The significant seasonal pattern was seen for fasciolosis, dicrocoeliosis, and hydatidosis, statistically (p<0.01. Conclusion: According to this study, it seems that Neyshabour is considered as an endemic region for Fasciola spp. and D. dendriticum infections and D. dendriticum is the most widespread liver fluke found in sheep and goats.

  11. Profilings of MicroRNAs in the Liver of Common Carp (Cyprinus carpio) Infected with Flavobacterium columnare

    Science.gov (United States)

    Zhao, Lijuan; Lu, Hong; Meng, Qinglei; Wang, Jinfu; Wang, Weimin; Yang, Ling; Lin, Li

    2016-01-01

    MicroRNAs (miRNAs) play important roles in regulation of many biological processes in eukaryotes, including pathogen infection and host interactions. Flavobacterium columnare (FC) infection can cause great economic loss of common carp (Cyprinus carpio) which is one of the most important cultured fish in the world. However, miRNAs in response to FC infection in common carp has not been characterized. To identify specific miRNAs involved in common carp infected with FC, we performed microRNA sequencing using livers of common carp infected with and without FC. A total of 698 miRNAs were identified, including 142 which were identified and deposited in the miRbase database (Available online: http://www.mirbase.org/) and 556 had only predicted miRNAs. Among the deposited miRNAs, eight miRNAs were first identified in common carp. Thirty of the 698 miRNAs were differentially expressed miRNAs (DIE-miRNAs) between the FC infected and control samples. From the DIE-miRNAs, seven were selected randomly and their expression profiles were confirmed to be consistent with the microRNA sequencing results using RT-PCR and qRT-PCR. In addition, a total of 27,363 target genes of the 30 DIE-miRNAs were predicted. The target genes were enriched in five Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways, including focal adhesion, extracellular matrix (ECM)-receptor interaction, erythroblastic leukemia viral oncogene homolog (ErbB) signaling pathway, regulation of actin cytoskeleton, and adherent junction. The miRNA expression profile of the liver of common carp infected with FC will pave the way for the development of effective strategies to fight against FC infection. PMID:27092486

  12. Modulation of methylmercury uptake by methionine: Prevention of mitochondrial dysfunction in rat liver slices by a mimicry mechanism

    International Nuclear Information System (INIS)

    Roos, Daniel Henrique; Puntel, Robson Luiz; Farina, Marcelo; Aschner, Michael; Bohrer, Denise; Rocha, Joao Batista T.; Vargas Barbosa, Nilda B. de

    2011-01-01

    Methylmercury (MeHg) is an ubiquitous environmental pollutant which is transported into the mammalian cells when present as the methylmercury-cysteine conjugate (MeHg-Cys). With special emphasis on hepatic cells, due to their particular propensity to accumulate an appreciable amount of Hg after exposure to MeHg, this study was performed to evaluate the effects of methionine (Met) on Hg uptake, reactive species (RS) formation, oxygen consumption and mitochondrial function/cellular viability in both liver slices and mitochondria isolated from these slices, after exposure to MeHg or the MeHg-Cys complex. The liver slices were pre-treated with Met (250 μM) 15 min before being exposed to MeHg (25 μM) or MeHg-Cys (25 μM each) for 30 min at 37 o C. The treatment with MeHg caused a significant increase in the Hg concentration in both liver slices and mitochondria isolated from liver slices. Moreover, the Hg uptake was higher in the group exposed to the MeHg-Cys complex. In the DCF (dichlorofluorescein) assay, the exposure to MeHg and MeHg-Cys produced a significant increase in DFC reactive species (DFC-RS) formation only in the mitochondria isolated from liver slices. As observed with Hg uptake, DFC-RS levels were significantly higher in the mitochondria treated with the MeHg-Cys complex compared to MeHg alone. MeHg exposure also caused a marked decrease in the oxygen consumption of liver slices when compared to the control group, and this effect was more pronounced in the liver slices treated with the MeHg-Cys complex. Similarly, the loss of mitochondrial activity/cell viability was greater in liver slices exposed to the MeHg-Cys complex when compared to slices treated only with MeHg. In all studied parameters, Met pre-treatment was effective in preventing the MeHg- and/or MeHg-Cys-induced toxicity in both liver slices and mitochondria. Part of the protection afforded by Met against MeHg may be related to a direct interaction with MeHg or to the competition of Met with

  13. Translational models of infection prevention and control: lessons from studying high risk aging populations.

    Science.gov (United States)

    Mody, Lona

    2018-06-13

    The present review describes our research experiences and efforts in advancing the field of infection prevention and control in nursing facilities including postacute and long-term care settings. There are over two million infections in postacute and long-term care settings each year in the United States and $4 billion in associated costs. To define a target group most amenable to infection prevention and control interventions, we sought to quantify the relation between indwelling device use and microbial colonization in nursing facility patients. Using various methodologies including survey methods, observational epidemiology, randomized controlled studies, and collaboratives, we showed that indwelling device type is related to the site of multidrug-resistant organism (MDRO) colonization; multianatomic site colonization with MDROs is common; community-associated methicillin-resistant Staphylococcus aureus (MRSA) appeared in the nursing facility setting almost immediately following its emergence in acute care; (4) MDRO prevalence and catheter-associated infection rates can be reduced through a multimodal targeted infection prevention intervention; and (5) using a collaborative approach, such an intervention can be successfully scaled up. Our work advances the infection prevention field through translational research utilizing various methodologies, including quantitative and qualitative surveys, patient-oriented randomized controlled trials, and clinical microbiologic and molecular methods. The resulting interventions employ patient-oriented methods to reduce infections and antimicrobial resistance, and with partnerships from major national entities, can be implemented nationally.

  14. Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update

    Science.gov (United States)

    Anderson, Deverick J.; Podgorny, Kelly; Berríos-Torres, Sandra I.; Bratzler, Dale W.; Dellinger, E. Patchen; Greene, Linda; Nyquist, Ann-Christine; Saiman, Lisa; Yokoe, Deborah S.; Maragakis, Lisa L.; Kaye, Keith S.

    2014-01-01

    PURPOSE Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections (HAIs). The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their surgical site infection (SSI) prevention efforts. This document updates “Strategies to Prevent Surgical Site Infections in Acute Care Hospitals,”1 published in 2008. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.2 PMID:24799638

  15. Vitamin C and Vitamin E in Prevention of Nonalcoholic Fatty Liver Disease (NAFLD in Choline Deficient Diet Fed Rats

    Directory of Open Access Journals (Sweden)

    Lopasso Fabio P

    2003-10-01

    Full Text Available Abstract Aim Oxidative stress has been implicated in the pathogenesis of Nonalcoholic Fatty Liver Disease (NAFLD. Vitamin C and vitamin E are known to react with reactive oxygen species (ROS blocking the propagation of radical reactions in a wide range of oxidative stress situations. The potential therapeutic efficacy of antioxidants in NAFLD is unknown. The aim of this study was to evaluate the role of antioxidant drugs (vitamin C or vitamin E in its prevention. Methods Fatty liver disease was induced in Wistar rats by choline-deficient diet for four weeks. The rats were randomly assigned to receive vitamin E (n = 6 – (200 mg/day, vitamin C (n = 6 (30 mg/Kg/day or vehicle orally. Results In the vehicle and vitamin E-treated rats, there were moderate macro and microvesicular fatty changes in periportal area without inflammatory infiltrate or fibrosis. Scharlach stain that used for a more precise identification of fatty change was strong positive. With vitamin C, there was marked decrease in histological alterations. Essentially, there was no liver steatosis, only hepatocellular ballooning. Scharlach stain was negative. The lucigenin-enhanced luminescence was reduced with vitamin C (1080 ± 330 cpm/mg/minx103 as compared to those Vitamin E and control (2247 ± 790; 2020 ± 407 cpm/mg/minx103, respectively (p Conclusions 1 Vitamin C reduced oxidative stress and markedly inhibited the development of experimental liver steatosis induced by choline-deficient diet ; 2Vitamin E neither prevented the development of fatty liver nor reduced the oxidative stress in this model.

  16. Energy restriction does not prevent insulin resistance but does prevent liver steatosis in aging rats on a Western-style diet.

    Science.gov (United States)

    Hennebelle, Marie; Roy, Maggie; St-Pierre, Valérie; Courchesne-Loyer, Alexandre; Fortier, Mélanie; Bouzier-Sore, Anne-Karine; Gallis, Jean-Louis; Beauvieux, Marie-Christine; Cunnane, Stephen C

    2015-03-01

    The aim of this study was to evaluate the effects of long-term energy restriction (ER) on plasma, liver, and skeletal muscle metabolite profiles in aging rats fed a Western-style diet. Three groups of male Sprague-Dawley rats were studied. Group 1 consisted of 2 mo old rats fed ad libitum; group 2 were 19 mo old rats also fed ad libitum; and group 3 were 19 mo old rats subjected to 40% ER for the last 11.5 mo. To imitate a Western-style diet, all rats were given a high-sucrose, very low ω-3 polyunsaturated fatty acid (PUFA) diet. High-resolution magic angle spinning-(1)H nuclear magnetic resonance spectroscopy was used for hepatic and skeletal muscle metabolite determination, and fatty acid profiles were measured by capillary gas chromatography on plasma, liver, and skeletal muscle. ER coupled with a Western-style diet did not prevent age-induced insulin resistance or the increase in triacylglycerol content in plasma and skeletal muscle associated with aging. However, in the liver, ER did prevent steatosis and increased the percent of saturated and monounsaturated fatty acids relative to ω-6 and ω-3 PUFA. Although steatosis was reduced, the beneficial effects of ER on systemic insulin resistance and plasma and skeletal muscle metabolites observed elsewhere with a balanced diet seem to be compromised by high-sucrose and low ω-3 PUFA intake. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. The level of nurses’ knowledge of the prevention of nosocomial infections – a pilot study

    Directory of Open Access Journals (Sweden)

    Izabela Gąska

    2017-08-01

    Full Text Available Introduction. A basic element in preventing and combating nosocomial infections is the medical personnel knowledge. It is up to health care workers to determine whether the hospital environment will be safe for both patients and those employed in this sector. The aim of the study was to present the level of nursing staff knowledge of nosocomial infections. Materials and methods. The research was carried out in the Podkarpackie Center of Cardiovascular Interventions in Sanok. The study group consisted of all nurses working in the Hemodynamic Department - 20 people. The tests were carried out using the diagnostic survey method. The research tool was the author's questionnaire. Results. The nurses were aware that the scale of the problem of nosocomial infections was important. Almost all nurses rated their level of knowledge of hospital-acquired infections very well. However, the full definition of the term "nosocomial infections" was not given by about a quarter of respondents. In hospitals nurses did not always follow the rules of aseptic and antiseptic treatment. In addition, they did not see the need to educate patients and their families about the prevention of infections. Conclusions. Hospitals should carry out monitoring of nurses’ compliance with the procedures that are aimed at the elimination of ward infections and should consistently strive at their best to apply these procedures at their workplace. The ward staff should be involved in the education of patients and their families in the prevention of nosocomial infections.

  18. Destructive disinfection of infected brood prevents systemic disease spread in ant colonies.

    Science.gov (United States)

    Pull, Christopher D; Ugelvig, Line V; Wiesenhofer, Florian; Grasse, Anna V; Tragust, Simon; Schmitt, Thomas; Brown, Mark Jf; Cremer, Sylvia

    2018-01-09

    In social groups, infections have the potential to spread rapidly and cause disease outbreaks. Here, we show that in a social insect, the ant Lasius neglectus , the negative consequences of fungal infections ( Metarhizium brunneum ) can be mitigated by employing an efficient multicomponent behaviour, termed destructive disinfection, which prevents further spread of the disease through the colony. Ants specifically target infected pupae during the pathogen's non-contagious incubation period, utilising chemical 'sickness cues' emitted by pupae. They then remove the pupal cocoon, perforate its cuticle and administer antimicrobial poison, which enters the body and prevents pathogen replication from the inside out. Like the immune system of a metazoan body that specifically targets and eliminates infected cells, ants destroy infected brood to stop the pathogen completing its lifecycle, thus protecting the rest of the colony. Hence, in an analogous fashion, the same principles of disease defence apply at different levels of biological organisation.

  19. Vaccines for preventing infection with Pseudomonas aeruginosa in cystic fibrosis

    DEFF Research Database (Denmark)

    Johansen, H.K.; Gøtzsche, Peter C.; Johansen, Helle Krogh

    2008-01-01

    BACKGROUND: Chronic pulmonary infection in cystic fibrosis results in progressive lung damage. Once colonisation of the lungs with Pseudomonas aeruginosa occurs, it is almost impossible to eradicate. Vaccines, aimed at reducing infection with Pseudomonas aeruginosa, have been developed. OBJECTIVES......: To assess the effectiveness of vaccination against Pseudomonas aeruginosa in cystic fibrosis. SEARCH STRATEGY: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register using the terms vaccines AND pseudomonas (last search May 2008) and PubMed using the terms vaccin* AND cystic...... fibrosis (last search May 2008). SELECTION CRITERIA: Randomised trials (published or unpublished) comparing Pseudomonas aeruginosa vaccines (oral, parenteral or intranasal) with control vaccines or no intervention in cystic fibrosis. DATA COLLECTION AND ANALYSIS: The authors independently selected trials...

  20. Vaccines for preventing infection with Pseudomonas aeruginosa in cystic fibrosis

    DEFF Research Database (Denmark)

    Johansen, Helle Krogh; Gøtzsche, Peter C

    2015-01-01

    BACKGROUND: Chronic pulmonary infection in cystic fibrosis results in progressive lung damage. Once colonisation of the lungs with Pseudomonas aeruginosa occurs, it is almost impossible to eradicate. Vaccines, aimed at reducing infection with Pseudomonas aeruginosa, have been developed....... This is an update of a previously published review. OBJECTIVES: To assess the effectiveness of vaccination against Pseudomonas aeruginosa in cystic fibrosis. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register using the terms vaccines AND pseudomonas (last search 30...... March 2015). We previously searched PubMed using the terms vaccin* AND cystic fibrosis (last search 30 May 2013). SELECTION CRITERIA: Randomised trials (published or unpublished) comparing Pseudomonas aeruginosa vaccines (oral, parenteral or intranasal) with control vaccines or no intervention in cystic...

  1. Teamwork and Collaboration for Prevention of Surgical Site Infections.

    Science.gov (United States)

    Dellinger, E Patchen

    2016-04-01

    The surgeon has been regarded as the "captain of the ship" in the operating room (OR) for many years, but cannot accomplish successful operative intervention without the rest of the team. Review of the pertinent English-language literature. Many reports demonstrate very different impressions of teamwork and communication in the OR held by different members of the surgical team. Objective measures of teamwork and communication demonstrate a reduction in complications including surgical site infections with improved teamwork and communication, with fewer distractions such as noise, and with effective use of checklists. Efforts to improve teamwork and communication and promote the effective use of checklists promote patient safety and improved outcomes for patients with reduction in surgical site infections.

  2. Inhibition of sortase A by chalcone prevents Listeria monocytogenes infection.

    Science.gov (United States)

    Li, Hongen; Chen, Yutao; Zhang, Bing; Niu, Xiaodi; Song, Meng; Luo, Zhaoqing; Lu, Gejin; Liu, Bowen; Zhao, Xiaoran; Wang, Jianfeng; Deng, Xuming

    2016-04-15

    The critical role of sortase A in gram-positive bacterial pathogenicity makes this protein a good potential target for antimicrobial therapy. In this study, we report for the first time the crystal structure of Listeria monocytogenes sortase A and identify the active sites that mediate its transpeptidase activity. We also used a sortase A (SrtA) enzyme activity inhibition assay, simulation, and isothermal titration calorimetry analysis to discover that chalcone, an agent with little anti-L. monocytogenes activity, could significantly inhibit sortase A activity with an IC50 of 28.41 ± 5.34 μM by occupying the active site of SrtA. The addition of chalcone to a co-culture of L. monocytogenes and Caco-2 cells significantly inhibited bacterial entry into the cells and L. monocytogenes-mediated cytotoxicity. Additionally, chalcone treatment decreased the mortality of infected mice, the bacterial burden in target organs, and the pathological damage to L. monocytogenes-infected mice. In conclusion, these findings suggest that chalcone is a promising candidate for the development of treatment against L. monocytogenes infection. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Infective endocarditis in patients on haemodialysis - possible strategies for prevention.

    Science.gov (United States)

    Oun, Hadi A; Price, Andrew J; Traynor, Jamie P

    2016-05-01

    Infective endocarditis is an important cause of morbidity and mortality in patients receiving haemodialysis for established renal failure. We carried out a prospective audit of patients developing infective endocarditis in a single renal unit. From 1 January 2000 to 31 December 2013, we collected data on all cases of endocarditis occurring in patients receiving haemodialysis at Monklands Hospital, Airdrie. Twenty-nine patients developed endocarditis during our audit period. Twenty-three (79.3%) of the patients had pre-existing cardiac valve abnormalities such as regurgitation or calcification. Staphylococcus aureus was the most common microorganism cultured from the blood of 22 patients (75.9%). MRSA bacteraemia was identified in eight of these patients and all eight patients died during that first presentation. Different strategies were introduced within the unit during the audit period aiming to reduce the rate of bacteraemia. Since 2011, a successful strategy has been introduced under the auspices of the Scottish Patient Safety Programme. This led to our Staph aureus bacteraemia rate related to non-tunnelled venous catheters going from an average of 15 days between episodes to having had no episodes between 2 December 2011 and the end of the study period (760 days). This also appears to have had a positive impact on reducing the rate of endocarditis. Infective endocarditis remains a devastating consequence of bacteraemia in patients receiving haemodialysis. An effective strategy aimed at reducing the rate of bacteraemia appears to have a similar effect on the rate of endocarditis. © The Author(s) 2016.

  4. Malaria, preventive practices and vector infectivity studies in Makurdi ...

    African Journals Online (AJOL)

    Three hundred questionnaires were administered for information on the use of preventive practices. Four hundred and twenty-fourmosquitoes were collected from Kanshio (sub-urban) and Old GRA (urban) using Human Landing Catch, aspirator and hand net. Vectors were identified morphologically, sexed and dissected.

  5. Strategies for Prevention and Treatment of Trichomonas vaginalis Infections.

    Science.gov (United States)

    Bouchemal, Kawthar; Bories, Christian; Loiseau, Philippe M

    2017-07-01

    The last estimated annual incidence of Trichomonas vaginalis worldwide exceeds that of chlamydia and gonorrhea combined. This critical review updates the state of the art on advances in T. vaginalis diagnostics and strategies for treatment and prevention of trichomoniasis. In particular, new data on treatment outcomes for topical administration of formulations are reviewed and discussed. Copyright © 2017 American Society for Microbiology.

  6. Changes in gastric microbiota induced by Helicobacter pylori infection and preventive effects of Lactobacillus plantarum ZDY 2013 against such infection.

    Science.gov (United States)

    Pan, Mingfang; Wan, Cuixiang; Xie, Qiong; Huang, Renhui; Tao, Xueying; Shah, Nagendra P; Wei, Hua

    2016-02-01

    Helicobacter pylori is a gram-negative pathogen linked to gastric ulcers and stomach cancer. Gastric microbiota might play an essential role in the pathogenesis of these stomach diseases. In this study, we investigated the preventive effect of a probiotic candidate Lactobacillus plantarum ZDY 2013 as a protective agent against the gastric mucosal inflammation and alteration of gastric microbiota induced by H. pylori infection in a mouse model. Prior to infection, mice were pretreated with or without 400 µL of L. plantarum ZDY 2013 at a concentration of 10(9) cfu/mL per mouse. At 6 wk postinfection, gastric mucosal immune response and alteration in gastric microbiota mice were examined by quantitative real-time PCR and high-throughput 16S rRNA gene amplicon sequencing, respectively. The results showed that L. plantarum ZDY 2013 pretreatment prevented increase in inflammatory cytokines (e.g., IL-1β and IFN-γ) and inflammatory cell infiltration in gastric lamina propria induced by H. pylori infection. Weighted UniFrac principal coordinate analysis showed that L. plantarum ZDY 2013 pretreatment prevented the alteration in gastric microbiota post-H. pylori infection. Linear discriminant analysis coupled with effect size identified 22 bacterial taxa (e.g., Pasteurellaceae, Erysipelotrichaceae, Halomonadaceae, Helicobacteraceae, and Spirochaetaceae) that overgrew in the gastric microbiota of H. pylori-infected mice, and most of them belonged to the Proteobacteria phylum. Lactobacillus plantarum ZDY 2013 pretreatment prevented this alteration; only 6 taxa (e.g., Lachnospiraceae, Ruminococcaceae, and Clostridiaceae), mainly from the taxa of Firmicutes and Bacteroidetes, were dominant in the gastric microbiota of the L. plantarum ZDY 2013 pretreated mice. Administration of L. plantarum ZDY 2013 for 3 wk led to increase in several bacterial taxa (e.g., Rikenella, Staphylococcus, Bifidobacterium), although a nonsignificant alteration was found in the gastric microbiota

  7. Malaria parasite-synthesized heme is essential in the mosquito and liver stages and complements host heme in the blood stages of infection.

    Directory of Open Access Journals (Sweden)

    Viswanathan Arun Nagaraj

    Full Text Available Heme metabolism is central to malaria parasite biology. The parasite acquires heme from host hemoglobin in the intraerythrocytic stages and stores it as hemozoin to prevent free heme toxicity. The parasite can also synthesize heme de novo, and all the enzymes in the pathway are characterized. To study the role of the dual heme sources in malaria parasite growth and development, we knocked out the first enzyme, δ-aminolevulinate synthase (ALAS, and the last enzyme, ferrochelatase (FC, in the heme-biosynthetic pathway of Plasmodium berghei (Pb. The wild-type and knockout (KO parasites had similar intraerythrocytic growth patterns in mice. We carried out in vitro radiolabeling of heme in Pb-infected mouse reticulocytes and Plasmodium falciparum-infected human RBCs using [4-(14C] aminolevulinic acid (ALA. We found that the parasites incorporated both host hemoglobin-heme and parasite-synthesized heme into hemozoin and mitochondrial cytochromes. The similar fates of the two heme sources suggest that they may serve as backup mechanisms to provide heme in the intraerythrocytic stages. Nevertheless, the de novo pathway is absolutely essential for parasite development in the mosquito and liver stages. PbKO parasites formed drastically reduced oocysts and did not form sporozoites in the salivary glands. Oocyst production in PbALASKO parasites recovered when mosquitoes received an ALA supplement. PbALASKO sporozoites could infect mice only when the mice received an ALA supplement. Our results indicate the potential for new therapeutic interventions targeting the heme-biosynthetic pathway in the parasite during the mosquito and liver stages.

  8. HIV treatment as prevention: debate and commentary--will early infection compromise treatment-as-prevention strategies?

    Directory of Open Access Journals (Sweden)

    Myron S Cohen

    Full Text Available Universal HIV testing and immediate antiretroviral therapy for infected individuals has been proposed as a way of reducing the transmission of HIV and thereby bringing the HIV epidemic under control. It is unclear whether transmission during early HIV infection--before individuals are likely to have been diagnosed with HIV and started on antiretroviral therapy--will compromise the effectiveness of treatment as prevention. This article presents two opposing viewpoints by Powers, Miller, and Cohen, and Williams and Dye, followed by a commentary by Fraser.

  9. Preventive effect of zinc on nickel-induced oxidative liver injury in rats

    African Journals Online (AJOL)

    MIDOU

    2013-12-18

    Dec 18, 2013 ... induced oxidative liver injury and lipid peroxidation probably due to its antioxidant proprieties. ... enzyme in every enzyme classification (Coyle et al.,. 2002). Others .... control group had a regular histological structure with a.

  10. Enhanced surveillance of Staphylococcus aureus bacteraemia to identify targets for infection prevention.

    Science.gov (United States)

    Morris, A K; Russell, C D

    2016-06-01

    Surveillance of Staphylococcus aureus bacteraemia (SAB) in Scotland is limited to the number of infections per 100,000 acute occupied bed-days and susceptibility to meticillin. To demonstrate the value of enhanced SAB surveillance to identify targets for infection prevention. Prospective cohort study of all patients identified with SAB over a five-year period in a single health board in Scotland. All patients were reviewed at the bedside by a clinical microbiologist. In all, 556 SAB episodes were identified: 261 (46.6%) were hospital-acquired; 209 (37.9%) were healthcare-associated; 80 (14.4%) were community-acquired; and in six (1.1%) the origin of infection was not hospital-acquired, but could not be separated into healthcare-associated or community-acquired. These were classified as non-hospital-acquired. Meticillin-resistant S. aureus (MRSA) bacteraemia was associated with hospital-acquired and healthcare-associated infections. In addition, there was a significantly higher 30-day mortality associated with hospital-acquired (31.4%) and healthcare-associated (16.3%) infections compared to community-acquired SAB (8.7%). Vascular access devices were associated with hospital-acquired SAB and peripheral venous cannulas were the source for most of these (43.9%). Community-acquired infections were associated with intravenous drug misuse, respiratory tract infections and skeletal and joint infections. Skin and soft tissue infections were more widely seen in healthcare-associated infections. The data indicate that enhanced surveillance of SAB by origin of infection and source of bacteraemia has implications for infection prevention, empirical antibiotic therapy, and health improvement interventions. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  11. Drug-induced liver toxicity and prevention by herbal antioxidants: an overview

    Directory of Open Access Journals (Sweden)

    Divya eSingh

    2016-01-01

    Full Text Available The liver is the center for drug and xenobiotic metabolism, which is influenced most with medication/xenobiotic-mediated toxic activity. Drug-induced hepatotoxicity is common and its actual frequency is hard to determine due to underreporting, difficulties in detection or diagnosis, and incomplete observation of exposure. The death rate is high, up to about 10% for medication instigated liver danger. Endorsed medications (counting acetaminophen represented >50% of instances of intense liver failure in a study from the Acute Liver Failure Study Group (ALFSG of the patients admitted in 17 US healing facilities. Albeit different studies are accessible uncovering the mechanistic aspects of medication prompted hepatotoxicity, we are in the dilemma about the virtual story. The expanding prevalence and effectiveness of Ayurveda and herbal products in the treatment of various disorders led the investigators to look into their potential in countering drug-induced liver toxicity. Several plant products have been reported to date to mitigate the drug-induced toxicity. The dietary nature and less side reactions of the herbs provide them an extra edge over other candidates of supplementary medication. In this paper, we have discussed on the mechanism involved in drug-induced liver toxicity and the potential of herbal antioxidants as supplementary medication.

  12. Preventive effect of halofuginone on concanavalin A-induced liver fibrosis.

    Directory of Open Access Journals (Sweden)

    Jie Liang

    Full Text Available Halofuginone (HF is an active component of extracts derived from the plant alkaloid febrifugine and has shown therapeutic promise in animal models of fibrotic disease. Our main objectives were to clarify the suppressive effect of HF on concanavalin A (ConA-induced liver fibrosis. ConA injection into the tail vein caused a great increase in the serum aspartate aminotransferase (AST and alanine aminotransferase (ALT levels, while orally administration of HF significantly decreased the levels of the transaminases. In addition, the levels of hyaluronic acid (HA, procollagen III (PCIII and TGF-β1 in the serum and collagen I, α-SMA, tissue inhibitors of metalloproteinase 2 (TIMP2 and Smad3 in the liver tissue were significantly lowered with the treatment of HF. Histological examination also demonstrated that HF significantly reduced the severity of liver fibrosis. Since ConA-induced liver fibrosis is caused by the repeated activation of T cells, immunomodulatory substances might be responsible for the suppressive effect of HF. We found that the production of nuclear factor (NF-kB in the serum was increased in ConA-treated group, while decreased significantly with the treatment of HF. The changes of inflammatory cytokines tumor necrosis factor (TNF-α, IL-6 and IL-1β in the serum followed the same rhythm. All together, our findings indicate that orally administration HF (10ppm would attenuate the liver fibrosis by suppressing the synthesis of collagen I and inflammation-mediated liver injury.

  13. Probiotics for the Primary and Secondary Prevention of C. difficile Infections: A Meta-analysis and Systematic Review

    Directory of Open Access Journals (Sweden)

    Lynne V. McFarland

    2015-04-01

    Full Text Available Clostridium difficile infections are a global clinical concern and are one of the leading causes of nosocomial outbreaks. Preventing these infections has benefited from multidisciplinary infection control strategies and new antibiotics, but the problem persists. Probiotics are effective in preventing antibiotic-associated diarrhea and may also be a beneficial strategy for C. difficile infections, but randomized controlled trials are scarce. This meta-analysis pools 21 randomized, controlled trials for primary prevention of C. difficile infections (CDI and four trials for secondary prevention of C. difficile recurrences and assesses the efficacy of specific probiotic strains. Four probiotics significantly improved primary CDI prevention: (Saccharomyces boulardii, Lactobacillus casei DN114001, a mixture of L. acidophilus and Bifidobacterium bifidum, and a mixture of L. acidophilus, L. casei and L. rhamnosus. None of the tested probiotics significantly improved secondary prevention of CDI. More confirmatory randomized trials are needed to establish if probiotics are useful for preventing C. difficile infections. v

  14. Inverse association between hepatitis B virus infection and fatty liver disease: a large-scale study in populations seeking for check-up.

    Directory of Open Access Journals (Sweden)

    Yuan-Lung Cheng

    Full Text Available BACKGROUND: Although many studies have attempted to clarify the association between hepatitis B virus (HBV infection and fatty liver disease, no prior studies have emphasized the relationship of HBV and fatty liver regarding different demographics of age and body mass index (BMI. AIM: To investigate the correlation of HBV and fatty liver in the different demographics of age and BMI. METHODS: We enrolled consecutive subjects who had received health check-up services at the Taipei Veterans General Hospital from 2002 to 2009 and ultrasonography was used to diagnose fatty liver according to the practice guidelines of the American Gastroenterological Association. RESULTS: Among the 33,439 subjects enrolled in this study, fatty liver was diagnosed in 43.9% of the population and 38.9% of patients with chronic HBV infection. Multivariate analysis showed that BMI, age, waist circumference, systolic blood pressure, fasting glucose, cholesterol, alanine aminotransferase (ALT levels, and platelet counts were positively associated, while hepatitis B surface antigen (HBsAg positivity was inversely associated with fatty liver, especially for subjects with BMI>22.4 kg/m(2 and age>50 years. On the contrary, HBV infection was positively correlated with the presence of elevated serum ALT levels in subjects with fatty liver disease regardless of their age and BMI. CONCLUSIONS: Metabolic factors are important determinants for the prevalence of fatty liver. Patients with HBV infection were inversely associated with fatty liver disease than the general population, especially in older and obese patients. Furthermore, metabolic factors and HBV infection were associated with elevated serum ALT levels in fatty liver disease.

  15. Decreased expression of liver X receptor-α in macrophages infected with Chlamydia pneumoniae in human atherosclerotic arteries in situ.

    Science.gov (United States)

    Bobryshev, Yuri V; Orekhov, Alexander N; Killingsworth, Murray C; Lu, Jinhua

    2011-01-01

    In in vitro experiments, Chlamydia pneumoniae has been shown to infect macrophages and to accelerate foam cell formation. It has been hypothesized that the C. pneumoniae infection affects foam cell formation by suppressing the expression of liver X receptors (LXR), but whether such an event occurs in human atherosclerosis is not known. In this study we examined carotid artery segments, obtained by endarterectomy, in which the presence of C. pneumoniae was confirmed by both polymerase chain reaction and immunohistochemistry. The expression of LXR-α in macrophages infected with C. pneumoniae and macrophages that were not infected was compared using a quantitative immunohistochemical analysis. The analysis revealed a 2.2-fold reduction in the expression of LXR-α in C. pneumoniae-infected cells around the lipid cores in atherosclerotic plaques. In the cytoplasm of laser-capture microdissected cells that were immunopositive for C. pneumoniae, electron microscopy demonstrated the presence of structures with the appearance of elementary, reticulate and aberrant bodies of C. pneumoniae. We conclude that LXR-α expression is reduced in C. pneumoniae-infected macrophages in human atherosclerotic lesions which supports the hypothesis that C. pneumoniae infection might suppress LXR expression in macrophages transforming into foam cells. Copyright © 2011 S. Karger AG, Basel.

  16. Curcumin-arteether combination therapy of Plasmodium berghei-infected mice prevents recrudescence through immunomodulation.

    Directory of Open Access Journals (Sweden)

    Palakkod G Vathsala

    Full Text Available Earlier studies in this laboratory have shown the potential of artemisinin-curcumin combination therapy in experimental malaria. In a parasite recrudescence model in mice infected with Plasmodium berghei (ANKA, a single dose of alpha,beta-arteether (ART with three oral doses of curcumin prevented recrudescence, providing almost 95% protection. The parasites were completely cleared in blood with ART-alone (AE or ART+curcumin (AC treatments in the short-term, although the clearance was faster in the latter case involving increased ROS generation. But, parasites in liver and spleen were not cleared in AE or AC treatments, perhaps, serving as a reservoir for recrudescence. Parasitemia in blood reached up to 60% in AE-treated mice during the recrudescence phase, leading to death of animals. A transient increase of up to 2-3% parasitemia was observed in AC-treatment, leading to protection and reversal of splenomegaly. A striking increase in spleen mRNA levels for TLR2, IL-10 and IgG-subclass antibodies but a decrease in those for INFγ and IL-12 was observed in AC-treatment. There was a striking increase in IL-10 and IgG subclass antibody levels but a decrease in INFγ levels in sera leading to protection against recrudescence. AC-treatment failed to protect against recrudescence in TLR2(-/- and IL-10(-/- animals. IL-10 injection to AE-treated wild type mice and AC-treated TLR2(-/- mice was able to prolong survival. Blood from the recrudescence phase in AE-treatment, but not from AC-treatment, was able to reinfect and kill naïve animals. Sera from the recrudescence phase of AC-treated animals reacted with several parasite proteins compared to that from AE-treated animals. It is proposed that activation of TLR2-mediated innate immune response leading to enhanced IL-10 production and generation of anti-parasite antibodies contribute to protective immunity in AC-treated mice. These results indicate a potential for curcumin-based combination therapy to

  17. Vaccines for preventing infection with Pseudomonas aeruginosa in cystic fibrosis.

    Science.gov (United States)

    Johansen, Helle Krogh; Gøtzsche, Peter C

    2015-08-23

    Chronic pulmonary infection in cystic fibrosis results in progressive lung damage. Once colonisation of the lungs with Pseudomonas aeruginosa occurs, it is almost impossible to eradicate. Vaccines, aimed at reducing infection with Pseudomonas aeruginosa, have been developed. This is an update of a previously published review. To assess the effectiveness of vaccination against Pseudomonas aeruginosa in cystic fibrosis. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register using the terms vaccines AND pseudomonas (last search 30 March 2015). We previously searched PubMed using the terms vaccin* AND cystic fibrosis (last search 30 May 2013). Randomised trials (published or unpublished) comparing Pseudomonas aeruginosa vaccines (oral, parenteral or intranasal) with control vaccines or no intervention in cystic fibrosis. The authors independently selected trials, assessed them and extracted data. Six trials were identified. Two trials were excluded since they were not randomised and one old, small trial because it was not possible to assess whether is was randomised. The three included trials comprised 483, 476 and 37 patients, respectively. No data have been published from one of the large trials, but the company stated in a press release that the trial failed to confirm the results from an earlier study and that further clinical development was suspended. In the other large trial, relative risk for chronic infection was 0.91 (95% confidence interval 0.55 to 1.49), and in the small trial, the risk was also close to one. In the large trial, one patient was reported to have died in the observation period. In that trial, 227 adverse events (4 severe) were registered in the vaccine group and 91 (1 severe) in the control group. In this large trial of a vaccine developed against flagella antigens, antibody titres against the epitopes contained in the vaccine were higher in the vaccine group compared to the placebo group (P Vaccines against

  18. Generalized Liver- and Blood-Derived CD8+ T-Cell Impairment in Response to Cytokines in Chronic Hepatitis C Virus Infection.

    Directory of Open Access Journals (Sweden)

    Stephanie C Burke Schinkel

    Full Text Available Generalized CD8+ T-cell impairment in chronic hepatitis C virus (HCV infection and the contribution of liver-infiltrating CD8+ T-cells to the immunopathogenesis of this infection remain poorly understood. It is hypothesized that this impairment is partially due to reduced CD8+ T-cell activity in response to cytokines such as IL-7, particularly within the liver. To investigate this, the phenotype and cytokine responsiveness of blood- and liver-derived CD8+ T-cells from healthy controls and individuals with HCV infection were compared. In blood, IL-7 receptor α (CD127 expression on bulk CD8+ T-cells in HCV infection was no different than controls yet was lower on central memory T-cells, and there were fewer naïve cells. IL-7-induced signalling through phosphorylated STAT5 was lower in HCV infection than in controls, and differed between CD8+ T-cell subsets. Production of Bcl-2 following IL-7 stimulation was also lower in HCV infection and inversely related to the degree of liver fibrosis. In liver-derived CD8+ T-cells, STAT5 activation could not be increased with cytokine stimulation and basal Bcl-2 levels of liver-derived CD8+ T-cells were lower than blood-derived counterparts in HCV infection. Therefore, generalized CD8+ T-cell impairment in HCV infection is characterized, in part, by impaired IL-7-mediated signalling and survival, independent of CD127 expression. This impairment is more pronounced in the liver and may be associated with an increased potential for apoptosis. This generalized CD8+ T-cell impairment represents an important immune dysfunction in chronic HCV infection that may alter patient health.

  19. Hand hygiene in preventing nosocomial infections:a nursing research.

    Science.gov (United States)

    Di Muzio, M; Cammilletti, V; Petrelli, E; Di Simone, E

    2015-01-01

    To verify whether there is some correlation between the nursing workload and the occurrence of healthcare-associated infections. An anonymous questionnaire made up of 20 items has been drafted for this specific purpose and delivered to a sample of 70 participants, including 33 nurses and 37 nursing students of a well-known University Hospital in Rome. The study is supported by extensive documental research, and a specific literature review. Hand hygiene is a mandatory daily practice, simple but critical, but not always clear enough for both nurses and students. The investigation demonstrated inconsistencies between nurses' and students' behaviour and what is recommended by the new WHO international guidelines. The documented correlation between the workload and the occurrence of healthcare-associated infections may be explained by the negative effect of nursing workload on correct hand-washing procedures. Out of the total sample, 58.6% answered affirmatively to both the presence of healthcare-associated infections within their unit and an excessive daily workload. Indeed, the remaining 41.4% of the sample do not report an excessive workload and states that "there are no healthcare-associated infections within their operational reality, at least not in the time period covered by the present investigation". Although limited to a small sample, this study may reveal that the correct practice of hand washing, prompted and considered fundamental by WHO, is still much underrated. Hand hygiene should be better understood and practiced in all healthcare facilities, through a series of interventions such as: specific training courses, the presence of a gel sanitizer next to each patient's bed or in each patient's room, as well as the adoption of the new international guidelines in all units. The analysis of other correlations found the presence of a protective factor (RRinfections. In fact, we found no statistically significant values to support such considerations (p>0

  20. Infection prevention needs assessment in Colorado hospitals: rural and urban settings.

    Science.gov (United States)

    Reese, Sara M; Gilmartin, Heather; Rich, Karen L; Price, Connie S

    2014-06-01

    The purpose of our study was to conduct a needs assessment for infection prevention programs in both rural and urban hospitals in Colorado. Infection control professionals (ICPs) from Colorado hospitals participated in an online survey on training, personnel, and experience; ICP time allocation; and types of surveillance. Responses were evaluated and compared based on hospital status (rural or urban). Additionally, rural ICPs participated in an interview about resources and training. Surveys were received from 62 hospitals (77.5% response); 33 rural (75.0% response) and 29 urban (80.6% response). Fifty-two percent of rural ICPs reported multiple job responsibilities compared with 17.2% of urban ICPs. Median length of experience for rural ICPs was 4.0 years compared with 11.5 years for urban ICPs (P = .008). Fifty-one percent of rural ICPs reported no access to infectious disease physicians (0.0% urban) and 81.8% of rural hospitals reported no antimicrobial stewardship programs (31.0% urban). Through the interviews it was revealed that priorities for rural ICPs were training and communication. Our study revealed numerous differences between infection prevention programs in rural versus urban hospitals. An infection prevention outreach program established in Colorado could potentially address the challenges faced by rural hospital infection prevention departments. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  1. Outcomes of an infection prevention project focusing on hand hygiene and isolation practices.

    Science.gov (United States)

    Aragon, Daleen; Sole, Mary Lou; Brown, Scott

    2005-01-01

    Nosocomial infections are a major health problem for hospitalized patients and their families. Since the 1800s, hand hygiene has been recognized as the single best method to prevent the spread of pathogens and nosocomial infections. Despite this fact, many healthcare workers do not adhere to hand hygiene policies. The Centers for Disease Control and Prevention issued a guideline for hand hygiene practices in 2002. Multifaceted approaches to improve hand hygiene have been shown to increase compliance among healthcare workers and subsequently reduce infections. A performance improvement project was initiated to implement this guideline and other strategies to prevent nosocomial infection. This article summarizes the performance improvement processes and the preliminary outcomes on adherence to infection prevention policies related to hand hygiene and isolation practices. Clinically and statistically significant increases were noted for hand hygiene prior to patient care and in wearing masks when indicated. Nurses and patient care technicians had the greatest increases in compliance. Increases in hand hygiene after patient contact and wearing of gown and gloves were also noted, but results were not statistically significant. Nosocomial infection rates from antibiotic-resistant organisms decreased in the first surveillance, but rates increased during the 1-year surveillance. Consumption of alcohol-based foam disinfectant doubled from baseline. Findings are consistent with other published studies. The project will continue with further reinforcement and education over the second year.

  2. High prevalence of antibodies against hepatitis E virus in HIV-infected patients with unexplained liver disease.

    Science.gov (United States)

    Merchante, Nicolás; Parra-Sánchez, Manuel; Rivero-Juárez, Antonio; Cifuentes, Celia; Camacho, Ángela; Macías, Juan; Martínez-Dueñas, Loreto; Pérez-Navarro, Elisabet; Rivero, Antonio; Pineda, Juan A

    2015-10-01

    To look for evidence of hepatitis E virus (HEV) exposure in HIV-infected patients with unexplained elevations of liver stiffness (LS). Case-control study conducted in 31 HIV-infected patients with unexplained elevations of LS and in 31 HIV-controls with normal LS, matched by age, sex and CD4 cell-counts. Serum HEV antibodies were tested by two ELISA procedures and by Immunoblot. We defined exposure to HEV as the detection of serum HEV antibodies by at least one of the two ELISA assays, provided that it was confirmed by Immunoblot. A real-time PCR RNA assay was conducted in all plasma samples to identify subjects with active HEV infection. Exposure to HEV was demonstrated, according to the criteria used in this study, in 9 (29%) of the cases, whereas it was shown in 5 (16%) of the controls (p=.3). Serum HEV RNA was detected in none of the controls and in only in one case. This patient had a documented chronic hepatitis E with progression to cirrhosis. HEV antibodies are frequently found in HIV-infected patients with unexplained liver disease. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  3. Facilitating central line-associated bloodstream infection prevention: a qualitative study comparing perspectives of infection control professionals and frontline staff.

    Science.gov (United States)

    McAlearney, Ann Scheck; Hefner, Jennifer L

    2014-10-01

    Infection control professionals (ICPs) play a critical role in implementing and managing healthcare-associated infection reduction interventions, whereas frontline staff are responsible for delivering direct and ongoing patient care. The objective of our study was to determine if ICPs and frontline staff have different perspectives about the facilitators and challenges of central line-associated bloodstream infection (CLABSI) prevention program success. We conducted key informant interviews at 8 hospitals that participated in the Agency for Healthcare Research and Quality CLABSI prevention initiative called "On the CUSP: Stop BSI." We analyzed interview data from 50 frontline nurses and 26 ICPs to identify common themes related to program facilitators and challenges. We identified 4 facilitators of CLABSI program success: education, leadership, data, and consistency. We also identified 3 common challenges: lack of resources, competing priorities, and physician resistance. However, the perspective of ICPs and frontline nurses differed. Whereas ICPs tended to focus on general descriptions, frontline staff noted program specifics and often discussed concrete examples. Our results suggest that ICPs need to take into account the perspectives of staff nurses when implementing infection control and broader quality improvement initiatives. Further, the deliberate inclusion of frontline staff in the implementation of these programs may be critical to program success. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  4. Electronic surveillance systems in infection prevention: organizational support, program characteristics, and user satisfaction.

    Science.gov (United States)

    Grota, Patti G; Stone, Patricia W; Jordan, Sarah; Pogorzelska, Monika; Larson, Elaine

    2010-09-01

    The use of electronic surveillance systems (ESSs) is gradually increasing in infection prevention and control programs. Little is known about the characteristics of hospitals that have a ESS, user satisfaction with ESSs, and organizational support for implementation of ESSs. A total of 350 acute care hospitals in California were invited to participate in a Web-based survey; 207 hospitals (59%) agreed to participate. The survey included a description of infection prevention and control department staff, where and how they spent their time, a measure of organizational support for infection prevention and control, and reported experience with ESSs. Only 23% (44/192) of responding infection prevention and control departments had an ESS. No statistically significant difference was seen in how and where infection preventionists (IPs) who used an ESS and those who did not spend their time. The 2 significant predictors of whether an ESS was present were score on the Organizational Support Scale (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.02-1.18) and hospital bed size (OR, 1.004; 95% CI, 1.00-1.007). Organizational support also was positively correlated with IP satisfaction with the ESS, as measured on the Computer Usability Scale (P = .02). Despite evidence that such systems may improve efficiency of data collection and potentially improve patient outcomes, ESSs remain relatively uncommon in infection prevention and control programs. Based on our findings, organizational support appears to be a major predictor of the presence, use, and satisfaction with ESSs in infection prevention and control programs.

  5. Electronic surveillance systems in infection prevention: Organizational support, program characteristics, and user satisfaction

    Science.gov (United States)

    Grota, Patti G.; Stone, Patricia W.; Jordan, Sarah; Pogorzelska, Monika; Larson, Elaine

    2012-01-01

    Background The use of electronic surveillance systems (ESSs) is gradually increasing in infection prevention and control programs. Little is known about the characteristics of hospitals that have a ESS, user satisfaction with ESSs, and organizational support for implementation of ESSs. Methods A total of 350 acute care hospitals in California were invited to participate in a Web-based survey; 207 hospitals (59%) agreed to participate. The survey included a description of infection prevention and control department staff, where and how they spent their time, a measure of organizational support for infection prevention and control, and reported experience with ESSs. Results Only 23% (44/192) of responding infection prevention and control departments had an ESS. No statistically significant difference was seen in how and where infection preventionists (IPs) who used an ESS and those who did not spend their time. The 2 significant predictors of whether an ESS was present were score on the Organizational Support Scale (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.02-1.18) and hospital bed size (OR, 1.004; 95% CI, 1.00-1.007). Organizational support also was positively correlated with IP satisfaction with the ESS, as measured on the Computer Usability Scale (P = .02). Conclusion Despite evidence that such systems may improve efficiency of data collection and potentially improve patient outcomes, ESSs remain relatively uncommon in infection prevention and control programs. Based on our findings, organizational support appears to be a major predictor of the presence, use, and satisfaction with ESSs in infection prevention and control programs. PMID:20176411

  6. Probiotics for Treatment and Prevention of Urogenital Infections in Women: A Systematic Review.

    Science.gov (United States)

    Hanson, Lisa; VandeVusse, Leona; Jermé, Martha; Abad, Cybéle L; Safdar, Nasia

    2016-05-01

    Probiotics are a complementary and integrative therapy useful in the treatment and prevention of urogenital infections in women. This study extends the work of researchers who systematically investigated the scientific literature on probiotics to prevent or treat urogenital infections. A systematic review was conducted to determine the efficacy of probiotics for prevention and/or treatment of urogenital infections in adult women from January 1, 2008, through June 30, 2015. We searched in CINAHL, MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, Dissertations and Theses, and Alt-HealthWatch. After removing duplicates and studies that did not meet inclusion criteria, 20 studies were reviewed. All included at least one species of Lactobacillus probiotic as an intervention for treatment or prevention of urogenital infections. Data extracted included samples, settings, study designs, intervention types, reported outcomes, follow-up periods, and results. We evaluated all randomized controlled trials for risk of bias and made quality appraisals on all studies. Fourteen of the studies focused on bacterial vaginosis (BV), 3 on urinary tract infections (UTIs), 2 on vulvovaginal candidiasis, and one on human papillomavirus (HPV) as identified on Papanicolaou test. Studies were heterogeneous in terms of design, intervention, and outcomes. Four studies were of good quality, 9 of fair, and 7 poor. Probiotic interventions were effective for treatment and prevention of BV, prevention of recurrences of candidiasis and UTIs, and clearing HPV lesions. No study reported significant adverse events related to the probiotic intervention. The quality of the studies in this systematic review varied. Although clinical practice recommendations were limited by the strength of evidence, probiotic interventions were effective in treatment and prevention of urogenital infections as alternatives or co-treatments. More good quality research is needed to strengthen the body

  7. N-Methyl-d-Aspartate (NMDA) Receptor Blockade Prevents Neuronal Death Induced by Zika Virus Infection.

    Science.gov (United States)

    Costa, Vivian V; Del Sarto, Juliana L; Rocha, Rebeca F; Silva, Flavia R; Doria, Juliana G; Olmo, Isabella G; Marques, Rafael E; Queiroz-Junior, Celso M; Foureaux, Giselle; Araújo, Julia Maria S; Cramer, Allysson; Real, Ana Luíza C V; Ribeiro, Lucas S; Sardi, Silvia I; Ferreira, Anderson J; Machado, Fabiana S; de Oliveira, Antônio C; Teixeira, Antônio L; Nakaya, Helder I; Souza, Danielle G; Ribeiro, Fabiola M; Teixeira, Mauro M

    2017-04-25

    Zika virus (ZIKV) infection is a global health emergency that causes significant neurodegeneration. Neurodegenerative processes may be exacerbated by N -methyl-d-aspartate receptor (NMDAR)-dependent neuronal excitoxicity. Here, we have exploited the hypothesis that ZIKV-induced neurodegeneration can be rescued by blocking NMDA overstimulation with memantine. Our results show that ZIKV actively replicates in primary neurons and that virus replication is directly associated with massive neuronal cell death. Interestingly, treatment with memantine or other NMDAR blockers, including dizocilpine (MK-801), agmatine sulfate, or ifenprodil, prevents neuronal death without interfering with the ability of ZIKV to replicate in these cells. Moreover, in vivo experiments demonstrate that therapeutic memantine treatment prevents the increase of intraocular pressure (IOP) induced by infection and massively reduces neurodegeneration and microgliosis in the brain of infected mice. Our results indicate that the blockade of NMDARs by memantine provides potent neuroprotective effects against ZIKV-induced neuronal damage, suggesting it could be a viable treatment for patients at risk for ZIKV infection-induced neurodegeneration. IMPORTANCE Zika virus (ZIKV) infection is a global health emergency associated with serious neurological complications, including microcephaly and Guillain-Barré syndrome. Infection of experimental animals with ZIKV causes significant neuronal damage and microgliosis. Treatment with drugs that block NMDARs prevented neuronal damage both in vitro and in vivo These results suggest that overactivation of NMDARs contributes significantly to the neuronal damage induced by ZIKV infection, and this is amenable to inhibition by drug treatment. Copyright © 2017 Costa et al.

  8. Levosimendan: a cardiovascular drug to prevent liver ischemia-reperfusion injury?

    Directory of Open Access Journals (Sweden)

    Peter Onody

    Full Text Available INTRODUCTION: Temporary occlusion of the hepatoduodenal ligament leads to an ischemic-reperfusion (IR injury in the liver. Levosimendan is a new positive inotropic drug, which induces preconditioning-like adaptive mechanisms due to opening of mitochondrial KATP channels. The aim of this study was to examine possible protective effects of levosimendan in a rat model of hepatic IR injury. MATERIAL AND METHODS: Levosimendan was administered to male Wistar rats 1 hour (early pretreatment or 24 hours (late pretreatment before induction of 60-minute segmental liver ischemia. Microcirculation of the liver was monitored by laser Doppler flowmeter. After 24 hours of reperfusion, liver and blood samples were taken for histology, immuno- and enzyme-histochemistry (TUNEL; PARP; NADH-TR as well as for laboratory tests. Furthermore, liver antioxidant status was assessed and HSP72 expression was measured. RESULTS: In both groups pretreated with levosimendan, significantly better hepatic microcirculation was observed compared to respective IR control groups. Similarly, histological damage was also reduced after levosimendan administration. This observation was supported by significantly lower activities of serum ALT (p early = 0.02; p late = 0.005, AST (p early = 0.02; p late = 0.004 and less DNA damage by TUNEL test (p early = 0.05; p late = 0.034 and PAR positivity (p early = 0.02; p late = 0.04. Levosimendan pretreatment resulted in significant improvement of liver redox homeostasis. Further, significantly better mitochondrial function was detected in animals receiving late pretreatment. Finally, HSP72 expression was increased by IR injury, but it was not affected by levosimendan pretreatment. CONCLUSION: Levosimendan pretreatment can be hepatoprotective and it could be useful before extensive liver resection.

  9. Urinary tract infections in extended care facilities: preventive management strategies.

    Science.gov (United States)

    Regal, Randolph E; Pham, Co Q D; Bostwick, Thomas R

    2006-05-01

    To provide health care professionals with an overview of interventions that may be done to reduce the incidence of urinary tract infections (UTIs) in elderly patients, especially those residing in extended care facilities. A Medline search of the English literature was performed from 1980 to January 2006 to find literature relevant to urinary tract prophylaxis. Further references were hand-searched from relevant sources. When assessing the effectiveness of various clinical interventions for reducing the incidence of UTIs in the elderly, preference was given to more recent, double-blind, placebo-controlled randomized studies, but studies of less robust design also were included in the discussions when the former were lacking. Where possible, recent publications were favored over older studies. References were all reviewed by the authors and chosen to present key citations. Data selection was prioritized to address specific subtopics. Though still frequent in occurrence and quite costly in terms of morbidity, mortality, and cost to the health care system, numerous measures may be taken to ameliorate the incidence of UTIs in elderly, institutionalized residents. First and foremost, establishing and adhering to good infection-control practices by health care givers and minimizing the use of indwelling catheters are essential. Adequate staffing and training are germane to this effort. Reasonably well-designed clinical studies also give credence to the use of topical estrogens and lactobacillus "probiotics" for female subgroups and cranberry juice for a wider array of patients. Vitamin C is of no proven benefit. With regard to antibiotics, with the relative paucity of data available for this patient population, concerns for resistance proliferation must be balanced against perceived gains in UTI reduction.

  10. Immunomorphologic Manifestations in Mice Liver Infected with Influenza A/H5N1, A/Goose/Krasnoozerskoye/627/05 Strain

    Directory of Open Access Journals (Sweden)

    Oxana V. Potapova

    2013-01-01

    Full Text Available Highly pathogenic avian influenza H5N1 (HPAI H5N1 viruses can infect mammals, including humans, causing severe systemic disease with the inhibition of the immune system and a high mortality rate. In conditions of lymphoid tissue depletion, the liver plays an important role in host defence against viruses. The changes in mice liver infected with HPAI H5N1 virus A/goose/Krasnoozerskoye/627/05 have been studied. It has been shown that the virus persistence in the liver leads to the expression of proinflammatory cytokines (TNF-α, IL-6 and intracellular proteases (lysozyme, cathepsin D, and myeloperoxidase by Kupffer cells. Defective antiviral response exacerbates destructive processes in the liver accelerating the development of liver failure.

  11. [Tuberculosis and HIV infection: experience of the national tuberculosis prevention program in Djibouti: 1990-1996].

    Science.gov (United States)

    Renoux, E; Matan, A Barreh; Sevre, J P; Mohamed Ali, I; Chami, D; Vincent, V

    2002-01-01

    Based on analysis of data collected from the national tuberculosis prevention program in Djibouti between 1990 and 1996, the authors analyzed the relationship between HIV infection and tuberculosis. The study cohort comprised a total of 22,000 patients including 14,000 with documented HIV infection. Although HIV infection probably worsened the situation, it was neither the only nor the main factor involved in the resurgence of tuberculosis. Demographic growth, higher population density, and increasing poverty as well as the quality of the national tuberculosis prevention program must be taken into account. The incidence of smear-negative tuberculosis was not significantly higher in HIV-infected patients (incidence of smear positive cases, > 92%). Extrapulmonary tuberculosis especially of pleural involvement was more common (15% versus 9.4%). Treatment was effective in HIV-infected patients. If directly observed (DOT) therapy was used, there was no risk of emergence of multidrug-resistant tuberculosis strains. Drug side-effects associated with the protocols used in Djibouti were not greater in HIV-infected patients. Most additional mortality observed in HIV-infected tuberculosis patients (10.5% versus 2%) was due to progression of HIV infection.

  12. Serologic Screening for Genital Herpes Infection: US Preventive Services Task Force Recommendation Statement.

    Science.gov (United States)

    Bibbins-Domingo, Kirsten; Grossman, David C; Curry, Susan J; Davidson, Karina W; Epling, John W; García, Francisco A R; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phillips, William R; Phipps, Maureen G; Pignone, Michael P; Silverstein, Michael; Tseng, Chien-Wen

    2016-12-20

    Genital herpes is a prevalent sexually transmitted infection in the United States, occurring in almost 1 in 6 persons aged 14 to 49 years. Infection is caused by 2 subtypes of the herpes simplex virus (HSV), HSV-1 and HSV-2. Antiviral medications may provide symptomatic relief from outbreaks but do not cure HSV infection. Neonatal herpes infection, while uncommon, can result in substantial morbidity and mortality. To update the 2005 US Preventive Services Task Force (USPSTF) recommendation on screening for genital herpes. The USPSTF reviewed the evidence on the accuracy, benefits, and harms of serologic screening for HSV-2 infection in asymptomatic persons, including those who are pregnant, as well as the effectiveness and harms of preventive medications and behavioral counseling interventions to reduce future symptomatic episodes and transmission to others. Based on the natural history of HSV infection, its epidemiology, and the available evidence on the accuracy of serologic screening tests, the USPSTF concluded that the harms outweigh the benefits of serologic screening for genital HSV infection in asymptomatic adolescents and adults, including those who are pregnant. The USPSTF recommends against routine serologic screening for genital HSV infection in asymptomatic adolescents and adults, including those who are pregnant. (D recommendation).

  13. Soluble FGFR4 extracellular domain inhibits FGF19-induced activation of FGFR4 signaling and prevents nonalcoholic fatty liver disease

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Qiang [State Key Laboratory of Stress Cell Biology, School of Life Sciences, Xiamen University, Xiamen (China); The First Affiliated Hospital of Xiamen University, Xiamen (China); Jiang, Yuan; An, Yuan; Zhao, Na; Zhao, Yang [State Key Laboratory of Stress Cell Biology, School of Life Sciences, Xiamen University, Xiamen (China); Yu, Chundong, E-mail: cdyu@xmu.edu.cn [State Key Laboratory of Stress Cell Biology, School of Life Sciences, Xiamen University, Xiamen (China)

    2011-06-17

    Highlights: {yields} Soluble FGFR4 extracellular domain (FGFR4-ECD) was effectively expressed. {yields} FGFR4-ECD inhibited FGF19-induced activation of FGFR4 signaling. {yields} FGFR4-ECD reduced palmitic acid-induced steatosis of HepG2 cells. {yields} FGFR4-ECD reduced tetracycline-induced fatty liver in mice. {yields} FGFR4-ECD partially restored tetracycline-repressed PPAR{alpha} expression. -- Abstract: Fibroblast growth factor receptor 4 (FGFR4) is a transmembrane tyrosine kinase receptor that plays a crucial role in the regulation of hepatic bile acid and lipid metabolism. FGFR4 underlies high-fat diet-induced hepatic steatosis, suggesting that inhibition of FGFR4 activation may be an effective way to prevent or treat nonalcoholic fatty liver disease (NAFLD). To determine whether neutralization of FGFR4 ligands by soluble FGFR4 extracellular domain (FGFR4-ECD) can inhibit the activation of FGFR4, we constructed FGFR4-ECD expression vector and showed that FGFR4-ECD was effectively expressed in cells and secreted into culture medium. FGFR4-ECD inhibited FGF19-induced activation of FGFR4 signaling and reduced steatosis of HepG2 induced by palmitic acid in vitro. Furthermore, in a tetracycline-induced fatty liver model, expression of FGFR4-ECD in mouse liver reduced the accumulation of hepatic lipids and partially restored the expression of peroxisome proliferator-activated receptor {alpha} (PPAR{alpha}), which promotes the mitochondrial fatty acid beta-oxidation but is repressed by tetracycline. Taken together, these results demonstrate that FGFR4-ECD can block FGFR4 signaling and prevent hepatic steatosis, highlighting the potential value of inhibition of FGFR4 signaling as a method for therapeutic intervention against NAFLD.

  14. Soluble FGFR4 extracellular domain inhibits FGF19-induced activation of FGFR4 signaling and prevents nonalcoholic fatty liver disease

    International Nuclear Information System (INIS)

    Chen, Qiang; Jiang, Yuan; An, Yuan; Zhao, Na; Zhao, Yang; Yu, Chundong

    2011-01-01

    Highlights: → Soluble FGFR4 extracellular domain (FGFR4-ECD) was effectively expressed. → FGFR4-ECD inhibited FGF19-induced activation of FGFR4 signaling. → FGFR4-ECD reduced palmitic acid-induced steatosis of HepG2 cells. → FGFR4-ECD reduced tetracycline-induced fatty liver in mice. → FGFR4-ECD partially restored tetracycline-repressed PPARα expression. -- Abstract: Fibroblast growth factor receptor 4 (FGFR4) is a transmembrane tyrosine kinase receptor that plays a crucial role in the regulation of hepatic bile acid and lipid metabolism. FGFR4 underlies high-fat diet-induced hepatic steatosis, suggesting that inhibition of FGFR4 activation may be an effective way to prevent or treat nonalcoholic fatty liver disease (NAFLD). To determine whether neutralization of FGFR4 ligands by soluble FGFR4 extracellular domain (FGFR4-ECD) can inhibit the activation of FGFR4, we constructed FGFR4-ECD expression vector and showed that FGFR4-ECD was effectively expressed in cells and secreted into culture medium. FGFR4-ECD inhibited FGF19-induced activation of FGFR4 signaling and reduced steatosis of HepG2 induced by palmitic acid in vitro. Furthermore, in a tetracycline-induced fatty liver model, expression of FGFR4-ECD in mouse liver reduced the accumulation of hepatic lipids and partially restored the expression of peroxisome proliferator-activated receptor α (PPARα), which promotes the mitochondrial fatty acid beta-oxidation but is repressed by tetracycline. Taken together, these results demonstrate that FGFR4-ECD can block FGFR4 signaling and prevent hepatic steatosis, highlighting the potential value of inhibition of FGFR4 signaling as a method for therapeutic intervention against NAFLD.

  15. A Novel Antihepatitis Drug, Bicyclol, Prevents Liver Carcinogenesis in Diethylnitrosamine-Initiated and Phenobarbital-Promoted Mice Tumor Model

    Directory of Open Access Journals (Sweden)

    Hua Sun

    2012-01-01

    Full Text Available Bicyclol, an antihepatitis drug developed by Chinese scientists, has been shown to prevent the malignant transformation induced by 3-methylcholanthrene and 12-O-tetradecanoylphorbol-13-acetate in WB-F344 rat liver epithelial cells. This study provides further evidence on its role as a chemopreventive agent in experimental mice with diethylnitrosamine- (DEN- initiated and phenobarbital- (PB- promoted liver carcinoma. Liver tissue and serum were collected. In the two-stage model of hepatocarcinogenesis in mice, oral administration of bicyclol (100, 200 mg/kg before DEN injection showed significant reduction in the incidence of hepatocellular foci, nodules, or carcinoma. Histopathological examination revealed that there was no hepatocellular carcinoma (HCC and hepatoma formation in the mice pretreated with bicyclol (200 mg/kg at week 20, while the mice treated with DEN/PB developed 33.3% HCC and 55.6% hepatoma. Furthermore, the serum levels of alanine aminotransferase (ALT, alkaline phosphatase (ALP, and α-fetal protein (AFP in serum significantly increased in the DEN/PB model group in comparison with the control group. Pretreatment with bicyclol showed a marked reduction in the above condition. Bicyclol also decreased the expression of AFP and proliferating cell nuclear antigen level in the liver tissue and attenuated the decrease in body weight. In this study, we also found that 10 weeks after stopping the administration of PB and drugs, the control and bicyclol-treated (200 mg/kg animals showed no HCC and hepatoma formation at the time of termination whereas DEN/PB-induced mice developed 100% hepatoma and 50% HCC. These results further indicate that bicyclol has the chemopreventive potential for liver carcinogenesis induced by carcinogens.

  16. Liver-Specific Activation of AMPK Prevents Steatosis on a High-Fructose Diet

    Directory of Open Access Journals (Sweden)

    Angela Woods

    2017-03-01

    Full Text Available AMP-activated protein kinase (AMPK plays a key role in integrating metabolic pathways in response to energy demand. We identified a mutation in the γ1 subunit (γ1D316A that leads to activation of AMPK. We generated mice with this mutation to study the effect of chronic liver-specific activation of AMPK in vivo. Primary hepatocytes isolated from these mice have reduced gluconeogenesis and fatty acid synthesis, but there is no effect on fatty acid oxidation compared to cells from wild-type mice. Liver-specific activation of AMPK decreases lipogenesis in vivo and completely protects against hepatic steatosis when mice are fed a high-fructose diet. Our findings demonstrate that liver-specific activation of AMPK is sufficient to protect against hepatic triglyceride accumulation, a hallmark of non-alcoholic fatty liver disease (NAFLD. These results emphasize the clinical relevance of activating AMPK in the liver to combat NAFLD and potentially other associated complications (e.g., cirrhosis and hepatocellular carcinoma.

  17. Small-for-Size Liver Transplantation Increases Pulmonary Injury in Rats: Prevention by NIM811

    Directory of Open Access Journals (Sweden)

    Qinlong Liu

    2012-01-01

    Full Text Available Pulmonary complications after liver transplantation (LT often cause mortality. This study investigated whether small-for-size LT increases acute pulmonary injury and whether NIM811 which improves small-for-size liver graft survival attenuates LT-associated lung injury. Rat livers were reduced to 50% of original size, stored in UW-solution with and without NIM811 (5 μM for 6 h, and implanted into recipients of the same or about twice the donor weight, resulting in half-size (HSG and quarter-size grafts (QSG, respectively. Liver injury increased and regeneration was suppressed after QSG transplantation as expected. NIM811 blunted these alterations >75%. Pulmonary histological alterations were minimal at 5–18 h after LT. At 38 h, neutrophils and monocytes/macrophage infiltration, alveolar space exudation, alveolar septal thickening, oxidative/nitrosative protein adduct formation, and alveolar epithelial cell/capillary endothelial apoptosis became overt in the lungs of QSG recipients, but these alterations were mild in full-size and HSG recipients. Liver pretreatment with NIM811 markedly decreased pulmonary injury in QSG recipients. Hepatic TNFα and IL-1β mRNAs and pulmonary ICAM-1 expression were markedly higher after QSG transplantation, which were all decreased by NIM811. Together, dysfunctional small-for-size grafts produce toxic cytokines, leading to lung inflammation and injury. NIM811 decreased toxic cytokine formation, thus attenuating pulmonary injury after small-for-size LT.

  18. Where do youth in foster care receive information about preventing unplanned pregnancy and sexually transmitted infections?

    Science.gov (United States)

    Hudson, Angela L

    2012-10-01

    Adolescents in foster care are at risk for unplanned pregnancy and sexually transmitted infections, including HIV infection. A study using a qualitative method was conducted to describe how and where foster youth receive reproductive health and risk reduction information to prevent pregnancy and sexually transmitted infections. Participants also were asked to describe their relationship with their primary health care provider while they were in foster care. Nineteen young adults, recently emancipated from foster care, participated in individual interviews. Using grounded theory as the method of analysis, three thematic categories were generated: discomfort visiting and disclosing, receiving and not receiving the bare essentials, and learning prevention from community others. Recommendations include primary health care providers providing a confidential space for foster youth to disclose sexual activity and more opportunities for foster youth to receive reproductive and risk prevention information in the school setting. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Testing the Quality Health Outcomes Model Applied to Infection Prevention in Hospitals.

    Science.gov (United States)

    Gilmartin, Heather M; Sousa, Karen H

    2016-01-01

    To test the Quality Health Outcomes Model to investigate the relationship between health care-associated infection (HAI) prevention interventions, organizational context, and HAI outcomes using structural equation modeling. Variables for adherence to the central line bundle, organizational context, and central line-associated bloodstream infections (CLABSIs) were selected for this secondary data analysis from 614 US hospitals that participated in the Prevention of Nosocomial Infection and Cost-effectiveness-Refined study. One half of the dataset was used for exploration of the concepts, the second half for confirmation of the measurement models and testing of the structural model. The final model resulted in a good fit to the data (χ (1215) = 1906.86, P preventing HAIs, ongoing research is needed to reveal the exact aspects of context that influence interventions and outcomes.

  20. Using human factors engineering to improve the effectiveness of infection prevention and control.

    Science.gov (United States)

    Anderson, Judith; Gosbee, Laura Lin; Bessesen, Mary; Williams, Linda

    2010-08-01

    Human factors engineering is a discipline that studies the capabilities and limitations of humans and the design of devices and systems for improved performance. The principles of human factors engineering can be applied to infection prevention and control to study the interaction between the healthcare worker and the system that he or she is working with, including the use of devices, the built environment, and the demands and complexities of patient care. Some key challenges in infection prevention, such as delayed feedback to healthcare workers, high cognitive workload, and poor ergonomic design, are explained, as is how human factors engineering can be used for improvement and increased compliance with practices to prevent hospital-acquired infections.

  1. Disinfection efficacy of an ultraviolet light on film cassettes for preventive of the nosocomial infection

    International Nuclear Information System (INIS)

    Kweon, Dae Cheol; Jeon, Yong Woong; Cho, Am

    2001-01-01

    The bacterial infection on film cassette contact surface was examined at the diagnostic radiology department of the S. hospital. The objective of this study was to assess the contamination level on film cassette contact surface as a predictor of patient prevention from nosocomial infection and for improvement of the hospital environment. The laboratory result was identified non-pathologic bacterial in the five different cassette size of the contact surface. Film cassettes were exposed to ultraviolet light for 1, 2 and 3 minutes. Ultraviolet light disinfection is proven suitable for bacterial. The study concludes that presence of a bacterial infection will prevent a using antiseptic technique on film cassette contact surface. In addition education of nosocomial infection for radiographers will be required. In conclusion, ultraviolet is considered effective to irradiate bacterial. Additionally, two minutes are required to sterilize film cassettes

  2. [Surface disinfection in the context of infection prevention in intensive care units].

    Science.gov (United States)

    Kossow, A; Schaber, S; Kipp, F

    2013-03-01

    The highest proportion of nosocomial infections occurs on intensive care units (ICU) and infections with multiresistant pathogens are an ever increasing problem. Preventative measures should consist of a bundle of different measures including measures that address a specific problem and standard hygiene measures that are relevant in all areas. Specific measures in ICUs primarily aim at the prevention of ventilator associated pneumonia, blood vessel catheter associated infections and nosocomial urinary tract infections. Surface disinfection belongs to the standard hygiene measures and plays an inferior role compared to hand hygiene; however, surfaces come into focus in outbreak situations. The Commission on Hospital Hygiene (KRINKO) at the Robert Koch Institute (the German health protection agency) published recommendations regarding the cleaning and disinfection of surfaces. The frequency with which cleaning and/or disinfection is required varies according to defined areas of risk. The frequency and the disinfection agents used are documented in the disinfection plan.

  3. Disinfection efficacy of an ultraviolet light on film cassettes for preventive of the nosocomial infection

    Energy Technology Data Exchange (ETDEWEB)

    Kweon, Dae Cheol [Seoul National Univ. Hospital, Seoul (Korea, Republic of); Jeon, Yong Woong; Cho, Am [Dongguk Univ., Seoul (Korea, Republic of)

    2001-06-01

    The bacterial infection on film cassette contact surface was examined at the diagnostic radiology department of the S. hospital. The objective of this study was to assess the contamination level on film cassette contact surface as a predictor of patient prevention from nosocomial infection and for improvement of the hospital environment. The laboratory result was identified non-pathologic bacterial in the five different cassette size of the contact surface. Film cassettes were exposed to ultraviolet light for 1, 2 and 3 minutes. Ultraviolet light disinfection is proven suitable for bacterial. The study concludes that presence of a bacterial infection will prevent a using antiseptic technique on film cassette contact surface. In addition education of nosocomial infection for radiographers will be required. In conclusion, ultraviolet is considered effective to irradiate bacterial. Additionally, two minutes are required to sterilize film cassettes.

  4. Quality improvement initiative: Preventative Surgical Site Infection Protocol in Vascular Surgery.

    Science.gov (United States)

    Parizh, David; Ascher, Enrico; Raza Rizvi, Syed Ali; Hingorani, Anil; Amaturo, Michael; Johnson, Eric

    2018-02-01

    Objective A quality improvement initiative was employed to decrease single institution surgical site infection rate in open lower extremity revascularization procedures. In an attempt to lower patient morbidity, we developed and implemented the Preventative Surgical Site Infection Protocol in Vascular Surgery. Surgical site infections lead to prolonged hospital stays, adjunctive procedure, and additive costs. We employed targeted interventions to address the common risk factors that predispose patients to post-operative complications. Methods Retrospective review was performed between 2012 and 2016 for all surgical site infections after revascularization procedures of the lower extremity. A quality improvement protocol was initiated in January 2015. Primary outcome was the assessment of surgical site infection rate reduction in the pre-protocol vs. post-protocol era. Secondary outcomes evaluated patient demographics, closure method, perioperative antibiotic coverage, and management outcomes. Results Implementation of the protocol decreased the surgical site infection rate from 6.4% to 1.6% p = 0.0137). Patient demographics and comorbidities were assessed and failed to demonstrate a statistically significant difference among the infection and no-infection groups. Wound closure with monocryl suture vs. staple proved to be associated with decreased surgical site infection rate ( p site infections in the vascular surgery population are effective and necessary. Our data suggest that there may be benefit in the incorporation of MRSA and Gram-negative coverage as part of the Surgical Care Improvement Project perioperative guidelines.

  5. 4Ps medicine of the fatty liver: the research model of predictive, preventive, personalized and participatory medicine-recommendations for facing obesity, fatty liver and fibrosis epidemics.

    Science.gov (United States)

    Trovato, Francesca Maria; Catalano, Daniela; Musumeci, Giuseppe; Trovato, Guglielmo M

    2014-01-01

    Relationship between adipose tissue and fatty liver, and its possible evolution in fibrosis, is supported by clinical and research experience. Given the multifactorial pathogenesis of non-alcoholic fatty liver disease (NAFLD), treatments for various contributory risk factors have been proposed; however, there is no single validated therapy or drug association recommended for all cases which can stand alone. Mechanisms, diagnostics, prevention and treatment of obesity, fatty liver and insulin resistance are displayed along with recommendations and position points. Evidences and practice can get sustainable and cost-benefit valuable outcomes by participatory interventions. These recommendations can be enhanced by comprehensive research projects, addressed to societal issues and innovation, market appeal and industry development, cultural acceptance and sustainability. The basis of participatory medicine is a greater widespread awareness of a condition which is both a disease and an easy documented and inclusive clue for associated diseases and unhealthy lifestyle. This model is suitable for addressing prevention and useful for monitoring improvement, worsening and adherence with non-invasive imaging tools which allow targeted approaches. The latter include health psychology and nutritional and physical exercise prescription expertise disseminated by continuous medical education but, more important, by concrete curricula for training undergraduate and postgraduate students. It is possible and recommended to do it by early formal teaching of ultrasound imaging procedures and of practical lifestyle intervention strategies, including approaches aimed to healthier fashion suggestions. Guidelines and requirements of research project funding calls should be addressed also to NAFLD and allied conditions and should encompass the goal of training by research and the inclusion of participatory medicine topics. A deeper awareness of ethics of competences in health professionals

  6. Identification and Characterization of MicroRNAs in the Liver of Blunt Snout Bream (Megalobrama amblycephala Infected by Aeromonas hydrophila

    Directory of Open Access Journals (Sweden)

    Lei Cui

    2016-11-01

    Full Text Available MicroRNAs (miRNAs are small RNA molecules that play key roles in regulation of various biological processes. In order to better understand the biological significance of miRNAs in the context of Aeromonas hydrophila infection in Megalobrama amblycephala, small RNA libraries obtained from fish liver at 0 (non-infection, 4, and 24 h post infection (poi were sequenced using Illumina deep sequencing technology. A total of 11,244,207, 9,212,958, and 7,939,157 clean reads were obtained from these three RNA libraries, respectively. Bioinformatics analysis identified 171 conserved miRNAs and 62 putative novel miRNAs. The existence of ten randomly selected novel miRNAs was validated by RT-PCR. Pairwise comparison suggested that 61 and 44 miRNAs were differentially expressed at 4 and 24 h poi, respectively. Furthermore, the expression profiles of nine randomly selected miRNAs were validated by qRT-PCR. MicroRNA target prediction, gene ontology (GO annotation, and Kyoto Encylopedia of Genes and Genomes (KEGG analysis indicated that a variety of biological pathways could be affected by A. hydrophila infection. Additionally, transferrin (TF and transferrin receptor (TFR genes were confirmed to be direct targets of miR-375. These results will expand our knowledge of the role of miRNAs in the immune response of M. amblycephala to A. hydrophila infection, and facilitate the development of effective strategies against A. hydrophila infection in M. amblycephala.

  7. Unique factors rural Veterans' Affairs hospitals face when implementing health care-associated infection prevention initiatives.

    Science.gov (United States)

    Harrod, Molly; Manojlovich, Milisa; Kowalski, Christine P; Saint, Sanjay; Krein, Sarah L

    2014-01-01

    Health care-associated infection (HAI) is costly to hospitals and potentially life-threatening to patients. Numerous infection prevention programs have been implemented in hospitals across the United States. Yet, little is known about infection prevention practices and implementation in rural hospitals. The purpose of this study was to understand the infection prevention practices used by rural Veterans' Affairs (VA) hospitals and the unique factors they face in implementing these practices. This study used a sequential, mixed methods approach. Survey data to identify the HAI prevention practices used by rural VA hospitals were collected, analyzed, and used to inform the development of a semistructured interview guide. Phone interviews were conducted followed by site visits to rural VA hospitals. We found that most rural VA hospitals were using key recommended infection prevention practices. Nonetheless, a number of challenges with practice implementation were identified. The 3 most prominent themes were: (1) lack of human capital including staff with HAI expertise; (2) having to cultivate needed resources; and (3) operating as a system within a system. Rural VA hospitals are providing key infection prevention services to ensure a safe environment for the veterans they serve. However, certain factors, such as staff expertise, limited resources, and local context impacted how and when these practices were used. The creative use of more accessible alternative resources as well as greater flexibility in implementing HAI-related initiatives may be important strategies to further improve delivery of these important services by rural VA hospitals. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

  8. Observations of infection prevention and control practices in primary health care, Kenya.

    Science.gov (United States)

    Bedoya, Guadalupe; Dolinger, Amy; Rogo, Khama; Mwaura, Njeri; Wafula, Francis; Coarasa, Jorge; Goicoechea, Ana; Das, Jishnu

    2017-07-01

    To assess compliance with infection prevention and control practices in primary health care in Kenya. We used an observational, patient-tracking tool to assess compliance with infection prevention and control practices by 1680 health-care workers during outpatient interactions with 14 328 patients at 935 health-care facilities in 2015. Compliance was assessed in five domains: hand hygiene; protective glove use; injections and blood sampling; disinfection of reusable equipment; and waste segregation. We calculated compliance by dividing the number of correct actions performed by the number of indications and evaluated associations between compliance and the health-care worker's and facility's characteristics. Across 106 464 observed indications for an infection prevention and control practice, the mean compliance was 0.318 (95% confidence interval, CI: 0.315 to 0.321). The compliance ranged from 0.023 (95% CI: 0.021 to 0.024) for hand hygiene to 0.871 (95% CI: 0.866 to 0.876) for injection and blood sampling safety. Compliance was weakly associated with the facility's characteristics (e.g. public or private, or level of specialization) and the health-care worker's knowledge of, and training in, infection prevention and control practices. The observational tool was effective for assessing compliance with infection prevention and control practices across multiple domains in primary health care in a low-income country. Compliance varied widely across infection prevention and control domains. The weak associations observed between compliance and the characteristics of health-care workers and facilities, such as knowledge and the availability of supplies, suggest that a broader focus on behavioural change is required.

  9. Progress and challenges in the prevention and control of nonalcoholic fatty liver disease.

    Science.gov (United States)

    Cai, Jingjing; Zhang, Xiao-Jing; Li, Hongliang

    2018-05-30

    Nonalcoholic fatty liver disease (NAFLD) is rapidly becoming the most common liver disease worldwide. Individuals with NAFLD have a high frequency of developing progressive liver disease and metabolism-related comorbidities, which result from of a lack of awareness and poor surveillance of the disease and a paucity of approved and effective therapies. Managing the complications of NAFLD has already begun to place a tremendous burden on health-care systems. Although efforts to identify effective therapies are underway, the lack of validated preclinical NAFLD models that represent the biology and outcomes of human disease remains a major barrier. This review summarizes the characteristics and prevalence of the disease and the status of our understanding of its mechanisms and potential therapeutic targets. © 2018 Wiley Periodicals, Inc.

  10. The cost effectiveness of vancomycin for preventing infections after shoulder arthroplasty: a break-even analysis.

    Science.gov (United States)

    Hatch, M Daniel; Daniels, Stephen D; Glerum, Kimberly M; Higgins, Laurence D

    2017-03-01

    Increasing methicillin resistance and recognition of Propionibacterium acnes as a cause of infection in shoulder arthroplasty has led to the adoption of local vancomycin powder application as a more effective method to prevent expensive periprosthetic infections. However, no study has analyzed the cost effectiveness of vancomycin powder for preventing infection after shoulder replacement. Cost data for infection-related care of 16 patients treated for deep periprosthetic shoulder infection was collected from our institution for the break-even analysis. An equation was developed and applied to the data to determine how effective vancomycin powder would need to be at reducing a baseline infection rate to make prophylactic use cost effective. The efficacy of vancomycin (absolute risk reduction [ARR]) was evaluated at different unit costs, baseline infection rates, and average costs of treating infection. We determined vancomycin to be cost effective if the initial infection rate decreased by 0.04% (ARR). Using the current costs of vancomycin reported in the literature (range: $2.50/1000 mg to $44/1000 mg), we determined vancomycin to be cost effective with an ARR range of 0.01% at a cost of $2.50/1000 mg to 0.19% at $44/1000 mg. Baseline infection rate does not influence the ARR obtained at any specific cost of vancomycin or the cost of treating infection. We have derived and used a break-even equation to assess efficacy of prophylactic antibiotics during shoulder surgery. We further demonstrated the prophylactic administration of local vancomycin powder during shoulder arthroplasty to be a highly cost-effective practice. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  11. Probiotics in the Prevention and Treatment of Postmenopausal Vaginal Infections: Review Article.

    Science.gov (United States)

    Kim, Jun-Mo; Park, Yoo Jin

    2017-12-01

    Bacterial vaginosis (BV) and complicated vulvovaginal candidiasis (VVC) are frequently occurring vaginal infections in postmenopausal women, caused by an imbalance in vaginal microflora. Postmenopausal women suffer from decreased ovarian hormones estrogen and progesterone. A normal, healthy vaginal microflora mainly comprises Lactobacillus species (spp.), which act beneficially as a bacterial barrier in the vagina, interfering with uropathogens. During premenopausal period, estrogen promotes vaginal colonization by lactobacilli that metabolizing glycogen and producing lactic acid, and maintains intravaginal health by lowering the intravaginal pH level. A lower vaginal pH inhibits uropathogen growth, preventing vaginal infections. Decreased estrogen secretion in postmenopausal women depletes lactobacilli and increases intravaginal pH, resulting in increased vaginal colonization by harmful microorganisms (e.g., Enterobacter , Escherichia coli , Candida , and Gardnerella ). Probiotics positively effects on vaginal microflora composition by promoting the proliferation of beneficial microorganisms, alters the intravaginal microbiota composition, prevents vaginal infections in postmenopausal. Probiotics also reduce the symptoms of vaginal infections (e.g., vaginal discharge, odor, etc.), and are thus helpful for the treatment and prevention of BV and VVC. In this review article, we provide information on the intravaginal mechanism of postmenopausal vaginal infections, and describes the effectiveness of probiotics in the treatment and prevention of BV and VVC.

  12. State of infection prevention in US hospitals enrolled in the National Health and Safety Network.

    Science.gov (United States)

    Stone, Patricia W; Pogorzelska-Maziarz, Monika; Herzig, Carolyn T A; Weiner, Lindsey M; Furuya, E Yoko; Dick, Andrew; Larson, Elaine

    2014-02-01

    This report provides a national cross-sectional snapshot of infection prevention and control programs and clinician compliance with the implementation of processes to prevent health care-associated infections (HAIs) in intensive care units (ICUs). All hospitals, except Veterans Affairs hospitals, enrolled in the National Healthcare Safety Network (NHSN) were eligible to participate. Participation involved completing a survey assessing the presence of evidence-based prevention policies and clinician adherence and joining our NHSN research group. Descriptive statistics were computed. Facility characteristics and HAI rates by ICU type were compared between respondents and nonrespondents. Of the 3,374 eligible hospitals, 975 provided data (29% response rate) on 1,653 ICUs, and there were complete data on the presence of policies in 1,534 ICUs. The average number of infection preventionists (IPs) per 100 beds was 1.2. Certification of IP staff varied across institutions, and the average hours per week devoted to data management and secretarial support were generally low. There was variation in the presence of policies and clinician adherence to these policies. There were no differences in HAI rates between respondents and nonrespondents. Guidelines for IP staffing in acute care hospitals need to be updated. In future work, we will analyze the associations between HAI rates and infection prevention and control program characteristics, as well as the inplementation of and clinician adherence to evidence-based policies. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  13. Probiotics in the Prevention and Treatment of Postmenopausal Vaginal Infections: Review Article

    Science.gov (United States)

    Park, Yoo Jin

    2017-01-01

    Bacterial vaginosis (BV) and complicated vulvovaginal candidiasis (VVC) are frequently occurring vaginal infections in postmenopausal women, caused by an imbalance in vaginal microflora. Postmenopausal women suffer from decreased ovarian hormones estrogen and progesterone. A normal, healthy vaginal microflora mainly comprises Lactobacillus species (spp.), which act beneficially as a bacterial barrier in the vagina, interfering with uropathogens. During premenopausal period, estrogen promotes vaginal colonization by lactobacilli that metabolizing glycogen and producing lactic acid, and maintains intravaginal health by lowering the intravaginal pH level. A lower vaginal pH inhibits uropathogen growth, preventing vaginal infections. Decreased estrogen secretion in postmenopausal women depletes lactobacilli and increases intravaginal pH, resulting in increased vaginal colonization by harmful microorganisms (e.g., Enterobacter, Escherichia coli, Candida, and Gardnerella). Probiotics positively effects on vaginal microflora composition by promoting the proliferation of beneficial microorganisms, alters the intravaginal microbiota composition, prevents vaginal infections in postmenopausal. Probiotics also reduce the symptoms of vaginal infections (e.g., vaginal discharge, odor, etc.), and are thus helpful for the treatment and prevention of BV and VVC. In this review article, we provide information on the intravaginal mechanism of postmenopausal vaginal infections, and describes the effectiveness of probiotics in the treatment and prevention of BV and VVC. PMID:29354612

  14. Infection control in intensive care units and prevention of ventilator-associated pneumonia.

    Science.gov (United States)

    Bonten, M J; Weinstein, R A

    2000-12-01

    Ventilator-associated pneumonia (VAP) is considered the most frequent infection in the intensive care unit (ICU), although incidence rates depend on the diagnostic methods. Because VAP has been associated with increased mortality and greater costs for medical care, prevention remains an important goal for intensive care medicine. Selective digestive decontamination (SDD), the most frequently studied method of infection prevention, is still controversial despite more than 30 prospective randomized trials and 6 metaanalyses. SDD reduces the incidence of VAP diagnoses, but beneficial effects on duration of ventilation or ICU stay, antibiotic use, and patient survival have not been shown unequivocally. Although recent metaanalyses suggest a 20% to 40% decrease in ICU mortality for SDD used with systemic prophylaxis, this benefit should be confirmed in a large, prospective, randomized study, preferably with a cost-benefit analysis. Selection of pathogens resistant to the antibiotics used in SDD remains the most important drawback of SDD, rendering SDD contraindicated in wards with endemic resistant problems. Other methods of infection prevention that do not create a selective growth advantage for resistant microorganisms may be more useful. Among these are the use of endotracheal tubes with the possibility of continuous aspiration of subglottic secretions, oropharyngeal decontamination with antiseptics, or the semirecumbent treatment position of patients. Although these methods were successful in single studies, more data are needed. Notwithstanding the potential benefits of these interventions, such classic infection control measures as handwashing remain the cornerstone of infection prevention.

  15. Prevention of infection in children and adolescents with primary immunodeficiency disorders.

    Science.gov (United States)

    Papadopoulou-Alataki, Efimia; Hassan, Amel; Davies, E Graham

    2012-12-01

    Primary Immunodeficiency diseases (PIDs) are a heterogenous group of inherited disorders that may involve one or multiple components of the immune system. PIDs are uncommon, chronic and severe disorders, in which patients cannot mount a sufficiently protective immune response, leading to an increased susceptibility to infections. This review addresses the current practices for the prevention of infection in children and adolescents with PIDs, particular covering immunisations and antimicrobial prophylaxis. Over recent years, there have been major advances in molecular and cellular understanding in the field of PIDs. Many different disorders are recognised with variable spectra of infection susceptibility depending on the particular aspects of the immune response that are affected. Immunoglobulin prophylaxis is the mainstay of treatment for PIDs and provides passive protection. Prophylactic antimicrobials are efficacious in children and adolescents with predominant defects in primary T cell immunodeficiency diseases and phagocytic disorders, and also with predominant defects in antibody production. Prophylactic antibiotics are suggested for patients with antibody deficiency diseases if recurrent infections exceed three per year, if severe infections occur despite adequate immunoglobulin replacement and in hypogammaglobulinaemic patients who have bronchiectasis. Certain immunisations are effective in antibody deficiencies, T cell deficiencies, complement deficiencies and phagocytic disorders. There are remarkably few published data relating to clinical management aimed at preventing infectious complications in children and adolescents with PIDs. The cornerstones of the prevention of infection in most PID patients are: antimicrobial prophylaxis, appropriate vaccination, immunoglobulin replacement, for the more severe cases, and regular ongoing follow-up.

  16. Prevention of urogenital infections by oral administration of probiotic lactobacilli

    Directory of Open Access Journals (Sweden)

    Vedran Slačanac

    2010-09-01

    Full Text Available In general, lactobacilli are nonpathogenic part of the normal urogenital microflora and have been recognized as a barrier against colonization of unwanted (pathogen microflora. The results of many in vitro studies suggest following mechanisms of probiotic lactobacilli action in urogenital tract: adhesion to urogenital cells, competition with pathogens for adhesive sites, production of biosurfactants, co-aggregation with pathogens, production of antimicrobial substances (organic acids, hydrogen peroxide and bacteriocins and stimulation of immune system. From 80 different lactobacilli species isolated from human or animal intestinal and urogenital tract, only few lactobacilli strains possess optimal properties to be effective as probiotic therapeutics against infections in the urogenital tract. Combination of Lactobacillus rhamnosus GR-1 and Lactobacillus fermentum RC-14 was proposed as the best one for epithelial vaginal cells colonization and inhibition of uropathogens adhesion. The results of a number of clinical studies confirmed beneficial role of oral lactobacilli. However, the most of commercially available Lactobacillus strains, which are ordinary used in fermented dairy products,are seriously limited in protection of urogenital tract when they are ingested orally.

  17. Guide: Monitoring Programme for unannounced inspections undertaken against the National Standards for the Prevention and Control of Healthcare Associated Infections

    OpenAIRE

    2014-01-01

    This is a guide to the Health Information and Quality Authority?s (the Authority) programme of monitoring service providers? compliance with the National Standards for the Prevention and Control of Healthcare Associated Infections (referred to in this guide as the Infection, Prevention and Control Standards). This guide explains the approach that the Authority takes when monitoring the compliance of service providers ? including hospitals ? with the Infection, Prevention and Control Standards...

  18. A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates.

    Science.gov (United States)

    Yokoe, Deborah S; Anderson, Deverick J; Berenholtz, Sean M; Calfee, David P; Dubberke, Erik R; Ellingson, Katherine D; Gerding, Dale N; Haas, Janet P; Kaye, Keith S; Klompas, Michael; Lo, Evelyn; Marschall, Jonas; Mermel, Leonard A; Nicolle, Lindsay E; Salgado, Cassandra D; Bryant, Kristina; Classen, David; Crist, Katrina; Deloney, Valerie M; Fishman, Neil O; Foster, Nancy; Goldmann, Donald A; Humphreys, Eve; Jernigan, John A; Padberg, Jennifer; Perl, Trish M; Podgorny, Kelly; Septimus, Edward J; VanAmringe, Margaret; Weaver, Tom; Weinstein, Robert A; Wise, Robert; Maragakis, Lisa L

    2014-08-01

    Since the publication of "A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals" in 2008, prevention of healthcare-associated infections (HAIs) has become a national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. They are the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).

  19. Improving surgical site infection prevention practices through a multifaceted educational intervention.

    LENUS (Irish Health Repository)

    Owens, P

    2015-03-01

    As part of the National Clinical Programme on healthcare-associated infection prevention, a Royal College of Surgeons in Ireland (RCSI) and Royal College of Physicians of Ireland (RCPI) working group developed a quality improvement tool for prevention of surgical site infection (SS). We aimed to validate the effectiveness of an educational campaign, which utilises this quality improvement tool to prevent SSI in a tertiary hospital. Prior to the SSI educational campaign, surgical patients were prospectively audited and details of antibiotic administration recorded. Prophylactic antibiotic administration recommendations were delivered via poster and educational presentations. Post-intervention, the audit was repeated. 50 patients were audited pre-intervention, 45 post-intervention. Post-intervention, prophylaxis within 60 minutes prior to incision increased from 54% to 68% (p = 0.266). Appropriate postoperative prescribing improved from 71% to 92% (p = 0.075). A multifaceted educational program may be effective in changing SSI prevention practices.

  20. [Influence of kaempferol on TGF-β1/Smads signal path in liver tissue of mice with Schistosoma japonicum infection].

    Science.gov (United States)

    Cai, Wen; Zhao, Lei; Li, Hua-rong; Zhang, Shu-ling

    2014-08-01

    To investigate the influence of kaempferol on transforming growth factor(TGF-β1/Smads signal tiransduction in liver tissue of mice with schistosomiasis liver fibrosis. Forty BALB/c mice were randomly divided into a normal control group (8 mice), a praziquantel group (8 mice ), and 4 praziquantel + kaempferol groups with different kaempferol dosages (5, 10, 15, 20 mg/kg respectively, 6 mice each group). Besides the normal control group, all the mice in the other 5 groups were infected with Schistosoma japonicum. After the infection for 6 weeks, the praziquantel group and the 4 praziquantel + kaempferol groups were treated with praziquantel 500 mg/(kg.d) for 2 d, then the mice in the praziquantel group were drenched with normal saline for 6 weeks, and those in the 4 praziquantel + kaempferol groups were drenched with kaempferol 5, 10, 15, 20 mg/kg respectively for 6 weeks. After the treatment, all the animals were sacrificed by the cervical dislocation method, and the area of egg granuloma and the degree of fibrosis in the livers of the mice were observed by HE and Masson staining. The expressions of TGF-β1, Smad2/3, Smad7 proteins were measured by the immunohistochemical method, and the mRNA levels of the 3 proteins were detected by RT-PCR. Compared with the mice in the praziquantel group, the areas of egg granuloma of the liver of the mice in the 4 praziquantel + kaempferol groups were smaller, and the degrees of the hepatic fibrosis of the mice were lesser, and their expressions of Smad2 and Smad3 at protein and their mRNA levels were significantly lower (all P kaempferol can significantly reduce the degrees of hepatic fibrosis and granuloma caused by schistosome eggs after the praziquantel treatment.

  1. Implementation of surgical quality improvement: auditing tool for surgical site infection prevention practices.

    Science.gov (United States)

    Hechenbleikner, Elizabeth M; Hobson, Deborah B; Bennett, Jennifer L; Wick, Elizabeth C

    2015-01-01

    Surgical site infections are a potentially preventable patient harm. Emerging evidence suggests that the implementation of evidence-based process measures for infection reduction is highly variable. The purpose of this work was to develop an auditing tool to assess compliance with infection-related process measures and establish a system for identifying and addressing defects in measure implementation. This was a retrospective cohort study using electronic medical records. We used the auditing tool to assess compliance with 10 process measures in a sample of colorectal surgery patients with and without postoperative infections at an academic medical center (January 2012 to March 2013). We investigated 59 patients with surgical site infections and 49 patients without surgical site infections. First, overall compliance rates for the 10 process measures were compared between patients with infection vs patients without infection to assess if compliance was lower among patients with surgical site infections. Then, because of the burden of data collection, the tool was used exclusively to evaluate quarterly compliance rates among patients with infection. The results were reviewed, and the key factors contributing to noncompliance were identified and addressed. Ninety percent of process measures had lower compliance rates among patients with infection. Detailed review of infection cases identified many defects that improved following the implementation of system-level changes: correct cefotetan redosing (education of anesthesia personnel), temperature at surgical incision >36.0°C (flags used to identify patients for preoperative warming), and the use of preoperative mechanical bowel preparation with oral antibiotics (laxative solutions and antibiotics distributed in clinic before surgery). Quarterly compliance improved for 80% of process measures by the end of the study period. This study was conducted on a small surgical cohort within a select subspecialty. The

  2. Prevention and Therapeutic Effects and Mechanisms of Tanshinone IIA Sodium Sulfonate on Acute Liver Injury Mice Model

    Directory of Open Access Journals (Sweden)

    Lunjie Lu

    2016-01-01

    Full Text Available Tanshinone IIA sodium sulfonate (TSS is a water-soluble derivative of tanshinone IIA, which is the main pharmacologically active component of Salvia miltiorrhiza. This study aimed to verify the preventive and therapeutic effects of TSS and its combined therapeutic effects with magnesium isoglycyrrhizinate (MI in D-galactosamine- (D-Gal- induced acute liver injury (ALI in mice. The potential regulatory mechanisms of TSS on ALI were also examined. Our results may provide a basis for the development of novel therapeutics for ALI.

  3. n-3 Fatty acids combined with flavan-3-ols prevent steatosis and liver injury in a murine model of NAFLD.

    Science.gov (United States)

    Vauzour, David; Rodriguez-Ramiro, Ildefonso; Rushbrook, Simon; Ipharraguerre, Ignacio R; Bevan, Damon; Davies, Susan; Tejera, Noemi; Mena, Pedro; de Pascual-Teresa, Sonia; Del Rio, Daniele; Gavrilovic, Jelena; Minihane, Anne Marie

    2018-01-01

    Non-alcoholic fatty liver disease (NAFLD) affects 25% of adults and at present no licensed medication has been approved. Despite its complex patho-physiology, dietary strategies aiming at delaying or preventing NAFLD have taken a reductionist approach, examining the impact of single components. Accumulating evidence suggests that n-3 LC-PUFAs are efficacious in regulating lipogenesis and fatty acid oxidation. In addition, plant derived flavonoids are also emerging as a dietary strategy for NAFLD prevention, with efficacy attributed to their insulin sensitising and indirect antioxidant effects. Based on knowledge of their complementary molecular targets, we aimed to demonstrate that the combination of n-3 LC-PUFA (n-3) and flavan-3-ols (FLAV) prevents NAFLD. In a high-fat high-fructose (HF/HFr) fed C57Bl/6J mouse model, the independent and interactive impact of n-3 and FLAV on histologically defined NAFLD, insulin sensitivity, weight gain, intestinal and hepatic gene expression, intestinal bile acids were examined. Only the combination of FLAV and n-3 (FLAVn-3) prevented steatosis as evidenced by a strong reduction in hepatocyte ballooning. While FLAV reduced body (-28-30%), adipose tissue (-45-50%) weights and serum insulin (-22-25%) as observed following an intra-peritoneal glucose tolerance test, n-3 downregulated the expression of Srebf1 and the lipogenic genes (Acaca, Fasn). Significant impacts of interventions on intestinal bile acid metabolism, farnesoid X receptor (Fxr) signalling in the intestine and liver, and hepatic expression of fatty acid transporters (Fabp4, Vldlr, Cd36) were also evident. FLAVn-3 may be a novel intervention for NAFLD. Future research should aim to demonstrate its efficacy in the prevention and treatment of human NAFLD. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. effect of hepatitis b virus co-infection on cd4 cell count and liver

    African Journals Online (AJOL)

    2015-03-01

    Mar 1, 2015 ... total Protein, and liver enzymes were determined using standard ... The mean serum ALT, AST and ALP of mono ... HIV positivity was diagnosed by positive reactions to ..... the colorimetric Biuret method of protein determi.

  5. Preventive effects of indole-3-carbinol against alcohol-induced liver injury in mice via antioxidant, anti-inflammatory, and anti-apoptotic mechanisms: Role of gut-liver-adipose tissue axis.

    Science.gov (United States)

    Choi, Youngshim; Abdelmegeed, Mohamed A; Song, Byoung-Joon

    2018-05-01

    Indole-3-carbinol (I3C), found in Brassica family vegetables, exhibits antioxidant, anti-inflammatory, and anti-cancerous properties. Here, we aimed to evaluate the preventive effects of I3C against ethanol (EtOH)-induced liver injury and study the protective mechanism(s) by using the well-established chronic-plus-binge alcohol exposure model. The preventive effects of I3C were evaluated by conducting various histological, biochemical, and real-time PCR analyses in mouse liver, adipose tissue, and colon, since functional alterations of adipose tissue and intestine can also participate in promoting EtOH-induced liver damage. Daily treatment with I3C alleviated EtOH-induced liver injury and hepatocyte apoptosis, but not steatosis, by attenuating elevated oxidative stress, as evidenced by the decreased levels of hepatic lipid peroxidation, hydrogen peroxide, CYP2E1, NADPH-oxidase, and protein acetylation with maintenance of mitochondrial complex I, II, and III protein levels and activities. I3C also restored the hepatic antioxidant capacity by preventing EtOH-induced suppression of glutathione contents and mitochondrial aldehyde dehydrogenase-2 activity. I3C preventive effects were also achieved by attenuating the increased levels of hepatic proinflammatory cytokines, including IL1β, and neutrophil infiltration. I3C also attenuated EtOH-induced gut leakiness with decreased serum endotoxin levels through preventing EtOH-induced oxidative stress, apoptosis of enterocytes, and alteration of tight junction protein claudin-1. Furthermore, I3C alleviated adipose tissue inflammation and decreased free fatty acid release. Collectively, I3C prevented EtOH-induced liver injury via attenuating the damaging effect of ethanol on the gut-liver-adipose tissue axis. Therefore, I3C may also have a high potential for translational research in treating or preventing other types of hepatic injury associated with oxidative stress and inflammation. Copyright © 2017 Elsevier Inc. All

  6. Knowledge and beliefs of international travellers about the transmission and prevention of HIV infection.

    OpenAIRE

    Allard, R; Lambert, G

    1992-01-01

    OBJECTIVES: To measure the perceived risk of acquired immunodeficiency syndrome (AIDS) among international travellers, to measure their knowledge of the transmission and prevention of HIV infection abroad and to identify some of the determinants of this knowledge. DESIGN: Survey. SETTING: Travellers' immunization clinic providing mostly primary preventive care to international travellers. PARTICIPANTS: All clients aged 18 to 50 years seen at the clinic between Oct. 2 and Dec. 21, 1989, before...

  7. The antiviral drug tenofovir, an inhibitor of Pannexin-1-mediated ATP release, prevents liver and skin fibrosis by downregulating adenosine levels in the liver and skin.

    Directory of Open Access Journals (Sweden)

    Jessica L Feig

    Full Text Available Fibrosing diseases are a leading cause of morbidity and mortality worldwide and, therefore, there is a need for safe and effective antifibrotic therapies. Adenosine, generated extracellularly by the dephosphorylation of adenine nucleotides, ligates specific receptors which play a critical role in development of hepatic and dermal fibrosis. Results of recent clinical trials indicate that tenofovir, a widely used antiviral agent, reverses hepatic fibrosis/cirrhosis in patients with chronic hepatitis B infection. Belonging to the class of acyclic nucleoside phosphonates, tenofovir is an analogue of AMP. We tested the hypothesis that tenofovir has direct antifibrotic effects in vivo by interfering with adenosine pathways of fibrosis using two distinct models of adenosine and A2AR-mediated fibrosis.Thioacetamide (100mg/kg IP-treated mice were treated with vehicle, or tenofovir (75mg/kg, SubQ (n = 5-10. Bleomycin (0.25U, SubQ-treated mice were treated with vehicle or tenofovir (75mg/kg, IP (n = 5-10. Adenosine levels were determined by HPLC, and ATP release was quantitated as luciferase-dependent bioluminescence. Skin breaking strength was analysed and H&E and picrosirus red-stained slides were imaged. Pannexin-1expression was knocked down following retroviral-mediated expression of of Pannexin-1-specific or scrambled siRNA.Treatment of mice with tenofovir diminished adenosine release from the skin of bleomycin-treated mice and the liver of thioacetamide-treated mice, models of diffuse skin fibrosis and hepatic cirrhosis, respectively. More importantly, tenofovir treatment diminished skin and liver fibrosis in these models. Tenofovir diminished extracellular adenosine concentrations by inhibiting, in a dose-dependent fashion, cellular ATP release but not in cells lacking Pannexin-1.These studies suggest that tenofovir, a widely used antiviral agent, could be useful in the treatment of fibrosing diseases.

  8. Latent M. tuberculosis infection--pathogenesis, diagnosis, treatment and prevention strategies.

    Science.gov (United States)

    Druszczyńska, Magdalena; Kowalewicz-Kulbat, Magdalena; Fol, Marek; Włodarczyk, Marcin; Rudnicka, Wiesława

    2012-01-01

    One third of the earths population is infected with Mycobacterium tuberculosis (Mtb), but only 5-10% of the infected individuals develop active tuberculosis (TB) over their lifetime. The remaining 90-95% stay healthy and are called latently infected individuals. They are the biggest reservoir of the tubercle bacilli and identifying the cases of latent TB is a part of the global plan of TB control. From the clinical point of view detection of latent TB infections (LTBI) in individuals with the highest active TB risk including cases of HIV infection, autoimmune inflammatory diseases or cancer, is a priority. This review summarizes the recent findings in the pathogenesis of latent TB, its diagnosis, treatment and prevention.

  9. An image-guided tool to prevent hospital acquired infections

    Science.gov (United States)

    Nagy, Melinda; Szilágyi, László; Lehotsky, Ákos; Haidegger, Tamás; Benyó, Balázs

    2011-03-01

    Hospital Acquired Infections (HAI) represent the fourth leading cause of death in the United States, and claims hundreds of thousands of lives annually in the rest of the world. This paper presents a novel low-cost mobile device|called Stery-Hand|that helps to avoid HAI by improving hand hygiene control through providing an objective evaluation of the quality of hand washing. The use of the system is intuitive: having performed hand washing with a soap mixed with UV re ective powder, the skin appears brighter in UV illumination on the disinfected surfaces. Washed hands are inserted into the Stery-Hand box, where a digital image is taken under UV lighting. Automated image processing algorithms are employed in three steps to evaluate the quality of hand washing. First, the contour of the hand is extracted in order to distinguish the hand from the background. Next, a semi-supervised clustering algorithm classies the pixels of the hand into three groups, corresponding to clean, partially clean and dirty areas. The clustering algorithm is derived from the histogram-based quick fuzzy c-means approach, using a priori information extracted from reference images, evaluated by experts. Finally, the identied areas are adjusted to suppress shading eects, and quantied in order to give a verdict on hand disinfection quality. The proposed methodology was validated through tests using hundreds of images recorded in our laboratory. The proposed system was found robust and accurate, producing correct estimation for over 98% of the test cases. Stery-Hand may be employed in general practice, and it may also serve educational purposes.

  10. HBsAg-redirected T cells exhibit antiviral activity in HBV-infected human liver chimeric mice.

    Science.gov (United States)

    Kruse, Robert L; Shum, Thomas; Tashiro, Haruko; Barzi, Mercedes; Yi, Zhongzhen; Whitten-Bauer, Christina; Legras, Xavier; Bissig-Choisat, Beatrice; Garaigorta, Urtzi; Gottschalk, Stephen; Bissig, Karl-Dimiter

    2018-04-06

    Chronic hepatitis B virus (HBV) infection remains incurable. Although HBsAg-specific chimeric antigen receptor (HBsAg-CAR) T cells have been generated, they have not been tested in animal models with authentic HBV infection. We generated a novel CAR targeting HBsAg and evaluated its ability to recognize HBV+ cell lines and HBsAg particles in vitro. In vivo, we tested whether human HBsAg-CAR T cells would have efficacy against HBV-infected hepatocytes in human liver chimeric mice. HBsAg-CAR T cells recognized HBV-positive cell lines and HBsAg particles in vitro as judged by cytokine production. However, HBsAg-CAR T cells did not kill HBV-positive cell lines in cytotoxicity assays. Adoptive transfer of HBsAg-CAR T cells into HBV-infected humanized mice resulted in accumulation within the liver and a significant decrease in plasma HBsAg and HBV-DNA levels compared with control mice. Notably, the fraction of HBV core-positive hepatocytes among total human hepatocytes was greatly reduced after HBsAg-CAR T cell treatment, pointing to noncytopathic viral clearance. In agreement, changes in surrogate human plasma albumin levels were not significantly different between treatment and control groups. HBsAg-CAR T cells have anti-HBV activity in an authentic preclinical HBV infection model. Our results warrant further preclinical exploration of HBsAg-CAR T cells as immunotherapy for HBV. Copyright © 2018 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

  11. Prevention and management of brain edema in patients with acute liver failure

    DEFF Research Database (Denmark)

    Wendon, J.; Larsen, Finn Stolze

    2008-01-01

    1. Intracranial pressure is the pressure exerted by the cranial contents on the dural envelope and consists of the partial pressures of the brain, blood, and cerebrospinal fluid. 2. Severe cases of acute liver failure are frequently complicated by brain edema (due to cytotoxic edema...

  12. Infection prevention and control measures for acute respiratory infections in healthcare settings: an update.

    Science.gov (United States)

    Seto, W H; Conly, J M; Pessoa-Silva, C L; Malik, M; Eremin, S

    2013-01-01

    Viruses account for the majority of the acute respiratory tract infections (ARIs) globally with a mortality exceeding 4 million deaths per year. The most commonly encountered viruses, in order of frequency, include influenza, respiratory syncytial virus, parainfluenza and adenovirus. Current evidence suggests that the major mode of transmission of ARls is through large droplets, but transmission through contact (including hand contamination with subsequent self-inoculation) and infectious respiratory aerosols of various sizes and at short range (coined as "opportunistic" airborne transmission) may also occur for some pathogens. Opportunistic airborne transmission may occur when conducting highrisk aerosol generating procedures and airborne precautions will be required in this setting. General infection control measures effective for all respiratory viral infections are reviewed and followed by discussion on some of the common viruses, including severe acute respiratory syndrome (SARS) coronavirus and the recently discovered novel coronavirus.

  13. A multicenter qualitative study on preventing hospital-acquired urinary tract infection in US hospitals.

    Science.gov (United States)

    Saint, Sanjay; Kowalski, Christine P; Forman, Jane; Damschroder, Laura; Hofer, Timothy P; Kaufman, Samuel R; Creswell, John W; Krein, Sarah L

    2008-04-01

    Although urinary tract infection (UTI) is the most common hospital-acquired infection, there is little information about why hospitals use or do not use a range of available preventive practices. We thus conducted a multicenter study to understand better how US hospitals approach the prevention of hospital-acquired UTI. This research is part of a larger study employing both quantitative and qualitative methods. The qualitative phase consisted of 38 semistructured phone interviews with key personnel at 14 purposefully sampled US hospitals and 39 in-person interviews at 5 of those 14 hospitals, to identify recurrent and unifying themes that characterize how hospitals have addressed hospital-acquired UTI. Four recurrent themes emerged from our study data. First, although preventing hospital-acquired UTI was a low priority for most hospitals, there was substantial recognition of the value of early removal of a urinary catheter for patients. Second, those hospitals that made UTI prevention a high priority also focused on noninfectious complications and had committed advocates, or "champions," who facilitated prevention activities. Third, hospital-specific pilot studies were important in deciding whether or not to use devices such as antimicrobial-impregnated catheters. Finally, external forces, such as public reporting, influenced UTI surveillance and infection prevention activities. Clinicians and policy makers can use our findings to develop initiatives that, for example, use a champion to promote the removal of unnecessary urinary catheters or exploit external forces, such public reporting, to enhance patient safety.

  14. Prevalence of endoparasitic infection in children and its relation with cholera prevention efforts in Mexico.

    Science.gov (United States)

    Faulkner, Charles T; Garcia, Benito Borrego; Logan, Michael H; New, John C; Patton, Sharon

    2003-07-01

    To investigate whether increased knowledge and use of public health measures promoted for cholera prevention is reflected in lower prevalence of parasitic infection in households in a community in the state of Tamaulipas, Mexico, that is close to the border with the United States of America. Between 1994 and 1997, fecal samples from 438 children were collected through convenience sampling and then examined for helminth eggs/larvae and protozoan cysts as biologic indicators of household compliance with recommended cholera prevention measures. The suggested measures were to wash hands before meals and after defecation, to drink purified water, to wash fruits and vegetables, and to eat well-cooked food. In addition, information on the knowledge of and the use of cholera preventive measures was collected by interviews with adult informants in 252 households (186 of those households also provided a fecal sample for analysis). Parasitic infections occurred in 131 of the 438 children (30%), who resided in 79 of the 186 households (42%) that provided fecal samples. Giardia lamblia accounted for 12.5% of all infections. Infections with Hymenolepis nana, Ascaris lumbricoides, Trichuris trichiura, Enterobius vermicularis, Ancylostoma/Necator, Strongyloides stercoralis, Entamoeba coli, Entamoeba hartmanni, Entamoeba histolytica, Endolimax nana, and Iodamoeba bütschlii were also noted. Infected children were older and more often had an infected sibling. Households with three or more children were also more likely to have an infected child. The primary caregivers in the households where at least one child had a parasitic infection were distinguished by their inability to list at least three cholera prevention measures from memory. The 42% household prevalence of parasitic infection was relatively high and indicates that some residents of this community may not have fully embraced the public health education efforts promoted for prevention of cholera. The occurrence of

  15. Prevalence of endoparasitic infection in children and its relation with cholera prevention efforts in Mexico

    Directory of Open Access Journals (Sweden)

    Charles T. Faulkner

    2003-07-01

    Full Text Available OBJECTIVE: To investigate whether increased knowledge and use of public health measures promoted for cholera prevention is reflected in lower prevalence of parasitic infection in households in a community in the state of Tamaulipas, Mexico, that is close to the border with the United States of America. METHODS: Between 1994 and 1997, fecal samples from 438 children were collected through convenience sampling and then examined for helminth eggs/larvae and protozoan cysts as biologic indicators of household compliance with recommended cholera prevention measures. The suggested measures were to wash hands before meals and after defecation, to drink purified water, to wash fruits and vegetables, and to eat well-cooked food. In addition, information on the knowledge of and the use of cholera preventive measures was collected by interviews with adult informants in 252 households (186 of those households also provided a fecal sample for analysis. RESULTS: Parasitic infections occurred in 131 of the 438 children (30%, who resided in 79 of the 186 households (42% that provided fecal samples. Giardia lamblia accounted for 12.5% of all infections. Infections with Hymenolepis nana, Ascaris lumbricoides, Trichuris trichiura, Enterobius vermicularis, Ancylostoma/Necator, Strongyloides stercoralis, Entamoeba coli, Entamoeba hartmanni, Entamoeba histolytica, Endolimax nana, and Iodamoeba bütschlii were also noted. Infected children were older and more often had an infected sibling. Households with three or more children were also more likely to have an infected child. The primary caregivers in the households where at least one child had a parasitic infection were distinguished by their inability to list at least three cholera prevention measures from memory. CONCLUSIONS: The 42% household prevalence of parasitic infection was relatively high and indicates that some residents of this community may not have fully embraced the public health education efforts

  16. Pediatric parenteral nutrition-associated liver disease and cholestasis: Novel advances in pathomechanisms-based prevention and treatment.

    Science.gov (United States)

    Orso, Giuseppe; Mandato, Claudia; Veropalumbo, Claudio; Cecchi, Nicola; Garzi, Alfredo; Vajro, Pietro

    2016-03-01

    Parenteral nutrition constitutes a life-saving therapeutic tool in patients unable to ingest/absorb oral or enteral delivered nutrients. Liver function tests abnormalities are a common therapy-related complication, thus configuring the so-called Parenteral Nutrition Associated Liver Disease (PNALD) or cholestasis (PNAC). Although the damage is frequently mild, and resolves after discontinuation of parenteral nutrition, in some cases it progresses into cirrhotic changes, especially in neonates and infants. We present a literature review focusing on the pathogenetic mechanisms-driven prevention and therapies for the cases where parenteral nutrition cannot be discontinued. Ursodeoxycholic acid has been proposed in patients with cholestatic hepatopathy, but its efficacy needs to be better established. Little evidence is available on efficacy of anti-oxidants, antibiotics, probiotics and anti TNFα. Lipid emulsions based on fish oil with a high content of long-chain polyunsaturated fatty acids ω-3 appear effective both in decreasing intrahepatic inflammation and in improving biliary flow. Most recent promising variations such as soybean/MCT/olive/fish oil emulsion [third generation lipid emulsion (SMOFlipid)] are under investigation. In conclusion, we remark the emergence of a number of novel pathomechanisms underlying the severe liver impairment damage (PNALD and PNAC) in patients treated with parenteral nutrition. Only few traditional and innovative therapeutic strategies have hitherto been shown promising. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  17. Morphological aspects of liver CT in patients with HIV infections. CT-morphologische Aspekte der Leber bei Patienten mit HIV-Infektion

    Energy Technology Data Exchange (ETDEWEB)

    Schedel, H [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Wicht, L [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Roegler, G [2. Medizinische Klinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Langer, R [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Felix, R [Strahlenklinik und Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany)

    1994-07-01

    CT examinations of the liver in HIV-infected patients show more frequent pathological findings. The extended spectrum of differential diagnosis and atypical manifestations of disorders in immunodeficient patients needs to be considered in the interpretation of CT scans. Difficulties in the differential diagnosis of focal hepatic lesions in HIV-infected patients are demonstrated in the following. Besides the relatively common findings in HIV-infection such as hepato- or hepatosplenomegalia, lymphoma, and inflammatory changes of the bowel an infection with Cryptococcus neoformans, hepatitis, and local steatosis of the liver are discussed as the rare causes for suspect computertomographic findings in the live of HIV-infected patients. The examinations were obtained consecutively in 76 HIV-infected patients during abdominal CT staging. (orig.)

  18. Prevalence of fascioliasis (liver flukes) infection in cattle and buffaloes slaughtered at the municipal abattoir of El-Kharga, Egypt

    Science.gov (United States)

    Elshraway, Nagwa T.; Mahmoud, Wafaa G.

    2017-01-01

    Aim: The main objectives of this study were to determine the prevalence of fascioliasis infections in cattle and buffaloes, slaughtered in El-Kharga city slaughterhouse at New Valley Governorate. Materials and Methods: The slaughtered animals were daily inspected for liver fascioliasis allover 2016. Macroscopic fascioliasis was detected from a total of 2251 basing on animals specie, sex, season, and Fasciola spp. in addition to microscopic examination of blood, fecal samples which collected from female cattle and buffalo (50 each). Results: The total prevalence rate of Fasciola sp. infection occurs in the study area were about 695/2251 (30.88%) from the total cattle and bovine slaughtered carcasses. The incidence of fascioliasis was 4/12 (33.33%) and 678/2200 (30.82%) for females and males cattle carcasses, respectively, while the infection rate in buffalo carcasses was 1/4 (25.00%) and 12/35 (34.29%) for females and males buffalo carcasses, respectively. Conclusion: The moderate fasciolosis infection in cattle and buffaloes slaughtered at the municipal abattoir of El-Kharga, Egypt. The highest fascioliasis infection was recorded during winter and autumn. It constitutes a major cause of economic losses at El-Kharga abattoir and threat public health. PMID:28919682

  19. Congenital cytomegalovirus infection in pregnancy: a review of prevalence, clinical features, diagnosis and prevention.

    Science.gov (United States)

    Naing, Zin W; Scott, Gillian M; Shand, Antonia; Hamilton, Stuart T; van Zuylen, Wendy J; Basha, James; Hall, Beverly; Craig, Maria E; Rawlinson, William D

    2016-02-01

    Human cytomegalovirus (CMV) is under-recognised, despite being the leading infectious cause of congenital malformation, affecting ~0.3% of Australian live births. Approximately 11% of infants born with congenital CMV infection are symptomatic, resulting in clinical manifestations, including jaundice, hepatosplenomegaly, petechiae, microcephaly, intrauterine growth restriction and death. Congenital CMV infection may cause severe long-term sequelae, including progressive sensorineural hearing loss and developmental delay in 40-58% of symptomatic neonates, and ~14% of initially asymptomatic infected neonates. Up to 50% of maternal CMV infections have nonspecific clinical manifestations, and most remain undetected unless specific serological testing is undertaken. The combination of serology tests for CMV-specific IgM, IgG and IgG avidity provide improved distinction between primary and secondary maternal infections. In pregnancies with confirmed primary maternal CMV infection, amniocentesis with CMV-PCR performed on amniotic fluid, undertaken after 21-22 weeks gestation, may determine whether maternofetal virus transmission has occurred. Ultrasound and, to a lesser extent, magnetic resonance imaging are valuable tools to assess fetal structural and growth abnormalities, although the absence of fetal abnormalities does not exclude fetal damage. Diagnosis of congenital CMV infection at birth or in the first 3 weeks of an infant's life is crucial, as this should prompt interventions for prevention of delayed-onset hearing loss and neurodevelopmental delay in affected infants. Prevention strategies should also target mothers because increased awareness and hygiene measures may reduce maternal infection. Recognition of the importance of CMV in pregnancy and in neonates is increasingly needed, particularly as therapeutic and preventive interventions expand for this serious problem. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  20. Measures Taken to Prevent Zika Virus Infection During Pregnancy - Puerto Rico, 2016.

    Science.gov (United States)

    D'Angelo, Denise V; Salvesen von Essen, Beatriz; Lamias, Mark J; Shulman, Holly; Hernandez-Virella, Wanda I; Taraporewalla, Aspy J; Vargas, Manuel I; Harrison, Leslie; Ellington, Sascha R; Soto, Leslianne; Williams, Tanya; Rodriguez, Aurea; Shapiro-Mendoza, Carrie K; Rivera, Brenda; Cox, Shanna; Pazol, Karen; Rice, Marion E; Dee, Deborah L; Romero, Lisa; Lathrop, Eva; Barfield, Wanda; Smith, Ruben A; Jamieson, Denise J; Honein, Margaret A; Deseda, Carmen; Warner, Lee

    2017-06-09

    Zika virus infection during pregnancy remains a serious health threat in Puerto Rico. Infection during pregnancy can cause microcephaly, brain abnormalities, and other severe birth defects (1). From January 1, 2016 through March 29, 2017, Puerto Rico reported approximately 3,300 pregnant women with laboratory evidence of possible Zika virus infection (2). There is currently no vaccine or intervention to prevent the adverse effects of Zika virus infection during pregnancy; therefore, prevention has been the focus of public health activities, especially for pregnant women (3). CDC and the Puerto Rico Department of Health analyzed data from the Pregnancy Risk Assessment Monitoring System Zika Postpartum Emergency Response (PRAMS-ZPER) survey conducted from August through December 2016 among Puerto Rico residents with a live birth. Most women (98.1%) reported using at least one measure to avoid mosquitos in their home environment. However, only 45.8% of women reported wearing mosquito repellent daily, and 11.5% reported wearing pants and shirts with long sleeves daily. Approximately one third (38.5%) reported abstaining from sex or using condoms consistently throughout pregnancy. Overall, 76.9% of women reported having been tested for Zika virus by their health care provider during the first or second trimester of pregnancy. These results can be used to assess and refine Zika virus infection prevention messaging and interventions for pregnant women and to reinforce measures to promote prenatal testing for Zika.