Combined immunoprophylaxis in the prevention of perinatal transmission of hepatitis B and hepatitis D virus infections in Saudi children.

The efficacy of the combined immunoprophylaxis approach (passive plus active immunization) was evaluated in babies born to 52 HBsAg-carrier Saudi mothers, of whom seven (13.5%) were HBeAg-positive and seven were anti-HDV-positive. Newborns were given 100 IU of hepatitis B immune globulin (HBIG) from the Hepuman Berna-Swiss Serum and Vaccine Institute, Berne, and hepatitis B vaccine (5 micrograms) within 12 hours of birth, and the vaccine was given again at 1 and 6 months of age (5 micrograms/injection). After 18 months of follow-up, all but one baby had protective levels of antibody to HBsAg and none of the babies born to anti-HDV-positive carrier mothers showed evidence of HDV infection. These results show that the combined immunoprophylaxis approach is quite successful in protecting against perinatal transmission of HBV and HDV in the Saudi population. Furthermore, early vaccination against HBV will also protect against HDV infection later in life.     

Evaluation of the antioxidant capacity of a milk protein matrix in vitro and in vivo in women aged 50–70 years

Bovine milk proteins have emerged as a novel, dairy-based source of dietary antioxidants and a component of a nutritional strategy to maintain muscle mass during ageing. The aim of this study was to characterise the in vitro antioxidant capacity (AOC) of a milk-based protein matrix (MPM) before and after simulated gastrointestinal digestion (SGID) and determine whether plasma AOC was similarly modified in vivo following acute ingestion of the MPM in healthy 50–70 years old women. To achieve this, the AOC of the MPM was measured by the oxygen radical absorbance capacity (ORAC) assay prior to and following SGID. In parallel, plasma obtained from women prior to and for 3?h following ingestion of the MPM was analysed ex vivo for change in AOC to evaluate the translation in vivo. SGID of the MPM increased AOC by ～35% (27,365?±?2152 versus 42,592?±?2299?μmol TE/100?g dw; p?ex vivo, ingestion of the MPM increased fasting plasma AOC by ～23% (10,952?±?751 to 13,519?±?800?μmol TE/L; p?in vitro and the change in plasma AOC following ingestion of the MPM sampled ex vivo from healthy elderly women.     

Is Radical Surgery Feasible in Liver Hydatid Cysts in Contact with the Inferior Vena Cava?

Background

Cysts in contact with the inferior vena cava (IVC) represent a challenge for hepato-pancreatico-biliary surgeons. Although the literature on the topic is scarce, the most widely accepted approach is conservative surgery. Partial cyst resection is recommended, because radical resection is considered a high-risk procedure.

Study design

This was a retrospective study over the period January 2007–December 2012. We operated on 103 patients with liver hydatidosis. A total of 32 patients (31 %) had a liver cyst in contact with the IVC. We proposed a cyst classification based on location of the cyst and length of contact and degrees of involvement of the IVC.

Results

Median size of the contacting cyst measured by computed tomography (CT) was 12 cm. On CT, median length of contact with the IVC was 37 mm. The median degree of involvement was 90°. Radical surgery was performed in 20 patients (62.5 %). No IVC resection was done. Morbidity rate was 28 %, and mortality was 3 %. In follow-up (median 27 months), no relapses or problems related to IVC flow were detected. Postoperative stay and transfusion rate were higher in the conservative surgery group, but these patients presented fewer complications. There was no relationship between circumferential grades and length of contact with the IVC and the type of surgery performed.

Conclusions

Liver hydatid cysts in contact with the IVC are large cysts usually located in the right liver. They do not normally cause clinical symptoms related to IVC contact. Radical surgery is feasible, and was performed in 60 % of our series, but it is technically demanding. We propose a classification of cysts in contact with the IVC.