Antibodies to hepatitis E virus among several populations in Greece: increased prevalence in an hemodialysis unit

BACKGROUND: Hepatitis E virus (HEV) has been found to be the causative agent of enterically transmitted non-A, non-B hepatitis in tropical and subtropical countries. Several investigators, however, have indicated that HEV could be endemic in Europe, albeit at a low prevalence. STUDY DESIGN AND METHODS: The purpose of this study was to estimate the prevalence of anti-HEV in various populations in northwestern Greece (Epirus region). Healthy blood donors (2636), refugees from southern Albania (350), children (165), injecting drug users (IDUs) (65), multiply transfused patients (62), patients with chronic viral hepatitis (75), and chronic hemodialysis patients (149) were investigated for anti-HEV by enzyme immunoassay and confirmatory Western blot assay. In addition, 380 consecutive healthy blood donors and 62 hemodialysis patients from a neighboring area (Agrinion, Greece) were investigated. RESULTS: A very low presence of anti-HEV antibody was found among healthy blood donors from Epirus (0.23%) and Agrinion (0.53%). Anti-HEV was not detected in children, IDUs, or multiply transfused patients. In contrast, a low but significant prevalence of anti-HEV was found among refugees (4.85%), patients with chronic viral hepatitis (5.3%), and hemodialysis patients from Epirus (1.34%), as compared with healthy blood donors from Epirus: p < 0.0001, p < 0.00001, and p < 0.10, respectively. A high prevalence (9.7%) of anti- HEV was revealed in patients at the hemodialysis unit of the General Hospital of Agrinion (p < 0.00005, compared to healthy blood donors from Agrinion). No significant association was found between anti-HEV positivity and the age or sex of donors, the duration of hemodialysis, positivity for hepatitis B or C virus infection markers, history of hepatitis, increased alanine aminotransferase, renal transplantation, a history of transfusion, or the number of units transfused. CONCLUSION: This study demonstrated a high prevalence of anti-HEV in a separate hemodialysis unit, without an association with the known routes of transmission of blood-borne viruses. This observation suggests that a still-undefined intra-unit factor or other factors are associated with HEV transmission.     

Effects of repetitive superficial chemical peels on facial sebum secretion in acne patients

BACKGROUND: Glycolic acid and Jessner's solution are popular superficial chemical peel agents for the treatment of facial acne, and increased sebum secretion is one of the major aetiological factors of acne. OBJECTIVE: To compare the effects of 30% glycolic acid peels and Jessner's solution peels on sebum secretion in facial acne patients. METHODS: Thirty-eight patients with mild to moderate facial acne were included. Twenty-seven patients were treated with 30% glycolic acid peels and 11 patients with Jessner's solution peels. Each peel was performed twice with an interval of 2 weeks. Before and 2 weeks after each peel, sebum levels of forehead, nose, chin and cheeks were measured by using a Sebumeter (SM810 Courage & Khazaka, Cologne, Germany). RESULTS: The sebum levels were not significantly changed by two peels treatments of 30% glycolic acid peels or Jessner's solution peels on the facial skins of patients with facial acne. CONCLUSIONS: The two types of peels, 30% glycolic acid peels and Jessner's solution peels, did not affect sebum secretion of the facial skins of patients with facial acne after the two peels treatments. The accumulative effects of more than two peels treatments using these modalities need further evaluation.     

人参中人参皂苷HPLC定量方法的测量不确定度的评定

目的探讨人参中人参皂苷R_g1，R_e和 R_b1的HPLC定量分析方法的测量不确定度的评定方法。方法通过分析测量过程，确定并简化不确定度来源；利用HPLC法测定人参中人参皂苷Rg1，Re和 Rb1的方法验证数据及经验数据，通过统计学方法，量化不确定度分量；计算合成不确定度和扩展不确定度。结果用HPLC法测定人参中人参皂苷Rg1，Re和 Rb1的扩展不确定度分别为0.12c，0.14c和0.13c。结论测量不确定度可用于人参中人参皂苷的标准限量的制定；测量不确定度的评定方法的确立对于中药质量标准的研究具有重要意义。     

Corneal volume measures for monitoring contact lens induced corneal swelling: a pilot study

Background: This study investigated the use of corneal volume to monitor the corneal swelling response induced by wearing high plus power contact lenses. Methods: Twelve young non‐contact lens wearers were recruited with one eye fitted with a soft contact lens (Polymacon material, 38.6 per cent water, Dk of 9 and 0.27 mm centre thickness) and the fellow eye served as control. The treated eye was patched for two hours leaving the control eye uncovered. Central corneal thickness (CCT) was measured with non‐contact specular microscopy and corneal volumes (at three, five and 10 mm zones) were measured with a corneal topographer (Pentacam, Oculus Inc, Germany), before eye patching as well as immediately after and every 20 minutes for 100 minutes. Results: Subjects had similar CCT and corneal volumes between the two eyes before treatment. The treatment eyes showed a mean corneal swelling of 8.1 per cent immediately after lens removal. Corneal volume was significantly increased at the three (mean swelling of 5.9 per cent), five (5.6 per cent) and 10 millimetre (3.3 per cent) zones. It took 20 minutes for the corneal volume at the 10 mm zone to return to baseline but required 60 minutes for the three and five millimetre zones to return to the baseline level. The central corneal thickness was still significantly thicker 80 minutes after patching. Conclusion: Corneal volume could be a useful parameter to monitor corneal change when an event affects the entire cornea. Corneal volume combined with central corneal thickness could give more comprehensive information to monitor central corneal swelling.     

创伤病人输注浓缩红细胞导致的高钾血症

研究表明病人输注细胞类制品,特别是浓缩红细胞(PRBC)和新鲜全血,将导致钾离子稳态的紊乱.在成人和儿童中,报道的低钾血症比高钾血症常见.我们所知的最大的回顾性研究是肝移植儿童,低钾血症的发生率为72%,高钾血症低于5%.     

Elective re‐intubation to treat complete left lung collapse following Tetralogy of Fallot repair in a very young child

An 18‐month‐old boy weighing 6 kilograms developed complete collapse of left lung following total correction of Tetralogy of Fallot on the next day of extubation. He received extensive chest physiotherapy, along with lung recruitment maneuver by using bubble CPAP, which failed to show any improvement in lung expansion in 2 days. He was then electively intubated on 3rd postoperative day (POD3) for the purpose of suctioning tracheobronchial secretions and maintaining positive airway pressure to open up the left lung. Good results were obtained immediately after intubation, and he was extubated 9 h later. His lung showed complete aeration afterward. He was transferred out of ICU on POD5 and discharged home on POD10.     

Xenotransplantation: A historical–ethical account of viewpoints

Formal clinical trials of pig-to-human organ transplant—known asxenotransplantation—may begin this decade, with the first trials likely to consist of either adult renal transplants or pediatric cardiac transplant patients. Xenotransplantation as a systematic scientific study only reaches back to the latter half of the 20th century, with episodic xenotransplantation events occurring prior to that. As the science of xenotransplantation has progressed in the 20th and 21st centuries, the public's knowledge of the potential therapy has also increased. With this, there have been shifting ethical stances toward xenotransplantation in key areas, such as religious and public viewpoints towards xenotransplantation, animal rights, and public health concerns. This review provides a historical–ethical account of xenotransplantation and details if or how viewpoints have shifted over time.     

Management of COVID-19 and vaccination in Nepal: A qualitative study

Objective

The aim of this research is to investigate the perspective of citizens of Nepal on the management COVID-19, the roll-out of the vaccine, and to gain an understanding of attitudes towards the governments' handling of the COVID-19 pandemic.

Method

A qualitative methodology was used. In-depth interviews were conducted with 18 males and 23 females aged between 20 and 86 years old from one remote and one urban district of Nepal. Interviews were conducted in November and December 2021. A thematic approach was used to analyse the data, utilising NVivo 12 data management software.

Result

Three major themes were identified: (1) Peoples' perspective on the management of COVID-19, (2) people's perception of the management of COVID-19 vaccination and (3) management and dissemination of information. It was found that most participants had heard of COVID-19 and its mitigation measures, however, the majority had limited understanding and knowledge about the disease. Most participants expressed their disappointment concerning poor testing, quarantine, vaccination campaigns and poor accountability from the government towards the management of COVID-19. Misinformation and stigma were reported as the major factors contributing to the spread of COVID-19. People's knowledge and understanding were mainly shaped by the quality of the information they received from various sources of communication and social media. This heavily influenced their response to the pandemic, the preventive measures they followed and their attitude towards vaccination.

Conclusion

Our study concludes that the study participants' perception was that testing, quarantine centres and vaccination campaigns were poorly managed in both urban and rural settings in Nepal. Since people's knowledge and understanding of COVID-19 are heavily influenced by the quality of information they receive, we suggest providing contextualised correct information through a trusted channel regarding the pandemic, its preventive measures and vaccination. This study recommends that the government proactively involve grassroots-level volunteers like Female Community Health Volunteers to effectively prepare for future pandemics.

Patient and Public Contribution

This study was based on in-depth interviews with 41 people from diverse socioeconomic backgrounds. This study would not have been possible without their participation.