Impulsiveness in chronic hepatitis C patients

Objective

The objective was to investigate impulsiveness among chronic hepatitis C (CHC) patients and its association with sociodemographic, clinical and psychopathological factors.

Method

Ninety-one CHC individuals were enrolled in a cross-sectional study at a Brazilian public university-based outpatient’s service for infectious diseases. They were assessed using the Barrat Impulsiveness Scale, Brief Fatigue Inventory, Beck Depression Inventory and Hamilton Anxiety Scale. Structured psychiatric interview was performed according to the Mini International Neuropsychiatric Interview. Multivariate analysis was performed according to linear stepwise forward regression.

Results

The total score of impulsiveness according to BIS in studied population was 64.6±9.8. The scores for the nonplanning, cognitive–attentional and motor domains were 23.8±5, 19.4±2.9 and 21.4±5, respectively. Impulsiveness was associated with lower educational level, current interferon-α (IFN) use, attention-deficit/hyperactivity disorder, alcohol use disorder, mixed anxiety and depressive disorder, specific phobia, bipolar spectrum disorders and anxiety symptoms. During IFN treatment, impulsiveness was also associated with suicide risk.

Conclusion

Impulsiveness was frequent in CHC patients and was associated with several psychopathological alterations. Impulsiveness management should be considered when attending CHC patients.     

ROLE of exercise in maintaining the integrity of the neuromuscular junction

Physical activity plays an important role in preventing chronic disease in adults and the elderly. Exercise has beneficial effects on the nervous system, including at the neuromuscular junction (NMJ). Exercise causes hypertrophy of NMJs and improves recovery from peripheral nerve injuries, whereas decreased physical activity causes degenerative changes in NMJs. Recent studies have begun to elucidate molecular mechanisms underlying the beneficial effects of exercise. These mechanisms involve Bassoon, neuregulin‐1, peroxisome proliferator–activated receptor gamma coactivator 1α, insulin‐like growth factor‐1, glial cell line–derived neurotrophic factor, neurotrophin 4, Homer, and nuclear factor of activated T cells c1. For example, NMJ denervation and active zone decreases have been observed in aged NMJs, but these age‐dependent degenerative changes can be ameliorated by exercise. In this review we assess the effects of exercise on the maintenance and regeneration of NMJs and highlight recent insights into the molecular mechanisms underlying these exercise effects. Muscle Nerve 49 :315–324, 2014     

局限性肾癌的外科治疗进展

在过去三十年,随着横断面影像学的发展及在临床上的应用增多,使偶然发现的肾肿块数量不断增加,导致无症状、局限性、肾小肿块发生率随之升高。对于临床上发现的局限性肾癌,长期以来根治性肾切除一直是传统治疗的"金标准",但随着早期肾癌检出率的增高以及许多新技术和新观念的出现,应该对肾癌的治疗方式进行重新评估。     

还原型谷胱甘肽辅助治疗慢性乙型肝炎肝纤维化的临床分析

目的：评价还原型谷胱甘肽辅助治疗慢性乙型肝炎肝纤维化的临床疗效。方法慢性乙型肝炎肝纤维化患者120例根据入院顺序分为治疗组与对照组各60例,两组都给予常规药物治疗,对照组给予苦参碱治疗,治疗组给予还原型谷胱甘肽片治疗,疗程1个月。结果治疗组的有效率为96.7%,对照组的有效率为80.0%,治疗组的有效率明显高于对照组（P＜0.05）。两组治疗前的血清ALT与AST含量对比差异无统计学意义,治疗后上述值都明显下降,与治疗前对比差异明显（P＜0.05）,同时组间对比差异也有统计学意义（P＜0.05）。结论还原型谷胱甘肽辅助治疗慢性乙型肝炎肝纤维化能有效提高治疗疗效,改善预后肝功能,值得推广应用。     

The link between genetic variation and variability in vaccine responses: Systematic review and meta-analyses

Although immune response to vaccines can be influenced by several parameters, human genetic variations are thought to strongly influence the variability in vaccine responsiveness. Systematic reviews and meta-analyses are needed to clarify the genetic contribution to this variability, which may affect the efficacy of existing vaccines. We performed a systematic literature search to identify all studies describing the associations of allelic variants or single nucleotide polymorphisms in immune response genes with vaccine responses until July 2013. The studies fulfilling inclusion criteria were meta-analyzed.     

不同程度肝纤维化患者基质细胞衍生因子-1α水平对肝脏储备能力的影响

目的分析不同程度肝纤维化患者基质细胞衍生因子-1α水平对肝脏储备能力的影响。方法选择慢性乙型肝炎患者206例,根据肝纤维化程度分为轻度组、中度组、重度组及肝硬化组,分别有61、60、45、40例,分别检测SDF-1α、ICGR15、PA等肝储备功能相关指标。结果中度组SDF-1α及ICGR15较轻度组显著下降(P0.05),重度组SDF-1α及ICGR15较轻度组、中度组均有显著下降(P0.05),肝硬化组SDF-1α及ICGR15较其余3组均有显著下降(P0.05)。中度组较轻度组PA、ALT、AST、CHE均有显著性差异(P0.05),重度组PA、ALT、AST、CHE较轻度组及中度组均有显著性差异(P0.05),肝硬化组PA、CHE较其余3组均有显著差异(P0.05),ALT、AST较轻度组及重度组显著升高(P0.05)。SDF-1α与ICGR15、PA呈显著正相关(P0.05),与CHE呈显著负相关(P0.05)。结论 SDF-1α与慢性乙肝患者肝脏储备能力密切相关,肝脏再生与修复能力可能是导致储备能力下降的重要因素。     

Epidemiological Investigation of the Jaundice Outbreak in Lalkuan,Nainital District,Uttarakhand

Background:

In March 2013, cases of acute hepatitis were reported from Lalkuan, Nainital district. We investigated the outbreak to identify the source of infection and to facilitate control measures.

Objectives:

To study the distribution of hepatitis cases, to find the source of infection, and to initiate the control measures in the affected area.

Materials and Methods:

We defined a case of acute hepatitis as those cases that had jaundice with at least one of the following symptoms: Dark urine, fever, pain in abdomen, vomiting, and loss of appetite in the affected area between January and March 2013. Door-to-door survey was carried out. Thirteen blood samples were randomly collected from jaundice cases for immunoglobulin M (IgM) antibody for hepatitis A virus (HAV) and hepatitis E virus (HEV). Water samples were collected to test residual chlorine.

Results:

Total 2,785 individuals were surveyed; of which 240 were suffering from acute viral hepatitis (attack rate (AR) = 8.61%). Out of 13 serum samples, 10 were found positive for HEV IgM antibodies and three cases had IgM antibodies for both HAV and HEV, which confirmed a hepatitis E outbreak. The difference in attack rate of hepatitis of both the sexes was statistically significant (P < 0.001). The attack rate was significantly higher in age groups >12 years of age (P < 0.001). Environmental investigation also confirmed the sewage contamination of drinking water in the distribution system. The attack rate was much higher (29.4%) among those who were exposed to the leaking pipeline than the nonexposed (χ² = 574.26, P < 0.01).

Conclusion:

HEV was confirmed as the major etiological agent in this outbreak that was transmitted by contaminated drinking water. The recognition of early warning signals, timely investigation, and application of specific control measures can contain the outbreak.     

公众对“疑似乙肝疫苗致死事件”知晓情况及对调查结果信任度的调查分析

目的 为了解公众对“疑似乙肝疫苗致死事件”知晓情况及对调查结果的信任状况,分析其知晓率、知晓途径以及对调查结果信任度的人口社会学特征,为采取有针对性的干预措施、快速提振公众信心提供依据.方法 调查人员以进单位或入户的形式,现场发放调查问卷,调查对象在知情自愿的情况下匿名自主答卷以获取相关信息.结果 调查对象对“疑似乙肝疫苗事件”的知晓率、知晓途径和对调查结果的信任度因人口社会学特征不同而存在差异：事件知晓率基本上随调查对象居住地级别和受教育程度的提高而上升,有医学知识背景的调查对象的知晓率高于其他职业,工作人员的知晓率普遍高于非工作人员,农民、学生和家中待业者知晓率最低;知晓途径以电视最多,占53.53％,其次是网络,占23.56％;同意“接种的乙肝疫苗是合格的”及“死亡与接种疫苗无关”的调查对象分别占53.80％和48.82％,不同意者分别占12.58％和20.17％,半信半疑者分别占33.62％和31.00％;同意及不同意调查结果的调查对象比例基本上随居住地级别的上升而下降,而半信半疑则相反;有医学知识背景的调查对象职业高于其他职业;预防接种人员对两项调查结果的同意率分别为59.92％和55.64％,同意“接种乙肝疫苗是合格”者随着受教育程度的提高而明显上升,但大专和本科及以上文化程度同意“死亡与接种疫苗无关”者的比例又有所下降.结论 公众对调查结果的低信任度,一时之间难以改变其对接种疫苗的恐惧和担心,也必然导致接种率的下降从而影响传染病防控成果.结合调查对象对事件知晓的人口社会学特征,卫生、媒体及相关行业人员急需在有利政策的保障下共同努力,采取科学的干预措施,快速提振公众信心,以便尽快减小事件造成的不良影响,巩固、促进来之不易的成果.