Characteristics of patients with chronic hepatitis-B virus infection in an urban hospital

BACKGROUND: In the United States, among patients with hepatocellular carcinoma (HCC) and portal hypertension from chronic hepatitis-B virus infection, 44% were Hispanic and 28% were African American. Because our institution (Bronx Lebanon Hospital Center, Bronx, NY) predominantly serves these populations, we studied retrospectively the characteristics of patients with chronic hepatitis-B virus infection. METHODS: We reviewed the medical records of all patients aged > 18 years with chronic hepatitis-B virus infection who had been evaluated at our institution between January 1, 2002 and May 31, 2005. RESULTS: We identified 167 patients with chronic hepatitis-B virus infection. Only 12 (7%) patients underwent chronic hepatitis-B virus treatment. One-hundred-forty-six (87%) patients without decompensated liver cirrhosis were not treated owing to the following reasons: normal alanine aminotransferase level (86%), active injection drug or heavy alcohol use (9%), lack of health insurance coverage (3%) and noncompliance with visits during the evaluation period (2%). HCC screening was performed in 78 patients (47%). Lack of insurance coverage and compliance issues were predictors for HCC screening (p = 0.04 and p < 0.001, respectively). CONCLUSIONS: In the South Bronx, 87% patients were not considered candidates for hepatitis-B virus treatment because of normal alanine aminotransferase levels and the interference of potentially modifiable social factors. Only 47% of our patients with chronic hepatitis-B virus infection underwent HCC screening because of lack of insurance coverage and compliance issues.     

Endocan: A novel circulating proteoglycan

Endocan is a novel endothelium derived soluble dermatan sulfate proteoglycan. It has the property of binding to a wide range of bioactive molecules associated with cellular signaling and adhesion and thus regulating proliferation, differentiation, migration, and adhesion of different cell types in health and disease. An increase in tissue expression or serum level of endocan reflects endothelial activation and neovascularization which are prominent pathophysiological changes associated with inflammation and tumor progression. Consequently, endocan has been used as a blood-based and tissue-based biomarker for various cancers and inflammation and has shown promising results.KEY WORDS: Cancer, endocan, endothelial cell-specific molecule, proteoglycan     

Outcomes of junctional ectopic tachycardia ablation in adult population—a multicenter experience

Purpose

Idiopathic junctional ectopic tachycardia (JET) is typically refractory to antiarrhythmic agents. Catheter ablation for JET is feasible but is associated with high risk of unintended atrioventricular (AV) block. There is limited data on the appropriate procedural technique and clinical outcomes with catheter ablation for idiopathic JET in adults.

Methods

This is a multicenter, retrospective study of all adult patients (age?≥?18 years) who underwent catheter ablation for idiopathic JET. Patient, procedural characteristics, and long-term outcomes were evaluated.

Results

Fifteen patients [radiofrequency ablation (RF)?=?14 and cryoablation?=?1) were treated with catheter ablation. The median age was 58 years with 67% males. All patients underwent mapping of the right atrium and the aortic cusps prior to energy delivery. The location of earliest activation in relation to the atrioventricular (AV) node was postero-superior in 73% (11/15), posterior in 13% (2/15), and superior in 13% (2/15) respectively. Acute success was 100%. Arrhythmia recurrence occurred in 53% (8/15) all of whom underwent a repeat ablation. High-grade AV block requiring permanent pacemaker occurred in 20% (3/15). At 12-month follow-up in the redo-ablation group, 37.5% (3/8) had recurrence of the arrhythmia two of which underwent a third ablation procedure.

Conclusion

Catheter ablation of idiopathic JET in adults is associated with a high rate of recurrence requiring multiple procedures and high risk of AV block requiring a permanent pacemaker. Mapping and ablation of the non-coronary cusp can be considered as the arrhythmia was controlled in 3 patients with no inadvertent AV block.

     

Activity of Galidesivir in a Hamster Model of SARS-CoV-2

Coronavirus disease 2019 (COVID-19) has claimed the lives of millions of people worldwide since it first emerged. The impact of the COVID-19 pandemic on public health and the global economy has highlighted the medical need for the development of broadly acting interventions against emerging viral threats. Galidesivir is a broad-spectrum antiviral compound with demonstrated in vitro and in vivo efficacy against several RNA viruses of public health concern, including those causing yellow fever, Ebola, Marburg, and Rift Valley fever. In vitro studies have shown that the antiviral activity of galidesivir also extends to coronaviruses. Herein, we describe the efficacy of galidesivir in the Syrian golden hamster model of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Treatment with galidesivir reduced lung pathology in infected animals compared with untreated controls when treatment was initiated 24 h prior to infection. These results add to the evidence of the applicability of galidesivir as a potential medical intervention for a range of acute viral illnesses, including coronaviruses.