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Patrick B Trotter, Dominic M Summers, Matthew Robb, William Hulme, Ines Ushiro-Lumb, Christopher J E Watson, James Neuberger, Andrew J Bradley
BACKGROUND: Deceased organ donors are routinely screened for behaviors that increase the risk of transmissible blood borne viral (BBV) infection, but the impact of this information on organ donation and transplant outcome is not well documented. Our aim was to establish the impact of such behavior on organ donation and utilization, as well transplant recipient outcomes. METHODS: We identified all UK deceased organ donors from 2003-2015 with a disclosed history of increased risk behavior (IRB) including intravenous drug use (IVDU), imprisonment and increased risk sexual behavior...
March 13, 2017: Transplantation
P McGettrick, B Ghavami-Kia, W Tinago, A Macken, J O'Halloran, J S Lambert, G Sheehan, P W G Mallon
BACKGROUND: The HIV Care Cascade model can be used to measure how clinical services align with United Nations' (UN) HIV treatment targets. Previous models have highlighted sequential losses at each step of the Cascade with a significant proportion being not retained in care (NRIC). OBJECTIVE: We aimed to assess the feasibility of meeting the UN targets and assess factors associated with, and calculate the true proportion of those, NRIC. METHODS: All people living with HIV who were linked to our service, one of three specialist HIV care providers in Dublin Ireland, from its establishment in 1993 to 1 December 2014, were included in the cohort and were categorized as linked to care, retained in care (RIC), on antiretroviral therapy (on ART), virally suppressed (HIV RNA <40copies/ml), and NRIC...
March 14, 2017: HIV Clinical Trials
Amrit Lamba, Meghan Kapp, Paisit Paueksakon, Parth J Parekh
This case of infective endocarditis masquerading as mixed cryoglobulinemia in a man with a history of intravenous drug use (IVDU) and hepatitis C virus (HCV) highlights the importance of maintaining a broad differential and continually re-evaluating the working diagnosis as new information presents itself. The patient presented to an outside hospital and was treated for presumptive mixed cryoglobulinemia with corticosteroid therapy. When the patient did not improve, he was transferred to a tertiary care center for possible Rituximab and/or plasmapheresis...
2017: IDCases
Claudia R Libertin, Ulas M Camsari, Walter C Hellinger, Terry D Schneekloth, Teresa A Rummans
We report a case of an intravenous drug user (IVDU) patient who had 4 episodes of endocarditis within a 2-year time period in rural Georgia. The institutional cost was approximately $380,000. The lack of an established transitional care plan for IVDUs to outpatient care is a common phenomenon at institutions. Guidelines are essential to optimize the quality of care rendered to IVDUs with such infections, to assist providers in utilizing limited resources, and to limit the cost to the institutions.
2017: IDCases
Pallavi D Annambhotla, Brian M Gurbaxani, Matthew J Kuehnert, Sridhar V Basavaraju
BACKGROUND: In 2013, guidelines were released for reducing the risk of viral bloodborne pathogen transmission through organ transplantation. Eleven criteria were described that result in a donor being designated at increased infectious risk. Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) transmission risk from an increased-risk donor (IRD), despite negative nucleic acid testing (NAT), likely varies based on behavior type and timing. METHODS: We developed a Monte Carlo risk model to quantify probability of HIV among IRDs...
February 8, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Zoran Bogdanović, Ivana Marinović-Terzić, Sendi Kuret, Ana Jerončić, Nikola Bradarić, Gea Forempoher, Ozren Polašek, Šimun Anđelinović, Janoš Terzić
BACKGROUND: Several genes and their single nucleotide polymorphisms (SNPs) are associated with either spontaneous resolution of hepatitis C infection or better treatment-induced viral clearance. We tested a cohort of intravenous drug users (IVDU) diagnosed with chronic hepatitis C virus (HCV) for treatment response and its association with the SNPs in the interleukin-6 (rs1800795-IL6) and the interleukin-28B (rs12979860-IL28B) genes. METHODS: The study included 110 Croatian IVDU positive for anti-HCV antibody...
2016: PeerJ
Sima Barmania, Syed Mohamed Aljunid
BACKGROUND: Malaysia is a multicultural society, predominantly composed of a Muslim majority population, where Islam is influential. Malaysia has a concentrated HIV epidemic amongst high risk groups, such as, Intravenous Drug Users (IVDU), sex workers, transgender women and Men who have sex with Men (MSM). The objective of this study is to understand how Islam shapes HIV prevention strategies in Malaysia by interviewing the three key stakeholder groups identified as being influential, namely the Ministry of Health, Religious leaders and People living with HIV...
2016: BMC Public Health
Bilal A Zahoor
Rhizobium radiobacter, a soil-based organism, is not, usually, pathogenic unless in the immunecompromised. Endocarditis, in the immunocompromised, is a typical presentation generally as a result of catheter-based infections. We describe the presentation of R. radiobacter prosthetic valve endocarditis and the inherent challenges in its presentation and diagnosis. A patient presented with acute limb ischemia secondary to R. radiobacter-mediated endocarditis and subsequent thromboembolization of the distal superior femoral and proximal popliteal arteries in the left lower limb...
August 2016: Annals of Vascular Surgery
J Kant, J Kratzsch, M Maier, U G Liebert, T Berg, J Wiegand
BACKGROUND: Elderly patients are under-represented in hepatitis B and C screening approaches, but may be at increased risk for advanced liver disease. We therefore screened a hospitalized elderly population. MATERIALS AND METHODS: 6011 admissions to the department of internal medicine and neurology within one year were screened for HBsAg and anti-HCV (Elecsys(®)-HBsAg and -anti-HCV). Positive anti-HCV results were confirmed with the INNO-LIA™ assay. HCV-RNA was analyzed by real-time PCR in the case of confirmed positive anti-HCV results, HBV-DNA in the confirmed HBsAg positive individuals...
March 2016: Zeitschrift Für Gastroenterologie
Maria Elena Tosti, Valeria Alfonsi, Eleonora Lacorte, Alfonso Mele, Cristina Galli, Alessandro Remo Zanetti, Luisa Romanò
BACKGROUND: Hepatitis B vaccination has proven to be very safe and highly effective. This study assessed the proportion of successfully vaccinated individuals among cases with acute hepatitis B, the proportion of preventable cases if individuals were vaccinated as recommended, and the reasons for failures. METHODS: We analyzed data reported to the Italian Surveillance System for Acute Viral Hepatitis from 1993 to 2014. RESULTS: A total of 362 of 11 311 (3...
June 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Ra Ri Cha, Sang Soo Lee, Chang Min Lee, Sung Bok Ji, Hee Cheul Jung, Hyun Chin Cho, Jin Joo Kim, Jae Min Lee, Hong Jun Kim, Chang Yoon Ha, Hyun Jin Kim, Tae-Hyo Kim, Woon Tae Jung, Ok-Jae Lee
Hepatitis C virus (HCV) genotype 3 infection is very rare in high-income Asia Pacific. The aim of our retrospective observational study was to evaluate the incidence, clinical features, and treatment outcomes of patients with a genotype 3 HCV infection in the Gyeongnam Province of Korea. Ninety-eight consecutive patients diagnosed with a genotype 3 HCV infection at Gyeongsang National University Hospital, between January 2005 and December 2014, were enrolled into the study. Relevant characteristics of the study group included: 80...
February 2016: Medicine (Baltimore)
Oliver N Lin, Christine Chang, Joyce Lee, Ailinh Do, Marina Martin, Andy Martin, Mindie H Nguyen
The World Health Organization estimates that 170 million persons are infected with HCV worldwide, but only 22 million are from the Americas and Europe, compared to 94 million from Asia. HCV prevalence in the general US population is 1.6 %, but data for Asian Americans are limited. Our goal was to examine HCV prevalence in Asian Americans in a large ethnically diverse patient cohort seeking primary care at a free clinic in Northern California. A total of 1347 consecutive patients were seen from September 2009 to October 2012 and were studied via individual chart review using case report forms...
February 2017: Journal of Immigrant and Minority Health
G Madeddu, A Spanu, P Solinas, S Babudieri, G M Calia, C Lovigu, M Mannazzu, S Nuvoli, B Piras, P Bagella, M S Mura, G Madeddu
OBJECTIVE: To evaluate the changes in Bone Mineral Density (BMD) and bone remodelling markers in a group of HIV patients treated with HAART and controlled in a long follow-up and to identify possible risk factors for accelerated bone mass loss. PATIENTS AND METHODS: In a series of 172 HIV patients treated with HAART a total of 67 patients (44 males and 33 females) underwent repeated bone mineral density measurement by DEXA in lumbar spine and in femur; the patients were classified according to T-score WHO criteria...
December 2015: European Review for Medical and Pharmacological Sciences
E Seminari, A De Silvestri, V Ravasio, S Ludovisi, R Utili, N Petrosillo, F Castelli, M Bassetti, F Barbaro, P Grossi, N Barzaghi, M Rizzi, L Minoli
Few data have been published regarding the epidemiology and outcome of infective endocarditis (IE) in patients with chronic hepatic disease (CHD). A retrospective analysis of the Studio Endocarditi Italiano (SEI) database was performed to evaluate the epidemiology and outcome of CHD+ patients compared with CHD- patients. The diagnosis of IE was defined in accordance with the modified Duke criteria. Echocardiography, diagnosis, and treatment procedures were in accordance with current clinical practice. Among the 1722 observed episodes of IE, 300 (17...
February 2016: European Journal of Clinical Microbiology & Infectious Diseases
Nabha Shetty, Dave Nagpal, Sharon Koivu, Marko Mrkobrada
BACKGROUND: Tricuspid valve (TV) infective endocarditis (IE) is a known complication of intravenous drug use (IVDU). This study assessed long-term outcomes of surgically and medically treated cases of TV IE. METHODS: This was a retrospective cohort study of all cases of native TV IE treated in London, Ontario between 2008 and 2011. Outcomes for medically and surgically managed cases were assessed at two years. Outcomes related to the timing of surgery were also assessed...
February 2016: Journal of Cardiac Surgery
Monica I Rap, Abraham Chacko
OBJECTIVES: We evaluated the clinical indication and incremental diagnostic yield gained by transoesophageal echocardiography (TOE) performed after transthoracic echocardiography (TTE) in patients with suspected infective endocarditis (IE). METHODS AND RESULTS: We retrospectively analysed 60 pairs of TOE and TTE exams for suspected IE, performed between July 2011 and July 2013 in our district general hospital. The TOE results were classified as 'positive' or'negative' based on the Duke criteria, while TTEs were classified as 'no vegetation', 'vegetation', 'suspected vegetation' and 'cannot exclude vegetation' according to the final reports...
August 2015: Acta Cardiologica
Daisy Torres-Miranda, Farah Al-Saffar, Saif Ibrahim, Stephanie Font-Diaz
This report describes a 64-years-old male patient that presented to our hospital with a chief complaint of acute worsening of his usual chronic lower back pain, progressive weakness in lower extremities and subjective fevers at home. Spine CT failed to demonstrate any infectious foci but showed partially visualized lung cavitary lesion and renal pole abnormalities. Blood cultures grew methicillin-sensitive Staphylococcus Aureus (MSSA). Transthoracic echocardiogram (TTE) showed no signs of infective endocarditis (IE)...
April 2015: Boletín de la Asociación Médica de Puerto Rico
Luis M Real, Rocío Herrero, Antonio Rivero-Juárez, Ángela Camacho, Juan Macías, Sandra Vic, Vincent Soriano, Sergio Viedma, Josep M Guardiola, Joan Fibla, Antonio Rivero, Juan A Pineda, Antonio Caruz
The interferon (IFN)L4 polymorphism rs368234815 is associated with hepatitis C virus (HCV) spontaneous clearance and response to IFN-based treatments. The role of this polymorphism in HIV-1 infection is controversial. We investigated whether genetic variation at IFNL4 is associated to HIV-1 acquisition. The HCV protective allele TT was associated with decreased likelihood of HIV-1 infection in male intravenous drug users [odds ratio (OR): 0.3; P = 0.006], and this association was not modified by the genotype of CCR5...
September 10, 2015: AIDS
Julie Y Tse, Morayo Adisa, Lynne J Goldberg, Rosalynn M Nazarian
BACKGROUND: The rate of intravenous drug use (IVDU) has been increasing nationally; however, cutaneous manifestations of IVDU have infrequently been investigated. We report a series of the clinicopathological correlation of IVDU in the skin. METHODS: A search of surgical pathology files between the years 2000 and 2014 was performed for cutaneous specimens from patients with a reported history of IVDU for which the histopathological findings could not be attributed to another etiology...
November 2015: Journal of Cutaneous Pathology
Jemell Geraghty
Chronic venous leg ulceration is a long-term condition commonly associated with lower-limb injecting and chronic venous hypertension caused by collapsed veins, incompetent valves, deep vein thrombosis and reflux. It is not usually a medical emergency, but intravenous (IV) drug users with leg ulcers can attend emergency departments (EDs) with a different primary complaint such as pain or because they cannot access local primary care or voluntary services. Leg ulceration might then be identified during history taking, so it is important that ED nurses know how to assess and manage these wounds...
September 2015: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
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