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Hepatitis and pregnancy

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https://www.readbyqxmd.com/read/28524363/donor-transmitted-mutation-of-the-abcb11-gene-and-ensuing-intra-hepatic-cholestasis-of-pregnancy-in-a-liver-transplant-recipient
#1
Tiong Yeng Lim, Iona Coltart, Pierre Foskett, Richard Thompson, Sandra Strautnieks, Leonie Penna, Catherine Williamson, Rosa Miquel, Michael A Heneghan
In liver transplant (LT) recipients, the cause of graft dysfunction in pregnancy is often difficult to ascertain. Moreover, a liver biopsy in late pregnancy is often avoided as a consequence of patient and physician factors. Management of graft dysfunction can be difficult in this setting. We report a 30-year-old female LT recipient who developed acutely deranged liver biochemistry during the third trimester of her first pregnancy. At 29 weeks gestation, her liver function test (LFT) became abnormal; AST peaked at 978 IU/L (normal range 10-50), GGT 25 IU/L (normal range 1-55), bilirubin 1...
May 19, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28523061/duel-stage-treatment-for-biliary-cysts-with-cholangitis-during-pregnancy
#2
Baoxing Jia, Ludong Tan, Zhe Jin, Yahui Liu
BACKGROUND & OBJECTIVE: Biliary cysts in pregnant women are a complex medical issue, especially when complicated with cholangitis. It is a serious and life-threatening diagnosis that can seriously endanger both the expectant mother and the fetus. However, during pregnancy, surgical treatment would lead to further complications and higher fetal mortality. Here, we propose a novel therapeutic approach that would be safe for both mother and child during pregnancy, with a definitive treatment postponed until after delivery...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28522204/peg-interferon-plus-nucleotide-analogue-treatment-versus-no-treatment-in-patients-with-chronic-hepatitis-b-with-a-low-viral-load-a-randomised-controlled-open-label-trial
#3
Annikki de Niet, Louis Jansen, Femke Stelma, Sophie B Willemse, Sjoerd D Kuiken, Sebastiaan Weijer, Carin M J van Nieuwkerk, Hans L Zaaijer, Richard Molenkamp, R Bart Takkenberg, Maarten Koot, Joanne Verheij, Ulrich Beuers, Hendrik W Reesink
BACKGROUND: Antiviral treatment is currently not recommended for patients with chronic hepatitis B with a low viral load. However, they might benefit from acquiring a functional cure (hepatitis B surface antigen [HBsAg] loss with or without formation of antibodies against hepatitis B surface antigen [anti-HBs]). We assessed HBsAg loss during peg-interferon-alfa-2a (peg-IFN) and nucleotide analogue combination therapy in patients with chronic hepatitis B with a low viral load. METHODS: In this randomised controlled, open-label trial, patients were enrolled from the Academic Medical Center (AMC), Amsterdam, Netherlands...
May 15, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28521326/the-yield-of-abdominal-ultrasound-in-the-evaluation-of-elevated-liver-enzymes-during-the-second-and-the-third-trimester-of-pregnancy
#4
Aya Mohr-Sasson, Eyal Schiff, Ramy Rahamim Suday, Zehava Hayman, Yeruham Kleinbaum, Anat Kalter-Farber, Roy Mashiach, Yoav Yinon, Moti Dulitzki, Eyal Sivan, Shali Mazaki-Tovi
AIMS: To determine the clinical yield of abdominal ultrasound in the evaluation of elevated liver enzymes (ELEs) in the second and the third trimester of pregnancy. METHODS: A retrospective cohort study including all pregnant women admitted to a single tertiary care center was conducted between April 2011 and January 2015 with ELE. Inclusion criteria included gestational age above 24 weeks and ELEs, abdominal ultrasound report, and live fetus. Exclusion criteria included known maternal liver disease, structural or chromosomal fetal anomalies, and positive serology for viral hepatitis...
May 19, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28507928/the-role-of-direct-acting-antivirals-in-the-treatment-of-children-with-chronic-hepatitis-c
#5
REVIEW
Christine Hong Ting Yang, Eric R Yoo, Aijaz Ahmed
In the United States, chronic infection with the hepatitis C virus (HCV) affects an estimated 0.1-2% of the pediatric population, who are consequently at risk for major complications, including cirrhosis, hepatocellular carcinoma, and death. The current standard of treatment for chronic hepatitis C (CHC) in children is pegylated-interferon-alpha (PEG-IFN) in combination with ribavirin. PEG-IFN/ribavirin therapy is approved for children ages 3 and older; however, it is often held from use until adulthood because of its extensive list of potential side effects and high likelihood of causing adverse symptoms...
March 28, 2017: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/28500083/hepatic-thyroid-signaling-of-heat-stressed-late-pregnant-and-early-lactating-cows
#6
Joachim Weitzel, Thorsten Viergutz, Dirk Albrecht, Rupert M Bruckmaier, Marion Schmicke, Armin Tuchscherer, Franziska Koch, Björn Kuhla
During the transition between late gestation and early lactation dairy cows experience severe metabolic stress due to the high energy and nutrient requirements of the fetus and the mammary gland. Additional thermal stress as occurring with rising temperatures during the ongoing climate change has further adverse implications on energy intake, metabolism and welfare. The thyroid hormone (TH)-mediated cellular signaling has a pivotal role in regulation of body temperature, energy intake and metabolic adaptation to heat...
May 12, 2017: Journal of Endocrinology
https://www.readbyqxmd.com/read/28495266/maternal-pre-pregnancy-infection-with-hepatitis-b-virus-and-the-risk-of-preterm-birth-a-population-based-cohort-study
#7
Jue Liu, Shikun Zhang, Min Liu, Qiaomei Wang, Haiping Shen, Yiping Zhang
BACKGROUND: Preterm birth is the leading cause of child death in children younger than 5 years. Large cohort studies in developed countries have shown that maternal hepatitis B virus infection is associated with preterm birth, but there is little reliable evidence from China and other developing countries, where hepatitis B virus prevalence is intermediate or high. Hence, we designed this study to investigate the association between pre-pregnancy hepatitis B virus infection and risk of preterm and early preterm birth...
June 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28495194/neospora-caninum-abortion-in-a-malayan-tapir-tapirus-indicus
#8
M Peters, C Osmann, P Wohlsein, G Schares
A captive 17-year old female Malayan tapir (Tapirus indicus) aborted a fetus with a crown rump length of 19cm in early pregnancy. The fetus showed an early state of mummification. Histologically, a multifocal mononuclear encephalitis, myocarditis and periportal hepatitis was present indicating a possible protozoal cause of abortion. Although immunohistologically, Neospora (N.) caninum antigen could not be demonstrated, N. caninum DNA was detected by Polymerase Chain Reaction (PCR) in brain, heart, liver and lung of the fetus...
May 30, 2017: Veterinary Parasitology
https://www.readbyqxmd.com/read/28493860/hepatitis-c-virus-infection-among-women-giving-birth-tennessee-and-united-states-2009-2014
#9
Stephen W Patrick, Audrey M Bauer, Michael D Warren, Timothy F Jones, Carolyn Wester
Hepatitis C virus (HCV) affects an estimated 3.5 million persons in the United States (1), making it the most common bloodborne infection in the country. Recent surveillance data showed increased rates of HCV infection among adolescents and adults who are predominantly white, live in nonurban areas, and have a history of injection drug use.* U.S. birth certificate data were used to analyze trends and geographic variations in rates of HCV infection among women giving birth during 2009-2014. Birth certificates from Tennessee were used to examine individual characteristics and outcomes associated with HCV infection, using a multivariable model to calculate adjusted odds of HCV-related diagnosis in pregnancy among women with live births...
May 12, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28493270/public-health-alternatives-to-incarceration-for-drug-offenders
#10
REVIEW
Nicholas Clark, Kate Dolan, David Farabee
Drug users are vastly overrepresented in prison populations. Once inside they face increased risks of acquiring infections such as HIV, hepatitis and TB, and on release they face an elevated risk of fatal overdose. Relapse and recidivism are the norm following release from prison. The implementation of evidence-based drug treatment programmes in prison is rare, yet drug treatment in prison reduces the transmission of infections, recidivism and fatal overdose on release. Recognising the negative returns associated with incarceration, many jurisdictions have begun to consider alternatives such as depenalisation of the personal use of illicit drugs, provision of treatment and social reintegration of drug offenders, and a shift in focus from supply reduction to demand and harm reduction measures in the community and in prison...
May 1, 2017: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
https://www.readbyqxmd.com/read/28492929/hepatitis-c-virus-infection-among-reproductive-aged-women-and-children-in-the-united-states-2006-to-2014
#11
Kathleen N Ly, Ruth B Jiles, Eyasu H Teshale, Monique A Foster, Rick L Pesano, Scott D Holmberg
Background: In the United States, hepatitis C virus (HCV) infection has increased among young persons who inject drugs, but the extent of this epidemic among reproductive-aged women and their children is unknown. Objective: To estimate numbers and describe characteristics of reproductive-aged women with HCV infection and of their offspring. Design: Analysis of the National Notifiable Diseases Surveillance System (NNDSS) from 2006 to 2014 and the Quest Diagnostics Health Trends national database from 2011 to 2014...
May 9, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28474821/application-of-physiologically-based-pharmacokinetic-modeling-to-predict-drug-disposition-in-pregnant-populations
#12
Vamshi Krishna Jogiraju, Suvarchala Avvari, Rakesh Gollen, David R Taft
Pregnancy is associated with numerous physiologic changes that influence absorption, distribution, metabolism and excretion. Moreover, the magnitude of these effects changes as pregnancy matures. For most medications, there is limited information available about changes in drug disposition that can occur in pregnant patients, yet most women are prescribed one or more medications during pregnancy. In this investigation, PBPK modeling was used to assess the impact of pregnancy on the pharmacokinetic profiles of three medications (metformin, tacrolimus, oseltamivir) using the Simcyp® Simulator...
May 5, 2017: Biopharmaceutics & Drug Disposition
https://www.readbyqxmd.com/read/28467109/a-novel-technique-for-the-assessment-of-total-liver-blood-flow-in-pregnancy-interrater-and-intrarater-agreements
#13
Eugenio P Q Aires, Mônica G Almeida, Vitor M Marques, Fernanda C Silva, Guillermo C Velarde, Renato Augusto M Sá
OBJECTIVE: To improve the technique for hepatic blood flow examination, with the objective of investigating a role for Doppler flowmetry of the liver in monitoring pregnant women with preeclampsia. METHODS: Two physicians independently examined a group of 50 healthy pregnant women. The main difference in the proposed technique is the measurement of the vessel cross sectional area and the adjustment of the Doppler samples according to the diameter of each vessel...
May 3, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28462680/does-placental-mdsc-mediated-modulation-of-arginine-levels-help-protect-the-foetus-from-auxotrophic-pathogens
#14
Abdul Qader Tahir Ismail
Myeloid-derived suppressor cells (MDSCs) are immunosuppressive precursors of dendritic cells, macrophages and granulocytes. MDSCs normally quickly differentiate, but have elevated levels in chronic infection and cancer, where they help tumours evade the immune system through induction of T-cell dysfunction. MDSC levels are also raised in pregnancy, and in the neonate. During pregnancy they may help to prevent maternal rejection of the semiallogenic foetus. In the immediate postnatal period they may aid in allowing tolerance of gut microbiological colonisation and non-pathological environmental antigens...
May 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28451049/sero-prevalence-for-hepatitis-b-virus-among-pregnant-women-attending-antenatal-clinic-in-juba-teaching-hospital-republic-of-south-sudan
#15
Anthony Laku Stephen Kirbak, Zipporah Ng'ang'a, Jared Omolo, Hakim Idris, Abdulmumini Usman, William Baguma Mbabazi
INTRODUCTION: Hepatitis B virus infection is a major public health problem worldwide and in Africa. This would be the first ever documented study on epidemiology of Hepatitis B infections in the newly formed Republic of South Sudan. This study was designed to estimate the sero-prevalence of Hepatitis B virus infection amongst pregnant women attending antenatal services in Juba. METHODS: A cross-sectional study was conducted among pregnant women attending antenatal clinic services in Juba Teaching Hospital, in the period between December 2012 and March 2013...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28436552/systematic-review-with-meta-analysis-the-efficacy-and-safety-of-tenofovir-to-prevent-mother-to-child-transmission-of-hepatitis-b-virus
#16
REVIEW
M H Hyun, Y-S Lee, J H Kim, J H Je, Y J Yoo, J E Yeon, K S Byun
BACKGROUND: Preventing mother to child transmission of chronic hepatitis B infection in the setting of a high maternal viral load is challenging. The idea has emerged from antepartum tenofovir treatment with combination immunoprophylaxis. AIMS: To demonstrate the efficacy and safety of tenofovir to prevent mother to child transmission of hepatitis B virus. METHODS: PubMed, EMBASE, and Cochrane databases were searched through August 16, 2016...
April 24, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28434207/maternal-rates-of-lipolysis-and-glucose-production-in-late-pregnancy-are-independently-related-to-fetal-weight
#17
Barbro Diderholm, Kathryn Beardsall, Peter Murgatroyd, Christoph Lees, Jan Gustafsson, David Dunger
OBJECTIVE: Associations between maternal glucose levels and increased fetal growth are well established and independent relationships with maternal weight, weight gain and insulin resistance are also observed. The relative roles of lipolysis and glucose production in the determination of these observations remain unclear. DESIGN: We examined, through detailed physiological studies, the relationship between maternal late gestational energy substrate production (glucose and glycerol), maternal weight and weight gain, and estimated fetal size in the third trimester...
April 23, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28434087/hepatitis-b-during-pregnancy-in-endemic-areas-screening-treatment-and-prevention-of-mother-to-child-transmission
#18
Naichaya Chamroonkul, Teerha Piratvisuth
The proper management of pregnant women infected with hepatitis B virus (HBV) is necessary to prevent maternal and fetal morbidity and mortality and to protect the baby from HBV infection. In the majority of cases, vertical transmission can be prevented with a universal screening program, HBV vaccine immunoprophylaxis, and administration of hepatitis B immunoglobulin (HBIg) for babies born to mothers with HBV. However, in mothers with a high viral load (>200,000 or >1,000,000 IU/ml, depending on the guideline), the chance of immunoprophylaxis failure remains high...
April 22, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28425250/retrospective-analysis-of-maternal-fetal-and-neonatal-outcomesof-intrahepatic-cholestasis-of-pregnancy-at-gazi-university
#19
Berrin Günaydin, Merih Bayram, Melis Altuğ, Semra Cevher, Nuray Bozkurt
BACKGROUND/AIM: Maternal, fetal, and neonatal outcomes in parturients with intrahepatic cholestasis of pregnancy (ICP) have been retrospectively documented. We aimed to present pregnancy outcomes of parturients with ICP who underwent delivery. The study was conducted during a 1-year period. MATERIALS AND METHODS: After ethics committee approval, data from 1 January to 31 December 2015 were collected to identify parturients with ICP. RESULTS: Ten out of 37 patients underwent normal spontaneous vaginal delivery (NSVD), and the remaining 27 parturients underwent cesarean section (CS)...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28420650/changes-in-lxr-signaling-influence-early-pregnancy-lipogenesis-and-protect-against-dysregulated-fetoplacental-lipid-homeostasis
#20
Vanya Nikolova, Georgia Papacleovoulou, Elena Bellafante, Luiza Borges Manna, Eugene Jansen, Silvère Baron, Shadi Abu-Hayyeh, Malcolm G Parker, Catherine Williamson
Human pregnancy is associated with enhanced de novo lipogenesis in the early stages followed by hyperlipidemia during advanced gestation. Liver X receptors (LXRs) are oxysterol-activated nuclear receptors which stimulate de novo lipogenesis and also promote the efflux of cholesterol from extrahepatic tissues followed by its transport back to the liver for biliary excretion. Although LXR is recognized as a master regulator of triglyceride and cholesterol homeostasis it is unknown whether it facilitates the gestational adaptations in lipid metabolism...
April 18, 2017: American Journal of Physiology. Endocrinology and Metabolism
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