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Hepatitis

Hepatitis

Hepatitis can be caused by many different things including viral infections, parasites, bacteria, chemicals, autoimmunity, drugs or alcohol. Of these, viral infection is the most common cause of chronic (long-term) hepatitis, which can lead to severe liver damage including cirrhosis and liver cancer.

Hepatitis B and C viruses (HBV and HCV) are among the world’s most common infectious pathogens. It is estimated that 500 million people – 1 in 12 of the global population – are chronically infected with one or both of these viruses.1,2  The majority of these people live in the developing world and many of them are unaware that they are infected. Chronically infected patients are at increased risk of developing cirrhosis, hepatic decompensation and hepatocellular carcinoma (HCC), which together account for more than 1 million deaths annually.3

The hepatitis B virus is a resilient virus present in all bodily fluids of infected individuals. It is resistant to breakdown and able to survive outside the body. It can be transmitted effectively through contact with infected bodily fluids in the same way as HIV. However, HBV is 50–100 times more infectious than HIV.

Screening for HBV and HCV infection is crucial, not only to detect patients who may require treatment to reduce the risk of progression to severe sequelae, but also to reduce transmission rates.

The primary objective of therapy for chronic HBV is to achieve control of viral replication and halt disease progression/improve liver histology. This will decrease pathogenicity and infectivity and thereby stop or reduce hepatic necroinflammation.

Chronic hepatitis C infection may result in severe liver damage leading to liver failure, HCC and death. As a consequence, therapeutic intervention can arrest, and perhaps even reverse, the disease before irreversible liver damage occurs. 

Enter the Hepatitis B and C Knowledge Centre


References

1. World Health Organization. World Health Organization Hepatitis B Fact Sheet. 1998.
2. World Hepatitis Alliance. www.aminumber12.org
3. Lai CL, Ratziu V, Yuen MF, Poynard T. Viral hepatitis B. Lancet 2003;362:2089–94

Men's Health

Men's Health

As a disease topic Men's Health covers a broad set of issues affecting men of all ages. Some of the issues requiring greater focus and more thorough dissemination of information amongst the healthcare community, are those that have the potential to go undetected in the early stages. Diseases where early detection and more regular health checks not only improve prognosis and efficacy of treatment outcomes, but also quality of life.

These include:

Erectile Dysfunction (ED)

Erectile dysfunction is characterized by the regular or repeated inability to obtain or maintain an erection. Although not considered a part of the aging process, it is associated with certain physiologic and psychological changes related to age. ED is most common in men between 40-70 years of age. However incidence is also higher amongst men with certain medical conditions which include, diabetes, heart disease, and hypertension. ED can also be a warning sign/symptom of these underlying conditions. 1

Hypogonadism (low testosterone)

Testosterone is an essential male hormone produced in the testes that plays a crucial role in the health and well being of male bodies. It is responsible for typical male sexual characteristics and is required by all men for a healthy life physically and psychologically.

Low testosterone, clinically known as hypogonadism, consists of decreased functional activity of the testes with diminished production and action of testosterone.  Although there is a progressive decline in testosterone levels as men age, hypogonadism can occur in men of any age.

Men with low testosterone are also at increased risk of cardiovascular disease, diabetes and metabolic syndrome and osteoporosis.

For your information, the Mens Health knowledge centre concentrates on the understanding, management and treatment of erectile dysfunction and hypogonadism.  The website also provides extensive details on up-coming conferences as well as an extensive library of useful resource. You can also access the knowledge centre via www.menshealthfocus.com.

Enter the Men's Health Knowledge Centre


References

1. McVary, Kevin T. Erectile. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL et al., editors. Harrison's Internal Medicine. 16th ed. New York: McGraw-Hill; 2005. p. 272-274

Clinical Case Studies

Needlestick Injuries and Post-exposure Prophylaxis Against HIV Infection

Infection: HIV Infection

Nneka Nwokolo, Consultant in Genitourinary Medicine, Chelsea and Westminster Hospital, Chelsea and Westminster NHS Foundation Trust, London, UK

Case History
A junior doctor is referred by the occupational health department having sustained a deep puncture wound to his left thumb 30 minutes previously. He had been attempting to resheath an arterial blood gas needle used on an unconscious patient admitted the day before with Pneumocystis jirovecii pneumonia.

HIV Seroconversion

Infection: HIV Infection

Antonia Ho, Specialist Registrar in Infectious Diseases, Gartnavel General Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK

Case History
A 29-year-old man was admitted with a week's history of general malaise accompanied by severe myalgia, abdominal pain, diarrhoea, headache, dry cough and swelling and redness of his eyes. He was a heavy drinker, and had fallen into the river Clyde two weeks previously while inebriated.

Medical Videos

The Risk Factors Associated With Sexually Transmitted Diseases
The Risk Factors Associated With Sexually Transmitted Diseases

Recent Drug Updates

Medical Journal Abstracts on Sexual Health

Hypogonadal symptoms in young men are associated with a serum total testosterone threshold of 400ng/dL

Thu 23 Oct 2014 -  BJU International

Objective:To investigate the association between hypogonadal symptoms and total serum testosterone levels in young men (<40 years of age) with an attempt to determine whether there exists a ...

Acupuncture for the Treatment of Vulvodynia

Wed 08 Oct 2014 -  Journal of Midwifery & Women’s Health

Purpose: A randomized controlled pilot study was conducted to evaluate the effect of an acupuncture protocol for the treatment of vulvodynia. Hypotheses: 1) Acupuncture reduces vulvar pain ...

Medical Images

Key events leading up to the era of HAART
Key events leading up to the era of HAART
HIV-1 group M subtypes and CRFs
HIV-1 group M subtypes and CRFs
gp120 and the CCR5 co-receptor
 gp120 and the CCR5 co-receptor
HIV envelope glycoprotein
HIV envelope glycoprotein
Pneumocystis jirovecii pneumonia
Pneumocystis jirovecii pneumonia
HIV-1 genome
HIV-1 genome

Online CME

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Clinical Trials

Treatment With MSC in HIV-infected Patients With Controlled Viremia and Immunological Discordant Response

10-11-2014

Clinical trial phase I/II, of test of concept, blind double, and controlled with placebo, randomized 2:1 (Treatment: placebo), in which a total of 15 patients will be included

Effects of VSL#3 on Neuro-cognitive Profile of HIV Patients

17-10-2014

Aim of the study is to evaluate the effects of a change in the intestinal microflora on the neuro-cognitive profile of patients with HIV infection receiving HAART treatment. Improvements will be evaluated with questionnaires on Quality of life and..

... Cognitive and Behavior function.

20 patients will be enrolled and will receive 4 sachets of VSL#3 per day.

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