Most Read Articles
5 days ago
A strong belief in the necessity of medication is associated with better adherence to oral disease-modifying antirheumatic drugs (DMARDs) or prednisone, while higher self-efficacy correlates with poor adherence, in a diverse cohort of patients with rheumatoid arthritis (RA), suggests a study.
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Low-dose administrations of haloperidol after thoracic surgery does not appear to prevent postoperative delirium, according to a new study.
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Percutaneous coronary intervention (PCI) displays comparable rates of mortality and serious composite outcomes but a higher rate of target-vessel revascularization at 10 years relative to coronary artery bypass grafting (CABG) in patients with significant left main coronary artery (LMCA) disease, reports a study. On the other hand, CABG delivers lower mortality and serious composite outcome rates compared with PCI with drug-eluting stents after 5 years.
Pearl Toh, 4 days ago
Apixaban slashes the risk of recurrent venous thromboembolism (VTE) by 90 percent in cancer patients compared with the low-molecular-weight heparin (LMWH) dalteparin, with no increase in major bleeding risk, according to the ADAM VTE study presented at ASH 2018.

Hepatitis E virus a common underlying cause of acute-on-chronic liver failure

02 Dec 2018

Alcohol contributes largely to the development of acute-on-chronic liver failure (ACLF), whereas hepatitis E virus (HEV) is the most common infectious cause of ACLF, suggesting a need for vaccination in such patients, a study has found.

Researchers examined 50 ACLF patients and 50 patients with stable chronic liver disease (CLD; controls), the majority of which were 31–60 years of age and male. They collected blood samples and performed two anti-HEV IgM enzyme-linked immunosorbent assays (ELISA; detection and capture). Additionally, they quantified HEV RNA in plasma and stool.

Results revealed ethanol to be the most common cause of acute insult in ACLF patients (54 percent), followed by HEV infection (14 percent).

IgM detection ELISA detected positivity for IgM antibodies to HEV in 10 ACLF patients vs two controls (20 percent vs 4 percent; p=0.0138). Only one ACLF patient showed HEV viremia (403 IU/ml), faecal shedding (2,790 IU/ml) and HEV antigenemia.

On the other hand, IgM capture ELISA detected five patients and one control. Agreement between detection and capture assays was 0.638 (kappa value).

The present data demonstrate a significant role of HEV in the causation of ACLF, highlighting a need to have an expanded diagnostic approach for HEV in such individuals, researchers said.

Researchers also pointed out that the time of presentation is of essence in the laboratory diagnosis of HEV. In the cohort, viremia, faecal shedding, antigenemia and IgM positivity were detected in one ACLF patient who presented on the fourth day of illness. In previous studies, 100 percent positivity for HEV RNA and antigen was observed in the first 3 days of illness, while the rate decreased by 46 percent for HEV RNA detection and by 12 percent for antigen detection by day 7 of illness. [J Med Virol 2013;85:823-827]

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Most Read Articles
5 days ago
A strong belief in the necessity of medication is associated with better adherence to oral disease-modifying antirheumatic drugs (DMARDs) or prednisone, while higher self-efficacy correlates with poor adherence, in a diverse cohort of patients with rheumatoid arthritis (RA), suggests a study.
4 days ago
Low-dose administrations of haloperidol after thoracic surgery does not appear to prevent postoperative delirium, according to a new study.
2 days ago
Percutaneous coronary intervention (PCI) displays comparable rates of mortality and serious composite outcomes but a higher rate of target-vessel revascularization at 10 years relative to coronary artery bypass grafting (CABG) in patients with significant left main coronary artery (LMCA) disease, reports a study. On the other hand, CABG delivers lower mortality and serious composite outcome rates compared with PCI with drug-eluting stents after 5 years.
Pearl Toh, 4 days ago
Apixaban slashes the risk of recurrent venous thromboembolism (VTE) by 90 percent in cancer patients compared with the low-molecular-weight heparin (LMWH) dalteparin, with no increase in major bleeding risk, according to the ADAM VTE study presented at ASH 2018.