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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A recent analysis demonstrated a change in incidence approaching 100% for diseases against which we routinely immunize in the United States. At present, measles, mumps, rubella, invasive Haemophilus disease, poliomyelitis, diphtheria and tetanus are well-controlled but not eliminated. Diseases that now pose special problems include pertussis, hepatitis A and B and varicella. The incidence of pertussis surged in 1994, possibly in part because of waning immunity in the immunized population. Acellular pertussis vaccines are available for booster doses in children but are not now recommended for adults. Licensure of acellular pertussis vaccines for primary immunization of infants is eagerly awaited. Recombinant hepatitis B vaccine has been licensed for more than 10 years but there has been little change in disease incidence in the United States. Routine immunization of infants is now recommended but concerns exist about cost and persistence of immunity into adolescence. Inactivated hepatitis A vaccines appear to be highly effective in preventing clinical hepatitis and controlling epidemics. Potential target populations include military personnel, day-care attendees and travelers. Hepatitis A vaccine may be recommended for all children after approval by the United States Food and Drug Administration and if a combination vaccine becomes available. A live, attenuated varicella vaccine developed in 1974 and unlicensed in the United States is safe and highly effective in preventing varicella in healthy and immunocompromised populations. It also appears to reduce subsequent development of herpes zoster. Vaccines against pneumococci (conjugate vaccine), respiratory syncytial virus, rotavirus, tuberculosis and human immunodeficiency virus are needed. Research and technology to develop these vaccines must be developed, and efficient delivery mechanisms must be created and implemented.
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PMID:Present and future challenges of immunizations on the health of our patients. 763 35

Implementation of the Safe Motherhood initiative in India calls for the institution of good prenatal care for all women. The first aspect of prenatal care is collecting the patient's history and reviewing the health history of her family. The physical examination should include inspection for reproductive tract diseases, a bimanual examination early in pregnancy to correlate the size of the uterus and the reported last menstrual period, and routine abdominal palpation. Ultrasonography should be performed at least once. Laboratory tests should include analysis of hemoglobin and hematocrit levels, urine analysis, blood grouping and Rh typing, serological tests for syphilis, antibody screening and screening for rubella and hepatitis antigen, and cervical cytology. Additional screening and genetic testing may be necessary in certain cases. Women with no complications should be seen once a month for 28-30 weeks, once every two weeks until 36 weeks, and once a week thereafter. High-risk patients should be seen more frequently. Infections detected during pregnancy must be properly treated with antibiotics, although, in general, women should avoid medications during pregnancy. In India, hematinics and vitamins should be given to all pregnant women. Drugs and substances to be avoided during pregnancy include tetracycline, chloramphenicol, streptomycin, cotrimoxazole, diuretics, alcohol, trimethadone, warfarin, lithium, quinine, sex hormones, anesthetics, tobacco, vitamin D, and all live vaccines except BCG. Common sense should dictate the safe level of activity for a pregnant woman.
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PMID:Role of antenatal care in safe motherhood. 765 37

Current US military recruit vaccination policy presumes that recruits have had a complete childhood immunization series. This assumption may not be appropriate for recruits from Micronesia, who may have had limited access to modern health care, including immunization programs. During 1988 and 1990, a cross-sectional serosurvey was conducted among 66 US military recruits, 56 from the Federated States of Micronesia and 10 from the Republic of the Marshall Islands, collectively referred to as Micronesia. Antibody seronegativity levels for 12 vaccine-preventable (or potentially so) diseases were: measles (52%), mumps (14%), rubella (21%), varicella (38%), diphtheria (39%) tetanus (0%), polio type 1 (4%), polio type 2 (0%), polio type 3 (14%), hepatitis A (9%), hepatitis B (17%), and hepatitis C (98%). Compared with Army recruits in general, Micronesian recruits were significantly more likely to be seronegative for measles and varicella and seropositive for hepatitis types A and B. Personal histories of disease were felt to be inadequate in predicting antibody status.
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PMID:Vaccine-preventable disease susceptibility in a young adult Micronesian population. 777 28

With the introduction of new, albeit noncommercial, diagnostic tests for the detection of HEV, our understanding of this virus has been greatly enhanced. With these tests, it has been possible to begin a delineation of the process of pathogenesis in infected humans. These tests have also shown us that, at least in some individuals, an IgG response to HEV is long lasting and may confer immunity, and it may be possible to develop a recombinant vaccine against HEV. Contrary to past results, HEV appears to be the most common cause of acute sporadic hepatitis in pediatric populations in endemic regions. HEV has been shown to be a positive-sense single-stranded RNA virus that has been tentatively classified as a calicivirus, although its nonstructural proteins exhibit sequence similarity to rubella virus and furoviruses. Despite these advances in our understanding of HEV, it is still necessary to depend on exclusion of hepatitis caused by other viruses to diagnose a hepatitis E infection; however, this situation should change with the anticipated release of commercially available diagnostic tests.
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PMID:Hepatitis E. 798 94

In Ethiopia during 1960-1962, more than 100,000 people in the Omo and Didessa river valleys acquired yellow fever and 30,000 died. There have been no yellow fever cases since 1966. Some other aboviruses that arise sporadically are Jos virus, dengue fever, Crimean-Congo hemorrhagic fever, and group A arboviruses. By age 15, all people in surveyed regions were positive for hepatitis A virus. Prevalence of hepatitis B virus increases with age ( 75% of adults in urban areas and many rural areas). The frequency of carriers of hepatitis Bs antigen is greatest in areas where people practice ceremonial tattooing. During 1988-1989, 93% of jaundiced patients in a military camp in Ethiopia had antibodies to hepatitis E virus as a result of a waterborne outbreak. Other hepatitis viruses in Ethiopia are delta and C viruses. All 3 serotypes of poliovirus exist, especially type III. 93% of 1-year-olds have already acquired immunity to it. Peak frequency of onset among paralytic cases is 2 cases. Measles epidemics are common in children. An outbreak in southwestern Ethiopia had a mortality rate of 20%. Immunity to rubella is around 85% for 14-year-olds. It increases with age. Rotavirus causes diarrhea in many children, especially among 7-12 month old infants and in June and November. Most children have been exposed to Epstein-Barr virus, which is responsible for mononucleosis and maybe for Burkitt's lymphoma. Officials do not conduct ongoing surveillance of influenza in Ethiopia. Influenza epidemics have occurred in 1957 and 1963. Rabies is endemic, with dogs being responsible for most cases. In November 1992, there were 3978 AIDS cases. 75% are less than 40 years old, with males more likely to be HIV infected than females. The Falashas of northwest Ethiopia have the world's second highest endemic rate of human T cell leukemia virus-1. Officials do not know the extent of viral diseases because there is no well organized national laboratory. One is needed to conduct surveillance and to evaluate the effectiveness of vaccination activities.
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PMID:Viral diseases in Ethiopia: a review. 818 57

Yale has been fortunate indeed to have had Dorothy Horstmann as a member of its faculty for all but one of the last 50 years. It has had also the wisdom to take cognizance of her value as an individual and of her contributions to biomedical science and human welfare on two occasions in recent years. Her studies of poliomyelitis, hepatitis, and rubella, executed with perceptiveness, rigor and modesty, have benefited countless numbers; and for her many achievements all are in her debt. I am beholden to her colleagues for this opportunity to pay tribute to a wise and gracious friend. In casting about for a subject befitting this occasion, the thought occurred that it might be of interest to examine the contributions of some former and present members of Yale's faculty to the subject of a group of infections still endemic in all human societies, namely those caused by Streptococcus pneumoniae or the pneumococcus. The list is doubtless not exhaustive but includes such notables as Winternitz, Blake, Paul, Trask, Eaton, and Beeson of former days, as well as reflecting ongoing investigations today by Eugene Shapiro and his colleagues. In reviewing some of this earlier work, it will be my endeavor to place it in the context of contemporary understanding. In the interest of some semblance of order, the material will be examined in topical rather than in chronological order, dealing with bacteriologic and immunologic, pathogenetic, therapeutic, and prophylactic considerations in that sequence.
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PMID:The pneumococcus and some men who came to Yale: the Dorothy M. Horstmann Lecture. 820 63

Rubella was accompanied by hepatic dysfunction in a 28-year-old male. Serum aminotransferase levels were moderately elevated and LDH markedly increased, especially LDH isoenzyme 5, whereas total bilirubin and ALP remained almost normal. GOT, GPT and LDH levels were completely normalized by the 21st hospital day. Paired antibody titers of viruses which may cause hepatitis, other than rubella, were of no significance. Laparoscopy showed enlarged, red liver. Histologic and electron microscopic findings of the liver were consistent with acute hepatitis. Hepatic damage with rubella is rare, and it is possible that the hepatic dysfunction seen in adult rubella may be mediated by an immunopathologic mechanism.
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PMID:Hepatitis in an adult with rubella. 828 39

Generation of epidemiological data on perinatally-transmitted infections is a fundamental tool for the formulation of health policies. In Brazil, this information is scarce, particularly in Northeast, the poorest region of the country. In order to gain some insights of the problem we studied the seroprevalence of some perinatally-transmitted infections in 1,024 low income pregnant women in Salvador, Bahia. The prevalences were as follow: HIV-1 (0.10%), HTLV-I/II (0.88%), T.cruzi (2.34%). T.pallidum (3.91%), rubella virus (77.44%). T.gondii IgM (2.87%) and IgG (69.34%), HBs Ag (0.6%) and anti-HBs (7.62%). Rubella virus and T.gondii IgG antibodies were present in more than two thirds of pregnant women but antibodies against other pathogens were present at much lower rates. We found that the prevalence of HTLV-I/II was nine times higher than that found for HIV-1. In some cases such as T.cruzi and hepatitis B infection there was a decrease in the prevalence over the years. On the other hand, there was an increase in the seroprevalence of T.gondii infection. Our data strongly recommend mandatory screening tests for HTLV-I/II, T.gondii (IgM), T.pallidum and rubella virus in prenatal routine for pregnant women in Salvador. Screening test for T.cruzi, hepatitis and HIV-1 is recommended whenever risk factors associated with these infections are suspected. However in areas with high prevalence for these infections, the mandatory screening test in prenatal care should be considered.
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PMID:Seroprevalence of HIV, HTLV-I/II and other perinatally-transmitted pathogens in Salvador, Bahia. 859 64

1. Anesthetic gases, particularly nitrous oxide, have been investigated for potential reproductive, mutagenic, and carcinogenic effects. Waste gases have been found in high concentrations, even with work settings with scavenger systems in place. 2. Antineoplastic drugs, commonly used to treat persons with cancer, are virtually all considered to be embryo-fetal toxic. OSHA has issued comprehensive guidelines covering staff training, handling practices, and use of protective equipment. 3. The toxic effect of non-ionizing radiation has been a frequent topic of public and scientific debate. At this time no evidence exists of a reproductive hazard to health care workers. 4. Biologic agents such as rubella, hepatitis, cytomegalovirus, varicella, and human immunodeficiency virus frequently have the potential for adverse effects on the fetus. Administration of a vaccine or care of patients with active infection may be contraindicated in pregnancy.
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PMID:Reproductive hazards: an overview of exposures to health care workers. 869 64

Viral exanthems can be classified as erythematous vesicular and papular. The majority are erythematous with the most common viral causes being non polio enteroviruses, respiratory viruses, acute. Epstein-Barr virus, human herpes viruses 6 and 7, and parvovirus B-19. Measles, rubella, mumps, acute GMV, hepatitis viruses. HIV seroconversion, Ross River and Barmah Forest viruses are less commonly seen. The differential diagnosis includes drug eruption, erythematous bacterial exanthems and Kawasaki's syndrome.
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PMID:Viral exanthems in childhood. 871 3


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