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Query: UMLS:C0028754 (obesity)
124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Serum alanine aminotransferase (ALT) activity and antibody to hepatitis B core antigen (anti-HBc) were proposed as surrogate markers of non-A, non-B (NANB) infection. In this study we analyzed 649 consecutive repeat blood donors to define the possible exclusion rate if both surrogate markers were implemented in our Blood Service, and to assess risk factors associated with elevated ALT levels. One hundred and seven blood donors (16.5%) had slightly elevated ALT levels (higher than the upper reference value, but less than twice this level), but only 15 (2.3%) had a level higher than mean log + 2.25 SD. Seventy-seven (11.8%) resulted anti-HBc positive. Blood donors with elevated ALT levels and those who were anti-HBc positive belonged to different populations, being only 6 (0.9%) positive for both surrogate markers. Only two known donors (0.3%) resulted anti-HCV positive, and each of them was implicated in one of the four post-transfusion hepatitis (PTH) cases observed in 200 recipients of blood from these 649 donors. Both were negative for anti-HBc but one had elevated ALT levels. Male sex, age, alcohol use and obesity resulted all independently and significantly associated with elevated ALT levels. For both alcohol use and body weight we observed a significant linear relationship with serum ALT levels. These findings suggest that in our Region the exclusion of blood donors with ALT levels above the reference value, or those anti-HBc positive, would exclude an unacceptably high rate of blood donors without proven evidence of post-transfusion hepatitis prevention.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Serum alanine aminotransferase levels among volunteer blood donors: effect of sex, alcohol intake and obesity. 162 21

The clinical course and immunodiagnosis of hepatitis B infection is discussed. Immunization is necessary to prevent the clinical disease, the development of carriers, and the transmission of the hepatitis B virus to susceptible persons. Host factors that can curtail the immune response include increasing age, obesity, smoking cigarettes, and having a medical condition that compromises the immune system. Increasing the dose of vaccine, administering the inoculations intramuscularly, and giving the vaccine more frequently can enhance the immune response. The duration of immunity following vaccination has not yet been defined, but booster dose guidelines for selected groups are provided. Finally, recommendations for developing and implementing hepatitis B immunization protocols are presented.
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PMID:Factors influencing the immune response to hepatitis B vaccine, booster dose guidelines, and vaccine protocol recommendations. 252 97

Factors associated with lack of antibody response to the hepatitis B virus plasma vaccine were retrospectively evaluated by means of a logistic regression in 194 previously seronegative staff members of a community hospital. All subjects had received three doses of vaccine by intramuscular buttock injection using a 1-in, 23-gauge needle. Overall, only 55.7% of subjects developed detectable antibody to hepatitis B surface antigen in serum after immunization. The weight-height index served as a surrogate measure of obesity. Predictors of poor immunogenic response to hepatitis B vaccine included higher weight-height index, older age, and vaccine batch. Sex, race, timing of vaccine doses, and timing of postimmunization determination of antibody to hepatitis B surface antigen were not predictors of vaccine efficacy.
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PMID:Obesity as a predictor of poor antibody response to hepatitis B plasma vaccine. 293 32

Plasma-derived vaccines and yeast-derived recombinant vaccines against hepatitis B virus (HBV) infection have gained an acceptable record of efficacy. However, non- or hyporesponsiveness to immunization does not only occur in cases of obesity, renal failure or immune suppression, but also in healthy individuals. There is therefore a rationale for developing more immunogenic vaccines against HBV, especially for those populations who are potential non- or hyporesponders. Currently used recombinant hepatitis B vaccines consist of antigen particles assembled with the product of 226 amino acids encoded in the S gene. Since proteins encoded in the pre-S gene are also incorporated in the HBV envelope, pre-S gene products should, at least in theory, be useful in improving protection with hepatitis B vaccines. Inactivated hepatitis A vaccines are more potent than currently used hepatitis B vaccines. Two injections of a standard dose of HAVRIX (SB) by the intramuscular route, or even a single injection using a higher dose (HAVRIX 1440), will achieve protective levels of antibodies. Therefore, increased potency is not essential with inactivated hepatitis A vaccines. New hepatitis A vaccines are likely to be recombinant or attenuated live types. Another aspect of the improvement of existing hepatitis A and B vaccines is unification into a combined form.
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PMID:New approaches to hepatitis A and B vaccines. 765 55

A set of new guidelines were formulated by an expert group meeting in Sweden organized by the pharmaceutical office during March 31-April 1, 1993. It contains various methods to avoid an undesired pregnancy and also advice about postcoital contraception. Among barrier methods, the condom is the only reversible method for men with a method failure of 2 and user failure of 10. It protects against gonorrhea, chlamydia, condyloma, herpes simplex, HIV, and hepatitis B. The diaphragm can be used with a spermicide and protects to a lesser degree against chlamydia, gonorrhea, and cervical cancer. The female condom is as effective as the condom. Among spermicides, nonoxynol-9 is not only effective against sperms but also against bacteria, viruses, and certain vaginal and cervical cells. The vaginal sponge is impregnated with nonoxynol-9 and is effective up to 24 hours. The copper IUD, with a method failure of less than 1, can cause profuse menstrual bleeding, dysmenorrhea, and endometritis-salpingitis. Hormonal methods include combination pills (2-phase and 3-phase pills) and gestagen methods (high dose with 150 mg of medroxyprogesterone acetate injection every 3 months and low-dose minipills with levonorgestrel, norethisterone, or lynestrol). Mechanisms of action concern combination pills, gestagen methods, minipills, Norplant, and Levonova. Drug cross reaction can reduce effectiveness. Side effects include bleeding and amenorrhea. Risk-benefit determination is based on health effects. Possible risks are associated with breast cancer, cervical cancer, blood pressure increase, venous thromboembolism, and heart infarction. Various phases of the reproductive age include young women, lactating women, and women in the later part of the reproductive age. Special groups include those who have experienced ectopic pregnancy, infections (candida, sexually transmitted diseases: chlamydia trachomatis, HIV infections), obesity, cardiovascular diseases, diabetes mellitus, tumors of the reproductive organs, liver diseases, migraine, epilepsy, surgery, and handicapped women. Postcoital contraception is used only in need, and methods for postcoital contraception include hormonal method and the copper IUD.
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PMID:[Contraception. Recommendations from a group of experts]. 790 65

Although hepatic transplantation is now a well-accepted treatment modality for end-stage liver diseases there are little detailed data on the clinical profile of patients who survive beyond 1 year following transplantation. The aim of this study was to develop a cross-sectional profile on 53 adults who have survived beyond 2 years following liver transplantation. These patients have been followed for a mean of 43.5 months (range 24-84) since the time of transplant. Nineteen patients had persisting liver enzyme abnormalities, 11 due to chronic viral hepatitis (seven hepatitis C virus, three hepatitis B virus), four due to biliary disease. Two had post severe rejection, one steatosis secondary to obesity while in one the aetiology was unclear. Nineteen (36%) of patients required anti-hypertensive medications. The median doses of Prednisone, Cyclosporin and Imuran were 7.5, 300 and 50 mg daily, respectively. The mean serum creatinine was 117 +/- 27 mumol/L. However 22 (41%) had an elevated serum creatinine (> 120 mumol/L) but in only seven was the serum creatinine > 150 mumol/L. Fourteen (26%) of patients were obese (body mass index > 30) whilst 46% had a higher than recommended serum cholesterol (mean level 5.6 +/- 1.5 mumol/L). There has only been one case of internal malignancy (lymphoma) although 19 patients attend regular dermatological review for skin cancer surveillance. Forty-eight patients had a Karnofsky Score > 80. In conclusion, the vast majority of these patients have excellent clinical function but some caution is required with respect to renal function, hypertension, obesity and mild hypercholesterolaemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A follow up of 53 adult patients alive beyond 2 years following liver transplantation. 828 Aug 46

We investigated the factors which may influence post-operative liver and renal function using a multiple regression analysis after isoflurane or sevoflurane anesthesia in 844 patients (ASA I or II, age 20-90 yr). Hepatic and renal surgeries were excluded from this study. The parameters examined were sex, age, degree of obesity, preoperative liver function, preoperative renal function, infection with hepatitis B or hepatitis C virus, inhalation anesthetics used, MAC.h of anesthesia, the duration of operation, blood loss, amount of blood transfusion, urine volume during operation, and surgical site. Serum GOT, GPT, total bilirubin, BUN and serum creatinine were examined on the 3rd and 7th day after surgery. An increase in serum GOT, GPT or bilirubin was observed for each of the following parameters; male, infection with hepatitis C virus, long operation, and upper abdominal surgery. Postoperative BUN and serum creatinine increased in patients with preoperative renal dysfunction, in elderly patients, and in hepatitis C carriers.
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PMID:[Multiple regression analysis of pre- and intra-operative factors in relation to post-operative liver and renal functions]. 854 85

We report a prospective, randomized, single-blinded trial comparing immunogenicity of rapid (0, 1, and 2 months) versus standard schedule (0, 1, 6 months) hepatitis B vaccinations of healthy adults with recombinant hepatitis B vaccine (Engerix-B, 20 micrograms i.m.) (230 of 234) negative to hepatitis B were randomized and completed the study. Groups were similar in age, weight, race, and obesity rate, but the rapid schedule group had more women. Both groups reached > or = 100 mIU/mL at a similar rate, but a higher seroprotection rate at > or = 500 mIU/mL was reached by the standard schedule. No demographic variables influenced the effect of dose schedule on anti-hepatitis B titer. We conclude that rapid schedule vaccination gives a rate that is quicker than, and identical to, the rate of seroprotection of the standard schedule vaccination.
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PMID:Comparison of a rapid hepatitis B immunization schedule to the standard schedule for adults. 856 Nov 9

Hepatitis B recombinant vaccine immunoresponsiveness was studied in 427 preadolescents vaccinated with a 0, 1 and 6 months vaccination schedule. AntiHBs postvaccination titres (measured one month after the last dose) were related to the following variables: sex; weight; height; and Quetelet index. The antiHBs postvaccination titres were used to predict the length of protection induced by the vaccine. All preadolescents developed antiHBs titres 10 IU l-1 and no statistically significant differences could be found between sexes. The relation study between antiHBs postvaccination levels and Quetelet index showed a statistically significant inverse correlation. According to the antiHBs postvaccination titres, the central 50% of the sample distribution would be protected during a period between 7.5 and 10.5 years. In pre-teenagers, the hepatitis B recombinant vaccine has proven to be highly immunogenic, obesity is a predictor of poor immunoresponse and this response is not influenced by sex. According to our results, we would propose the administration of a single booster dose 10 years after primary vaccination and thus protect these subjects during the period of greatest risk.
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PMID:Hepatitis B vaccine immunoresponsiveness in adolescents: a revaccination proposal after primary vaccination. 885 4

The aims of this study were to review what is currently known about comorbidity in people with Down's syndrome and to determine if their relative risk for certain disorders was increased. Analysis was carried out on the published literature from 1982 through 1994. In order to be included in this study, articles had to meet predetermined criteria. The strengths and weaknesses of the selected articles were considered in this review. The estimation of relative risks was done by calculating the odds ratio (OR). Odds ratios of > 2 or < 0.5 were found in more than one article for congenital heart defects, hypothyroidism, hearing impairment and hepatitis B. Only one article indicated an OR within this range for all of the following disorders: obesity, epilepsy, degenerative spine disorders and a wide atlanto-axial distance. The results were unclear in the areas of hyperthyroidism, visual disorders, dementia and psychiatric disorders. The concept of comorbidity, i.e. establishing the relationships between the various conditions in one person and understanding the implications for medical care, seems promising, especially for people with intellectual disability. Further work in this area may well improve the quality of care offered to these people.
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PMID:Comorbidity in people with Down's syndrome: a criteria-based analysis. 890 27


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