North American Journal of Medicine and Science
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Natural History of Hepatitis B Virus (HBV) Infection
Get PDFChronic hepatitis B is a global health burden and increasingly a public health concerns in US due to changing immigration pattern from mostly Western European immigrants to Asian, African and Eastern European where prevalence of chronic hepatitis B is higher. Therefore in these particular at risk populations, education of health providers and patients is vital in achieving successful disease prevention and control. Understanding the natural history of this complicated and dynamic disease will lay the ground works for comprehensive management of chronic hepatitis B. In this article, the natural history particularly the four phases of chronic hepatitis B and the outcome of the disease such as cirrhosis and HCC and the risk factors for disease progression and HCC development will be discussed. The importance of screening and vaccination is emphasized particularly the success of HCC prevention in countries with population-wide vaccination program. It is with the hope that this review will enhance and educate the primary health provider for the most at risk population of chronic hepatitis B in US and therefore alleviate the burden of this disease
Diagnostic Approach to Hepatitis B Virus (HBV) Infection
Get PDFHepatitis B infection is a global health problem, leading to cirrhosis and hepatocellular carcinoma in some patients and accounting for 6,000 deaths annually. The diagnosis of HBV infection is based largely on the interpretation of serologic markers and hepatitis B DNA levels, which allows establishment of the phase of infection and provides the groundwork for management strategies. More recently, genotyping and detection of genetic mutations that confer drug resistance provide additional data that assist in the therapeutic decisions. Histologic staging also presents important information that allows for individualized management of the disease. This paper reviews the various tests utilized in the diagnosis of HBV infection and their roles in the identification of the different phases of infection and in the determination of the need for further management
Tumor Cell Selective Cytotoxicity and Apoptosis Induction by an Herbal Preparation from Brucea javanica
Get PDFThe plant Brucea javanica has shown impressive efficacy for treating various diseases including cancer. However, the mechanism by which B. javanica acts is poorly understood. We have established tissue culture assays to study the effects of B. javanica on cervical and several other cancer cells. Our results demonstrated that the aqueous extract from B. javanica is selectively toxic to cancer cells. Induction of apoptosis by B. javanica appears to be a possible mechanism by which it kills cancer cells. Interestingly, a significant increase of p53 protein level was observed in these apoptotic cells. Our studies indicated that both p53-dependent and p53-independent activities contributed to herb-induced cell death. These results imply that further studies with B. javanica may lead to the development of novel anti-cancer drugs
Overcoming Barriers to Cervical Cancer Screening Among Asian American Women
Get PDFSignificant disparities in cervical cancer incidence and mortality exist among ethnic minority women, and in particular, among Asian American women. These disparities have been attributed primarily to differences in screening rates across ethnic/racial groups. Asian American women have one of the lowest rates of screening compared to other ethnic/racial groups. Yet Asian Americans, who comprise one of the fastest growing populations in the United States, have received the least attention in cancer control research. Studies suggest that various factors, including lack of knowledge, psychosocial and cultural beliefs, and access barriers, are associated with cervical cancer screening behaviors among Asian American women. Indeed, the few interventions that have been developed for Asian American women demonstrate that targeting these factors can yield significant increases in screening rates. It is important to note, however, that the effectiveness of educational interventions is often attenuated if access barriers are not adequately addressed. Hence, interventions that include key essential components, such as the use of community individuals as lay health workers, culturally-tailored and linguistically-appropriate educational materials, and navigation assistance to overcome access barriers, are more likely to be successful in enhancing screening rates. As the benefits of community-based cervical cancer prevention programs become more apparent, it will be essential to identify effective approaches for disseminating such programs more broadly. In conclusion, community-based cervical cancer screening programs have demonstrated promise in addressing existing cervical cancer disparities by increasing awareness and knowledge and promoting recommended screening behaviors. These findings will be instrumental in guiding future community-based programs to reduce cervical cancer health disparities among Asian American women
A Review of the Neurobiological Basis of Autism
Get PDFThis manuscript reviews ongoing developments in autism research that defines it as a behavioral phenotype with many known neurobiological and molecular causes. Strides in neuroimaging, histopathology, neurophysiology, genetics and metabolic disorders are discussed that support the understanding of autism as a pervasive abnormality of neural systems with particular dysfunction of neuronal connections that impacts the development of socialization, communication and behavior. The aim of this review is to provide insight into the current knowledge of the complex pathophysiology of autism
Synaptic Dysfunction Attributes to Autism Spectrum Disorder
Get PDFAutism spectrum disorders (ASD) are a range of high prevalent disorders that can be characterized as a syndrome of social communication deficits, repetitive behavior or restrictive interest. Rapid advance beyond environmental influence is made through identifications of associated genetic variations. Emerging evidence from human and animal models demonstrate impairment in synaptic function is an etiology of ASD. This review focuses on several synaptic proteins that are mutated in some patients and their autistic behaviors and cognitive deficits are recapitulated in animal models.
Effective Treatments for Auditory Sensitivities in Autism
Get PDFHypersensitivity to sound is a frequent symptom of autism spectrum disorders and can be difficult to manage. Because an individual with sound hypersensitivity may display disruptive behaviors for significant periods of time in response to the sound, the condition demands treatment. Behavioral and desensitization therapies, which employ some of the techniques of cognitive behavioral therapy, appear to be promising, efficient, and effective types of treatment for these symptoms.
Serum Uric Acid: A Risk Signal and a Treatment Target for Essential Hypertension
Get PDFUric acid is the end product of purine metabolism in humans. During the past several decades, lifestyle and dietary changes and the aging of overall population contribute to progressively rising of serum uric acid levels. Although a number of epidemiologic data has suggested that elevated serum uric acid levels are associated with increased risk for hypertension and cardiovascular diseases, the causal role of uric acid in the development of hypertension is still inconclusive. In this review, we summarize experimental and population studies on uric acid and possible links to hypertension and the pathogenic mechanisms. We also discuss environmental factors and genetic variations that affect serum uric acid levels and disease risks.
Left Atrial Pseudotumor Caused By Caseous Calcification of the Mitral Annulus, Case Report with Review of Literature
Get PDFCaseous calcification of the mitral annulus (CCMA) is a rare form of periannular calcification, occurring in 0.06% of all echocardiographic studies and in 0.63% of all patients with mitral annular calcification. Here, we report a case of CCMA manifesting as a left atrial mass. The patient is a 78-year-old African American female with multiple co-morbidities, who presented with symptomatic coronary artery disease and chest pain. A pre-operative echocardiogram revealed a mass in the posterior wall of the left atrium, which did not appear to affect the mitral valve or protrude into the left atrial chamber. Intra-operatively, white toothpaste-like material was removed from the mass lesion. Gross examination revealed multiple fragments of grey-white friable caseous material, measuring 3 x 2.5 x 1 cm in aggregate. Bacterial and fungal cultures from this material were both negative. Microscopic examination showed this material to be amorphous, non-viable, basophilic, and acellular, with foci of calcification. These morphological features were diagnostic for CCMA. Review of the literature indicated that CCMA is a very rare benign lesion, presenting as a round, tumor-like mass with central echolucencies on echocardiography. We believe our case report will further raise the awareness of CCMA so that pathologists and radiologists can get familiar with this rare disease to avoid potential misdiagnosis
Global Epidemiology of Hepatitis B Virus (HBV) Infection
Get PDFHepatitis B virus (HBV), a DNA virus with a human-only reservoir, is a worldwide public health problem. Hepatitis B is transmitted through parenteral or mucosal exposure to infected blood and body fluids. The mode of transmission is usually vertical or horizontal in highly endemic areas early in life, resulting in a high chronicity rate. In low endemic countries, transmission is usually in adulthood with self-limiting infection in most. The prevalence of chronic HBV infection is highly variable, ranging from 0.1% in the United States to 20-30% in some Pacific Island nations. There are an estimated 360 million people who are chronically infected, of whom almost one million people die annually of HBV-related liver disease. Chronic hepatitis B is the major cause of hepatocellular carcinoma in the world. Safe and effective HBV vaccines have been available since 1982. The implementation of effective vaccination programs has resulted in a significant decrease in the incidence of chronic hepatitis B infection. Nevertheless, hepatitis B remains an important cause of morbidity and mortality among the chronic carriers worldwide. Understanding the epidemiology of the disease is essential in developing programs to prevent and treat this global infection.