Outbreak of enterically-transmitted hepatitis due to hepatitis A and hepatitis E viruses

PURPOSE: To evaluate the uptake and transport of solid lipid nanoparticles (SLN), which have been proposed as alternative drug carriers, into the lymph and blood after duodenal administration in rats. METHODS: Single doses of two different concentrations of aqueous dispersions of unlabelled and labelled SLN (average diameter 80 nm) were administered intraduodenally to rats. At different times, samples of lymph were withdrawn by cannulating the thoracic duct and blood was sampled from the jugular vein. Monitoring continued for 45 and 180 minutes, for unlabelled and labelled SLN respectively. The biological samples were analysed by photon correlation spectroscopy (PCS), transmission electron microscopy (TEM) and gamma-counting. RESULTS: TEM analysis evidenced SLN in lymph and blood after duodenal administration to rats: the size of SLN in lymph did not change markedly compared to that before administration. The labelled SLN confirmed the presence of SLN in lymph and blood. CONCLUSIONS: The uptake and transport of SLN in the lymph, and to a lesser extent in the blood, were evidenced. The in vivo physical stability of SLN may have important implications in designing drug-carrying SLN.     

Ischemic hepatitis

In ischemic hepatitis, which is not rare, there is a marked but transient increase in serum aminotransferase activity to at least 20 times the upper limit of normal, without any other cause for hepatic necrosis. It is generally preceded by an acute cardiac complication, usually pulmonary edema or a tachyarrhythmia, causing decrease in cardiac output, or may follow acute respiratory failure. The typical histological lesion is centrilobular hepatic necrosis. We present 2 cases of ischemic hepatitis due to hypotension following rapid atrial fibrillation, sepsis and acute respiratory failure, highlighting the different etiologies, laboratories results, and the relative benign course, described in the literature. The patients were a woman aged 80 and a man aged 76. Awareness of the place of this disorder in the differential diagnosis of acute hepatitis may save needless, dangerous investigations.     

Isoniazid-related hepatitis

Conclusive evidence of isoniazid (INH)-related hepatotoxicity ranging from asymptomatic elevation of liver enzymes to fulminant hepatic failure resulting in liver transplantation and/or death has been firmly established. Anticipation of the widespread usage of INH in the prevention and treatment of tuberculosis is expected due to the recent increasing incidence of tuberculosis. The aim of this article is to review the current concepts of pathogenesis, histopathology, risk factors and clinical features of INH-related hepatitis, emphasizing the need for vigilance.     

Alcoholic hepatitis

Alcoholic hepatitis is the precursor of cirrhosis. Susceptibility is independent of amount and duration of ethanol intake or of diet. Centrilobular hyalin, the key morphologic abnormality, sensitizes lymphocytes to secrete factors which may account (in part) for necrosis, liver cell destruction, increased collagen synthesis and development of cirrhosis. Diagnosis may be facilitated by detection of alcoholic hyalin antigen (AHAg) and antibody (AHAb) in serum of patients with alcoholic hepatitis. Treatment requires abstinence. Steroids have not reduced mortality rates. Measures to improve immunologic reactivity may be helpful. Persons unable to abstain should be enrolled in a surveillance group.     

Viral hepatitis

On a background of acute bulbar dysfunction, a patient experienced the simultaneous onset of severe proprioceptive loss and paralysis of automatic respiration that rapidly reverted to normal. Subsequent progressive neurological deterioration over several months ended in death, and neuropathological examination revealed demyelination in discrete distribution. The anatomical and diagnostic implications of this are briefly discussed.     

Chronic hepatitis C virus positive hepatitis and antiphospholipid syndrome

The antiphospholipid syndrome, disorder in which venous and arterial thrombosis may occur, has been described in association with systemic lupus erythematosus and later in a great variety of entities, including infectious diseases. It has been described recently a high frequency of antiphospholipid syndrome in patients with chronic hepatitis C. We present a case of cirrhosis with hepatitis C virus markers and criteria for antiphospholipid syndrome, and we review the literature.     

Chronic hepatitis]

Parental investment theory postulates that where physical condition varies significantly then birth sex ratio will be correlated with social status. Application of this theory to man remains contentious. This study examines physique, wealth, and social status in relation to the sex of live births. It reports a female-biased sex ratio in high social and economic status Nepalese. Close consanguineous marriage, intended to conserve landed wealth within related lineages, and increased female work burdens accompanying larger farm size, are proximate factors which may underlie this finding. A differential payback hypothesis is one way of explaining this pattern.