Search

Prior international studies have shown mixed results regarding the association of hepatitis B and hepatitis C with adverse pregnancy outcomes. We performed an updated evaluation of the prevalence of associated adverse pregnancy outcomes and evaluated trends over time of diagnosis of chronic hepatitis B (HBV) and chronic hepatitis C (HCV) in pregnant women in a national database. All pregnant women with HBV and HCV were identified from the National Inpatient Sample database 2012 to 2018. Multivariate logistic regression analyses were performed to compare pregnancy‐related complications, including rates of preeclampsia/eclampsia, gestational diabetes, intrauterine growth restriction, antepartum/intrapartum hemorrhage, preterm labor, and Cesarean section. We evaluated all‐cause in‐hospital mortality, length of stay, and total cost of hospitalizations. A total of 28.7 million pregnancy‐related hospitalizations that met our eligibility criteria were identified, including 51,200 with HBV and 131,695 with HCV. In comparison with the uninfected controls, the HBV group was significantly more likely to develop gestational diabetes (12.94% vs. 6.94%, p < 0.001). The HCV group was more likely to have preterm labor (9.63% vs. 6.27%, p < 0.001), intrauterine growth restriction (6.04% vs. 2.89%, p < 0.001), longer length of stay (3.4 days vs. 2.7 days, p < 0.001), and higher hospitalization cost (15,052 dollars vs. 14,258 dollars, p < 0.001). These findings should inform counseling of women who are found to have HBV or HCV during pregnancy regarding the risk of adverse pregnancy outcomes and support the need for an interdisciplinary approach to optimize maternal and neonatal outcomes. [ABSTRACT FROM AUTHOR]

Hepatitis delta virus (HDV) infection is caused by a unique circular RNA virus that relies on both the hepatitis B virus (HBV) antigen and human host polymerases for its transmission and replication. HDV infection can be acquired simultaneously with HBV as a coinfection or as a superinfection in patients already chronically infected with HBV. Chronic HDV is the most severe and progressive form of viral hepatitis-- induced liver disease, accounting for significant morbidity and mortality worldwide. Despite the severity of disease and poor clinical outcomes, there are few therapeutic options for the treatment of HDV infection. This article discusses the epidemiology of HDV globally and in the United States, the diagnosis and clinical course of HDV infection, and the current and future therapeutic options for the management of HDV infection. [ABSTRACT FROM AUTHOR]

Instruction for counseling patients with diabetes is based primarily on intuition from clinical experience and inferences from related research. To identify potentially useful counseling techniques, we elicited descriptions of effective skills from analogue patients (APs) who played the roles of diabetic patients in practice counseling sessions with nurse and dietitian course participants. APs were first- and second-year graduate students in psychology, trained to play one of four patient roles. After each role play, the APs provided written feedback regarding “three things the counselor did that I felt best about.” The two most frequently cited behaviors were (1) considering needs other than those related to diabetes in making adherence recommendations, and (2) providing clear, concrete advice. Further research with actual diabetic patients is needed to validate the present findings and to explore such ambiguities as when to give advice versus when to ask questions. [ABSTRACT FROM PUBLISHER]

Although increasing emphasis has been placed on multidisci plinary teams, there is a signifi cant discrepancy between dia betes nurse educators' per ceptions of actual and ideal multidisciplinary participation in diabetes patient education (DPE). Twenty-six diabetes nurse educators rated frequencies of ideal and actual participation from 1 (never) to 5 (always). The mean ideal ratings for physicians, pharmacists, social workers, dietitians, and nurses were greater than 4.0, but only nurses and dietitians received comparable actual participation ratings. [ABSTRACT FROM PUBLISHER]

The multidimensionality of diabetes has become more apparent during the past 10 years. Science and technology have ex panded the tasks of patients as well as profes sionals. Awareness of psychosocial aspects of the disease has increased. The range of professionals and settings providing diabetes care has grown. Professional education in diabetes has also broad ened. Courses at Diabetes Research and Training Centers now target profes sionals as diverse as social workers, pharma cists, and hospital admin istrators, and discuss social/psychological im pacts, self-care, and institutional support for diabetes education. Com ing full circle, continuing technological advances highlight the need for renewed emphasis on physician education. [ABSTRACT FROM PUBLISHER]

Over a three-year period, 202 nurses and dietitians attended professional edu cation courses conducted at the Diabetes Research and Training Center. The courses were designed to develop trainee knowledge and skill for diabetes management and to guide the expansion of patient education programs. Trainees' satisfaction with the course components was high and knowledge changes were significant. Sixty-one percent of the trainees returned a follow- up survey indicating im provements in counseling and teaching skills. Trainees' reports indicated greatest progress in areas over which they had most direct control.Professional education may have positive effects on trainee knowledge, teaching preparation and counseling skills, and patient education programs. [ABSTRACT FROM PUBLISHER]

The frequency of symptoms between urban and rural schizophrenic patients was compared in 275 consecutive admissions of schizophrenics, who were rated on two rating scales by psychiatrists, using a structured interview. There were significant differences between urban and rural schizophrenics; rural patients were more frequently apathetic, blunted, labile, angry, aggressive, negativistic and uncooperative, while urban schizophrenics were more often anxious, rigid, ambivalent, disoriented, conceptually disorganised and asocial. Significant symptom differences were also found for only older or younger schizophrenics. [ABSTRACT FROM PUBLISHER]