Hepatitis C and the heart: to beat or not to beat

BACKGROUND

Many enteroviruses as well as hepatitis C have been increasingly found in association with cardiomyopathies, even though, the evidence has been inconclusive.

METHODS

From 1998 to 2001, at the liver clinic of our community-based hospital, in the cohort of hepatitis C patients, infection evidence by PCR confirmation and echocardiographic measures of left ventricular (LV) function were obtained.

RESULTS

One hundred-eight patients were identified. Fifty percent of them have echocardiographic abnormalities. Patient's mean age was 55 +/- 10 years; 45% women, 55% men; 32% had LVH, 13.8% had high right ventricular systolic pressures, and 4% displayed contractility abnormalities. No cases of dilated or hypertrophic cardiomiopathies were found.

CONCLUSIONS

Echocardiographic abnormalities are not uncommon findings associated with hepatitis C infection, however all these findings can easily be explained by existing co-morbidities. High right ventricular systolic pressure, suggestive of pulmonary hypertension, which may be secondary to portal hypertension, is an independent finding for hepatitis C.

Treatment of Sexual Disinhibition in Dementia: Case Reports and Review of the Literature

Behavioral problems are common in dementia patients. They are complex in nature and are often the presenting symptoms of dementia. Its management poses continuous challenge. Gabapentin is an antiepileptic agent that has a role in the management of behavioral problems in demented patients such as agitation and aggression. Its role in treating sexual disinhibition has never been addressed. We describe 3 nursing home residents in 2 dementia units whose sexual disinhibition was effectively treated with gabapentin.