Anti-racist approaches to increase access to general and oral health care during a pandemic in the Pacific Islander community

Limited data exists on Pacific Islander (PI) health, but a growing body of literature reports the existence of racial discrimination and inequities and mistrust of the healthcare system, leading to poor health outcomes. When COVID‐19 restricted health services, such inequities and mistrust due to historical trauma were magnified. This report describes one federally qualified health center's dental department's response utilizing culture‐based approaches, community relationships, and the social determinants of health (SDOH) to dispel the stigma of COVID and restrictions on in‐person care in order to lower barriers to accessing care. When the dental department transitioned to emergency‐only care, staff were redeployed to address significant inequities facing the PI community. Redeployment activities included building relationships with the most vulnerable patients, delivering healthy foods, supplies, oral hygiene kits to households, and canvasing neighborhood businesses with public health education. The mobile dental clinic, a trusted symbol in the community, also brought public health education to community testing events and food distributions. From March 2020 to July 2020, staff conducted over 800 outreach calls for health and food security, delivered over 2000 care packages and oral hygiene kits. Also, frequent community outreach by the mobile dental clinic led to a 10‐fold increase in COVID testing. Investing in relationship building can maintain access to health care and build trust in the health care system for PI communities. This approach may be relevant to others serving other communities experiencing racism.

Sequence analysis of hepatitis C virus isolated from a fulminant hepatitis patient

Although hepatitis C virus (HCV) is a major cause of non-A non-B hepatitis, its pathogenic role in fulminant hepatitis remains controversial. A 32-year-old man contracted hepatitis. Serum ALT concentration was reached to 6,970 IU/L, the lowest prothrombin time value was 16% and jaundice and stage II encephalopathy were developed. HCV RNA was detected in this patient by reverse transcription polymerase chain reaction in sera at the acute phase, and it was undetectable during the remission phase when anti-HCV was found. The entire genome of infected HCV was recovered, cloned, and sequenced from this patient, and compared with the clones of six other chronic hepatitis patients. Phylogenetic analysis revealed a clustering around genotype 2a and a deviation from the other 2a chronic hepatitis strains. Calculating the genetic distance in each subgenomic region revealed that the 5'untranslated region (5'UTR), core, nonstructural (NS) 3, and NS5A were severely deviated. Of 20 clones of the hypervariable region (HVR), 17 showed an identical sequence with the others showing a difference of only one amino acid. HCV was isolated from a fulminant hepatitis patient and its entire genome was recovered; a clustering around genotype 2a was observed, but the sequence deviated especially in 5'UTR, core, NS3, and NS5A; and monoclonality of the HVR sequence was found not only in the fulminant hepatitis patient but in a certain percentage of chronic hepatitis patients.

Sequence analysis of hepatitis C virus isolated from a fulminant hepatitis patient

Although hepatitis C virus (HCV) is a major cause of non-A non-B hepatitis, its pathogenic role in fulminant hepatitis remains controversial. A 32-year-old man contracted hepatitis. Serum ALT concentration was reached to 6,970 IU/L, the lowest prothrombin time value was 16% and jaundice and stage II encephalopathy were developed. HCV RNA was detected in this patient by reverse transcription polymerase chain reaction in sera at the acute phase, and it was undetectable during the remission phase when anti-HCV was found. The entire genome of infected HCV was recovered, cloned, and sequenced from this patient, and compared with the clones of six other chronic hepatitis patients. Phylogenetic analysis revealed a clustering around genotype 2a and a deviation from the other 2a chronic hepatitis strains. Calculating the genetic distance in each subgenomic region revealed that the 5'untranslated region (5'UTR), core, nonstructural (NS) 3, and NS5A were severely deviated. Of 20 clones of the hypervariable region (HVR), 17 showed an identical sequence with the others showing a difference of only one amino acid. HCV was isolated from a fulminant hepatitis patient and its entire genome was recovered; a clustering around genotype 2a was observed, but the sequence deviated especially in 5'UTR, core, NS3, and NS5A; and monoclonality of the HVR sequence was found not only in the fulminant hepatitis patient but in a certain percentage of chronic hepatitis patients.

Hepatitis C virus infection in patients with B-cell non-Hodgkin's lymphoma

OBJECTIVE

As a causative role of hepatitis C virus (HCV) in B-cell lymphoproliferative disorders (LPD) has been suggested by several reports, we investigated the prevalence of HCV infection among patients with LPD at our hospital with the aim of clarifying the clinical features and the outcome for HCV antibody-positive patients with non-Hodgkin's lymphoma (NHL).

METHODS

Retrospective chart review.

PATIENTS

A total of 123 patients with B-cell LPD (4 with chronic lymphocytic leukemia, 17 with multiple myeloma, and 100 with B-cell NHL), 38 patients with non-B-cell LPD (5 with adult T-cell lymphoma, 8 with Hodgkin's disease, and 25 with non-B-cell NHL) and 516 patients with miscellaneous diseases other than liver diseases or LPD (control) were studied.

RESULTS

HCV infection was detected in 17 of 100 patients with B-cell NHL versus none of 25 patients with non-B-cell NHL (p=0.023) and in 34 patients (6.6%) in the control group with miscellaneous diseases (p=0.0011). In HCV-positive B-cell NHL, primary liver involvement was detected in 3 of 17 patients compared to none of 83 HCV-negative patients (p=0.0019). Intermediate-grade lymphoma (Working Formulation) was the most frequent histology. Eleven of 15 HCV-positive patients achieved complete remission after chemotherapy, and 6 of 7 deaths were caused by liver-related diseases.

CONCLUSION

The prevalence of HCV infection was higher in patients with B-cell NHL than in those with non-B-cell NHL and the control group. Primary liver involvement and liver-related causes of death were frequent in HCV-positive patients with B-cell NHL.

Hepatocyte growth factor stimulates DNA synthesis in rat preneoplastic hepatocytes but not in liver carcinoma cells

BACKGROUND & AIMS

It is not well clarified whether hepatocyte growth factor (HGF) stimulates the growth of preneoplastic hepatocytes and liver carcinoma cells in vivo. The effect of HGF on in vivo DNA synthesis in these cells and also its effect on tyrosine phosphorylation of the HGF receptor protein (c-Met) in liver carcinoma were examined.

METHODS

Lesions were induced in rats using 3'-methyl-4-dimethylaminoazobenzene (3'-Me-DAB). The rats were given intravenous recombinant human HGF or vehicle, and DNA synthesis was assessed by the 5-bromo-2'-deoxyuridine labeling index. Tyrosine phosphorylation of c-Met by HGF was analyzed by Western blot.

RESULTS

The labeling indices were significantly higher in the HGF group than in the vehicle control group in altered foci and hyperplastic nodules (preneoplastic hepatic lesions). No significant differences in the labeling indices were observed between the two groups with carcinoma. Tyrosine phosphorylation of c-Met in carcinoma cells was unaffected by HGF administration.

CONCLUSIONS

HGF promotes the growth of preneoplastic hepatocytes but does not affect the growth of liver carcinoma cells in 3'-Me-DAB-treated rats.

Fumarate-enriched blood cardioplegia results in complete functional recovery of immature myocardium

Amino acid enrichment of cardioplegic solutions has been shown to improve both the metabolic and functional recovery of ischemic myocardium. However, because of the marked systemic vasodilatation involved, use of amino acid enrichment is limited to the periods of induction and reperfusion. Fumarate is a Krebs' cycle intermediate whose conversion to succinate is responsible for the generation of adenosone triphosphate and the oxidation of the reduced form of nicotinamide-adenine nucleotide which is the pathway by which aspartate exerts its effect. Fumarate may also function as a free-radical scavenger and is involved in calcium transport. To determine if fumarate-enriched blood cardioplegia would improve the functional recovery of the neonatal heart, 14 neonatal piglet hearts were isolated and placed on a blood-perfused working heart circuit. After the baseline functional and metabolic assessment was done, cold ischemic arrest was initiated with either standard blood cardioplegic solution (group I; N = 7) or fumarate-enriched (13 mmol/L) blood cardioplegic solution (group II; N = 7). Cardioplegic solution was given at a pressure of 40 mm Hg every 20 minutes for 2 hours, and topical hypothermia was used. Sixty minutes after warm whole blood reperfusion, the functional recovery at left atrial pressures of 3, 6, 9, and 12 mm Hg was 70%, 66%, 66%, and 65%, respectively, in group I, versus 102%, 106%, 105%, and 109%, respectively, in group II (p < 0.05). The tissue creatinine phosphate levels after reperfusion were significantly higher in group II hearts (15.0 +/- 1.2 mumol/g dry heart tissue) than in group I hearts (9.2 +/- 1.9 mumol/g dry heart tissue), although the adenosine triphosphate levels were not significantly different.(ABSTRACT TRUNCATED AT 250 WORDS)

Fiber optic reflectance spectrophotometry system for in vivo tissue diagnosis

Fiber optic probes for a small portable reflectance spectrophotometry system for noninvasive clinical diagnosis have been developed. A slender fiber optic probe, 3 m long, 2.4-mm diameter, which goes into the channel of a fiber optic endoscope, has been developed as the standard probe. To expand the availability and capability of this reflectance spectrophotometry system, some variations of the fiber optic probes were developed: contact sensor, pressure sensor, attachments for dental use, and a modified-shape probe head for continuous monitoring. The feasibility of these fiber optic probes was examined experimentally.