Evaluation of the compliance with recommended procedures in newborns exposed to HBsAg-positive mothers: a multicenter collaborative study.

BACKGROUND: Maternal-infant transmission of hepatitis B virus (HBV) during birth carries a high risk for chronic HBV infection in infants with frequent subsequent development of chronic disease. This can be efficiently prevented by early immunization of exposed newborns. The purpose of this study was to determine the compliance with official recommendations for prevention of perinatal HBV transmission in hepatitis B surface antigen (HBsAg) exposed infants. METHODS: Records of pregnant women at 4 sites in Switzerland, admitted for delivery in 2005 and 2006, were screened for maternal HBsAg testing. In HBsAg-exposed infants, recommended procedures (postnatal active and passive immunization, completion of immunization series, and serological success control) were checked. RESULTS: Of 27,131 women tested for HBsAg, 194 (0.73%) were positive with 196 exposed neonates. Of these neonates, 143 (73%) were enrolled and 141 (99%) received simultaneous active and passive HBV immunization within 24 hours of birth. After discharge, the HBV immunization series was completed in 83%. Only 38% of children were tested for anti-HBs afterwards and protective antibody values (>100 U/L) were documented in 27% of the study cohort. No chronically infected child was identified. Analysis of hospital discharge letters revealed significant quality problems. CONCLUSIONS: Intensified efforts are needed to improve the currently suboptimal medical care in HBsAg-exposed infants. We propose standardized discharge letters, as well as reminders to primary care physicians with precise instructions on the need to complete the immunization series in HBsAg-exposed infants and to evaluate success by determination of anti-HBs antibodies after the last dose.

Agreed-upon procedures report on the City of Prairie City, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Prairie City, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Granger, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Granger, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Wall Lake, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Wall Lake, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of New Vienna, Iowa for the period August 1, 2013 through July 31, 2014

Agreed-upon procedures report on the City of New Vienna, Iowa for the period August 1, 2013 through July 31, 2014

Agreed-upon procedures report on the City of Sidney, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Sidney, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Monroe, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Monroe, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Lambs Grove, Iowa for the period August 1, 2013 through July 31, 2014

Agreed-upon procedures report on the City of Lambs Grove, Iowa for the period August 1, 2013 through July 31, 2014

Agreed-upon procedures report on the City of Dallas Center, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Dallas Center, Iowa for the period July 1, 2013 through June 30, 2014

Roux-en-y Gastric Bypass is Superior to Gastric Banding in Non-superobese Patients. a Matched-case Study with Five-year Follow-up

Background: Roux-en-Y gastric bypass (RYGBP) and gastric banding (GB) are the two most popular bariatric procedures. Only few studies have compared their results and follow-up duration is usually limited to <3 years. Patients and Methods: Using our prospective bariatric database, we matched non-superobese GB to RYGBP patients for sex, age and BMI to RYGBP. Follow-up considered up to five years. Results: 442 patients were matched in 221 pairs. Mean age (38,6) and mean BMI (43) were identical. Overall operative morbidity was higher after RYGBP (17,2 versus 5,4 %, p<0,001), but major morbidity was similar (3,6 versus 2,2 %, p=0,57). More patients developed long-term complications after GB (43,9 % versus 19 %, p<0,001), and more required reoperations (24,4 % versus 12 %, p=0,001). After RYGBP, reoperations were mainly due to internal hernias (87 %), with no reversal, whereas 18,5 % of the GB patients required band removal. Even including only patients who retained their band, weight loss after RYGBP was better throughout the study period, with 5-year EBMIL of 77,6 % and 61,7 % (p<0,001) after RYGBP and GB respectively. RYGBP was associated with better food tolerance and greater improvement of the lipid profile. Conclusions: GB is associated with a smaller overall operative morbidity and similar major morbidity, but with more long-term complications, more reoperations, a significant number of reversal or conversion procedures, and reduced weight loss when compared with RYGBP. Five-year results of RYGBP are superior to GB and patients should be informed accordingly.

Agreed-upon procedures report on the City of Derby, Iowa for the period August 1, 2013 through July 31, 2014

Agreed-upon procedures report on the City of Derby, Iowa for the period August 1, 2013 through July 31, 2014

Agreed-upon procedures report on the City of Stanwood, Iowa for the period November 1, 2013 through October 31, 2014

Agreed-upon procedures report on the City of Stanwood, Iowa for the period November 1, 2013 through October 31, 2014

Agreed-upon procedures report on the City of Harper, Iowa for the period November 1, 2013 through October 31, 2014

Agreed-upon procedures report on the City of Harper, Iowa for the period November 1, 2013 through October 31, 2014

Agreed-upon procedures report on the City of Brayton, Iowa for the period September 1, 2013 through August 31, 2014

Agreed-upon procedures report on the City of Brayton, Iowa for the period September 1, 2013 through August 31, 2014

Agreed-upon procedures report on the City of Hamburg, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Hamburg, Iowa for the period July 1, 2013 through June 30, 2014