Prevalence of Hepatitis B Infection Among Young and Unsuspecting Hmong Blood Donors in the Central California Valley

Chronic hepatitis B virus (HBV) infection may result in cirrhosis and/or hepatocellular carcinoma and is one of the leading causes of mortality in Asian Americans including Hmong Americans. The Central California Valley is home to a huge Hmong population. To date, the true prevalence of HBV among Hmong is largely unknown. The aim of this study was to contribute to the limited data on HBV prevalence and its trends in Hmong population in the Central California Valley. Between fiscal years 2006 and 2010, a total of 219, 450 voluntary donors were identified at Central California Blood Center in Fresno. Of these, 821 (399 males and 422 females) were Hmong donors. A cross-sectional review of the HBV (hepatitis B surface antigen) positivity among all donors was carried out. Prevalence estimates with 95% confidence intervals (CI) were calculated. Ninety-two percent of Hmong donors were between age groups 16 and 35 years, and only 8% were ≥36 years. The overall prevalence in Hmong was noted at 3.41% (95%CI 2.3–4.9) compared to 0.06% (95%CI 0.05–0.07) in donors of all ethnicities. The calculated prevalence could be an underestimate of the true HBV prevalence in Hmong as the study enrolled only healthy blood donors with predominant younger age (≤35 years) population. These results underscore the persistent burden of HBV infection and potentially increased risk of premature death even in the second generation Hmong community of the Central California Valley. This study reemphasizes the unequivocal need to develop robust preventive and treatment strategies for HBV in Hmong community.     

Predicting nurses' turnover intentions by demographic characteristics,perception of health,quality of work attitudes

The purpose of this paper is to examine the impact of demographic variables, organizational commitment levels, perception of health and quality of work on turnover intentions. A self‐reported cross‐sectional survey design was used to collect data from Jordanian registered nurses who were working between June 2011 and November 2011. The findings showed strong effects of the quality of work, perception of health and normative organizational commitments on turnover intentions. This study sheds the light on the important work outcomes in health‐care organizations. Increasing nursing quality of work and normative organizational commitment are good strategies for reducing turnover intentions.     

Accelerated patent hemostasis using a procoagulant disk; a protocol designed to minimize the risk of radial artery occlusion following cardiac catheterization

Purpose

Radial artery occlusion flowing cardiac catheterisation has been linked to flow reduction and prolonged compression. We investigate whether these factors can be optimised following transradial cardiac catheterisation by using an accelerated band removal protocol facilitated by a haemostasis promoting pad, in combination with a patent haemostasis technique.

Lipomatous hypertrophy of the interatrial septum

Lipomatous hypertrophy of the interatrial septum is a rare conditionand it does not require any specific treatment. We present thetransoesophageal echocardiogram findings of a 70-year-old ladydemonstrating the appearances that were typical of lipomatoushypertrophy of the interatrial septum.     

A randomized trial of glyceryl trinitrate ointment and nitroglycerin patch in healing of anal fissures

Mean maximum anal resting pressure is directly related to the activity of the smooth muscles of the internal and external sphincters and has been found to be increased in the patients of anal fissure. It has been shown that blood flow at the posterior midline of anoderm is inversely related to the mean maximum anal resting pressure, and topical application of glyceryl trinitrate (GTN) ointments is a very successful treatment. This randomized study was designed to evaluate the relative value of a nitroglycerin patch applied at a distance from the fissure site in healing anal fissure compared to GTN ointment and compared to surgical treatment. Forty-two consecutive patients with chronic anal fissure of more than 4 months' duration were randomized into two equally sized groups: those in group A received 0.2% GTN ointment while those in group B received a 10-mg nitroglycerin patch for 8 weeks. Patients were also asked to rate their pain intensity on a scale of 0-10. Five patients were excluded for various reasons; results were analyzed for the remaining 37 patients (group A, n=18; group B, n=19). A control group C consisted of 12 patients who underwent surgical treatment. Fissures healed completely in 12 of 18 (66.7%) patients in group A, 12 of 19 (63.2%) in group B and 11/12 (91.7%) in group C. The healing rates in groups A and B did not differ significantly (P=0.7), nor was there a difference between these and surgical group C (P=0.13). The local application of GTN ointment and the nitroglycerin patch are both effective, economical, and alternative treatment options for most patients with anal fissures.