Cingles Info

Hi Pam,
A per our conversation:
As you know I was officially diagnosed with Hep-C in 2000 so I am familiar
with some of the issues of having the dragon. And I am veteran so
that makes it all the more interesting as well as challenging.
I want to produce a TV show about Hep-C. I am looking for people that
have stories that are unusual, in regards to how much of a disruption
the virus has caused in their lives either personally or professionally.
For example: A family that was broken up because of a misunderstanding
about the disease. One scenario may be something on the order of one
spouse contracting Hep_C and the other spouse acting under the
presumption that Hep-C was an STD and consequently breaks up the home.
Or the devastation that a family would go through if they discovered
their child was infected.
I want to bring the emotions of these types of scenarios to be "in the
face" of the viewer. In my opinion what we know and believe does not
constitute our reality near as much as what we feel. I'm not looking for
happy endings necessarily. I am looking for harsh stories that are
factual first of all and represent the ordeal(s) that the public may not
consider about Hep-C.
If you have any question or if you want to send me your story, you can
email me at:
hep-c@...
Best regards,
John

Thanks Tricia for giving me the straight coop,this is were this
groups do there best in helping each other out.I realize that i need
to learn more about HCV,and what it is doing to me.There is no reason
why I,m so ignorant in this field,my God,I should know what's going
on in my own body.I waiting for the results from my latest blood test
and yes I will ask for a copy and I will throw them out here for some
help.Thanks again for your post Tricia,LOL,David

HERE ARE SOME OF MY NUMBERS MAYBE SOMEONE CAN TELL ME WHY THEY DON'T GIVE ME
TREATMENT?
7/3/2002
ALT 357H
ST 131H
2/24/2003
AST H 114
ALT H 274

Hepatitis C Associated With Atherosclerosis in Patients With Diabetes
NEW YORK (Reuters Health) Mar 12 - Hepatitis C (HCV) seropositivity appears to
be an independent risk factor for atherosclerosis in patients with type 2
diabetes, Japanese physicians report in a Research Letter in the March 12th
issue of the Journal of the American Medical Association.
Dr. Michiaki Fukui, of Osaka General Hospital of West Japan Railway Company, and
colleagues evaluated 210 patients with type 2 diabetes who were being screened
with carotid ultrasonography.
Thirty-one patients tested positive for anti-HCV antibodies. Mean intima-media
thickness was greater, 1.03 mm (p = 0.040) compared with those without anti-HCV
antibodies (0.94 mm). The presence of any plaque was also more likely among
patients with HCV antibodies.
Median plaque score was also significantly higher in those with anti-HCV, and
remained an independent risk factor after controlling for age, hypertension,
hyperlipidemia, smoking history, and glycohemoglobin level (p < 0.001).
Dr. Fukui's team suggests that HCV may mediate its atherosclerotic activity
through increases in serum hepatocyte growth factor and interleukin-6.
They conclude that "prospective, large-scale studies are needed to assess the
association between HCV infection and atherosclerosis."
JAMA 2003;289:1245-1246.
Related Links
Resource Centers
Hepatitis C
http://www.medscape.com/viewarticle/450648?mpid=11033
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A 50-Year-Old Woman With Massive Splenomegaly and Hepatitis C Infection
from Medscape General Medicine [TM]
Posted
Author: Howard Hampel, MD
Series Editor: Richard Goodgame, MD
Case Presentation
The patient is a 50-year-old-woman who was well until 6 months ago when
she began having mild abdominal pain and decreased appetite. The pain was
constant, in the left upper quadrant, exacerbated by movement, and relieved
somewhat by rest. She had mild, early satiety but developed profound decreased
appetite such that she had lost 20 pounds during the previous 6-month period.
There was no dysphagia, dyspepsia, nausea, vomiting, altered bowel habits,
fever, or night sweats.
The patient used intravenous drugs briefly during her twenties and
thirties, but has not used for the last 20 years. She abused alcohol most of her
life but stopped drinking entirely 4 years ago. She has a stable family and
financial situation. There is no family history of serious illness.
Physical examination showed normal vital signs except for a temperature of
99.6ºF. There were no enlarged lymph nodes or skin lesions. There were no
peripheral stigmata of chronic liver disease. The head, ears, eyes, nose, and
throat were normal. Cardiac and pulmonary examinations were normal. The spleen
was massively enlarged, extending inferiorly to below the level of the umbilicus
and easily felt across the midline of the abdomen; it was soft and nontender.
The liver span was 10 cm by percussion; the edge was soft and smooth, easily
felt 2 cm below the right costal margin in the midclavicular line. The
neurologic examination was normal.
Results of routine laboratory studies revealed the following:
Hemoglobin, 10 g/dL
White blood cell count, 13 x 103 cells/mm3
Lymphocytes, 82%
Polymorphonuclear leukocytes, 15%
Platelets, 236 x 103/mm3
Mean corpuscular volume, 91 fL
Total protein, 5.5 g/dL
Albumin 3.1 g/dL
Total bilirubin, 1.1 g/dL
Direct bilirubin, 0.6 g/dL
Alkaline phosphatase, 177 U/L
Alanine aminotransferase (ALT), 111 U/L
Aspartate aminotransferase (AST), 47 U/L
Lactate dehydrogenase (LDH), 304 U/L
Prothrombin time, 12.6 sec
Viral serologies were negative for hepatitis A, hepatitis B, and HIV
markers, but were positive for hepatitis C virus (HCV) antibody. HCV RNA was
positive by polymerase chain reaction (
antinuclear antibody, alpha-1-antitrypsin, ceruloplasmin, alpha-fetoprotein, and
lipids, as well as results of iron studies, were normal or negative.

Medical Therapy, Not TIPS, Should be Standard Therapy for Ascites
Laurie Barclay, MD
March 13, 2003 - Transjugular intrahepatic portosystemic shunts (TIPS) plus
medical therapy is better than medical therapy alone in controlling ascites, but
not in improving survival, hospitalization rates, or quality of life, according
to the results of a multicenter, prospective trial reported in the March issue
of Gastroenterology. The investigators suggest that medical therapy should be
the principal therapy, with TIPS being offered selectively as a bridge to
transplant or for patients with bleeding varices.
"TIPS have recently been used for the treatment of patients with refractory
ascites. TIPS decompress the portal vein and correct portal hypertension without
the need for general anesthesia or major surgery," write Arun J. Sanyal, MD,
from the Medical College of Virginia in Richmond, and colleagues from the North
American Study for the Treatment of Refractory Ascites Group. "The clinical
utility of TIPS vis-a-vis total paracentesis in the management of refractory
ascites is unclear."
Of 109 subjects with refractory ascites, 57 were randomized to medical therapy
alone, consisting of sodium restriction, diuretics, and total paracentesis, and
52 were randomized to medical therapy plus TIPS. Shunting was technically
adequate in 49 of 52 subjects.
Although TIPS plus medical therapy was superior to medical therapy alone in
preventing recurrence of ascites (P < .001), overall and transplant-free
survival were similar in both groups, with 21 deaths in each group. Moderate to
severe encephalopathy showed a trend toward being more common in the TIPS group
(20 of 52 vs. 12 of 57; P = .058).
The two groups were similar in rates of liver failure (7 vs. 3), variceal
hemorrhage (5 vs. 8), and acute renal failure (3 vs. 2). The frequency of
emergency department visits, medically indicated hospitalizations, and quality
of life also did not differ significantly between groups, nor did TIPS obviate
the need for sodium restriction.
No baseline parameters identified a subset of patients who did better or worse
after TIPS placement. In those patients treated with TIPS, the authors recommend
initial placement of a 10-mm diameter TIPS, not pursuing a hepatic venous
pressure gradient target of 8 mm Hg or less, and follow-up sonography or
angiography to monitor for stent stenosis.
"TIPS may be more reasonable in an individual with variceal hemorrhage and
relatively preserved liver function, whereas medical therapy may be a better
option for those with advanced liver failure. It is also important to note that
liver transplantation is the only definitive treatment of cirrhosis with
refractory ascites," the authors write. "Based on these considerations, we
believe the use of TIPS should be reserved in most instances as second-line
therapy or a bridge to liver transplantation, particularly for those with
relatively preserved liver function."
Gastroenterology. 2003; 124:634-641
Reviewed by Gary D. Vogin, MD
Related Links
Clinical Articles
The Management of Cirrhotic Ascites
http://www.medscape.com/viewarticle/450646?mpid=11033
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Normal Liver Enzymes in Patients With Chronic Hepatitis B or C Infection
Posted 03/04/2003
from Medscape Gastroenterology
Question
What is the current status regarding the treatment of patients positive for
hepatitis C or B virus infection who have normal liver aminotransferase levels?
M-Elbagir K. Ahmed, MBBS, MD, FRCP
Response
from David E. Bernstein, MD, 03/04/2003
Normal liver enzymes are a common finding in patients with chronic hepatitis C
infection. Twenty-five percent to 30% of patients with chronic hepatitis C will
have persistently normal liver enzymes. Most patients with such persistently
normal aminotransferase levels will have mild disease on liver biopsy but, when
biopsied, as many as 25% will have significant inflammation or fibrosis. Experts
differ on whether to biopsy this population of patients. In general, patients
with hepatitis C virus infection and normal liver enzyme levels should undergo
liver biopsy. If mild disease is found, treatment is not warranted. If
significant disease is present, treatment is indicated. The best treatment for
this subset of patients is as of yet undetermined, but patients are most likely
to benefit from a combination of pegylated interferon and ribavirin. When
available, patients with hepatitis C and normal liver enzymes and significant
histologic disease should be treated in a study protocol.
Patients with chronic hepatitis B infection who are hepatitis B e antigen
positive and have detectable hepatitis B virus DNA (evidence of ongoing
replication) and an abnormal liver biopsy are candidates for treatment,
regardless of the aminotransferase level.
http://www.medscape.com/viewarticle/449935
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Hepatitis C: Pathogenesis, Virology, and Immunology
Disclosures
Adrian M. Di Bisceglie, MD, FACP
Introduction
Several themes emerged during this year's meeting of the American Association
for the Study of Liver Diseases that related to the pathology, virology, and
immunology of hepatitis C. This report explores these prominent topics and
places them in relevant clinical context.
The Association Between Steatosis and Hepatitis C
It has been recognized for some time that hepatic steatosis is frequently
present in patients with chronic hepatitis C, perhaps more so than in other
forms of hepatitis. The reasons for the latter are not clear. Certainly,
infection with hepatitis C virus (HCV) genotype 3 has been suggested as a risk
factor for hepatic steatosis, but this finding occurs even in patients infected
with other genotypes.
Patton and colleagues[1] conducted a comprehensive assessment of the role of
host and viral factors in the development of steatosis with HCV in a large
patient population. All patients (n = 576) with chronic hepatitis C who were
enrolled in a single-center database in the United States were included and were
naive to treatment at the time of their biopsy. These investigators found that
16% of this patient population had grade 2 or 3 steatosis based on results of
liver biopsy. According to stepwise logistic regression analysis, the only host
factor associated with steatosis was body mass index, whereas viral factors
included HCV genotype 3 and viral load.[1] It appears that hepatic steatosis is
associated with more severe hepatic fibrosis,[2] linked to increased serum
levels of c-peptide and insulin as markers of hyperinsulinism. Hyperinsulinism
has been closely linked with the development of nonalcoholic fatty liver
disease.
Sustained virologic response to antiviral therapy was found to result in a
decrease in hepatic steatosis, independent of weight loss; however, there was
controversy as to whether the latter occurred to a greater extent in patients
infected with HCV genotype 3. Infection with HCV genotype 3 appears to cause
hepatic steatosis to a greater extent than with other genotypes.[3,4]
Other Factors Effecting the Natural History of Hepatitis C
Role of Alcohol Consumption
The outcome of chronic HCV infection is quite variable, with some individuals
having rapidly progressive liver disease and others seemingly having
nonprogressive hepatitis. Alcohol consumption is well known to exacerbate the
chronic liver injury associated with HCV infection, although the mechanisms by
which this occurs are not known. The quantities of alcohol typically reported
are not sufficient to result in liver injury alone.
Sartori and colleagues[5] found that moderate alcohol intake was associated with
increased oxidative stress in patients with chronic hepatitis C. They measured
the products of lipid peroxidation in serum of patients with chronic hepatitis C
who consumed varying degrees of alcohol and compared them with those in normal
controls. Levels of these products were increased even in patients who consumed
moderate amounts of alcohol (up to 50 g per day).
Another interesting effect of alcohol consumption was highlighted by a study
among US Veterans with chronic hepatitis C.[6] The study authors found that the
proportion of patients at their institution who were seropositive for anti-HCV
but negative for HCV RNA (implying that these individuals had cleared HCV
infection) was lower among those with heavy alcohol consumption compared with
those with minimal or moderate consumption. These findings suggest that alcohol
may impair the immune response to HCV infection, thereby increasing the rate of
chronicity. The investigators did not address the issue of how ongoing alcohol
consumption might lead to more severe hepatic fibrosis in those with chronic HCV
infection.
Chemokine and Chemokine Receptor Polymorphisms
An important study of chemokine and chemokine receptor polymorphisms in patients
with hepatitis C failed to confirm a previously reported association between the
CCR5-delta 32 mutation, HCV infection, and increased viral loads. This mutation
has been very convincingly linked with susceptibility to HIV infection and, in a
preliminary report,[7] had been found to be linked with susceptibility to HCV
infection as well.
Promrat and coworkers[8] from the National Institutes of Health evaluated a
series of 5 polymorphisms in chemokines and chemokine receptors, including the
CCR5-delta 32 mutation, in a cohort of 339 patients with chronic HCV infection
and more than 2000 healthy blood donor controls. The frequency of mutations was
the same among patients with chronic HCV infection and controls. It was
interesting to note that a mutation in the RANTES promoter (which can activate
several chemokine receptors) correlated with a less severe degree of hepatic
inflammation, a finding that needs to be validated in further studies.
HIV Coinfection
It has been suggested that HIV infection may result in more severe liver disease
among patients with HCV infection. This concept has been called into question by
Bonacini and colleagues,[9] who followed a cohort of 474 patients with HIV
infection. Of these patients, 233 were seropositive for HCV RNA and 73 were
positive for hepatitis B surface antigen. In fact, patients with HIV infection
and no viral hepatitis had the highest all-cause mortality rates. When this
analysis was corrected for CD4 cell count, survival curves of the HIV alone,
HIV/HCV, and HIV/hepatitis B virus (HBV) groups were superimposable. However,
the rate of liver-related death was higher in patients with either HIV/HCV
coinfection or HIV/HBV coinfection.
Thus, the picture with HIV/HCV coinfection remains unclear. Certainly, these 2
infectious entities are often found together. The frequency of liver mortality
appears to be greater in individuals with coinfection than in those with HIV
infection alone, but the mechanism by which this occurs is the subject of much
speculation. The role of antiviral therapy directed against HIV-induced liver
damage requires further study.
Hepatitis C and the Brain
There is growing interest in the effect of HCV infection on the brain. It
appears that patients with hepatitis C suffer from mild, cognitive impairment
and an excess of psychiatric problems such as depression. The causes for the
latter are not known, but possible explanations include the effects of substance
abuse (frequently associated with HCV infection), presence of a premorbid
condition that may lead to an increased rate of substance abuse and hence to HCV
infection, or, possibly, the direct effects of HCV infection. In patients with
advanced liver disease, the development of hepatic encephalopathy may complicate
the picture even more.
To examine the hypothesis that HCV infects the brain, Laskus and colleagues[10]
studied cerebrospinal fluid from a small series of patients with HCV infection.
Many of these individuals were coinfected with HIV and had spinal tap done for
various clinical indications such as aseptic meningitis. They studied both the
fluid itself and cells found in that fluid, searching for the negative strand of
HCV (viral replicative intermediate) and for HCV quasispecies variability.
Findings from these samples were compared with those of the peripheral blood.
These investigators found an association with HCV-RNA positivity in the
cerebrospinal fluid of HCV-infected persons, particularly in association with
the cellular compartment. The presence of the negative strand of HCV suggested
active HCV replication rather than contamination from the peripheral blood. In
patients harboring different strains of HCV in serum and peripheral blood
mononuclear cells (PBMCs), as determined by phylogenetic analysis, cerebrospinal
fluid-derived strains were more closely related to those found in PBMCs than in
serum. The study authors proposed that PBMCs could carry the virus into the
central nervous system and provide a mechanism for HCV neuroinvasion.
Forton and colleagues[11] were able to identify brain-specific variants of HCV
from brain tissue of HCV-infected individuals collected at autopsy. These
variants had discrete genomic mutations in the internal-ribosomal entry site
(IRES) region of the genome, suggesting that the IRES may be important in
promoting replication of the virus in cells other than hepatocytes.
Newer Diagnostic Tests for HCV Infection
The performance of several newer diagnostic tests for HCV infection was
discussed during these meeting proceedings.
A newly developed qualitative assay for the detection of HCV RNA has a lower
limit of detection of 5.3 IU/mL of serum and appeared to have excellent
performance characteristics when evaluated by Schiff and coinvestigators.[12]
Thus, this assay may have a role in clinical practice for detecting low levels
of viremia, such as those that occur during antiviral therapy or when other
assays are negative.
A new assay is now available to detect HCV core antigen in serum of infected
individuals. This test has the advantages over PCR-based assays of simplicity,
short turnaround time, and low false-positivity rates, but does not quite have
the sensitivity of the PCR-based studies.[13] This novel assay may have a role
in monitoring the effect of antiviral therapy.[14]
In the setting of well-established diagnostic assays with good sensitivity and
specificity, the role of these new assays needs to be further defined.
Predictors of Cirrhosis
Progression of liver disease due to hepatitis C is marked by progression of
hepatic fibrosis. The degree of fibrosis is best assessed by liver biopsy.
However, the search for a noninvasive means of assessing hepatic fibrosis has
been a "holy grail" of hepatology for years.
Based on data from the HALT-C (Hepatitis C Antiviral Long-term Treatment Against
Cirrhosis) trial, Lok and colleagues[15] developed a clinical model to predict
cirrhosis in patients with chronic hepatitis C. They found that the use of
routine laboratory tests such as platelet count, aspartate
aminotransferase/alanine aminotransferase ratio, alkaline phosphatase level, and
prothrombin time give a very good idea of the presence of cirrhosis, but are not
yet accurate enough to replace the role of liver biopsy.
Myers and colleagues, in collaboration with Poynard,[16] evaluated the value of
a panel of serum fibrosis markers to predict the presence of cirrhosis. This
panel included alpha-2-macroglobulin, apolipoprotein A1, haptoglobin, gamma
glutamyl transferase, and total serum bilirubin. Evaluation of this test was
conducted using proprietary methods and the calculated score increased with
worsening fibrosis and could predict cirrhosis with 87% sensitivity and a
negative predictive value of 98%. It is clinically important to determine the
presence of cirrhosis, not only because these patients are at greater risk of
liver disease progression and therefore require aggressive antiviral therapy,
but also because these individuals are targets for screening for esophageal
varices and hepatocellular carcinoma.
References
1.. Patton H, Behling C, Patel K, et al. Body mass index, HCV genotype 3, and
HCV RNA levels are associated with steatosis severity in patients with chronic
hepatitis C. Hepatology. 2002;36:265A. [Abstract #408]
2.. Johnsson J, Hickman IJ, Clouston AD, et al. Fibrosis in chronic hepatitis
C correlates significantly with circulating C-peptide and insulin levels.
Hepatology. 2002;36:272A. [Abstract #436]
3.. Kumar D, Farrell GC, George J. Sustained viral response improves hepatic
steatosis in patients with chronic hepatitis C due to genotype 3, but not
genotype 1. Hepatology. 2002;36:267A. [Abstract #416]
4.. Patton HM, Behling C, Patel K, et al. Steatosis decreases significantly
following successful antiviral treatment for chronic hepatitis C infection.
Hepatology. 2002;36:280A. [Abstract #470]
5.. Sartori M, Mottaran E, Rigaminoti C, et al. Moderate alcohol intake
increases oxidative stress in patients with chronic hepatitis C. Hepatology.
2002;36:385A. [Abstract # 889]
6.. Piasecki B, Reddy R, Lewis JD, et al. Heavy alcohol consumption and
spontaneous clearance of hepatitis C virus infection. Hepatology. 2002;36:385A.
[Abstract #887]
7.. Woitas RP, Ahlenstiel G, Iwan A, et al. Frequency of the HIV-protective CC
chemokine receptor 5-32/32 genotype is increased in hepatitis C.
Gastroenterology. 2002;122:1721-1728.
8.. Promrat K, McDermott D, Gonzalez C, et al. Chemokine and chemokine
receptor polymorphisms and clinical outcomes of HCV infection. Hepatology.
2002;36:385A. [Abstract #890]
9.. Bonacini M, Louie S, Bzowej N. Liver mortality in patients with HIV
infection. Hepatology. 2002;36:230A. [Abstract #255]
10.. Laskus T, Radkowski M, Bednarska A, et al. Detection and analysis of
hepatitis C virus sequences in cerebrospinal fluid. Hepatology. 2002;36:295A.
[Abstract #530]
11.. Forton D, Karayiannis P, Mahmud N, Taylor-Robinson S, Thomas HC.
Identification of brain-specific hepatitis C (HCV) variants and comparative
analysis of translational efficiencies of internal ribosomal entry site (IRES)
RNA sequences. Hepatology. 2002;36:213A. [Abstract #185]
12.. Schiff ER, Shiffman ML, McHutchison JG, et al. A clinical study of the
VERSANT HCV RNA qualitative assays for detection of hepatitis C virus (HCV) RNA
in patients at risk for or suspected of active HCV infection. Hepatology.
2002;36:347A. [Abstract #736]
13.. Lunel F, Veillon P, Payan C. Evaluation of the Ortho total core antigen
assay in comparison to methods of detection and quantitation for HCV RNA.
Hepatology. 2002;36:353A. [Abstract #759]
14.. Maynard M, Buti M, Esteban J, et al. High clinical relevance of total HCV
core antigen testing for monitoring and predicting response to PEG-IFN/ribavirin
combination. Hepatology. 2002;36:353A. [Abstract #761]
15.. Lok ASF, Everhart J, Everson G, et al. Clinical model to predict
cirrhosis in patients in the hepatitis c antiviral long-term therapy against
cirrhosis (HALT-C) trial. Hepatology. 2002;36:315A. [Abstract #608]
16.. Myers RP, Messous D, Thabut D, et al. The prediction of fibrosis with
serum biochemical markers in patients with chronic hepatitis C: Prospective
validation in 534 patients. Hepatology. 2002;36:351A. [Abstract #752]
http://www.medscape.com/viewarticle/444782
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Hi and Welcome
I have been out of town and not able to catch up on posts here!
Anyways I'm Tom aka Tc in Michigan.

Hello,
What's new, whatsnext? I am John, aka Johnny O here. Nice to meet you.
What is your real name?
Johnny O
In a message dated 03/19/2003 6:09:31 PM Pacific Standard Time,
whatnexnow@... writes:

Hi, Tricia, thanks for writing, but I only received part of your e-mail
for some reason. It ended with "I had no insurance when I did treatment
and they had"--- that's all I got. Please resend....
Thanks,
Keith

Hello Group,
Just trying to put some prespective on things so I would like to just
hang around if you guys wouldn't mind.
Guess you could call this an introduction so...
hey...
what's next now....

Hi, Dana
Thanks for writing back. I'm tired and in need of a nap so I'll just say
thanks for now.
Keith

David that sounds like bull to me. I have never heard the viral count affecting
finding out your genotype. Some doc's don't think it matters but it does tell
how well you will do on treatment I believe. A lot of doctors don't do the test
cause it is a separate and expensive test and some insurances don't cover it. He
can't tell from your alts or your rna blood test what your genotype is. Print
out some info and give him or doc shop. Some hate us learning things on our own
cause they don't bother to read the new reports etc. The only good thing I can
say about my doc is he likes "educated" patients and will admit he is stumped
sometimes. Hang in there. Next blood tests ask for copies and you can go on hep
central or throw them out here and people can compare with you. I started in the
hundred thousands range of viral load then went to 4 then 7 million and steadily
up from there over a 6 year period. What I was always told is over 3 mil is
considered high and under is better. Really really high I have seen a couple
people in the 3 digits. I am in 2 now days at 60 mil. They have changed the
tests a lot and how they are measured so it is harder to keep up with it
anymore. I settle for the doc tellling me the little buggers are running wild in
me. Anyway take the reins, if your doctor won't give you real results you can go
to the lab or hospital for copies or ask for you records so you can take them to
another doc. They are supposed to be our property. Good luck, Tricia

Oh! THAT was my mistake...

Does anyone have a big boat we can all take off to the Netherlands in? LOL
Tricia in fantasy land

Hi Joel and welcome :-) It is nice to see some *new faces* speaking up in
this group......... Wish everyone would do that at least once :-) Sorry
to hear you are a non-responder.......... I responded but the treatment
tried to kill me LOL so I can't do it anymore :-( Hope that
something shows up for ALL of us that can't take or don't get results from
interferon/ribaviran. Take care of yourself!
Peace and Love,
·´¨¨)) -:¦:-
¸.·´.·´¨¨))
((¸¸.·´ ..·´ -:¦:-Pam
-:¦:- ((¸¸.·´*
"I have studied many philosophers and many cats. The wisdom of cats is
infinitely superior." - Hippolyte Taine

PRESIDENTIAL LIBRARY DESTROYED BY FLOOD
Crawford, Texas
A tragic flood this morning destroyed the personal library of President
George W. Bush. The flood began in the presidential bathroom where both of
the books were kept. Both books have been lost.
A presidential spokesman said the president was devastated, as he had
almost finished coloring the second one. The White House tried to call
FEMA, but there was no answer
~Bayla~
SVRnWaiting
'C' It! Treat It! Beat It!
If you cry me a river,
I'll build you a bridge
to get over it!

That's very true Tricia........ all the docs don't ever agree on anything!!
LOL You can always doc shop and find one that will *suit your needs*
Don't ever *settle* for one that you aren't happy with......... you need to
TRUST your doc with your health :-)
Peace and Love,
·´¨¨)) -:¦:-
¸.·´.·´¨¨))
((¸¸.·´ ..·´ -:¦:-Pam
-:¦:- ((¸¸.·´*
"I have studied many philosophers and many cats. The wisdom of cats is
infinitely superior." - Hippolyte Taine

New Law Allows Physicians in the Netherlands to Prescribe Medical Marijuana
Under a groundbreaking new law that became effective March 17, 2003 physicians
in the Netherlands will be able to prescribe medical marijuana and pharmacies
will dispense it to patients as they do other prescription medications.
This will make the Netherlands the first country to treat marijuana in the same
manner it treats other prescription drugs.
In order to establish a stable, quality-controlled supply of the medicine, the
Dutch government will shortly begin contracting with medical marijuana growers,
who will be required to meet specific standards covering product quality, as
well as security rules designed to prevent diversion into the illegal market.
Spokesman Bas Kuik of the Dutch government's Office of Medicinal Cannabis said
that he expects the first contract to be signed "somewhere near the end of
March," with the first crop reaching pharmacies in September. Once this system
is in place, pharmacies will be required to dispense only medical marijuana from
these government-licensed providers. Until then, they will be permitted to
obtain the medicine from producers of their own choosing.
While the Netherlands is the second nation to formally sanction the medical use
of marijuana, it is the first to incorporate it in its standard system of
prescription drug regulation. The Canadian government established a medical
marijuana program in July 2001, but only a limited number of patients have made
it through the complex permission process. In addition, Canada has yet to
provide these patients with a legal means of obtaining their medicine, a problem
that has led to continuing litigation.
"This is yet another indication of how out-of-step the U.S. is on medical
marijuana policy," said Robert Kampia, executive director of the Marijuana
Policy Project in Washington, D.C. "While the Netherlands is guaranteeing
patients safe access to quality-controlled medical marijuana through doctors and
pharmacies, we're still fighting just to keep people with cancer and AIDS out of
jail. Americans like Ed Rosenthal face up to 40 years in federal prison for
providing the same service to patients that the government of the Netherlands is
ensuring through licensed producers and pharmacies. The rest of the world
increasingly regards the U.S. policy of criminalizing medical marijuana patients
and providers as cruel and pointless."
The Dutch Office of Medicinal Cannabis can be reached by telephone at
011-31-70-340-5129. Spokesman Bas Kuik can also be reached by e-mail at
bm.kuik@.... The new Dutch law and implementation regulations can be
viewed at http://www.mpp.org/Dutch .
With 11,000 members nationwide, the Marijuana Policy Project works to minimize
the harm associated with marijuana -- both the consumption of marijuana and the
laws that are intended to prohibit such use. MPP believes that the greatest harm
associated with marijuana is imprisonment. To this end, MPP focuses on removing
criminal penalties for marijuana use, with a particular emphasis on making
marijuana medically available to seriously ill people who have the approval of
their doctors.
03/19/03
Source
Marijuana Policy Project (MPP), Washington DC
http://www.hivandhepatitis.com/health/031903b.html
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Cocaine May Blunt Immune Resistance to Infection
By Karla Gale
Intravenous cocaine appears to blunt the interleukin-6 (IL-6) response to
pro-inflammatory challenge, investigators at Harvard Medical School report,
which helps explain why cocaine users are more susceptible to infection.
Cocaine abuse is associated with increased susceptibility to infection and
enhanced progression of HIV disease (see Reuters Health reports, February 14 and
May 22, 2002). To investigate why, Dr. John Halpern and colleagues evaluated the
effects of cocaine on hormone and cytokine responses.
Their placebo-controlled trial involved placement of an indwelling venous
catheter, which leads to inflammation of the surrounding tissue and release of
IL-6. "Thus, catheter placement provides a model for examination of cocaine's
immunological effects," Dr. Halpern's group explains in the March issue of the
Journal of Clinical Endocrinology and Metabolism.
"The model we used is very novel, and involves a way of perturbing the immune
system safely, and seeing how the body reacts," Dr. Halpern told Reuters Health.
The trial included 30 known cocaine users who had used the drug within the
previous month. The subjects would be defined as "occasional users," Dr. Halpern
noted. "Subjects were excluded if they had ever met any of the criteria for
cocaine dependence."
The researchers placed an indwelling catheter into the antecubital vein of the
subjects' nondominant arm 30 minutes prior to i.v. injection of cocaine 0.4
mg/kg or saline into the contralateral arm.
After placebo injection, plasma levels of ACTH, cortisol and DHEA remained
unchanged, but they increased significantly after administration of cocaine (p <
0.002 for each). Hormone levels peaked within 40 minutes, all returning to
baseline levels by 180 minutes after cocaine infusion.
IL-6 levels rose sharply between 150 and 210 minutes after catheter placement,
but serum concentrations were significantly lower at 240 minutes after
administration of cocaine than after placebo (3.85 pg/mL versus 11.64 pg/mL; p =
0.0019). Findings were similar for the 16 female subjects and the 14 male
subjects.
The increased risk of infection among those who abuse drugs is assumed to be
correlated with lifestyle, high-risk behaviors, poor nutrition, and dirty
needles, Dr. Halpern said. "But here's a drug that makes you feel confident to
begin with. People may think, 'I don't engage in those high risk behaviors, so I
say I can handle it.'"
"Meanwhile, this drug is silently altering how the immune system responds to a
triggering event," the researcher added. "So you may end up engaging in
high-risk sexual behavior because you're under the influence of the drug. The
drug is priming tissue to not fight off infection right at the point when the
individual is most in need of a strong immune response."
"If cocaine knocks down immune system by only 5%, but you add to that poor
nutrition and high risk behaviors, that 5% could put you over the top--and you
get HIV."
03/19/03
J Clin Endocrinol Metab 2003;88:00-00.
http://www.hivandhepatitis.com/recent/misc/031903s.html
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38th Annual EASL Conference Is Cancelled Due to Impending Gulf War
Originally scheduled for March 29 - April 1, 2003 in Istanbul, Turkey, the 38th
Annual Meeting of the European Association for the Study of the Liver (EASL),
has been cancelled by its organizers due to the impending threat of war in the
region.
EASL is one of the preeminent annual scientific conferences on viral hepatitis
and other liver-related medical disorders.
No new date for the EASL meeting is set as yet. Release of information on the
results of several important studies on hepatitis B, hepatitis C and hepatitis
co-infection with HIV will be indefinitely delayed will be delayed indefinitely
as a results of the conference postponement.
In addition, the scheduled release of new recommendations by the EASL consensus
panel on Management of Hepatitis B will be delayed.
Following is the text of the announcement from the meeting's secretariat:
"It is with great regret that we have to announce that the EASL Annual Meeting
that was scheduled for 29 March - 1 April 2003 in Istanbul, Turkey, has been
cancelled. The uncertainty of the present political situation has been felt too
unstable by all parties involved in the meeting and this would have prompted a
poorly attended event with a major proportion of speakers not being there to
present the results of their research. We have waited until the very last days
to take this undesired and less than optimal decision in the hope that the
political situation would have clearly improved making the risk of war unlikely.
"We have to be supportive of our friends in Turkey whose tremendous efforts
during the last years had set up an outstanding event, that at this stage, we
will not be fortunate enough to enjoy. At the same time, we are evaluating the
best alternatives to be taken into account to still have a 2003 EASL Annual
Meeting.
"We wish, on this occasion, to stress that any registration fees paid to attend
the Annual Meeting in Istanbul 29 March - 1 April 2003, will be credited towards
the new dates of the meeting.
"Information about all aspects will be released through the usual electronic and
conventional mailing systems, but at this time it has to be stressed that all
new developments and final decisions will be posted on our web page.
Accordingly, please visit it regularly to access the most updated information as
soon as it is available."
We thank you for your understanding,
Jordi Bruix
Scientific Secretary
http://www.hivandhepatitis.com/hep_c/news/031903a.html
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Will the New Respiratory Syndrome Fizzle Out or Develop into a Lethal Pandemic?
By Ronald Baker, PhD
Scientists are holding their breath concerning recent reports on the severe
acute respiratory syndrome (SARS), a life-threatening illness that has affected
more than 500 people worldwide and killed 9, mostly in Asia.
The latest news from China has made health authorities guardedly optimistic.
China has reported 305 cases, including 5 deaths, in an outbreak that began in
November and which Chinese government officials say may have ended in late
February. The hope is that the illness will burn itself out elsewhere as well.
The respiratory infection is a pneumonia-like illness that causes a high fever,
breathing problems and a dry cough, among other symptoms (See "SARS Symptoms"
below). Laboratory tests have so far failed to identify any cause for the
illness, and neither antibiotics nor antiviral drugs have proved effective in
combating it. Scientists believe that it is a known organism that is difficult
to grow or a novel one.
The US Centers for Disease Control and Prevention (CDC) continues to advise
travelers to postpone elective and nonessential travel to affected areas. No
cases have been reported in the United States. Doctors have reported 14
suspicious US cases, but 10 have been judged not to be SARS, and it is unlikely
that the four others will turn out to be, Dr. Gerberding said.
The number of cases more than doubled yesterday in Hong Kong, to 95 from 49 on
Sunday; officials said 12 of the 95 were not confirmed. German health officials
said Germany had three cases. The World Health Organization (WHO) reports that
there were 169 cases, including 4 deaths, reported since Feb. 1. They are from
Canada, Germany, Hong Kong, Switzerland, Thailand and Vietnam. The agency
dropped the Philippines from its list yesterday because cases there did not meet
the criteria for SARS. Indonesia was dropped yesterday and Switzerland may be
dropped today for the same reason.
Initial story on SARS outbreak
SARS Symptoms
Health officials are advising all travelers to be aware of the symptoms of SARS.
These include the following
- sudden onset of a high fever (
- One or more signs or symptoms of respiratory illness including dry cough,
shortness of breath, difficulty in breathing, hypoxia, radiographic findings of
pneumonia, or respiratory distress; AND
One or more of the following:
- History of travel to Hong Kong or Guangdong Province in the People's
Republic of China or Hanoi, Vietnam, within 7 days of symptom onset
- Close contact with persons with respiratory illness having the above travel
history. Close contact includes having cared for, lived with, or had direct
contact with respiratory secretions and body fluids of a person with the severe
acute respiratory syndrome (also being called SARS)
Standard lab tests often show low numbers of white blood cells and platelets.
Any traveler who develops these symptoms is advised not to undertake further
travel until they have recovered.
In another unusual action, the CDC has activated its emergency operations center
in Atlanta. The agency has only done this twice in its history, once for the
West Nile fever epidemic in 2002 and then the anthrax attacks in 2001. WHO
officials said they could not recall the last time an emergency global travel
advisory was issued.
CDC Recommendations
In addition to the symptoms outlined above, the CDC has issued the following
information about signs of SARS:
Probable Case
- A suspect case with chest x-ray findings of pneumonia or Respiratory
Distress Syndrome OR
- A person with an unexplained respiratory illness resulting in death, with an
autopsy examination demonstrating the pathology of Respiratory Distress Syndrome
without an identifiable cause
- In addition to fever and respiratory symptoms, SARS may be associated with
other symptoms, including headache, muscular stiffness, loss of appetite,
malaise, confusion, rash, and diarrhea.
CDC has been working with WHO to investigate and confirm the outbreaks of this
severe form of pneumonia. The outbreaks appear to primarily involve health-care
workers and close family contacts to suspect cases. WHO recommends the use of
isolation and barrier nursing techniques for patients who have atypical
pneumonia and any possible links to the outbreaks and that suspect cases be
reported to national health authorities.
As an added measure for hospitalized patients, CDC recommends standard and
respiratory precautions with use of a personal respirator during any close
contact with cases and suspect cases. Standard precautions routinely include
careful attention to hand hygiene. When caring for patients with SARS,
health-care workers should wear eye protection for all patient contact.
To minimize the potential of transmission outside the hospital, case patients as
described above should limit interactions outside the home until the
epidemiology of illness transmission is better understood. Placing a surgical
mask on case patients in ambulatory health-care settings, during transport, and
during contact with others at home is prudent.
CDC advises that persons planning elective or nonessential travel to areas
affected by the outbreak may wish to postpone their trips until further notice.
Updates will be posted about the outbreaks as information becomes available.
03/19/03
Sources
US Centers for Disease Control and Prevention (CDC)
Msnbc.com
http://www.hivandhepatitis.com/health/031903a.html
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((((Tricia)))) So good to see you out and about...... hope you are doing
okay at your end........ I keep meaning to call you........ I promise to do
that SOON! Here are a few links for Keith
http://www.beincharge.com/resources/ctc.htm
http://www.pegasys.com/resources/pegassist.asp
http://www.hepatitisneighborhood.com
Peace and Love,
Pam
Dogs come when they're called. Cats take a message and get back to you. --
Missy Dizick

Gil,I had a blood test on 3/12/03,this is 1 1/2 years after my first
and i'm waiting for the results,but as we were going over my blood
tests that was taken in the last month of my tx,my viral load was
undetectable and when I ask him what was my geno type,he look at my
blood workup and it said there was'nt enough of the virus in my blood
to determine what geno type i was.I'm still waiting for my resent
blood work to come back.David

Hi Gil...... I guess I am confused........ your goal is NOT to live until
you are 90? I would sure like to live until I was 90 :-) LOL Anyway,
sometimes if the docs decide you are too depressed or too suicidal they will
deny you treatment as they have had people commit suicide while on treatment
(this is even documented in the medication insert infomation) Unless your
doc is sure that your *frame of mind* is somewhat under control before you
even attempt treatment I would think you would have a hard time finding any
doc that would go ahead with it. What do you mean by low numbers? Low alt
and ast is good. Low PCR or viral load is good too! That is what
treatment tries to do is to lower the viral load. Do you have your numbers
handy? Can you post them? I started with an 8 million viral load and went
undetectable at week 7 (less that 500) so that was good, however, i had to
stop treatment at week 17 when I wound up in intensive care. My alt and
ast has never been particularly abnormal...... they always hover at the high
normal end so numbers don't always tell the tale. Have you had a liver
biopsy? If you have normal LFTs and no liver damage and a low viral load I
wouldn't see much point in treatment right now :-) Hope this
helps.....Who knows..... you might even clear it on your own........ some
people have!........ There are lots of links to lots of good info at my site
at http://www.diac.com/~ekwall2/hepchat/links.shtml and if you go further
down the page there is a link for blood test explanations............. Good
luck!
Peace and Love,
Pam
Dogs come when they're called. Cats take a message and get back to you. --
Missy Dizick

David,
What is a low viral load? In numbers?

Ex-druggie bidding to help beat killer virus
A FORMER drug user who contracted Hepatitis C is to take part in the trek of a
lifetime to raise awareness of the virus.
Thomas Walker will trudge 100km through the foothills of the Himalayas to raise
cash for the Hepatitis C Trust Aware-ness Campaign.
The 45-year-old from Sheffield contracted the virus about 10 years ago and lived
with it for years with few symptoms.
Fortunately his body cleared the virus naturally, but Thomas is still involved
in campaigning to raise awareness of the illness.
He said: "I decided to join the trek after finding out I had contracted the
virus. Years later I was lucky to find out I no longer had it, but I do still
have the antibodies.
"I had a chaotic lifestyle and I did take drugs, but I am one of the lucky ones.
Now I want to help people who may also be living with Hepatitis C unknowingly to
get diagnosed and treated as early as possible."
The Nepalese trek, which takes place in October, will see 12 Hepatitis C team
members set off on an ambitious eight-day trip.
It is estimated 200,000 people in England have chronic Hepatitis C. Many are
unaware they have the condition and that it can cause serious liver damage.
The blood-borne virus is spread by the transfer of blood from person to person,
through the sharing of needles or syringes when injecting drugs.
It can also be spread through unprotected sex or tattoos, and body piercings
where unsterile equipment is used.
Those at risk include people who had a blood transfusion before Hepatitis C
screening was introduced in 1991.
Treatment is available but, as there is no vaccine against the virus, prevention
of new infections is important.
Earlier this year Thomas appeared in a government poster campaign to raise
awareness of the illness and his face was pasted across Sheffield.
He is now seeking sponsors for his trek.
Call 0114 237 5065.
27 April 2006
http://www.sheffieldtoday.net/ViewArticle2.aspx?SectionID=58&ArticleID=1467184

Hi Gil,our liver has certain levels and this levels are either in
ranges or out of ranges depending on the condition of our livers.For
example before i stared my tx my levels were out and after tx they
back to normal or in range and another number thing is your viral
load and i believe if I'm not mistaken is a number that tells the
Doctor how bad you have HCV.LOL,David

HIV, AIDS & Women Over 50
Sponsored By:
Georgia AIDS Coalition
Georgia Psychiatric Physicians Association
Bohan Auditorium - Decatur, GA
Seminar Agenda
8:00 a.m. - 8:45 a.m. Conference Registration
& Continental Breakfast
8:45 a.m. - 9:00 a.m. Welcome Cathalene Teahan
Introductions & Program Overview Georgia AIDS Coalition
9:00 a.m. - 10:00 a.m. Educating Women in Medically Under-served Areas Denise
Sutherland-Phillips,MD
10:00 a.m. - 10:15 a.m. Break
10:15 a.m. - 11:15 a.m. HIV/AIDS on the Rise Among Women Over 50 Nona Bear, MA
11:15 a.m. - 12:30 p.m. Lunch
12:30 p.m. - 1:30 p.m. Living with HIV/AIDS & Legal Implications Eva Johnson
Demetrius Mazacoufa, JD
1:30 p.m. - 2:30 p.m. Interface of HIV/AIDS & Mental Health Patrice Harris, MD
2:30 p.m. - 2:45 p.m. Break
2:45 p.m. - 3:45 p.m. Panel Discussion/ Q & A All Speakers

Marcus, sorry wish I knew the answers but I have no idea. I'll ask my nurse
when I go back for my first blood work and see what she says. Than I'll let you
know........Sheree
Marcus <marcuscal@...
Hey Sheree!!
Is this new? Havent heard about a Riba like that. Is it supposed to
be any different or more effective or anything like that? Who Makes
it? How come 680 when 800 is said to be the absolute minimum for
effectivenes? Tell me all about this stuff. ENUF Questions HEE HEE!
Gotta see you make SVR once and for ALL!!!
HUGGGZZZZZ, Marcus

I should have posted the link to Miles on-line diary...
http://www.mkandrew.com/hope.htm
Sorry about that.
Grace

If you get a chance - read the online diary of his tx journey. He's
hilarious!
Take care,
Grace

Hi Keith,
Welcome to the group! I am Dana, live in Pa, been through treatment
3 times, non responder! Welcome again......Dana

Source: EASL - European Association for the Study of the Liver
Reference: PIV210643-UK
EASL-Congress Vienna, 27th April - Hepatitis C: The Virus Outwits the Immune
System
VIENNA, Austria, April 27/PRNewswire/ -- The majority of people infected
with hepatitis C - up to 85 per cent of them - become chronically infected after
they have contracted the acute infection and about 20% of these patients will
subsequently develop cirrhosis and liver failure. As the immune system is unable
to eliminate the virus, this suggests that HCV might exert immunomodulatory
effects. Furthermore the immune system is a double-edged sword because an immune
response is required to get rid of the virus but the failed immune response is
also the main driver of liver damage and cirrhosis. At the EASL congress in
Vienna, a separate postgraduate course was devoted to HCV and the immune
response.
The adaptive immune response fails
The effective elimination of a viral infection requires the coordinated
action of various armies of the immune system, i.e. the innate immune response
and the adaptive immune system. "Several studies showed that the interferon
system as well as the adaptive immune response fail in the case of HCV", said
Dr. Margaret James Koziel, Harvard Medical School. In order to better understand
this failure one has to focus on natural killer cells (NK) and natural killer
T-cells (NKT) as elements of the inborn immune response.
In fact, certain NKT cells appear to be present in large quantities in the
liver, although their role, says Professor Koziel, is yet to be fully
understood. Dr Moretta reported that these cells may have either pro or
anti-inflammatory effects depending on how they are activated and how they
interact with other cells, particularly dendritic cells, suggesting that they
are central players in the emergence and persistence of hepatitis in chronic HCV
infection.
Loss of memory of the immune system
In order to achieve the state of a chronic infection HCV also has to
manipulate the dendritic cells in the liver. These play a major role in antigen
representation and the establishment of the adaptive immune response to a
specific virus. There is evidence that his mechanism functions poorly in the
presence of HCV, and that this prevents the elimination of the virus after acute
infection as well as the development of an effective vaccine. New insights into
the role of dendritic cells in HCV infection would be of major significance for
therapy as well as for the development of a vaccine, emphasized Dr. Pablo
Sarobe,Department of Hepatology and Gene Therapy at CIMA, University of Navarra,
Spain.
Immune therapy - a hope for the future
HCV infection first causes a massive reaction on the part of the
HCV-specific CD4+ and CD8+ T-cells. Thus, initially there is a marked reduction
of viremia and the virus is at least temporarily controlled. The small minority
of infected individuals in whom one is able to achieve permanent elimination of
the virus retain the specific CD4+ and CD8+ response to HCV whereas in the
majority of patients immune memory for the virus is lost, says Dr. Diepolder,
University Hospital M?nchen-Grosshadern. "The major exciting question now is,
whether specific and/or unspecific immune therapy will be able to overcome the
paralysis of the immune system caused by HCV and whether this approach will
enable us to eliminate the virus permanently."
Contact:
Manuela Bruck, +43-1-71786-108
Pleon Publico Vienna, mailto:manuela.bruck@...
www.easl.ch
Source: EASL - European Association for the Study of the Liver
Manuela Bruck, +43-1-71786-108, Pleon Publico Vienna,
mailto:manuela.bruck@...
http://www.ana.gr/anaweb/user/showprel?service=3&maindoc=4179906

I was concerned about Tylenol, too. My doc said that as long as its
taken as indicated, its safe. My private nurse (my wife) told me about
stacking Tylenol and Ibuprophen; you can take one an hour after the
other and they have a synergistic effect, and are more effective. I'm
taking them (alternating) on a regular schedule even when I feel fine,
so they stay "loaded."

hey keith hows it going your doctor that you had when
you were insured can help you get on a program that
pays for treatment do you know what kinda of meads
they want you on iterferon-rebotrol? let me know i
mite be able to lead you in the rite area valley med
they give you the run around and theres a 3 month
waiting list to get a doctor co let me know i have
freinds that went there and they werent to happy

Hey there Keith........ Welcome and CONGRATS on the stopping
drinking......... I stopped back in 1997 when I was diagnosed......... no
point in making this virus even angrier at me :-) I hope you can get on at
the Medical Center........ they usually have pretty good docs......... I
started out at Emory last Sept........ they are SLOW in returning phone
calls but I like the docs :-) Take care!
Peace and Love,
·´¨¨)) -:¦:-
¸.·´.·´¨¨))
((¸¸.·´ ..·´ -:¦:-Pam
-:¦:- ((¸¸.·´*
"I got rid of my husband. The cat was allergic. - Anonymous

Hey Sheree!!
Is this new? Havent heard about a Riba like that. Is it supposed to
be any different or more effective or anything like that? Who Makes
it? How come 680 when 800 is said to be the absolute minimum for
effectivenes? Tell me all about this stuff. ENUF Questions HEE HEE!
Gotta see you make SVR once and for ALL!!!
HUGGGZZZZZ, Marcus

Hi, everyone
I'm new to the web and this group--looking for someone- friends-chat
whatever--I have hep c 2-- haven't started treatment yet-on
unemployment right now-live in San Jose and I'm thinking about trying
to get on the ability to pay program at Valley Medical Center in San
Jose, Ca. Would appreciate any advice from any one. I feel pretty
good, a little tired sometimes but that's it. Sometimes I don't sleep
the greatest but usually o.k. Liver is in fibrosis stage. I quit
drinking on 7/28/01. I'm doing well other than that.
I will look forward to hearing from and getting to know some of you.
Everyone have a good day!
Keith

Dear Dana, I do change my viewpoint some times but only if I am convinced
something is better than before! LOL! Im a hardcase I know, but unlike the
bulk of the american sheeple I have been exposed to too much to even for a
second think that these people on the whole have anyones intrest at heart
other than their own. LOL just a wild eyed southern boy at heart LOL
(((((((((Dana))))))))...Mykal

Michael,
Good to hear! I hope and pray things keep getting better and easier
with treatment! Hugs......Dana

Mike, you're hilarious! I like your style, and I would definitely have
wild, unprotected discussions with you! I'm in Florida, where all "hot" women
are....
Karen

Reminder Reminder from the Calendar of HepCingles2
Chat reminder!
Sunday February 5, 2006
6:00 pm - 10:00 pm
This event repeats every week.
The next reminder for this event will be sent in 18 hours, 3 minutes.

thank you Pam! My neurologist and I have been trying to figure this
one out forever. Even the Toxicologist in Washington told me that if
you have HCV, Fibromyalgia should be ruled out. Same symptoms. So
confusing! Where ever you research you get a different answer!
Hugs...Dana

Gloria,
Yes, we will have to plan better next time! And I really know I
will! LOL I had to cancel do to family problems. So did not make
the trip at all! Still here in PA. The weather is warmer now
though, so at least I can get outside and the snow is finally melting
away! Give everyone big hugs for me and hope you have a safe and
happy trip! Hugs........Dana

Big congrats to you! Be sure and keep in touch! I know you are on
cloud nine right now! Hugs.....Dana in PA

Mykal,
Good to see you always keep the same neutral position! Smarty
Pants!! LMAO......Hugs........Dana

http://www.mkandrew.com/curehcv.htm
And if you get a chance - read his online diary of his journey on
treatment - he's hilarious!
http://mkandrew.com/

Well, one down!
The start of my treatment was delayed a week, waiting for the meds to
come by mail. They were very inexpensive that way, though. Started
the treatment Friday; Chris gave me my first weekly injection of
peg-interferon alpha 2B. I also take seven capsules of Ribovirin a
day, as well as Tylenol and Ibuprophen on a regular schedule.
It went pretty much as expected. "Flu-like symptoms." I had a fever,
headache, fatigue and muscle aches. Some nausea. Since I'd already
had some of those symptoms, the only thing really new was the fever
and nausea. (The body has natural interferon, which is the body's
response to a virus, such as the flu or Hep C. When someone has the
flu or Hep C, the symptoms actually come from their natural
interferon, not the virus!)
If this is the worst that it will be, its do-able. I slept most of
Saturday and Sunday. By last night I felt almost myself again.
Hopefully, the symptoms should ease over the next couple of weeks.
I'm glad a took a couple of days off work, but this should be do-able.
m

Transgenic Pigs May Bring Home Heart-Healthy Bacon
By Michael Smith, MedPage Today Staff Writer
Reviewed by Robert Jasmer, MD; Assistant Professor of Medicine, University of
California, San Francisco
March 27, 2006
Also covered by: BBC News, Boston Globe, LA Times, New York Times
COLUMBIA, Mo., March 27 - Heart-healthy bacon, an ostensible contradiction in
terms, might one day be a reality thanks to researchers here who have created
transgenic pigs with meat that contains high levels of omega-3 fatty acids.
"These levels are higher than what you would get if you fed pigs high levels of
omega-3 fatty acids," said Randall Prather, Ph.D., of the University of
Missouri-Columbia in an interview.
Working with researchers at the University of Pittsburgh and Massachusetts
General Hospital in Boston, Dr. Prather used nuclear transfer cloning to produce
six piglets whose genes express a protein that converts omega-6 fatty acids into
healthier omega-3s.
The six piglets have tissue in which the ratio of omega-6 acids to omega-3 acids
is significantly reduced, the researchers reported in the March 26 online issue
of Nature Biotechnology.
If the pigs were to become part of the human food supply, Dr. Prather said, they
might have two benefits. First, their own meat would healthier for consumers
because they naturally produce higher levels of omega-3 fatty acids. Second,
they would be healthier, which would limit livestock loss for farmers.
Dr. Prather's lab cloned the pigs, using technology developed by Jing Kang,
M.D., Ph.D., of Massachusetts General. Dr. Kang reported in 2004 that he and
colleagues had created the first omega-3 rich mammals.
The gene involved is dubbed fat-1 and it's found in the roundworm C. elegans,
which, unlike mammals, has the ability to convert omega-6 fatty acids into
omega-3s. Yifan Dai, M.D., Ph.D., of the University of Pittsburgh transferred
the fat-1 gene to pig primary fetal fibroblasts, the cells that give rise to
connective tissue.
Dr. Prather and his group used those fibroblasts to create more than 1,600
embryos and transfer them into female pigs; five pregnancies came to term and 12
male piglets were eventually born, 10 alive at birth.
Of the 10 live births, the researchers reported, six were positive for the fat-1
gene.
The researchers then cloned one of the transgenic piglets; the eight clones were
all transgenic, as expected, and showed significant changes in their fatty acid
profiles, compared to wild-type piglets.
Specifically:
a.. The concentration of omega-3 fatty acids in the transgenic piglets was
threefold higher than in the wild-type piglets.
b.. In particular, eicosapentaenoic acid (EPA) and docosapentaenoic acid (DPA)
were 15 times and four times higher, respectively.
c.. The concentration of total omega-6 fatty acids in the transgenic piglets
was reduced by 23%, compared to the wild-type animals.
d.. Consequently, there was a fivefold reduction -- from 8.52 to 1.69 -- of
the omega-6/omega-3 ratio in the transgenic piglets compared with wild-type
piglets. The difference was statistically significant at P<0.001.
In skeletal muscle from the transgenic pigs, the researchers found that the
omega-3 fatty acids -- alpha-linolenic acid (ALA), EPA, DPA, and docosahexaenoic
acid (DHA) -- averaged 8% of total muscle fat. In wild-type pigs the average is
about 1% or 2%, they said.
Feeding pigs diets that are high in omega-3 fatty acids can raise the average
from 1% to about 5%, the researchers noted, but the additional polyunsaturated
fatty acids have a negative effect on the meat.
"This is unlikely to be an issue" in the transgenic pigs, the researchers said,
because they convert omega-6 fatty acids to omega-3s, and therefore don't need
extra polyunsaturated fatty acids in their diets.
The researchers noted that people are urged to eat fish, which is naturally high
in omega-3 fatty acids. But many fish are also high in heavy metals and other
toxins as a result of pollution, making it difficult to get enough omega-3s
safely.
"Livestock with a healthy ratio of omega-3 to omega-6 fatty acids may be a
promising way to re-balance the modern diet without relying solely on
diminishing fish supplies or supplements," Dr. Kang said in a statement.
While heart-healthy bacon and pork chops now appear possible, Dr. Prather said,
it's unlikely they'll be on supermarket shelves soon. Instead, he said, the
transgenic pigs will probably serve mainly as model systems for testing theories
about such things as cardiovascular disease.
Pigs are often used a lot as a model of human disease, he said, because they're
physiologically similar to humans.
Pigs with naturally high levels of omega-3 fatty acids might be used to increase
scientific understanding of how the different types of fatty acids interact with
diet and exercise to produce -- or perhaps prevent -- cardiovascular disease, he
said.
"That's really the reason I was involved in the project," he said.
http://www.medpagetoday.com/Cardiology/Prevention/dh/2934

Calif. Hep C Conference - March 13
From: Stevenkersker@...
California Hep C Conference - March 13, 2003
What a success for people with Hepatitis C (HCV) and our supporters!
California is developing, with its system of County HCV Task Forces, a
strong base of support - a base that includes not just people with HCV,
but partners with the medical community, state health agencies,
correctional facilities, social services agencies, community substance
abuse providers, veteran organizations and the HIV/HCV coinfected
community.
One could tell this conference was different from the first presentation
by Dr. John Vierling when he said that people are being cured of HCV.
Just two years ago cure was not spoken of. We were just in remission.
Children were brought up at this conference when Dr. Zwiefer's
presentation included the saddening statistic that as many as 5,000
babies are born with HCV each year. And doctors don't even screen
pregnant women for HCV because for expectant moms there is no treatment
or way of preventing the transmission of the disease to newborns. Hence
there was no reason to screen.
A powerful argument for needle exchange programs was made because these
exchanges can develop bridges of trust and outreach to addicts by
professionals - bridges that can encourage IV drug abusers not only to
use clean needles but also begin engaging them in the drug treatment
process.
We also had fun. During the group presentation on activism that I was
involved with, I turned to one of the co-presenters, Carol Craig, and
announced to the audience that I'd finally found a"cute" HCV! But mainly
it was a chance to network and develop doable goals to expand
California's system of Task Forces, increase public awareness of HCV and
ways to reach increasing numbers of infected people.
From an advocacy perspective the conference made clear that HCV will
never get any meaningful funding for research, prevention, treatment and
care services until we develop a partnership amongst patients and our
natural allies. A unified voice that elected officials will pay attention
to and act upon.
HIV/AIDS has built such a community and look at the 17 billion dollars a
year that their unified voices garner compared to our 100 million
dollars. HIV/AIDS is no more worthy, their illness no more devastating
than HCV. But in a democracy the squeaky wheel gets greased. AIDS
patients did not pass silently into the night of death. They raised a
ruckus over their impending doom and so should people with HCV.
Only when we start fighting to expand the health care pie to include HCV
will we get the funding that our illness deserves.
Kudos are deserved by all the people who made this empowering conference
a reality through their years of persistent hard work. Steve Kersker,
conference participant.
For further information on California's HCV movement see:
www.CaliforniaHCVTASKFORCE.org

I absolutely could not resist passing this on :-)
*********************************************************
A good clean joke is hard to find these days! Enjoy!
****************************************
The famous Olympic skier Picabo Street is not just an athlete, she is a nurse.
She currently works at the Intensive Care Unit of a large metropolitan hospital.
She is NOT permitted to answer the telephone, however, as it caused too much
confusion when she would answer the phone and say, Picabo, ICU.
bwaaa haaaa haaaaa - pass it on!
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Hey Sheree!!
Is this new? Havent heard about a Riba like that. Is it supposed to
be any different or more effective or anything like that? Who Makes
it? How come 680 when 800 is said to be the absolute minimum for
effectivenes? Tell me all about this stuff.
Gotta see you SVR once and for ALL!!!
HUGGGZZZZZ, Marcus

I keep trying to eat healthier and I will keep sharing info as I run across
it........ this was an interesting article :-)
http://www.trunkerton.fsnet.co.uk/margarine_hoax.htm
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http://www.attractinggenuinelove.com/peace1.html
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Rare Health Alert Is Issued for Mystery Illness
By LAWRENCE K. ALTMAN and KEITH BRADSHER
s a mysterious respiratory illness spread to more countries, the World Health
Organization yesterday issued a rare health alert, declaring the ailment "a
worldwide health threat" and urging all countries to help in seeking its cause
and control.
The agency said that in the last week it had received reports of more than 150
new suspected cases of the illness, now known as Severe Acute Respiratory
Syndrome, or SARS. The syndrome has caused at least nine deaths, the last one a
nurse in Hanoi. Some victims have recovered but no one has been up, around and
healthy in the past two weeks.. It apparently does not respond to antiviral and
antibiotic drugs.
Reported cases have come from Canada and six countries in Asia - Hong Kong and
elsewhere in China, Indonesia, the Philippines, Singapore, Thailand and Vietnam,
the health organization said. There have been no reports of the illness in the
United States. But yesterday, an ill passenger and two companions who traveled
from New York City were removed from a flight after it arrived in Frankfurt and
put in isolation in a German hospital.
The ill passenger is a doctor from Singapore who treated one of the earliest
cases there, and who flew to a medical meeting in New York City, said Dick
Thompson, a W.H.O. spokesman. The doctor may have gone to a hospital in New York
- the agency is not certain which one - before flying back to Singapore via
Frankfurt with his wife and another doctor. Before boarding the flight, the
doctor called a colleague in Singapore to describe his symptoms, and the
colleague notified the World Health Organization.
The cause has not been identified, and scientists do not know whether it is a
virus or even an infectious agent. Although health officials have suspected
avian influenza, which has infected a small number of people sporadically in
Hong Kong since 1997, laboratory tests have not detected that rare strain, known
as influenza A(H5N1). As a result, laboratory scientists are focusing on the
possibility of a previously unknown infectious agent.
Dr. Julie L. Gerberding, director of the Centers for Disease Control and
Prevention, said in a news conference yesterday that it appeared to take direct
and sustained contact to transmit the illness from an affected individual to
other people. "There is no evidence to suggest that this can be spread through
brief contact or assemblages of large numbers of people," she said.
Asked whether this might be an instance of bioterrorism, she replied, "We are
keeping an open mind."
In an emergency advisory issued yesterday, the World Health Organization, an arm
of the United Nations based in Geneva, said that "there is presently no
indication to restrict travel to any destination."
But Dr. Gerberding said, "We are advising persons planning nonessential or
elective travel to affected areas that they may wish to postpone their trip
until further notice."
Updated information will be posted on the centers' Web site, www.cdc.gov/travel.
W.H.O. and American officials urged all travelers to be aware of the main signs.
In addition to the breathing problems, the illness can cause a dry cough and
other flulike symptoms that are thought to develop two to seven days after
exposure. They usually start with a sudden onset of high fever and go on to
include muscle aches, headache, sore throat and shortness of breath.
Standard lab tests often show low numbers of white blood cells and platelets,
which help blood to clot.
The health agency said any passenger or airline crew member who developed such
symptoms should immediately seek medical attention and ensure that information
about their recent travel was passed on to the health care staff. "Any traveler
who develops these symptoms is advised not to undertake further travel until
they have recovered," it said.
If a passenger became ill on a flight, the agency asked airlines to alert the
airport of destination and to refer any ill passengers to airport health
officials.
"There are currently no indications to restrict the onward travel of well
passengers, but all passengers and crew should be advised to seek medical
attention if they develop" symptoms, the agency said.
In another rare step, the Centers for Disease Control and Prevention activated
its emergency operations center in Atlanta, including sophisticated
communications technology, to enhance its ability to coordinate information from
other countries and to investigate any suspect cases in this country.
The C.D.C. has used the operations center only twice before, for the
mosquito-borne West Nile fever epidemic last year and the anthrax attacks in
2001. The last time it issued a global health alert was in 1993, to enhance
measures to control tuberculosis. W.H.O. officials said they could not recall
the last time an emergency global travel advisory was issued.
The secretary of health and human services, Tommy G. Thompson, said his
department "is applying a full-court press to learn more about this outbreak and
how it might impact on the United States."
The C.D.C. and New York City health officials are now investigating the travel
histories of the passengers now in a German hospital as well as one of the eight
cases suspected to be the new syndrome in Toronto and Vancouver, British
Columbia.
Two hours before the plane landed, the W.H.O. notified German health officials,
who had the plane moved to a separate runway where the doctor, his wife and a
colleague disembarked and were taken to a nearby hospital. German health
officials advised the other passengers to monitor their health and gave them a
telephone number to call if they developed any symptoms. Officials did not
release any information on his condition.
Mr. Thompson, the spokesman for the W.H.O., said the cases in Toronto involved a
family who returned home after flying to Hong Kong. A woman, Kwan Sui-chu, died
shortly after her return. Five other family members who had not been to Hong
Kong have since become ill; four are still in the hospital while the fifth, Mrs.
Kwan's son, Chi Kwai Tse, died on March 13, according to Toronto Public Health
officials.
Toronto health officials said they were aware of two other cases in Vancouver,
both people who had recently traveled to Hong Kong. C.D.C. officials are aiding
in the investigation because Mrs. Kwan's daughter, who is being treated in
Toronto, had flown to Atlanta recently, Mr. Thompson said.
So far, laboratory scientists have not been able to identify a known or novel
infectious agent, said Dr. David L. Heymann, a W.H.O. official.
Japanese officials said their tests showed that the influenza virus was not the
cause of the illness. But Dr. Heymann said samples from more victims needed to
be tested, because it can take weeks for the immune system to produce influenza
antibodies, the proteins that are formed to fight invading microbes.
"We have not ruled out influenza definitively," Dr. Heymann said.
Tests of victims' samples have found no evidence of mycoplasma or similar
microbes that are the usual causes of atypical pneumonia. Additional tests have
shown no evidence of Ebola or any of the other viruses that cause hemorrhagic
fevers, hanta virus and bacteria.
In Hong Kong, an American businessman died on Thursday after passing through
Hong Kong and falling ill in Hanoi, where 30 doctors and other medical personnel
have fallen ill at the hospital where the businessman was initially treated.
http://www.nytimes.com/2003/03/16/health/16INFE.html?th
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Hi Marcus, I'm doing pegintron and ribavirin.......150mg of peg and 680mg of
ribavirin. Now here is what is different my ribavirin is a oral suspension
(liquid). I do it twice a day once in the morning and at bedtime. Thank you for
all the positive thoughts........Sheree
Marcus <marcuscal@...
YES YOU ARE GONNA DO IT THIS TIME!! THREES A CHARM FOR SURE!!
You Cn Tell em I SAID SO! HEE HEE!!
What are you doing, the Pegasys now or what?
Thanks for the Congrats and warm thoughts, that was SOOO Super!
I will be waiting to CHEER YOU ACROSS THE FINISH LINE! OK? OH TAY!!
BIGGGGG HUGGGGZZZZ, Marcus

SHEREE!
YES YOU ARE GONNA DO IT THIS TIME!! THREES A CHARM FOR SURE!!
You Cn Tell em I SAID SO! HEE HEE!!
What are you doing, the Pegasys now or what?
Thanks for the Congrats and warm thoughts, that was SOOO Super!
I will be waiting to CHEER YOU ACROSS THE FINISH LINE! OK? OH TAY!!
BIGGGGG HUGGGGZZZZ, Marcus

GEORGE CARLIN "POST 9-11" (His wife died recently)
Isn't it amazing that the George Carlin - gross and mouthy comedian of the 70's
and 80's - could write something so eloquent...and so very appropriate "Post
9-11".
"The paradox of our time in history is that we have taller buildings but shorter
tempers, wider freeways, but narrower viewpoints. We spend more, but have less;
we buy more, enjoy less. We have bigger
houses and smaller families, more conveniences, but less time.
We have more degrees, but less sense, more knowledge, but less judgement, more
experts, yet more problems, more medicine---but less wellness. We drink too
much, smoke too much, spend too recklessly, laugh too little, drive too fast,
get too angry, stay up too late, get up too tired, read too little, watch TV too
much, and pray too seldom. We have multiplied our possessions, but reduced our
values.
We talk too much, love too seldom, and hate too often.
We've learned how to make a living, but not a life. We've added years to life
not life to years. We've been all the way to the moon and back, but have trouble
crossing the street to meet a new neighbor. We
conquered outer space but no inner space.
We've done larger things, but not better things. We've cleaned up the air, but
polluted the soul. We've conquered the atom, but not our prejudice.
We write more, but learn less. We plan more, but accomplish less.We've learned
to rush, but not to wait. We build more computers to hold more information, to
produce more copies than ever, but we communicate less and less.
These are the times of fast foods and slow digestion, big men and smaller
character, steep profits and shallow relationships. These are the days of two
incomes but more divorce, fancier houses, but broken homes. These are the days
of quick trips, disposable diapers, throwaway morality, one night stands,
overweight bodies, and pills that do everything from cheer, to quiet, to kill.
It is a time where there is too much in the showroom window and nothing in the
stockroom. A time when technology can bring this letter to you, and a time when
you can choose either to share this insight, or just hit "delete."
Remember: spend some time with your loved ones, because they are not going to be
around forever. Remember: say a kind word to someone who
looks up to you in awe, because that little person soon will grow up and leave
your side. Remember: to give a warm hug to the one next to you, because that is
the only treasure you can give with your heart
and it doesn't cost a cent. Remember to say, "I Love You" to your partner and
your loved ones, but most of all mean it. A kiss and an embrace will mend hurt
when it comes from deep inside of you.
Remember to hold hands and cherish the moment for someday that person will not
be there again. Give time to love, give time to speak and give time to share the
precious thoughts in your mind."
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In a message dated 03/15/2003 8:17:42 PM Pacific Standard Time,
If anyone is around tonight, I am in HepCingles at Delphi in chatroom now.
Johnny O
figment@... writes:

Greetings:
I host a Web community that you may enjoy.
It's called HepCingles.
At HepCingles, you can participate in the message board or jump into the chat
room.
To join our discussions, simply go to
http://forums.delphiforums.com/HepCingles/start
HepCingles is part of DelphiForums.com. If you've never used DelphiForums.com
before, you'll need to go through a quick registration (so you can post
messages). It only takes a minute and it's free!
Hope to see you there,
Figment
Moderator
=================================================
DelphiForums.com: Home to the Web's most vibrant
online communities. Explore more than 100,000 Forums
or create your own at http://www.delphiforums.com
=================================================

These are for the kitty people only :-) Just had to share them!
http://www.angelfire.com/me4/tugby/DontUseTheSwatter.jpg
http://www.angelfire.com/nc3/angelnc_2/images/allminekitty.gif
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Little Sleep Impairs Mind as Much as No Sleep
Fri Mar 4,6:30 PM
By Dana Frisch
NEW YORK (Reuters Health) - Many nights of little sleep--fewer than six hours a
night--can impair mental performance as much as not getting a wink for two
nights in a row, new research shows.
The data contradict a popular notion that our bodies can become accustomed to
functioning on sustained periods of little sleep without any consequences, said
lead author Dr. Hans P.A. Van Dongen, a research assistant professor at the
University of Pennsylvania School of Medicine in Philadelphia.
The 48 participants in the study were divided into four groups that slept either
four, six or eight hours a night for two weeks, or had no sleep for three days.
The groups were monitored in a laboratory throughout the two weeks to ensure
that they did not nod off or use caffeine. They were assessed on a battery of
mental and physiological tests periodically every day and were also asked to
evaluate how tired they felt.
People sleeping less than eight hours a night were slower to react, less able to
think clearly and perform simple memory tasks, the researchers report in the
March issue of the journal Sleep. They also performed as poorly on certain tasks
as the individuals evaluated after one or two nights of sleeplessness.
However, getting some sleep made individuals feel less tired than those who went
without sleep despite test results that showed they were just as impaired.
As a consequence, Van Dongen told Reuters Health, there should be
countermeasures in place for people who cannot avoid being chronically
sleep-deprived, such as military personnel, trainee doctors, shift workers and
others.
Van Dongen recommends that these professions limit the number of hours people
are allowed to work, give people the opportunity to nap at "strategic times" or
allow them to use caffeine or other chemical stimulants to maintain alertness.
This study is important and "relevant" because it shows what happens when the
body alone must deal with its tiredness in the absence of chemical stimulants
like caffeine or other distractions, said Dr. Meir Kryger, a professor of
medicine at the University of Manitoba in Winnipeg, Canada, and a sleep
researcher.
Data from the National Sleep Foundation show that Americans sleep an average
seven hours a night during the week, although 31 percent of all adults regularly
get less sleep.
The study also found that that there were large individual differences in how
much people needed to sleep.
Kryger said in an interview that everybody needs a different amount of sleep.
Getting sufficient amounts of shut-eye is a "life-style decision," he said. "It
is one of the important functions of life and you need to control it."
SOURCE: Sleep 2003;26:117-126.

http://www.nytimes.com/2003/03/14/health/14DRUG.html?th
F.D.A. Requires Bar Codes on Drugs
By DONALD G. McNEIL Jr.
oving to cut the high rate of medical errors, the Food and Drug Administration
announced yesterday that it would require bar codes on all medications so that
hospitals could use scanners to make sure patients get the correct dose of the
right drug.
The new requirement is one of several steps the agency said it was taking to
fight medical errors, which claim tens of thousands of lives a year in the
United States.
The food and drug commissioner, Dr. Mark B. McClellan, estimated that the
bar-code requirement, introduced as a proposal expected to gain final adoption
after a 90-day period of public comment, would prevent 400,000 bad drug
reactions - from headaches to death - over the next 20 years.
Under bar-code systems, already in use at veterans' hospitals and some others,
doctors enter prescriptions for hospitalized patients into a computer, which
checks those prescriptions against parameters like the patient's age, weight,
diagnosis and other drugs taken.
Then, at bedside, a nurse scans a bar code on the patient's bracelet and a bar
code on the medication. The computer instantly reads whether the medication is
the same drug, with the same dose, dispensing time and delivery method, that the
doctor ordered, and sounds an alarm if there is a mismatch.
Medical safety experts, patient care groups and associations representing
hospitals, pharmacists and drug companies all greeted the new rule with
enthusiasm.
"I'm really happy about this," said Michael R. Cohen, president of the Institute
for Safe Medication Practices, a consumer safety group. "Early studies show
massive reductions in errors, over 50 percent reductions."
Dr. David W. Bates, a Harvard Medical School professor who studies patient
safety, called the announcement "an enormously positive development."
The F.D.A. also announced that it was revamping its system for reporting bad
medication reactions and bad reactions to blood or blood products.
Under the new drug-reaction rules, minor reactions must be reported more
promptly by pharmaceutical companies, which will also be required to report even
"near misses," such as a wrong drug's being nearly given to a patient because of
confusion over similar medication names.
Blood banks and blood product makers will have to report all suspected serious
reactions, not just fatalities as at present.
As for bar-coded dispensing, the Veterans Health Administration, an agency of
the Department of Veterans Affairs, is a pioneer, having built a nationwide
pharmacy system using drugs ordered by computer, packed by robots and checked at
the bedside of veterans' hospital patients by nurses using bar-code scanners.
Dr. Jonathan B. Perlin, an official of the agency, said some of its 150
hospitals now had "virtually no dispensing errors," in contrast to findings of
previous studies that, he said, showed that one in seven hospitalizations
nationally was complicated by a bad reaction to a drug.
The V.A. prints its own bar codes, but that would be too expensive for most
hospital pharmacies. The F.D.A., which regulates drug makers, not hospitals,
will order the pharmaceutical companies to come up with codes identifying each
drug and dosage. Whether lot numbers and expiration dates will be included is
still under consideration.
The Food and Drug Administration estimated that it would cost pharmaceutical
companies $50 million to put bar codes on every product and that hospitals would
spend over $7 billion on scanners and computers.
Hospital groups acknowledged the high price to them, but said enhanced patient
safety would be worth the cost.
"There is a concern that it will cost a lot of money," said John Combes, a
spokesman for the American Hospital Association, who represents the organization
on hospital safety panels. But because it protects patients, "there's a lot of
interest in getting this going," he said.
The Institute of