ABSTRACT
Chronic hepatitis C virus (HCV) is common in the Department of Corrections (DOC). Telemedicine is an effective way to treat HCV. The goal of this report was to demonstrate high SVR rate in DOC patients using telemedicine irrespective of the HCV genotype (GT) and DAAs used. Demographic, clinical and laboratory data were prospectively collected. A total of 870 DOC patients were evaluated and completed HCV therapy June 2015-December 2019 with SVR data were included. The mean age was 50 years, 90% were male, 63% were Caucasian, the majority (79%) had GT 1, 92% were treatment naive, and 80% had advanced fibrosis (FIB-4 ≥ 3.25 and/or transient elastography ≥ 9.5 kPa). The overall SVR was 97% and was similar among all DAAs irrespective of age, sex, race, HIV status, fibrosis level, GT, ribavirin use, prior treatment experience or DAA duration. We conclude that HCV treatment in the DOC through telemedicine is achievable and highly effective with overall SVR 97%, irrespective of the underlying GT or DAA regimen used and can eliminate HCV in this microenvironment and reduce the overall burden of HCV.
Subject(s)
Hepatitis C, Chronic , Telemedicine , Antiviral Agents/therapeutic use , Drug Therapy, Combination , Female , Hepacivirus/genetics , Hepatitis C, Chronic/drug therapy , Humans , Infant, Newborn , Male , Treatment OutcomeSubject(s)
Lymphoma, Large B-Cell, Diffuse/diagnosis , Neoplasms, Multiple Primary/diagnosis , Pancreatic Neoplasms/diagnosis , Pancreatitis/etiology , Spinal Neoplasms/diagnosis , Abdominal Pain/etiology , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Biopsy , Endoscopic Ultrasound-Guided Fine Needle Aspiration , Female , Humans , Injections, Spinal , Lymphoma, Large B-Cell, Diffuse/complications , Lymphoma, Large B-Cell, Diffuse/drug therapy , Lymphoma, Large B-Cell, Diffuse/pathology , Magnetic Resonance Imaging , Middle Aged , Neoplasms, Multiple Primary/complications , Neoplasms, Multiple Primary/drug therapy , Pancreas/diagnostic imaging , Pancreas/pathology , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/drug therapy , Pancreatic Neoplasms/pathology , Pancreatitis/diagnosis , Positron-Emission Tomography , Recurrence , Spinal Neoplasms/complications , Spinal Neoplasms/drug therapy , Spinal Neoplasms/pathology , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Dissecting cellulitis is an inflammatory disease of the skin. We report a case of recurrent dissecting cellulitis in a patient with Crohn's disease. A 31-year-old man with a history of purulent scalp lesions presented with night sweats, weight loss, abdominal pain, and hematochezia. Colonoscopy revealed a diffuse friable mucosa with extensive pseudopolyps. Scalp biopsy demonstrated epidermoid inclusion cysts with granulation tissue and chronic inflammatory cell infiltration, indicative of dissecting cellulitis. The incidence of dissecting cellulitis with Crohn's disease is underreported. This dermatologic condition has a tendency to recur, and considering an underlying disease is key for its appropriate treatment.
ABSTRACT
Histoplasmosis is the most common endemic mycosis in the United States. Symptomatic gastrointestinal histoplasmosis is a rare entity. We report a case of isolated intestinal histoplasmosis that manifested as severe lower gastrointestinal bleeding in a renal transplant patient. The patient developed hematochezia, and colonoscopy showed diffuse, extensive areas of cratered, ulcerated mucosa in the entire colon. Biopsy showed prominent mucosal and submucosal infiltrate of plump histiocytes containing intracytoplasmic yeast forms morphologically compatible with florid histoplasmosis.
