Donor-derived (DD) herpes simplex virus (HSV) hepatitis in solid organ transplant (SOT) recipients is extremely uncommon but carries a high mortality rate. The diagnosis is challenging due to the non-specific presentation and lack of clinical suspicion.We report a case of DDHSV hepatitis in a HSV2 pre-transplant seronegative kidney How to cite this article: Zeidan JH, Casingal V, Hippen B, et al. Donor-derived herpes simplex virus hepatitis in a kidney transplant recipient and review of the literature.

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OBJECTIVEAsthma is the most common chronic childhood condition affecting 6.3 million (US) children aged less than 18 years. Home-based, multi-component, environmental intervention studies among children with asthma have demonstrated to be effective in reducing asthma symptoms. In this study, a local hospital and university developed an environmental intervention research pilot project, Eastern Carolina Asthma Prevention Program (ECAPP), to evaluate self-reported asthma symptoms, breathing measurements, and number of asthma-related emergency department (ED) visits among low-income, minority children with asthma living in rural, eastern North Carolina. Our goal was to develop a conceptual model and demonstrate any asthma respiratory improvements in children associated with our home-based, environmental intervention.METHODSThis project used a single cohort, intervention design approach to compare self-reported asthma-related symptoms, breathing tests, and ED visits over a 6 month period between children with asthma in an intervention study group (n = 12) and children with asthma in a control study group (n = 7). The intervention study group received intense asthma education, three home visits, 2 week follow-up telephone calls, and environmental intervention products for reducing asthma triggers in the home. The control group received education at baseline and 2 week calls, but no intervention products.RESULTSAt the end of the study period, significant improvements were observed in the intervention group compared with the control group. Overall, the intervention group experienced a 58% (46 ± SD 26.9) reduction in self-reported asthma symptoms; 76% (34 ± SD 29.7) decrease in rescue medicine; 12% (145 ± SD 11.3) increase in controller medicine; 37% decrease in mean exhaled nitric oxide levels and 33% fewer ED asthma-related visits.CONCLUSIONAs demonstrated, a combination of efforts appeared effective for improving asthma respiratory symptoms among children in the intervention group. ECAPP is a low cost pilot project that could readily be adapted and expanded into other communities throughout eastern North Carolina. Future efforts could include enhanced partnerships between environmental health professionals at local health departments and pediatric asthma programs at hospitals to carry out ECAPP.

we found improvements in verbal memory 6 months and 12 months post-placement and in visual memory between 12 and 24 months. Objectives: The purpose of the current follow-up study was to assess the impact of an increased sample (n = 17) and additional follow-up testing. Methods: We again compared cognition pre-and post-LVAD placement across time points (A: 3-6 months; B: 6-12 months; C: 2 years) for individuals using paired samples t-tests. Individuals were administered the Repeatable Battery for the Assessment of Neuropsychological Status and the Trail Making Test. Patients' cognition was stable or improved up to 24 months post-placement. Results: In addition to the verbal and visual memory impairment previously observed, we now saw. Statistically significant improvement in cognition was observed on measures assessing processing speed (Pre to A) and verbal recognition memory (Pre to B). Trends toward significance were observed in visual memory (Pre to A), delayed list memory (Pre to B), and delayed story memory (A to C). Conclusions: Findings add to limited extant research showing stable or modest improvements in cognition and provide further understanding of the effects of LVAD placement on neurocognition.

The treatment for patients with alcoholic hepatitis (AH) who have a discriminant function (DF) score greater than 32 has been steroids. A prior study reported that mortality approaches 100% when the DF score is greater than 54, despite the use of prednisolone. Our aim was to determine if a DF score greater than 54 is associated with high mortality despite steroids. We conducted a retrospective study of 531 first-time inpatient encounters of AH. We compared 30-day mortality between patients with DF 54 or less to those greater than 54 treated with steroids, as well as a matched group not treated with steroids. A total of 531 inpatients diagnosed with AH were identified, of which 124 had a DF greater than 32 and 52 were treated with steroids. Among patients treated with steroids, 30-day mortality for patients with DF greater than 54 (n = 27) and 54 or below (n = 25) was 22% and 12%, respectively (p = 0.47). Among patients with DF greater than 54, the 30-day mortality for those who did (n = 27) and did not (n = 29) receive steroids was 22% and 24%, respectively (p = 0.87). In our study population, steroids were not futile in patients with a DF score of greater than 54.