ABSTRACT
Hepatitis E is a major concern to public health, it is estimated that 44,000 people die annually due to hepatitis E. Hepatitis E virus (HEV) is the most common cause of acute viral hepatitis in the world. HEV has been found with 7 genotypes, only 4 can infect humans. Genotypes 1 and 2 are major causes of the epidemic and endemic acute hepatitis in developing countries. In the poor hygienic conditions, these genotypes are obligate human pathogens transmitted between humans by the fecal-oral route and via contaminated water. On the contrary, in developed countries, genotypes 3 and 4 are of zoonotic origin and they are transmitted by alimentary route and via direct contact with the infected animal. Transmission by blood, blood products and tissues from infected persons or animals and even mother-to-infant transmission is also possible. Hepatitis E clinical course varies from self-limiting disease to fulminant hepatic failure, and extrahepatic manifestations have occurred. Management to control and prevent this infection is mainly hygienic measures. The provision of clean drinking water and ameliorating the sanitation of human wastes are the most effective preventive approaches as in any infection outbreak transmitted through the fecal-oral route. Nevertheless, dietary habits, distribution of different zoonotic reservoirs and the hygienic level play a crucial role in limiting and preventing the spread of hepatitis E in the developed countries. Although HEV vaccine was developed, it is still available only in China. It protects against genotype 4 with no clear evidence of protection against other genotypes.
Subject(s)
Hepatitis E virus , Hepatitis E , Animals , China/epidemiology , Genotype , Hepatitis E/epidemiology , Hepatitis E/transmission , Hepatitis E virus/genetics , Humans , Zoonoses/epidemiologyABSTRACT
BACKGROUND: Pancreatic cancer is serious and rapidly progressing condition. Little is known about the role of diet in etiology of pancreatic cancer. The study focused on the role of selected dietary factors related to pancreatic cancer. MATERIAL AND METHODS: The case-control study was performed in the Czech Republic in 2006-â2009, involving three centers in Olomouc, Ostrava and Ceske Budejovice. It comprised a total of 530 persons, of whom 310 had pancreatic cancer and 220 were controls. Data were obtained directly from each participant in an interview with a trained interviewer and entered into a standardized questionnaire. The data were analyzed using a crude odds ratio (OR) and multivariate logistic regression with an adjusted OR and 95% CI. The statistical analysis was performed with the STATA v. 10 software. RESULTS: A very strong protective effect was found in pickled cabbage (OR 0.32; 95% CI 0.19-â0.55), broccoli (OR 0.37; 95% CI 0.25-â0.53), cooked onion (OR 0.14; 95% CI 0.08-â0.27), tomatoes (OR 0.28; 95% CI 0.13-â0.60), raw carrot (OR 0.33; 95% CI 0.20-â0.56), cooked carrot (OR 0.35; 95% CI 0.19-â0.62). In logistic regression model, statistically significant protective associations were found in consumption of more than three portions of cooked vegetables per week (OR 0.16; 95% CI 0.05-â0.55) and high consumption of citrus fruit (OR 0.46; 95% CI 0.23-â0.90). CONCLUSION: The study found statistically significant protective effect of consumption of more than three portions of cooked vegetables per week and high consumption of citrus fruit.