The initial regenerated PFTα film consisted of alpha-helix and random coil components. The aqueous ethanol treatment of the film resulted in significant increase in

beta-sheet component and improvement of water resistance of the film. This effect was strongly dependent on ethanol concentration, and 60-80%, (w/w) ethanol was most effective. (C) 2009 Wiley Periodicals, Inc. J Appl Polym Sci 116:461-467,2010″
“Study Design. Case report.

Objective. We report a rare case of postradiation sarcoma of the cervical spine 30 years after treatment for thyroid cancer.

Summary of Background Data. The reported case is a 66-year-old man with a history of thyroid cancer treated with surgery and radiotherapy at the age of 36 years. He was disease-free for 30 years, but then developed left upper limb weakness and numbness. Magnetic resonance imaging showed a homogeneously enhanced mass lesion with cystic parts involving the C4 vertebral body and occupying the left side of the spinal canal with extension to the paraspinal space through

the neural foramen.

Methods. Using staged posterior and anterior approaches, gross total tumor excision, C4 corpectomy, and spinal fusion were achieved.

Results. The histologic diagnosis revealed sarcoma that was immunoreactive to vimentin and focally to S100 and O13 antibodies. Radiation-induced sarcoma should be suspected in patients who have received radiation Napabucasin treatment previously and present with new neurologic symptoms and signs in the irradiated area. The patient’s muscle power returned to 5/5, except for the left upper extremity, which

reached 2/5; he was free from recurring symptoms during the follow-up period.

Conclusion. Because of advancements in diagnostic techniques and therapeutic methods, more patients survive primary cancer, and therefore an increase in the number of cases of postradiation sarcoma is expected. Postradiation A-1210477 molecular weight sarcomas have extremely long latent periods, and one should therefore always keep in mind such a complication of previous radiation treatment.”
“Objective-To compare 1-year outcomes after lateral fabellar suture stabilization (LFS) and tibial plateau leveling osteotomy (TPLO) for the treatment of dogs with cranial cruciate ligament disease.

Design-Randomized blinded controlled clinical trial.

Animals-80 dogs with naturally occurring unilateral cranial cruciate ligament disease.

Procedures-All dogs were randomly assigned to undergo LFS (n = 40) or TPLO (40). Clinical data collected included age, weight, body condition score, history information, stifle joint instability, radiographic findings, surgical findings, and complications.

Objective: The objective

was to investigate whether a long sensory exposure, due to differences in means of consumption and in viscosity, enhances learned associations between sensory signals and metabolic consequences and hence facilitates energy intake compensation. Design: A total of 105 healthy young adults with a mean (+/- SD) age of 22 +/- 3 y and a body mass index (in kg/m(2)) of 21.6 +/- 1.7 participated in a parallel intervention in 3 groups: liquid yogurt with a straw (liquid/straw; n = 34), liquid yogurt with a spoon (liquid/spoon; n = 36), or semisolid yogurt with a spoon (semisolid/spoon; n = 35). Novel flavored yogurts were offered ad libitum for breakfast in 2 energy densities: low (approximate to 215 kJ/100 g) and high (approximate to 600 kJ/100 g). Subjects were repeatedly exposed to the yogurt products (10 times), and yogurt intake was measured. Results: Intakes (P = 0.01) and eating rates (P = 0.01) were highest in www.selleckchem.com/products/Flavopiridol.html the liquid/straw group. Average intakes over 10 exposures were 575 +/- 260 g for liquid/straw, 475 +/- 192 g for liquid/spoon, and 470 +/- 223 g for semisolid/spoon; average eating rates were 132 +/- 83 g/min for liquid/straw, 106 +/- 53 g/min for liquid/spoon, and 105 +/- 88 g/min for semisolid/spoon. No significant interaction for intake

Fer-1 mw between intervention group, energy density, and repeated exposure was observed, and intakes of the low-and high-energy-dense yogurts did not change over time in any of the intervention groups. Conclusions: We observed no energy intake compensation after repeated exposure to yogurt products. Differences in ad libitum yogurt intake could be explained by eating rate, which was affected by the different means of consumption. This trial was registered with the Dutch trial registration at http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1853 as NTR1853. Am J Clin Nutr 2010; 91: 841-7.”
“Background and aims:

Cardiovascular (CV) events occur even when LDL-C are < 100 mg/dL. To improve the detection of CV risk we investigated the apoB/apoA-I ratio versus LDL-C in subjects considered normal glucose tolerant (NGT) by oral glucose tolerance test (OGTT).

Methods and results: We enrolled 616 NGT (273 men and Selleckchem PCI-32765 343 women), and we measured insulin resistance, lipid profile, apoB/apoA-I and the factors compounding the metabolic syndrome (MetS). An unfavourable apoB/apoA-I (>= 0.9 for males and >= 0.8 for females) was present in 13.9% of 108 patients with LDL-C < 100 mg/dL: compared to subjects with lower apoB/apoA-I (< 0.9 for males and < 0.8 for females), they had more elements of MetS and their lipid profile strongly correlated with high CV risk. Out of 314 patients with lower apoB/apoA-I, 40.12% had LDL-C >= 130 mg/dL: these retained a more favourable lipid profile than corresponding subjects with elevated apoB/apoA-I ratio. Finally, we found a significant correlation between LDL-C and apoB/apoA-I ratio (rZ0.

58%. Rate of OB caused by PCV7-serotypes and nonvaccine

serotypes were 0.16% and see more 0.42%, respectively. A total of 18 cases of S. pneumoniae OB were identified between January 1, 2006 and December 31, 2009. None of the 5 infants who had S. pneumoniae OB caused by vaccine serotypes had received PCV7. The decline in pneumococcal OB rates observed after PCV7 introduction in our area (Basque Country, Spain) continues 8 years later. There is no evidence of an OB rate increase caused by non-PCV7 serotypes.”
“Purpose: To predict the invasiveness of urothelial bladder carcinoma using a logistic regression model on preoperative peripheral blood samples. Patients and Methods: Hospital data of patients operated for urothelial carcinoma were

reviewed retrospectively. Preoperative blood samples were collected before the first cystoscopic examination. Any kind of infection or inflammation was an exclusion criterion. Patients were grouped as having a non-muscle-invasive or muscle-invasive urothelial carcinoma. The mean age was 69 years and was determined as the cut-off value. According to receiver operating characteristic curves, threshold points were determined for lymphocytes, neutrophil count, neutrophil-to-lymphocyte ratio (NLR), thrombocytes FK228 cost and mean platelet volume. Demographic specialties, parameters obtained from blood samples, tumor size and multiplicity were evaluated and significant parameters were put into a logistic regression model. Results: The study group consisted of 80 non-muscle-invasive Baf-A1 nmr and 102 muscle-invasive patients. Age (<= 69 vs. >69), female gender, NLR (2.57), mean platelet volume (7.9/fl) and platelet count (400,000/mu l) were significant parameters and put in a model. Using odds ratios, the probability of tumor invasiveness was calculated by a formula. Conclusion: Age,

female gender, NLR and platelet count were found to be the predictors of invasiveness of urothelial carcinoma. Copyright (c) 2012 S. Karger AG, Basel”
“A combined scanning tunneling microscopy and low-energy electron diffraction investigation of the Mn/GaAs(001) interface formation is reported. The interface, grown on a (2 x 4) reconstructed substrate produced by molecular beam epitaxy, was studied as a function of Mn evaporation with thickness ranging from 1/8 ML to 1 ML. The interaction of Mn atoms with the semiconductor surface is strong and leads to surface reconstructions involving a rearrangement of the two outmost atomic layers of the substrate. For Mn thickness lower than 1/2 ML, the surface is characterized by a (2 x 1) periodicity. Conversely, when the Mn deposition is increased to 1/2 ML the surface reconstruction is strongly dependent on the preparation procedure.

The early-stage tumors show favorable outcome, and postoperative regular clinical and radiological

follow-up is adequate in most cases. However, close follow-up is mandatory for tumors with histopathologically coexistence of squamous, papillary, and/or eosinophilic RCC component. This report describes a 12-year-old girl with a stage I HRCN who was closely followed after nephrectomy with no further treatment.”
“Current research in the field selleck of drug delivery devices, by which pulsatile release is achieved, has been intensified. In this article, an attempt has been made to discuss several types of drug delivery systems that show pulsatile drug delivery characteristics. As found frequently in the living body, many vital functions are regulated by pulsed or transient release of bioactive substances at a specific site and time. Thus it is important to develop new drug delivery devices to achieve pulsed delivery of a certain amount of drugs in order to mimic the function of the living systems, while minimizing undesired side-effects. Pulsatile delivery, which is meant as the liberation of drugs following programmed lag phases, has drawn increasing interest, especially in view of emerging

chronotherapeutic approaches. This review article is an attempt to discuss various design strategies, chiefly including reservoir, capsular, and osmotic formulations, and drug delivery systems which cause the pulsed or triggered release of bioactive compounds induced due to certain stimuli Selleckchem AZ 628 like thermal, electrical, and magnetic.”
“BACKGROUND: We previously proposed calculating forced vital capacity (FVC) by the number of segments for size matching in living-donor lobar lung transplantation (LDLLT). The primary purpose of this study was to compare spirometry-obtained calculations of lower lobe volumes with three-dimensional (3D) computed tomography (CT) volumetric images. Our second goal was to compare the data of pulmonary

function tests with CT volumetry in living lung donors.

METHODS: PF-00299804 nmr Pulmonary function test, including FVC and total lung capacity (TLC), and 3D CT volumetry were performed pre-operatively in 21 healthy donor candidates for LDLLT. The relationship of 3D CT volumetric data and calculated volume of lower lobes by the number of segments was investigated. Also studied were 3D CT volumetric data in relation to FVC and TLC. Various pre-operative variables were analyzed retrospectively.

RESULTS: According to 3D CT volumetry, the right and left lower lobe volume was 26.3% +/- 2.9% and 22.6% +/- 3.1% of the total lung volume, respectively. We found a significant, strong correlation between each lower lobe volume and the total lung volume. Because the calculated volumes of right and left lower lobes by the number of segments were 26.3% and 21.1%, respectively, our results implied that the volume of both lower lobes was accurately described by the number of segments.

Mean changes in overall HS from 3- to 5-year follow-up were significantly different for men and women (-4.12 vs. 1.69, P = 0.014). In male patients, overall HS was significantly lower at 5-year follow-up compared to the 3-year follow-up (66.7 vs. 62.6, P = 0.001). In female patients, there was no significant difference (58.1 vs. 59.8, P = 0.393).

Conclusions: Men and women experience different levels of HS over time. Attention should

be. paid to gender disparities in postoperative PAD patients. (C) 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.”
“The skin is the primary physical barrier between the body and the external environment and is also a substrate for the colonization of numerous microbes. Previously, dermatological microbiology research was dominated by culture-based techniques, but significant advances GSK2126458 cell line in genomic technologies have enabled the development of less-biased, culture-independent approaches to characterize skin microbial communities. These molecular microbiology approaches illustrate the great diversity of microbiota colonizing the skin and highlight unique features such as site specificity, temporal dynamics, and interpersonal variation. Disruptions in skin commensal KU 57788 microbiota are associated with the progression of many dermatological

diseases. A greater understanding of how skin microbes interact with each other and with their host, and how we can therapeutically manipulate those interactions, will provide powerful tools for treating and preventing dermatological disease.”
“Introduction. The inhibition see more of angiotensin-converting enzyme could be useful to avoid sarcopenia in the elderly.

Materials and methods. We compared in a prospective double blind trial, the effects of treatment with enalapril or nifedipine on muscle performance in hypertensive elderly subjects. Patients were followed for nine months, and at baseline, 4.5 months and the end of follow-up, quadriceps and hand grip muscle strength, walking capacity, timed up and go and the short physical

performance test were measured.

Results. During follow-up, more subjects on nifedipine than on enalapril discontinued the medication due to side-effects. No differences in the evolution of muscle strength, walking capacity or functional measures were observed. At nine months, plasma angiotensin-converting enzyme activity decreased by 6.0 +/- 2.5 U/L among patients on enalapril and increased by 8.5 +/- 4.2 U/L (p<0.001) among patients on nifedipine.

Conclusion. In this group of elderly subjects, enalapril was not superior to nifedipine with regard to the age-related decline of muscle performance.”
“Objective To develop fast and reliable testing routines for diagnosing retina and optic nerve diseases in canine cataract patients based on chromatic properties of the pupillary light reflex response.

“
“Objective The present study was undertaken to establish reference values for Schirmer tear test (STT) and intraocular pressure (IOP) in the long-eared hedgehog (Hemiechinus auritus). Animals Fourteen healthy long-eared hedgehogs (H.similar to auritus) selleckchem of either sex were studied. Procedures The hedgehogs were individually immobilized with an intramuscular injection of combined Ketamine (20 mg/kg) and Diazepam (0.5 mg/kg), and each animal

underwent ophthalmic examinations including: STT, tonometry, biomicroscopy, and indirect ophthalmoscopy. Results No significant effects of animal gender, weight, side (right vs. left eye) were found in this study. Mean (SD) STT values for all eyes (n = 28) were 1.7 +/- 1.2 mm/1 min with a range of 04 mm/1 min. Mean STT in male animals was 2.2 +/- 1.2. Mean STT in female Hedgehogs was 1.3 +/- 1.1. Mean (SD) IOP values by applanation tonometry were 20.1 +/- 4.0 mmHg (range 11.526.5 mmHg). Mean (SD) IOP values by applanation OICR-9429 price tonometry were 18.2 +/- 4.0 and 22.0 +/- 3.2 mmHg for males and females, respectively. Conclusions This study reports STT and IOP findings in long-eared hedgehogs (H.similar to auritus).”
“Objectives: To summarize current available data on simulation-based training in resuscitation for health care professionals.

Data sources: MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Web of Science, Scopus and reference lists of

published reviews.

Study selection: Published studies of any language or date that enrolled health professions’ Cediranib learners to investigate the use of technology-enhanced simulation to teach resuscitation in comparison with no intervention or alternative training.

Data extraction:

Data were abstracted in duplicate. We identified themes examining different approaches to curriculum design. We pooled results using random effects meta-analysis.

Data synthesis: 182 studies were identified involving 16,636 participants. Overall, simulation-based training of resuscitation skills, in comparison to no intervention, appears effective regardless of assessed outcome, level of learner, study design, or specific task trained. In comparison to no intervention, simulation training improved outcomes of knowledge (Hedges’ g) 1.05 (95% confidence interval, 0.81-1.29), process skill 1.13 (0.99-1.27), product skill 1.92 (1.26-2.60), time skill 1.77 (1.13-2.42) and patient outcomes 0.26 (0.047-0.48). In comparison with non-simulation intervention, learner satisfaction 0.79 (0.27-1.31) and process skill 0.35 (0.12-0.59) outcomes favored simulation. Studies investigating how to optimize simulation training found higher process skill outcomes in courses employing “”booster”" practice 0.13 (0.03-0.22), team/group dynamics 0.51 (0.06-0.97), distraction 1.76 (1.02-2.50) and integrated feedback 0.49 (0.17-0.80) compared to courses without these features.

Furthermore, pathophysiological involvement of the pain neuromatrix and of the central descending opiatergic pain control system was observed. Given the rapid advances in functional and structural neuroimaging methodologies, it can be expected that

these non-invasive techniques will continue to improve our understanding into the nature of the brain dysfunction in cluster headache and other trigeminal autonomic cephalalgias.”
“The aim of this study was to compare fibulin-5 expression in women with and without anterior vaginal wall prolapse. Vaginal tissues were sampled in a standardized fashion from women with (n = 12) or without (n = 10) anterior vaginal wall prolapse. IPI-145 supplier Quantitative real-time polymerase chain reaction was performed to measure mRNA levels of fibulin-5 (FIB-5). FIB-5 protein expression was assessed by immunohistochemistry. There were no significant differences in demographic data between the two groups. FIB-5 mRNA expression was significantly decreased in women with anterior vaginal wall prolapse compared to women without prolapse [(FIB-5 mean +/- SD mRNA expression in relative units) 0.01 +/- 0.01 vs. 0.09 +/- 0.14, P = 0.04]. Fibulin-5

staining intensity was diminished in women with prolapse compared to women without prolapse [intensity score, median (range), 1 (1-2) vs. 3 (2-3), P = 0.04]. Fibulin-5 expression is decreased in vaginal Batimastat in vivo biopsies from women with prolapse. Changes in fibulin expression may play a role in the development of pelvic organ prolapse.”
“Chemical investigation on the South China Sea gorgonian coral Subergorgia suberosa has led to the isolation of one new butenolide (5R)-5-(1-ethoxypropyl)-5-hydroxy-3,4-dimethylfuran-2(5H)-one (1) as a pair of inseparable

epimers, along with two known butenolides (S)-5-hydroxy-3,4-dimethyl-5-propylfuran-2(5H)-one (2) and (S)-5-hydroxy-3,4-dimethyl-5-pentylfuran-2(5H)-one (3). Their structures including absolute configurations were determined unambiguously by detailed analyses of spectroscopic data and by comparison with the available literature. Compounds 1-3 exhibited moderate antifouling activities against the settlement of Balanus amphitrite larvae, whereas compound 4, the acetyl derivative of 3, showed no antifouling activity selleck chemicals llc at the concentrations up to 25g/mL.”
“A large two-stage GWAS by Antilla et al. reported the minor allele of rs1835740 on 8q22.1 to be associated with common types of migraine. The objective of the present study was to determine the clinical correlate of the variant in migraine without aura (MO). Clinical data on 339 successfully genotyped MO patients (patients with attacks of migraine without aura and no attacks of migraine with aura) were obtained by an extensive validated semi-structured telephone interview performed by a physician or a trained senior medical student.

The long-term follow-up of two UK cohorts found some excess risk of liver cancer among severe, but not among mild, epileptics. Some excess risk of liver cancer was also found in cohort studies of patients hospitalized for epilepsy in Sweden and Taiwan, in the

absence, however, of association with any specific drugs. A UK General Practice database, comparing epileptics treated with valproate with unexposed ones, found a very low incidence of liver cancer. Of the studies of cancer in patients treated with phenobarbital, a large US pharmacy-based cohort investigation showed no excess risk of liver cancer. selleck products In a case-control study, nested in the Danish cohort of epileptics, no association was observed between phenobarbital and liver cancer among patients who had not received thorotrast (RR=1.0 for liver and 0.8 for biliary tract cancers). Thus, some, although not all, studies reported excess risk of all cancers and liver cancer in severe, but not in milder epileptics. There is no evidence of a specific role of phenobarbital in human liver cancer risk, but data on the topic are limited.”
“The chemical composition of the essential oils obtained from the fresh leaves of Cinnamomum tamala Nees et Eberm. was determined by GC and GC-MS. The yield of the oil on a dry weight basis ranged from 1.2% to 3.9% (w/w). Phenyl propanoids constitute the major portion

(88.9-95.0%) of the oils. Fifty-four compounds were identified from the oils. Eugenol (91.4-41.8%) was the main compound, followed by eugenyl acetate (0.0-47.1%) and alpha-phellandrene (0.6-2.5%) in the analysed oils.”
“This selleck screening library study examined the influence of manufacturing processes and extraction conditions on the chemical compositions of green tea. Green

tea samples grown in various areas (Korea, China, and Japan) and processed by 4 different methods (steaming, pan-firing, steaming and pan-firing, and heavy roasting after steaming and pan-firing) were collected for study. The chemical compositions of the green tea extracts and infusions were different according to their processing methods and extraction conditions, including www.selleckchem.com/products/ly2606368.html catechins, caffeine, and free amino acids contents. In all samples analyzed, (-)-epigallocatechin gallate (EGCG), (-)-epigallocatechin (EGC), and theanine were determined as the major catechins and free amino acid, respectively. Studies of samples grown in the same area (Jeju; Korea) showed that there were significant differences in the concentrations of catechins and caffeine in extract and infusion according to the processing methods. These results indicate that processing methods influenced the chemical compositions of the green tea extracts and infusions.”
“Colorectal cancer (CRC) accounts for 9.7% of all cancer cases and for 8% of all cancer-related deaths. Established risk factors include personal or family history of CRC as well as lifestyle and dietary factors.

00 for P-Cx43 and NP-Cx43). It also revealed that, after aconitine treatment, the amount of phosphorylated PKC alpha (P-PKC alpha) decreased significantly. Similar changes were revealed in phosphorylation status occurring in PKC alpha in the cultures under the same treatment conditions. These observations suggest that aconitine not only induces dephosphorylation of Cx43, but also alters expression of P-PKC alpha in cultured cardiomyocytes.”
“Pectic enzyme production was induced in vitro by culturing the pathogen (P flourescens) in minimal salt medium containing

citrus pectin as the only carbon source and in vivo by inoculating the pathogen into healthy onion bulbs. The spent broth and onion rot extract were obtained and enzyme detection was done using viscometric method and cup plate assay. The crude enzyme was partially purified by precipitating Napabucasin clinical trial with ammonium sulphate and dialyzed against water at 4 degrees C for 24 h before use. The activity of the purified enzyme was determined based Selleckchem CH5424802 on the macerating ability on Onion and Potato discs

and later by estimation of reducing sugars (galacturonic acid) level. The type of cleavage reaction of the enzyme was determined using the thiobarbituric acid reaction and the presence of antimicrobial substance in the rot tissue was also investigated. The pathogen produced a hydrolytic polygalacturonase in vitro and in vivo. The purified enzyme showed appreciable activity with all the assay methods used. Activity was highest at pH 5 in the culture filtrate sample and at pH 4 in the rot extract. Maceration was observed in potato and onion discs. The BIX 01294 detection of increasing concentration of polyphenols in the rot tissue during rot development demonstrated the plant’s response to the pathogen.”
“Background: It is known that daily smoking is associated with the development of alcohol use disorders. However,

non-daily smoking is prevalent in young adults and is associated with increased rates of problematic alcohol use in cross-sectional data. It is unknown whether non-daily smoking is predictive of hazardous drinking and alcohol use disorders using longitudinal data. The primary aim of the present investigation was to explore the temporal relationship between non-daily smoking and drinking in young adults, and secondarily, whether college status modified this relationship.

Methods: Using Waves 1 (200172002) and 2 (2004-2005) of the National Epidemiological Survey on Alcohol and Related Conditions (NESARC), we examined the predictive relationship of smoking status at Wave 1 and change in college status between Waves on alcohol drinking, hazardous drinking, and alcohol abuse and dependence disorders at Wave 2. The sample was restricted to individuals aged 18-25 years at Wave 1.

Findings: Daily and non-daily smokers at Wave 1, compared to nonsmokers, were at a greater risk for hazardous drinking and alcohol use disorders at Wave 2, after controlling for Wave 1 drinking.

In the reproductive phase sym28 shoots develops additional flowers, the stem fasciates, and the normal phyllotaxis is perturbed. Mutational substitution of an amino acid in one leucine

rich repeat of the corresponding Lotus japonicus LjCLV2 protein results in increased nodulation. Similarly, down-regulation of the Lotus Clv2 gene by RNAi mediated reduction of the transcript level also resulted in increased nodulation. Gene expression analysis of LjClv2 and Lotus STI571 price hypernodulation aberrant root formation Har1 (previously shown to regulate nodule numbers) indicated they have overlapping organ expression patterns. However, we were unable to demonstrate a direct protein-protein interaction between LjCLV2 and LjHAR1 proteins in contrast to the situation between equivalent proteins in Arabidopsis. LjHAR1 was localised to the plasma membrane using a YFP fusion whereas LjCLV2-YFP localised to the endoplasmic reticulum when transiently expressed in Nicotiana benthamiana leaves. This finding is the most likely explanation for the lack of interaction between these two

proteins.”
“The reason(s) that hepatitis A virus (HAV) infection may progress infrequently to acute liver failure are poorly understood. We examined host and viral factors in 29 consecutive adult patients with HAV-associated acute liver failure enrolled at 10 sites participating in the US ALF Study Group. Eighteen of twenty-four acute liver failure sera were PCR positive AG-014699 price while six had no detectable virus. HAV genotype was determined using phylogenetic analysis and the full-length genome sequences of the HAV from a cute liver failure sera were compared to those from self-limited acute HAV cases selected from the CDC database. We found that rates of nucleotide substitution did not vary significantly between the liver failure and non-liver failure cases and there was no significant variation in amino acid sequences between the two groups. Four of 18 HAV isolates were

sub-genotype IB, acquired from the same study site over a 3.5-year period. Sub-genotype IB was found more frequently among acute liver failure cases compared to the non-liver failure cases (chi-square test, P < 0.01). At another centre, a mother and her son presented Ricolinostat with HAV and liver failure within 1 month of each other. Predictors of spontaneous survival included detectable serum HAV RNA, while age, gender, HAV genotype and nucleotide substitutions were not associated with outcome. The more frequent appearance of rapid viral clearance and its association with poor outcomes in acute liver failure as well as the finding of familial cases imply a possible host genetic predisposition that contributes to a fulminant course. Recurrent cases of the rare sub-genotype IB over several years at a single centre imply a community reservoir of infection and possible increased pathogenicity of certain infrequent viral genotypes.