Opioid overdose and substance abuse treatment entry data suggest that injection drug use is increasing in nonurban locations. We sought to explore the prevalence and incidence of viral infections among people who inject drugs (PWID) residing in Fairfield and New Haven counties but outside of the six largest cities. A longitudinal cohort of PWID was assembled and incidence of HIV-1, hepatitis B virus, and hepatitis C virus infections was determined by annual antibody screening. Data on participants' socioeconomic situation and risk behaviors were collected. We identified 11 new hepatitis C virus infections and calculated incidence at 9.03 cases per 100 person-years. Only one new HIV infection and one new hepatitis B virus infection were detected. Factors associated with seroconversion were assessed. Given the high incidence of HCV and lack of HBV vaccination coverage, prevention and treatment resources need to be targeted to this population.
Gallbladder cancer is a rare malignancy [1], for which surgery remains the only curative option. The extent of the surgery has changed throughout the years [2]. Currently a radical cholecystectomy, typically including central hepatectomy with part of segments 4b/5 for a negative margin and portal lymph node dissection, is the recommended procedure for tumors T1b and beyond [3,4]. Minimally Invasive Surgery (MIS) has become the standard of care for routine cholecystectomies for benign disease, since it offers safe outpatient surgery, minimal scarring and comparable surgical outcomes when compared with open surgery [5,6].
