مرکز اطلاعات علمی Scientific Information Database (SID) - Trusted Source for Research and Academic Resources

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مرکز اطلاعات علمی Scientific Information Database (SID) - Trusted Source for Research and Academic Resources
مرکز اطلاعات علمی Scientific Information Database (SID) - Trusted Source for Research and Academic Resources
مرکز اطلاعات علمی Scientific Information Database (SID) - Trusted Source for Research and Academic Resources
مرکز اطلاعات علمی Scientific Information Database (SID) - Trusted Source for Research and Academic Resources
مرکز اطلاعات علمی Scientific Information Database (SID) - Trusted Source for Research and Academic Resources
مرکز اطلاعات علمی Scientific Information Database (SID) - Trusted Source for Research and Academic Resources
مرکز اطلاعات علمی Scientific Information Database (SID) - Trusted Source for Research and Academic Resources
مرکز اطلاعات علمی Scientific Information Database (SID) - Trusted Source for Research and Academic Resources
Journal: 

Hepatitis Monthly

Issue Info: 
  • Year: 

    2011
  • Volume: 

    11
  • Issue: 

    7 (36)
  • Pages: 

    507-510
Measures: 
  • Citations: 

    0
  • Views: 

    478
  • Downloads: 

    362
Abstract: 

Interventional radiologists are physicians who specialize in minimally invasive targeted therapies, offering the most in-depth knowledge of the less invasive therapies that are available and diagnostic and clinical experience across all specialties. Interventional radiologists offer treatments for hepatobiliary diseases without significant side effects or damage to the adjacent normal tissue.We briefly introduce some of the interventional procedures in gastroenterology.

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Author(s): 

DABBAGH ALI | RAJAEI SAMIRA

Journal: 

Hepatitis Monthly

Issue Info: 
  • Year: 

    2011
  • Volume: 

    11
  • Issue: 

    7 (36)
  • Pages: 

    511-512
Measures: 
  • Citations: 

    0
  • Views: 

    287
  • Downloads: 

    334
Abstract: 

The fluorinated hydrocarbons that are used for anesthesia are derived from ether. Although they have many benefits, there are several side effects of these drugs, including untoward hepatic effects. Whether the use of halothane gas can be revitalized is unknown. Introducing nanocarriers inside the halothane molecule can increase its benefits as an anesthetic in the lungs and cardiovascular system and prevent exposure to the liver. The findings of new fields, such as cancer therapy, and anesthetic agents, such as propofol, can improve the quality of the drug using nanomedicine.

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Journal: 

Hepatitis Monthly

Issue Info: 
  • Year: 

    2011
  • Volume: 

    11
  • Issue: 

    7 (36)
  • Pages: 

    513-518
Measures: 
  • Citations: 

    0
  • Views: 

    340
  • Downloads: 

    335
Abstract: 

Background: Alcohol consumption, current injecting drug use, and pre-existing mental illness have been identified as 3 of the main reasons for excluding patients from treatment for hepatitis C.Objectives: We reviewed the literature to obtain an evidence base for these common exclusion criteria.Materials and Methods: We reviewed original research and meta-analyses investigating the effects of alcohol consumption, current injecting drug use, and pre-existing mental illness.Results: We identified 66 study reports relevant to the review, but found only limited evidence to support withholding of treatment on the basis of the 3 previously mentioned exclusion criteria.Conclusions: Currently, there is a lack of evidence for many of the barriers faced by patients in availing treatment for hepatitis C. Adherence to treatment routine was found to be a better predictor of sustained virological response than injecting drug or alcohol consumption during treatment period or the presence of a pre-existing mental disorder. Although several challenges remain, we need to ensure that treatment decisions are based on the best available evidence and the treatment is performed appropriately on a case-by-case basis.

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Journal: 

Hepatitis Monthly

Issue Info: 
  • Year: 

    2011
  • Volume: 

    11
  • Issue: 

    7 (36)
  • Pages: 

    519-524
Measures: 
  • Citations: 

    0
  • Views: 

    325
  • Downloads: 

    312
Abstract: 

Background: The duplex mutation primers offer many advantages over other multi labeled probes for real-time detection of amplification products.Objectives: To develop and validate a novel real-time PCR for quantification of HCV RNA based on the duplex mutation primers technology.Materials and Methods: The duplex mutation primers were selected in the highly conservative 5' non-coding region (5'NCR) of the HCV RNA. The assay was validated with the Viral Quality Control panel, which also includes Chinese HCV RNA standards.Results: The detection limit was 57 IU/mL, and a good linear correlation in the range of 102-108 IU/mL was revealed (r2=0.999) with the novel method. This assay has a dynamic range of at least 8 log10 without the need for specimen dilution, good clinical intra and inter-run precision, and excellent correlation with a commercially available assay (r2=0.95).Conclusions: The high sensitivity, wide linear range, and good reproducibility, combined with low cost, make this novel quantitative HCV real-time PCR assay particularly well suited for application to clinical and epidemiological studies.

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Journal: 

Hepatitis Monthly

Issue Info: 
  • Year: 

    2011
  • Volume: 

    11
  • Issue: 

    7 (36)
  • Pages: 

    525-531
Measures: 
  • Citations: 

    0
  • Views: 

    452
  • Downloads: 

    353
Abstract: 

Background: Chronic hepatitis C is more aggressive during HIV infection. Available data about risk factors of liver fibrosis in HIV/HCV co-infected patients derive from studies based on a single liver biopsy.Objectives: To evaluate the risk factors of liver fibrosis progression (LFP) and to investigate the role of antiretroviral therapy (ARV) in HIV/HCV patients who underwent paired liver biopsy.Patients and Methods: We retrospectively studied 58 patients followed at two Infectious Diseases Departments in Northern Italy during the period 1988–2005. All specimens were double-blinded and centrally examined by two pathologists. LFP was defined when an increase of at least one stage occurred in the second biopsy, according to the Ishak-Knodell classification.Results: In a univariate analysis, serum levels of alanine aminotransferase (ALT)>150 IU/L at the first biopsy (P=0.02), and a>20% decrease in CD4+cell count between the two biopsies (P=0.007), were significantly associated with LFP. In multivariate analysis, a>20% decrease in CD4+cell count remained independently associated to LFP (odds ratio, 3.99; 95% confidence interval, 1.25–12.76; P<0.02). Analysis of life survival curves confirmed the correlation between CD4+cell count and LFP.Conclusions: Our findings highlight that in HIV/HCV coinfected patients, an effective antiretroviral therapy that assures a good immune-virological profile contributes to reducing the risk of LFP.

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Journal: 

Hepatitis Monthly

Issue Info: 
  • Year: 

    2011
  • Volume: 

    11
  • Issue: 

    7 (36)
  • Pages: 

    532-538
Measures: 
  • Citations: 

    0
  • Views: 

    327
  • Downloads: 

    380
Abstract: 

Background: In chronic liver diseases, a correct estimation of the severity of liver fibrosis is important for recommendations regarding the treatment. Nowadays, evaluation of fibrosis is done by noninvasive methods such as biochemical scores and transient elastography instead of liver biopsy. The lack of sensitivity to detect fibrosis, because of its heterogeneity is a drawback of liver biopsy (LB).Objectives: To compare transient elastography (TE) and acoustic radiation force impulse (ARFI) for the evaluation of liver stiffness (LS), against percutaneous LB.Patients and Methods: Our study comprised of 223 subjects; 52 without fibrosis (38 volunteers and 14 patients with F0 on LB), 36 with F1, 40 with F2, 26 with F3 and 69 with liver cirrhosis (46 with LB and 23 with signs of cirrhosis). For each patient we performed in the same session 10 TE and 5 ARFI measurements. The median values were calculated.Results: A strong linear correlation (Spearman rho=0.870) was found between TE and fibrosis (P<0.0001); there was also a weaker correlation between ARFI and fibrosis (Spearman rho=0.646; P<0.0001). TE measurements were also correlated with ARFI measurements (Spearman rho=0.733, P<0.0001). The best test for predicting significant fibrosis (F³2) was TE with a cut-off value of 7.1 kPa (AUROC 0.953). For ARFI, the cut-off value was 1.27 m/s-area under ROC curve (AUROC): 0.890, sensitivity (Se) of 88.7%, specificity (Sp) of 67.5%, positive predictive value (PPV) of 64.5%, and negative predictive value (NPV) of 90% (P=0.0044). For predicting cirrhosis (F=4), the optimum cut-off values were 14.4 kPa for TE (AUROC: 0.985, Se: 95.6%, Sp: 94.7%, PPV: 89.2%, NPV: 98%) and 1.7 m/s for ARFI (AUROC: 0.931, Se: 93%, Sp: 86.7%, PPV: 73.6%, NPV: 96.9%) (P=0.0102).Conclusions: LS evaluation by means of ARFI is not superior to TE for the assessment of liver fibrosis. ARFI is an accurate test for the diagnosis of cirrhosis.

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Author(s): 

BILSKI BARTOSZ

Journal: 

Hepatitis Monthly

Issue Info: 
  • Year: 

    2011
  • Volume: 

    11
  • Issue: 

    7 (36)
  • Pages: 

    539-543
Measures: 
  • Citations: 

    0
  • Views: 

    321
  • Downloads: 

    368
Abstract: 

Background: In medical terms, occupational diseases are defined as health disorders specifically associated with the working environment of people and their occupational activity. From the medical and legal perspectives, the vast majority of European countries consider particular diseases to be of occupational origin if they are mentioned in the current list of occupational diseases and caused by exposure to factors in the working environment that are harmful to health.Objectives: The aim of this study was to analyze the occurrence of cases of viral hepatitis certified as an occupational disease in Poland during 1979–2009. This article presents the medical, economic, and legal aspects of the epidemiology of hepatitis as an occupational disease in Poland.Materials and Methods: Publically available statistical data on certified occupational diseases in Poland and data contained in individual “occupational disease diagnosis cards” (based on data used in Poland statistical form), regarding certified cases of hepatitis among health care professionals, which were collected by the Department of Occupational Hygiene of the Polish Public Health Service, were analyzed in this study.Results: In Poland, the highest number of cases of hepatitis certified as an occupational disease was observed in 1987. A gradual reduction in the number of cases of hepatitis as an occupational disease has been noted since then. Currently, hepatitis C as an occupational disease is certified more frequently than hepatitis B. In Poland, the number of women with hepatitis certified as an occupational disease is higher than that of men. However, among health care professionals, particularly nurses, this difference is insignificant because women outnumber the men. The existence of such a situation is due to the significant quantitative predominance of women over men among medical personnel, especially among nurses.Conclusions: Immunization of health care professionals against the hepatitis B virus (HBV), introduced in Poland in 1988, was an important factor involved in reducing the number of cases of occupational viral hepatitis. Socioeconomic and financial factors affected the epidemiological data on cases of hepatitis certified as an occupational disease in Poland. An additional problem associated with the diagnosis of occupational diseases is the lack of obligatory testing for anti-hepatitis C virus (HCV) and anti-hepatitis B surface antigen (HBsAg) antibodies and examinations to ensure the efficacy of HBV vaccination among medical staff before and during employment.

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Journal: 

Hepatitis Monthly

Issue Info: 
  • Year: 

    2011
  • Volume: 

    11
  • Issue: 

    7 (36)
  • Pages: 

    544-547
Measures: 
  • Citations: 

    0
  • Views: 

    424
  • Downloads: 

    358
Abstract: 

Background: Prediction of esophageal varices in cirrhotic patients by noninvasive methods is still unsatisfactory.Objectives: To evaluate the accuracy of an artificial neural network (ANN) in predicting varices in patients with HBV related cirrhosis.Patients and Methods: An ANN was constructed with data taken from 197 patients with HBV related cirrhosis. The candidates for input nodes of the ANN were assessed by univariate analysis and sensitivity analysis. Five-fold cross validation was performed to avoid over-fitting.Results: 14 variables were reduced by univariate and sensitivity analysis, and an ANN was developed with three variables (platelet count, spleen width and portal vein diameter).With a cutoff value of 0.5. The ANN model has a sensitivity of 96.5%, specificity of 60.4%, positive predictive value of 86.9%, negative predictive value of 86.5% and a diagnostic accuracy of 86.8% for the prediction of varices.Conclusions: An ANN may be useful for predicting presence of esophageal varices in patients with HBV related cirrhosis.

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Journal: 

Hepatitis Monthly

Issue Info: 
  • Year: 

    2011
  • Volume: 

    11
  • Issue: 

    7 (36)
  • Pages: 

    548-555
Measures: 
  • Citations: 

    0
  • Views: 

    318
  • Downloads: 

    408
Abstract: 

Background: Liver biopsy (LB) is still considered to be the gold standard for assessment of liver fibrosis.Objectives: To evaluate the effectiveness of various non-invasive methods for predicting liver fibrosis, including transient elastography (TE), APRI score, Lok score, Forns score, FIB-4 score, Fibrosis Index, King score, and Bonacini score, in comparison with the effectiveness of LB and to create a new scoring system for fibrosis prediction.Patients and Methods: This study included 212 patients with chronic HCV hepatitis. LB, TE, and various biological tests were performed during a single hospital visit. Using established formulae, data from these tests were used to create scores for assessment of liver fibrosis.Results: The results of all the tests showed significant correlation with histological fibrosis.TE results (r=0.62), King score (r=0.57), and APRI score (r=0.56) showed the closest correlation with severity of fibrosis. The following formula was derived from our data by multiple regression: Predicted liver fibrosis score (PLF score) =0.956+ 0.084xTE – 0.004 x King score+0.124 x Forns score+0.202 x APRI score. A direct correlation (r=0.68) was found between the PLF score and liver fibrosis. The cut-off values of the PLF score for various stages of fibrosis were: F³1, 1.77 (Area under ROC curve (AUROC) =0.76); F³2, 2.18 (AUROC=0.78); F³3, 2.47 (AUROC=0.86); and F=4, 2.98 (AUROC=0.97).Conclusions: We found that our newly developed PLF score, which is derived from the scores of multiple tests, is more strongly correlated with fibrosis than each component score used individually. The PLF score is more effective than TE for predicting severe fibrosis, but they have similar effectiveness in predicting liver cirrhosis.

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Author(s): 

ADLER MICHAEL

Journal: 

Hepatitis Monthly

Issue Info: 
  • Year: 

    2011
  • Volume: 

    11
  • Issue: 

    7 (36)
  • Pages: 

    556-557
Measures: 
  • Citations: 

    0
  • Views: 

    351
  • Downloads: 

    367
Abstract: 

We read the article by Yilmaz et al. with interest (1). Chronic liver disease requires the regular assessment of fibrosis to risk-stratify patients to treat and monitor the complications of liver cirrhosis (2). Due to the overwhelming burden of liver disease worldwide, there is a patent need for noninvasive methods of assessing fibrosis to enable us to test large numbers of patients regularly. The aspartate transaminase-to-platelet ratio index (APRI) is valuable, primarily due its universal availability, simplicity, and, hence, ease of use.

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Journal: 

Hepatitis Monthly

Issue Info: 
  • Year: 

    2011
  • Volume: 

    11
  • Issue: 

    7 (36)
  • Pages: 

    558-559
Measures: 
  • Citations: 

    0
  • Views: 

    267
  • Downloads: 

    328
Abstract: 

We read with great interest the article entitled “Noninvasive assessment of liver fibrosis with the aspartate transaminase to platelet ratio (APRI): Usefulness in patients with chronic liver disease” by Yuma Yet al.published in a recent issue of Hepatitis Monthly (1). In this study, the authors investigated the diagnostic power of APRI for predicting hepatic fibrosis in patients with chronic hepatitis B (CHB) and C (CHC) and non-alcoholic fatty liver disease (NAFLD).

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Author(s): 

SIRLI ROXANA | SPOREA IOAN

Journal: 

Hepatitis Monthly

Issue Info: 
  • Year: 

    2011
  • Volume: 

    11
  • Issue: 

    7 (36)
  • Pages: 

    560-561
Measures: 
  • Citations: 

    0
  • Views: 

    317
  • Downloads: 

    339
Abstract: 

I read with interest the article by Yilmazet al. regarding the value of aspartate aminotransferases (AST) -to-platelet ratio index (APRI score) for the noninvasive assessment of liver fibrosis in chronic hepatitis, which was published in Hepatitis Monthly (1). The authors evaluated patients diagnosed with chronic hepatitis C and B and nonalcoholic fatty liver disease (NAFLD) and assessed their APRI scores to predict the presence of fibrosis (Metavir score of at least F1).

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Journal: 

Hepatitis Monthly

Issue Info: 
  • Year: 

    2011
  • Volume: 

    11
  • Issue: 

    7 (36)
  • Pages: 

    562-564
Measures: 
  • Citations: 

    0
  • Views: 

    350
  • Downloads: 

    363
Abstract: 

We read with interest the recent article by Malaguarnera et al.(1) on the reduction of non-alcoholic fatty liver disease (NAFLD) in patients receiving treatment for hepatitis C who were also treated with rosuvastatin. According to the results presented in the study, patients in the group receiving interferon, ribavirin, and rosuvastatin showed major improvements in their levels of aminotransferase, fasting glucose, insulin, and CRP and their HOMA index. Apparently, these parameters were predictors of sustained virological response (SVR) in the univariate analysis, but not in the multivariate analysis. We believe that the design of the clinical trial was adequate to eliminate potential confounding factors. Both groups were similar, and the liver tissue collected both before and after treatment allowed for an objective evaluation of steatosis in these patients.

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Author(s): 

ADLER MICHAEL

Journal: 

Hepatitis Monthly

Issue Info: 
  • Year: 

    2011
  • Volume: 

    11
  • Issue: 

    7 (36)
  • Pages: 

    565-566
Measures: 
  • Citations: 

    0
  • Views: 

    276
  • Downloads: 

    343
Abstract: 

In chronic liver diseases, the management of patients must include a determination of the stage of fibrosis (to select specific therapies), a prognosis, the prevention of complications, and the surveillance of the disease. Over the past several years, significant progress has been made in improving noninvasive methods of assessing liver fibrosis. The risks of liver biopsy and the potential for sampling errors with regard to fibrosis staging support the use of noninvasive modalities including serum fibrosis markers or scores and elastography.

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