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Satyendra Khichar Shyama Choudhary Veer Bahadur Singh Priyanka Tater R.V. Arvinda Vivek Ujjawal 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2017,11(1):19-23
Aims
To determine whether elevations of uric acid levels are associated with the cluster of disorders described in metabolic syndrome and to evaluate whether hyperuricemia may be considered a component of this syndrome.Methods
One year case-control study was conducted in Bikaner, Rajasthan, India from January to December 2013. The study population consisted of 200 subjects, 100 with metabolic syndrome (case) and 100 without metabolic syndrome (control) aged between 18 and 80 years, attending OPD at PBM Hospital were studied. Controls were age and sex matched to the cases. Blood tests and all physical variables were examined using standard methods. Subjects were divided into 6 groups according to their possession of 0, 1, 2, 3, 4 or 5 components of the metabolic syndrome. Statistical analysis was done using ANOVA, linear regression analysis and multivariate linear regression model.Results
Mean serum UA level was significantly associated with all components of metabolic syndrome (p < 0.001) and had strong positive correlation (r = +0.66 to +0.77, p < 0.0001) with all of them except serum HDL with which it showed strong negative correlation(r = ?0.71, p < 0.0001). It increased as the number of metabolic factors increased showing a highly significant trend (p < 0.0001). On multivariate regression analysis UA contributed to 66.84% variance of metabolic syndrome.Conclusion
The current multivariate regression analysis clearly infers that uric acid can be considered as a marker and potential modifier of metabolic syndrome. 相似文献4.
Weiyan Yu Yadong Wang Chuan Shen Ru Ji Li Zhang Xin Zhao Miao Su Ying Zhang Wenyan He Jianguo Cao Yanshuang Hao Shengpeng Chen Caiyan Zhao 《The Brazilian journal of infectious diseases》2017,21(3):213-218
Aims
To evaluate the HBeAg seroconversion rate in real clinical setting and explore its predictors in long-term nucleos(t)ide analogues (NAs) treatment for chronic hepatitis B (CHB).Methods
251 patients were recruited from January 2001 to September 2009 in four hospitals in Hebei province, China, for this retrospective study. Clinical and laboratory data before and after treatment with lamivudine (LAM, 100 mg daily), adefovir (ADV, 10 mg daily), telbivudine (LDT, 600 mg daily), entecavir (ETV, 0.5 mg daily), and LAM/ADV combination were compared among three groups according to treatment outcomes: synchronous HBeAg loss and HBeAg seroconversion, anti-HBe development after treatment, and no anti-HBe. Adherence was also evaluated.Results
In real clinical setting, cumulative HBeAg seroconversion rates were 14.3%, 32.7%, 43.0%, 46.9%, and 50.5% after 1, 2, 3, 5, and 8 years, respectively. 45 patients (17.9%) were non-adherent. Adherence (p < 0.001, Hazard Ratio (HR) = 2.203), elevated alanine aminotransferase (ALT) levels (p < 0.001, HR = 2.049), and non-vertical transmission (p = 0.006, HR = 1.656) were predictors of HBeAg seroconversion.Conclusion
Adherence, elevated ALT, and non-vertical transmission are predictors of HBeAg seroconversion in CHB patients treated with NAs. 相似文献5.
Henry Córdova Cristina Sánchez-Montes Pedro G. Delgado-Guillena Victor J. Morales Oriol Sendino Begoña González-Suárez Andrés Cárdenas Maria Pellisé Isis K. Araujo Àngels Ginés Josep Llach Gloria Fernández-Esparrach 《Gastroenterologia y hepatologia》2017,40(9):587-594
Introduction
There is an opportunity for improvement in the recording and measuring of quality indicators. However, no previous experiences exist in our field in terms of their compliance in esophagogastroduodenoscopy (EGD).Objective
To analyse compliance with EGD quality criteria and evaluate improvement after conducting a training programme.Patients and methods
Comparative study of 2 cohorts: one retrospective (control group) and one prospective (intervention group), before and after a training programme consisting of an information session and the report writing improvement programme. The quality indicators proposed by the American Society for Gastrointestinal Endoscopy and the American College of Gastroenterology were used.Results
A total of 1,200 EGDs were included in a sequential manner (600 in each group). Following the training programme, a significant improvement was observed in the following indicators: documented indication (93 vs. 99.8%; P < 0.01), documented full examinations (94.7 vs. 97.3%; P < 0.01), correct performance (63.7 vs. 87.9%; P < 0.01), appropriate biopsies according to protocols (57.9 vs. 83.8%; P < 0.01), photo-documentation of described lesions (84.1 vs. 94.9%; P < 0.01), photo-documentation per segment (52.9 vs. 70.5%; P < 0.01) and correct overall assessment (56,9 vs. 90.5%; P < 0.01). Biopsies for coeliac disease, documented indication, full examination and correct performance, if it went ahead, exceeded the recommended standard.Conclusion
A very simple training programme improves EGD quality indicators, with the majority reaching the standards recommended by the American Society for Gastrointestinal Endoscopy and the American College of Gastroenterology. 相似文献6.
Antonio Guardiola Arévalo Rafael Gómez Rodríguez Marta Romero Gutiérrez Ana Zaida Gómez Moreno Almudena García Vela Raquel Sánchez Simón Cesar Gómez Hernando Eva María Andrés Esteban 《Gastroenterologia y hepatologia》2017,40(2):59-69
Objective
To describe the epidemiological, analytical and histological characteristics and clinical course of hepatitis B virus (HBV) carriers with negative HBe antigen.Material and methods
Observational, retrospective cohort study of HBV carriers with negative HBe antigen (2005-2012), with no other causes of liver disease.Results
One hundred and thirty-eight patients were included, with mean age 40.5 ± 12.2 years; 54% were women, and 38% were of foreign origin; the number of foreign patients significantly increased (P < .001) over the years. Transaminases were normal in nearly 75% and HBV-DNA was < 2,000 IU/ml in 56% of patients at diagnosis. There was a gradual decrease in HBV-DNA levels in inactive carriers over the study period. Fibrosis study was performed in 47% of patients by Fibroscan® or liver biopsy: 55.4% normal histology and 6.1% cirrhosis. Just over three quarters of patients (77.77%) were inactive carriers. Treatment was required in 15.5% of patients (20% because of cirrhosis and 80% HBeAg-negative chronic hepatitis B). Five patients cleared HBsAg (annual rate .94%), all of whom presented HBV-DNA < 2,000 IU/ml at diagnosis. Five patients developed complications (3.6%), 4 of them hepatocellular carcinoma (HCC), of which only 2 had cirrhosis. There was 1 HBV-related death (.72%).Conclusion
Among HBV carriers with negative HBe antigen, inactive HBs-Ag carriers are predominant. HBV-DNA gradually decreases in the first few years after diagnosis. Morbidity and mortality are low, especially if glutamic pyruvic transaminase (GPT) is normal and HBV-DNA levels are low at diagnosis. Treatment is needed in a considerable number of patients. HCC is the most frequent complication, even in the absence of cirrhosis. 相似文献7.
Lívia D. Akl Ana L.R. Valadares Monica Jacques de Moraes Aarão M. Pinto-Neto Bianca Lagrutta Lúcia Costa-Paiva 《The Brazilian journal of infectious diseases》2017,21(3):263-269
Objectives
To determine the prevalence of metabolic syndrome (MetS) and its associated factors in a group of HIV-infected middle-aged women.Methods
Cross-sectional study including 273 HIV-infected climacteric women of 40–60 years of age under care in two HIV outpatient reference centers in Brazil. Metabolic syndrome diagnosis was based on 2006 International Diabetes Federation criteria. Sociodemographic, clinical and behavioral factors were evaluated as well as HIV infection-related parameters.Results
Mean age was 47.7 years; 59.1% of women were premenopausal, 91% were on antiretroviral therapy. Current CD4 count was >500 cells/mm3 in 61.7%, current viral load undetectable in 76.9% of women, and a quarter had previous diagnosis of aids. The prevalence of metabolic syndrome in the subgroup of menopausal women was 46.9%. Univariate analysis showed an association between metabolic syndrome and age ≥50 years (p = 0.002), schooling <8 years (p = 0.003), post-menopause (p < 0.001), body mass index (BMI) >25 kg/m2 (p < 0.001), and FSH ≥40 mIU/mL (p = 0.002). In the multivariate analysis only increased BMI (PR = 1.09; 95% CI: 1.05–1.13; p < 0.001) and FSH levels ≥40 mIU/mL (PR = 1.66; 95% CI: 1.14–2.40; p = 0.008) maintained statistical significance. There was no association between PI use or any other factor related to HIV-infection and MetS in any of the analyses performed.Conclusion
High BMI and FSH levels compatible with menopause were the only factors associated with MetS in these middle aged HIV-infected women. In the context of well-controlled, early treated HIV infection, traditional rather than HIV-related factors were associated with MetS. 相似文献8.
Maria Elena Lozoya Angulo Ignacio de las Heras Gómez Miriam Martinez Villanueva Jose Antonio Noguera Velasco Francisco Avilés Plaza 《Gastroenterologia y hepatologia》2017,40(3):125-131
Introduction
Diagnostic discrimination between inflammatory bowel disease (IBD) and functional gastrointestinal disorders is complex, as they cause similar signs and symptoms. Faecal calprotectin (FC) is a useful marker in this context, and can be used to select patients who will most benefit from colonoscopy. The aim of this study was to evaluate the utility of FC in discriminating between organic disease and functional disorders.Material and methods
The study included 264 patients presenting with gastrointestinal complaints consistent with an organic pathology. FC levels were determined and diagnostic accuracy was assessed using the area under the curve obtained from the final diagnosis.Results
Calprotectin levels in organic bowel disease patients were significantly higher (median 254 μg/g; 95% confidence interval [CI], interquartile range 105-588.5) than in functional disease patients (95 μg/g; 95% CI, 47.25-243.92) (P < .0001). Similarly, in patients with IBD, the values obtained were higher (270.85 μg/g; 95% CI, 96.85-674.00) than in those with irritable bowel syndrome (79.70 μg/g; 95% CI, 36.50-117.25) (P < .0001). For a cut-off of 150 μg/g, FC had an area under the ROC curve to discriminate between organic and functional disease of 0.718, and 0.872 to discriminate between irritable bowel syndrome and IBD.Conclusion
Our study supports the importance of FC as a marker in the evaluation of patients with IBD. The best diagnostic accuracy is obtained at a cut-off value of 150 μg/g. 相似文献9.
Lidia Argüello Viúdez Henry Córdova Hugo Uchima Cristina Sánchez-Montes Àngels Ginès Isis Araujo Begoña González-Suárez Oriol Sendino Josep Llach Gloria Fernández-Esparrach 《Gastroenterologia y hepatologia》2017,40(8):507-514
Introduction
Gastric polyps are usually asymptomatic lesions incidentally discovered during endoscopy.Objective
To study the frequency of different types of gastric polyps in our population and their possible association with other factors.Patients and methods
Retrospective study of gastroscopies performed in a tertiary hospital over a ten-year period. Demographics, medical history, indication for gastroscopy and morphological and histological characteristics of polyps were collected.Results
Gastric polyps were found in 827 out of 41253 (2%) reviewed gastroscopies, corresponding to 709 patients. Mean age was 65.6 years, and 62% were female. 53.9% of patients had multiple polyps. The most common location was the fundus and 83.3% were smaller than 1 cm. Histopathology was obtained in 607 patients: hyperplastic polyps were the most common (42.8%), followed by fundic gland polyps (37.7%). Factors independently associated with hyperplastic polyps were age and single polyp, size ≥ 6 mm and location other than fundus. In contrast, fundic gland polyps were associated with reflux and multiple polyps, size < 6 mm and located in fundus. Adenomas were independently associated with single polyp.Conclusions
Fundic gland and hyperplastic polyps are the most common in our population and have characteristic features that can guide histological diagnosis. With single polyps it is advisable to take biopsies to rule out adenoma. 相似文献10.
Zulqarnain Baloch Nafeesa Yasmeen Yuanyue Li Ke Ma Xiaomei Wu Shi-hua Yang Xueshan Xia 《The Brazilian journal of infectious diseases》2017,21(3):325-332
Background
Dai is a major Chinese ethnic minority group residing in rural areas of the southern part of Yunnan. However, no data exist on the Human Papillomavirus (HPV) prevalence and genotype distribution among Dai women.Method
A total of 793 participants (Dai = 324, Han = 251, other ethnic = 218) were included in this study. PCR was performed to detect the HPV-positive samples, and genotyping was performed with an HPV Geno-Array.Result
The overall HPV prevalence was very low among Dai women compared to the others. The prevalence of high-risk-HPV infections was significantly higher (p = 0.001) among other ethnic women (22.0%) than that among Han (13.1%) and Dai women (7.1%). The overall HPV, high-risk-HPV, single and multiple infection prevalence among rural women were 12.9%, 12.1%, 12.3%, and 0.5%, respectively. HPV-16 (5.5%) was shown to be the most prevalent genotype, followed by HPV-52 (2.6%) and HPV-58 (2.4%). Urban women had relatively higher rates of overall HPV (16.0%), high-risk-HPV (14.1%), single genotype (11.9%), and multiple genotype (4.1%) infections. In urban women, HPV-52 (3.6%) was the most prevalent genotype, followed by HPV-39 (2.7%) and HPV-16 (1.2%). In the urban area, HPV prevalence was highest in women aged <29 years, but declined with increasing age. However, in rural women, the highest HPV prevalence was observed among women at older age (>50 years). Education and smoking habit were significantly associated with HPV infection among both rural and urban area women (p < 0.001).Conclusion
The prevalence and genotype distribution of HPV varied among ethnic women in urban and rural area of Yunnan Province. 相似文献11.
Srujitha Marupuru Padmanav Senapati Swathi Pathadka Sonal Sekhar Miraj Mazhuvancherry Kesavan Unnikrishnan Mohan K. Manu 《The Brazilian journal of infectious diseases》2017,21(3):312-316
Background
World Health Organization estimated that people with diabetes (DM) are at 2–3 times higher risk for tuberculosis (TB). Studies have shown that DM not only increases the risk of active TB, but also puts co-affected persons at increased risk of poor outcomes.Objectives
To determine the protective effect of metformin against TB in DM patients and also, to investigate the relationship between poor glycemic control and TB.Methods
A case–control study was conducted over 8 months, where cases and controls were selected based on the inclusion and exclusion criteria of the study. The diabetics diagnosed with TB were selected as study group (SG = 152) and without TB were as control group (CG = 299). Exposure status of metformin in both groups were analyzed.Results
The mean (SD) age of both CG and SG were 55.54 ± 11.82 and 52.80 ± 11.75, respectively. Majority of the subjects in the study were males. The mean hospital stay of SG and CG were 7 days and 6 days, respectively. Poor glycemic control (HbA1c > 8) observed in SG (51.7%) vs CG (31.4%). HbA1c value <7 is associated protective factor for TB occurrence [OR = 0.52 (95% CI 0.29–0.93)]. The protective effect of metformin against TB was 3.9-fold in diabetics (OR = 0.256, 0.16–0.40).Conclusion
Poor glycemic control among diabetics is a risk factor for TB occurrence. The result shows metformin use is a protective agent against TB infection in diabetics. Hence, incorporation of metformin into standard clinical care would offer a therapeutic option for the prevention of TB. 相似文献12.
Vaishali Kolgiri Vinayak Wamanrao Patil 《The Brazilian journal of infectious diseases》2017,21(1):35-41
Background
The major complications of “treated” Human Immunodeficiency Virus (HIV) infection are cardiovascular disease, malignancy, renal disease, liver disease, bone disease, and perhaps neurological complications, which are phenomena of the normal aging process occurring at an earlier age in the HIV-infected population. The present study is aimed to explore protein carbonyl content as a biomarker for detecting oxidative DNA damage induced ART toxicity and/or accelerated aging in HIV/AIDS patients.Objective
To investigate the potential of carbonyl content as a biomarker for detecting oxidative Deoxyribonucleic acid (DNA) damage induced Antiretroviral Theraphy (ART) toxicity and/or accelerated aging in HIV/AIDS patients.Methods
In this case–control study a total 600 subjects were included. All subjects were randomly selected and grouped as HIV-negative (control group) (n = 300), HIV-infected ART naive (n = 100), HIV-infected on first line ART (n = 100), and HIV-infected on second line ART (n = 100). Seronegative control subjects were age- and sex-matched with the ART naive patients and the two other groups. Carbonyl protein was determined by the method described in Levine et al. DNA damage marker 8-OH-dG was determined using 8-hydroxy-2-deoxy Guanosine StressXpress ELA Kit by StressMarq Biosciences.Results
Protein carbonyl content levels and oxidative DNA damage were significantly higher (p < 0.05) in HIV-infected patients on second line ART and HIV-infected patients on first line ART than ART naive patients and controls. In a linear regression analysis, increased protein carbonyl content was positively associated with increased DNA damage (OR: 0.356; 95% CI: 0.287–0.426) p < 0.05.Conclusions
Carbonyl content may has a role as a biomarker for detecting oxidative DNA damage induced ART toxicity and/or accelerated aging in HIV/AIDS patients. Larger studies are warranted to elucidate the role of carbonyl content as a biomarker for premature aging in HIV/AIDS patients. 相似文献13.
Thaíssa S. Monteiro Marcelo G. Correia Wilma F. Golebiovski Giovanna Ianini F. Barbosa Clara Weksler Cristiane C. Lamas 《The Brazilian journal of infectious diseases》2017,21(3):240-247
Background
Embolic complications of infective endocarditis are common. The impact of asymptomatic embolism is uncertain.Objectives
To determine the frequency of emboli due to IE and to identify events associated with embolism.Methods
Retrospective analysis of an endocarditis database, prospectively implemented, with a post hoc study driven by analysis of data on embolic events. Data was obtained from the International Collaboration Endocarditis case report forms and additional information on embolic events and imaging reports were obtained from the medical records. Variables associated with embolism were analyzed by the statistical software R version 3.1.0.Results
In the study period, 2006–2011, 136 episodes of definite infective endocarditis were included. The most common complication was heart failure (55.1%), followed by embolism (50%). Among the 100 medical records analyzed for emboli in left-sided infective endocarditis, 36 (36%) were found to have had asymptomatic events, 11 (11%) to the central nervous system and 28 (28%) to the spleen. Cardiac surgery was performed in 98/136 (72%). In the multivariate analysis, splenomegaly was the only associated factor for embolism to any site (p < 0.01, OR 4.7, 95% CI 2.04–11). Factors associated with embolism to the spleen were positive blood cultures (p = 0.05, OR 8.9, 95% CI 1.45–177) and splenomegaly (p < 0.01, OR 9.28, 95% CI 3.32–29); those associated to the central nervous system were infective endocarditis of the mitral valve (p < 0.05, OR 3.5, 95% CI 1.23–10) and male gender (p < 0.05, OR 3.2, 95% CI 1.04–10). Splenectomy and cardiac surgery did not impact on in-hospital mortality.Conclusions
Asymptomatic embolism to the central nervous system and to the spleen were frequent. Splenomegaly was consistently associated with embolic events. 相似文献14.
Pedro J. Marcos Irene Nieto-Codesido Santiago de Jorge Dominguez-Pazos Arturo Huerta Eduardo Márquez Alejandro Maiso Rodrigo Verdeal Isabel Otero-González Marina Blanco-Aparicio Carmen Montero-Martínez 《Archivos de bronconeumología》2017,53(11):611-615
Introduction
It is not known whether clinical practice guidelines for the treatment of COPD exacerbations with short coursesofsystemic corticosteroids(SC-SCS) are followed in clinical practice.Method
Prospective, observational cohort study in patients admitted due to severe COPD exacerbation. The primary endpoint was the percentage of patients who received SC-SCS as treatment for severe exacerbation (doses of 200-300 mg for 5-6 days). Secondary variables were percentageof patients with duration or reduced dose, dose in the first 24 hours, days of intravenous systemic corticosteroids (SCS), and duration of hospital length of stay (LOS). Simple linear regression was performed with LOS as a dependent variable and multivariate analysis with factors associated with LOS.Results
158 patients were evaluated. 4.4% (7) patients received SC-SCS, 8.7% received a reduced dose and duration was reduced in 15.8%. The median dose and duration of SCS were 602.5 mg (200-1625) and 14 (4-36) days, respectively. We observed an association between days of SCSand LOS (P < .001) and doses of intrahospitalSCSand LOS (P < .001). Factors associated with LOS were doses of intrahospitalSCS received (.01 [95% CI:.007-.013]; P < 0.001), days of steroid treatment (.14 [95% CI .03-.25], P = .009) and PAFI (pO2/FiO2 ratio) at admission (-.012 [95% CI: -.012 to -.002], P = .015).Conclusions
The SCS schedules used in routine clinical practice are longer and administered at a higher dose than recommended, leading toa longer hospital stay. 相似文献15.
Mercedes Ramas Maria G. Donday Adrian G. McNicholl Javier P. Gisbert 《Gastroenterologia y hepatologia》2017,40(10):658-662
Background
A progressive decrease in Helicobacter pylori eradication rates has been described over the years, driving the need for new antibiotic treatments.Aim
To evaluate the efficacy and safety of the addition of rifaximin (Spiraxin®) to standard triple therapy (omeprazole, amoxicillin and clarithromycin) for the eradication of H. pylori.Methods
Independent prospective clinical trial (EUDRACT no.: 2013-001080-23). Forty consecutive adult patients were included with H. pylori infection, dyspeptic symptoms and naive to eradication treatment. A full blood test was performed in the first five patients enrolled to evaluate the safety of the treatment. H. pylori eradication was confirmed with the 13C-urea breath test at least four weeks after the end of treatment with rifaximin 400 mg/8 h, clarithromycin 500 mg/12 h, amoxicillin 1 g/12 h and omeprazole 20 mg/12 h for 10 days.Results
Forty patients were consecutively enrolled, 53% woman, mean age 44 years. Indication for eradication: 60% non-investigated dyspepsia, 38% functional dyspepsia and 2% gastric ulcer. Four patients did not attend the eradication confirmatory breath test. The eradication rate was 61% (95% CI: 45–77%) for the protocol and 55% (40–70%) for intention-to-treat. About 76% of the patients experienced adverse events (35% diarrhea, 14% nausea and 24% metallic taste), none of which was serious. The blood tests did not show significant alterations.Conclusion
Acceptable H. pylori eradication rates are not achieved with rifaximin associated with standard triple therapy for 10 days. 相似文献16.
Detection of high biliary and fecal viral loads in patients with chronic hepatitis C virus infection
Hugo Monrroy Jenniffer Angulo Karla Pino Pilar Labbé Juan Francisco Miquel Marcelo López-Lastra Alejandro Soza 《Gastroenterologia y hepatologia》2017,40(5):339-347
Background
The life cycle of the hepatitis C virus (HCV) is closely associated with lipid metabolism. Recently, NPC1L1 (a cholesterol transporter) has been reported to function as an HCV receptor. This receptor is expressed in the hepatocyte canalicular membrane and in the intestine; serving as a key transporter for the cholesterol enterohepatic cycle.Objectives
We hypothesized that HCV might have a similar cycle, so we aimed to study the presence of HCV in bile and stools of infected patients.Materials and methods
Blood, feces, and duodenal bile samples were collected from patients infected with HCV. The biliary viral load was normalized to the bile salt concentration of each sample and the presence of HCV core protein was also evaluated. A total of 12 patients were recruited. HCV RNA was detected in the bile from ten patients.Results
The mean viral load was 2.5 log10 IU/60 mg bile salt. In the stool samples, HCV RNA was detected in ten patients (mean concentration 2.7 log10 IU/g of feces).Conclusions
HCV RNA is readily detectable and is present at relatively high concentrations in the bile and stool samples of infected patients. This may be relevant as a source of infection in men who have sex with men. Biliary HCV secretion may perhaps play a role in the persistence of viral infection via an enterohepatic cycle of the virus or intrahepatic spread. 相似文献17.
Juan Antonio Riesco Miranda Bernardino Alcázar Inmaculada Alfageme Ciro Casanova Bartolomé Celli Juan P. de-Torres Carlos A. Jiménez Ruiz 《Archivos de bronconeumología》2017,53(10):574-582
Objective
To describe the evidence- and experience-based expert consensus on the use of single-agent bronchodilators in patients with stable mild-moderate chronic obstructive pulmonary disease (COPD).Methods
Using Delphi methodology, a panel of 7 respiratory medicine experts was established, who, in the first nominal group meeting defined the scope, users, and document sections. The panel drew up 14 questions on the use of single-agent bronchodilators in patients with mild-moderate stable COPD to be answered with a systematic review of the literature. The results of the review were discussed in a second nominal group meeting and 17 statements were generated. Agreement/disagreement with the statements was tested among16 different experts including respiratory medicine experts and primary care physicians. Statements were scored from 1 (total disagreement) to 10 (total agreement). Agreement was considered if at least 70% voted ≥ 7. The level of evidence and grade of recommendation of the systematic literature review was assessed using the Oxford Centre for Evidence-based Medicine levels.Results
A total of 12 of the 17 statements were selected. Specific statements were generated on different profiles of patients with stable mild-moderate COPD in whom single-agent bronchodilators could be prescribed.Conclusions
These statements on the use of single-agent bronchodilators might improve the outcomes and prognosis of patients with stable mild-moderate COPD. 相似文献18.
Asima Rani Syed Kashif Nawaz Shazia Irfan Muhammad Arshad Razia Bashir Najma Shaheen 《The Brazilian journal of infectious diseases》2017,21(4):418-423
Introduction
The present study was designed to investigate the association between rs8177374 polymorphism and malaria symptoms due to exposure of Plasmodium vivax and Plasmodium falciparum.Materials and methods
A total of 454 samples were included in the study (228 malaria patients and 226 healthy individuals). Malaria patients, divided into P. vivax and P. falciparum groups on the basis of the causative species of Plasmodium, were categorized into mild and severe on the basis of clinical outcomes according to WHO criteria. Healthy individuals were used as controls. Allele specific PCR based strategy was used for the identification of rs8177374 SNP.Results
MyD88-adaptor-like gene polymorphism was associated with susceptibility to malaria (p < 0.001). C allele frequency (0.74) was higher in the population compared to T allele frequency (0.26). CT genotype increased the susceptibility of malaria (OR: 2.661; 95% CI: 1.722–4.113) and was positively associated with mild malaria (OR: 5.609; 95% CI: 3.479–9.044, p = 0.00). On the other hand, CC genotype was associated with severe malaria (OR: 3.116; 95% CI: 1.560–6.224, p = 0.00). P. vivax infection rate was higher in CT genotype carriers compared to other genotypes (OR: 3.616; 95% CI: 2.219–5.894, p < 0.001).Conclusion
MyD88-adaptor-like/TIR domain containing adaptor protein polymorphism for single nucleotide polymorphism rs8177374 is related with the susceptibility of malaria. 相似文献19.
Marlone Cunha-Silva Fábio R.T. Marinho Paulo F. Oliveira Tirzah M. Lopes Tiago Sevá-Pereira Sonia L.S. Lorena Jazon R.S. Almeida 《The Brazilian journal of infectious diseases》2017,21(4):441-447
Background
Chronic hepatitis B is a major cause of cirrhosis, and the natural history of the disease has several clinical stages that should be thoroughly understood for the implementation of proper treatment. Nonetheless, curing the disease with antiviral treatment remains a challenge.Aims
To describe the clinical course, response to treatment, and poor prognostic factors in 247 hepatitis B virus chronic infection patients treated in a tertiary hospital in Brazil.Methods
This was a retrospective and observational study, by analyzing the medical records of HBV infected patients between January 2000 and January 2015.Results
Most patients were male (67.2%) and 74.1% were HBeAg negative. Approximately 41% had cirrhosis and 8.5% were hepatitis C virus coinfected. The viral load was negative after two years on lamivudine, entecavir and tenofovir in 86%, 90.6%, and 92.9% of the patients, respectively. The five-year resistance rates for lamivudine, adefovir, entecavir, and tenofovir were 57.5%, 51.8%, 1.9%, and 0%, respectively. The overall seroconversion rates were 31.2% for HBeAg and 9.4% for HBsAg. Hepatocellular carcinoma was diagnosed in 9.7% of patients, liver transplantation was performed in 9.7%, and overall mortality was 10.5%. Elevations of serum alanine aminotransferase (p = 0.0059) and viral load (p < 0.0001) were associated with progression to liver cirrhosis. High viral load was associated with progression to hepatocellular carcinoma (p < 0.0001). Significant risk factors associated with death were elevated alanine aminotransferase (p = 0.0039), liver cirrhosis (p < 0.0001), high viral load (p = 0.007), and hepatocellular carcinoma (p = 0.0008). HBeAg positive status was not associated with worse outcomes, and treatment may have been largely responsible.Conclusions
Elevations of viral load and serum alanine aminotransferase may select patients with worse prognosis, especially progression to cirrhosis and hepatocellular carcinoma, which were strongly association with death. 相似文献20.
Ángeles Rodríguez-Martínez Alberto Ruano-Ravina María Torres-Durán Iria Vidal-García Virginia Leiro-Fernández Jesús Hernández-Hernández Silvia García-García Mariano Provencio Olalla Castro-Añón Isaura Parente-Lamelas Ihab Abdulkader José Abal-Arca Carmen Montero-Martínez Margarita Amenedo Rosirys Guzmán-Taveras Alberto Fernández-Villar Juan Miguel Barros-Dios 《Archivos de bronconeumología》2017,53(12):675-681