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1.
Roberto Alonso Felipe Pérez-García Paula López-Roa Luis Alcalá Pilar Rodeño Emilio Bouza 《Enfermedades infecciosas y microbiología clínica》2018,36(3):175-178
Introduction
Detection of hepatitis C virus (HCV) RNA and the HCV core antigen assay (HCV-Ag) are reliable techniques for the diagnosis of active and chronic HCV infection. Our aim was to evaluate the HCV-Ag assay as an alternative to quantification of HVC RNA.Methods
A comparison was made of the sensitivity and specificity of an HCV-Ag assay (204 serum samples) with those of a PCR assay, and the correlation between the two techniques was determined.Results
The sensitivity and specificity of HCV-Ag was 76.6% and 100%, respectively. Both assays were extremely well correlated (Pearson coefficient = 0.951). The formula (Log CV = 1.15*Log Ag + 2.26) was obtained to calculate the viral load by PCR from HCV-Ag values. HCV-Ag was unable to detect viral loads below 5000 IU/mL.Conclusion
Although the HCV-Ag assay was less sensitive than the PCR assay, the correlation between both assays was excellent. HCV-Ag can be useful as a first step in the diagnosis of acute or chronic HCV infection and in emergency situations. 相似文献2.
Almudena Pérez-Torres M. Elena González Garcia Belén San José-Valiente M. Auxiliadora Bajo Rubio Olga Celadilla Diez Ana M. López-Sobaler Rafael Selgas 《Nefrología : publicación oficial de la Sociedad Espa?ola Nefrologia》2018,38(2):141-151
Introduction
Protein-energy wasting (PEW) is associated with increased mortality and differs depending on the chronic kidney disease (CKD) stage and the dialysis technique. The prevalence in non-dialysis patients is understudied and ranges from 0 to 40.8%.Objective
To evaluate the nutritional status of a group of Spanish advanced CKD patients by PEW criteria and subjective global assessment (SGA).Patients and methods
Cross-sectional study of 186 patients (101 men) with a mean age of 66.1 ± 16 years. The nutritional assessment consisted of: SGA, PEW criteria, 3-day dietary records, anthropometric parameters and bioelectrical impedance vector analysis.Results
The prevalence of PEW was 30.1%, with significant differences between men and women (22.8 vs. 33.8%, p < 0.005), while 27.9% of SGA values were within the range of malnutrition. No differences were found between the 2 methods. Men had higher proteinuria, percentage of muscle mass and nutrient intake. Women had higher levels of total cholesterol, HDL and a higher body fat percentage. The characteristics of patients with PEW were low albumin levels and a low total lymphocyte count, high proteinuria, low fat and muscle mass and a high Na/K ratio.The multivariate analysis found PEW to be associated with: proteinuria (OR: 1.257; 95% CI: 1.084–1.457, p = 0.002), percentage of fat intake (OR: 0.903; 95% CI: 0.893–0.983, p = 0.008), total lymphocyte count (OR: 0.999; 95% CI: 0.998–0.999, p = 0.001) and cell mass index (OR: 0.995; 95% CI: 0.992–0.998).Conclusion
Malnutrition was identified in Spanish advanced CKD patients measured by different tools. We consider it appropriate to adapt new diagnostic elements to PEW criteria. 相似文献3.
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4.
Jesús K. Yamamoto-Furusho Andrea Sarmiento-Aguilar Mario García-Alanis Luis Enrique Gómez-García Joel Toledo-Mauriño Laura Olivares-Guzmán Ana Fresán-Orellana 《Gastroenterologia y hepatologia》2018,41(8):477-482
Introduction
The Hospital Anxiety and Depression Scale (HADS) is a self-administered instrument for outpatients, but its behaviour differs according to the clinical population to which it is applied. In Mexico it is not validated in patients with Inflammatory Bowel Disease (IBD).Objectives
To validate the HADS scale in the Mexican population with IBD.Methods
112 patients with IBD from the “Salvador Zubirán” National Institute of Medical Sciences and Nutrition were included, to whom the HADS was applied and some demographic and clinical characteristics of the disease were evaluated. An exploratory factor analysis was performed and factorial congruence was calculated to determine the construct validity of the HADS, while reliability was evaluated using Cronbach's alpha.Results
The result of the varimax rotation of the 14 items of the HADS explained 50.1% of the variance, having two main factors. Ten items showed high factor loading for the dimensions originally proposed. The internal consistency of the HADS was high (alpha = 0.88) with high values for the congruence coefficients.Conclusions
The HADS scale is a valid instrument to detect possible cases of Anxiety and Depression in Mexican patients with IBD. The validation of this instrument allows its routine use for the integral evaluation of the patient and their timely referral to mental health. 相似文献5.
José María Moreno-Planas Juan Ramón Larrubia-Marfil Juan José Sánchez-Ruano Julia Morillas-Ariño Roberto Patón-Arenas Rosa María Sáiz-Chumillas Emilia Tébar-Romero Alfredo Lucendo-Villarín Pilar Gancedo-Bringas Mario Solera-Muñoz María del Mar Vicente-Gutiérrez Elisa Martínez-Alfaro 《Enfermedades infecciosas y microbiología clínica》2018,36(5):277-283
Introduction
There are few published studies on predictors of response to treatment with sofosbuvir and simeprevir in HCV patients.Objective
The objective of the study was to analyse possible predictors of response to simeprevir (SMV) and sofosbuvir (SOF) in patients infected with hepatitis C genotypes 1 or 4.Patients and methods
Prospective observational cohort study in 12 hospitals. The primary efficacy endpoint was SVR rate 12 weeks after end of treatment (SVR12).Results
204 patients (62.3% male, mean age 55 years) were included: 186 (91.2%) genotype 1 (60.3% 1 b 25% 1 a) and 18 (8.8%) genotype 4. 132 (64.7%) cirrhotic (87.9% Child A), 33 (16.2%) F3, 31 (15.2%) F2, 8 (3.9%) F0-1. 80.8% MELD < 10. 93 (45.6%) naive. Ribavirin was added in 68 (33.3%). Mean baseline viral load 2,151,549 IU/ml (SD: 2,391,840). Treatment duration 12 weeks in 93.1%. 4 discontinued therapy: suicide, psychotic attack, hyperbilirubinaemia and liver cancer recurrence. 190 (93.1%) achieved SVR12. There were no differences in SVR12 depending on the genotype, treatment duration, ribavirin use, prior therapy, viral load (VL) or baseline platelets. In univariate analysis, undetectable VL at 4 weeks (p = 0.042), absence of cirrhosis (p = 0.021), baseline albumin ≥ 4 g/dl (p = 0.001) and MELD < 10 (p < 0.0001) were associated with higher SVR12. In multivariate analysis, only baseline MELD score <10 patients had higher SVR12 (p < 0.001).Conclusions
The combination of simeprevir and sofosbuvir in patients infected with genotype 1 and 4 hepatitis C is highly effective. It is a safe therapy, especially in patients without ribavirin. This combination was more effective in patients with a MELD score below 10. 相似文献6.
Elena Pérez-Arellano María Isabel Rodriguez-Garcia Ana Belen Galera Rodenas Emilio de la Morena-Madrigal 《Gastroenterologia y hepatologia》2018,41(3):145-152
Introduction
The eradication of Helicobacter pylori infection represents a clinical challenge.Objective
To evaluate the efficacy and safety of quadruple therapy with esomeprazole plus a 3-in-1 capsule containing bismuth subcitrate, metronidazole and tetracycline, plus probiotics in patients diagnosed with H. pylori infection in routine clinical practice.Methods
A prospective, interventional, single-centre and open-label study in consecutive patients with a confirmed indication for eradication of H. pylori infection. Patients were treated with three capsules of Pylera® four times a day (breakfast, lunch, afternoon snack and dinner), plus 40 mg of esomeprazole twice daily for 10 days (30 min before breakfast and dinner) and probiotics for 30 days. Eradication of H. pylori infection was confirmed by labelled urea breath test performed at least 28 days after the end of treatment.Results
A total of 100 patients were consecutively enrolled. Twenty-five patients (25.0%) had a prior history of treatment for their H. pylori infection. In the intention-to-treat population, eradication rates were 90.7% (68/75) and 80.0% (20/25) in patients treated with Pylera® as the first line or as rescue therapy, respectively. Eighteen patients (18%) had at least one adverse event, most of which (89%) were mild.Conclusion
Ten days of treatment with a quadruple regimen of bismuth, metronidazole and tetracycline plus esomeprazole and probiotics is an effective and safe strategy in patients with H. pylori infection. 相似文献7.
Maria José Santiago-Lozano Marta Lucía Barquín-Conde Lucía Fuentes-Moreno Roberto Manuel León-Vela Lucas Madrid-Vázquez Amelia Sánchez-Galindo Jesús López-Herce Cid 《Enfermedades infecciosas y microbiología clínica》2018,36(9):563-567
Introduction
The aim of this study was to analyse the incidence, treatment and evolution of infections in children treated with ECMO.Methods
A retrospective study based on a prospective database was performed. Children under the age of 18 years treated with ECMO from September 2006 to November 2015 were included. The patients’ clinical characteristics were collected, together with ECMO technique, cultures and treatment of infection.Results
One hundred patients with a median age of 11 months were analysed. Heart disease was diagnosed in 94 patients. An infection was suspected and antibiotic treatment was initiated in 51 patients, although only 22 of them were microbiologically confirmed. The most common infection was sepsis (49%), followed by pneumonia (35.3%) and urinary tract infection (9.8%). There were no differences in haematological parameters and acute phase reactants between children with infection and those without. Children who died had a higher incidence of infection during ECMO (60.4%) than the survivors (40.3%), but the difference did not reach statistical significance (P = .07). The duration of admission in the PICU was 57 days in patients with infection vs 37 days in patients without infection but the difference was not statistically significant (P = .067).Conclusions
Infection in children with ECMO is common. There are no specific infection parameters and less than half of the clinical infections are confirmed microbiologically. There was no statistically significant correlation between infection and mortality or duration of PICU stay. 相似文献8.
Guilherme Bricks Jorge Figueiredo Senise Henrique Pott Junior Giuliano Grandi Amanda Passarini Débora Bellini Caldeira Dimas Carnaúba Junior Hamilton Antonio Bonilha de Moraes Celso Franscisco Hernandes Granato Adauto Castelo 《The Brazilian journal of infectious diseases》2018,22(2):85-91
Background and aims
Hepatitis E virus infection in patients with underlying chronic liver disease is associated with liver decompensation and increased lethality. The seroprevalence of hepatitis E virus in patients with chronic hepatitis C in Brazil is unknown. This study aims to estimate the seroprevalence of hepatitis E virus in patients with chronic hepatitis C and to describe associated risk factors.Methods
A total of 618 patients chronically infected with hepatitis C virus from three reference centers of São Paulo, Brazil were included. Presence of anti-HEV IgG was assessed by enzyme-linked immunosorbent assay (WANTAI HEV-IgG ELISA).Results
Out of the 618 patients tested, 10.2% turned out positive for anti-HEV IgG (95% CI 8.0–12.8%). Higher seroprevalence was found independently associated with age over 60 years (OR = 2.04; p = 0.02) and previous contact with pigs (OR = 1.99; p = 0.03).Conclusions
Patients with chronic hepatitis C are under risk of hepatitis E virus superinfection in São Paulo. Contact with pigs is a risk factor for the infection, suggesting a possible zoonosis with oral transmission. 相似文献9.
María Isabel Pacheco-Tenza José Antonio Ruiz-Maciá María Navarro-Cots Joan Gregori-Colomé José María Cepeda-Rodrigo Jara Llenas-García 《Enfermedades infecciosas y microbiología clínica》2018,36(1):24-28
Introduction
Strongyloides stercoralis infection is more prevalent in tropical regions but autochthonous cases have been reported in Spain, mainly in La Safor (Valencia). The objective is to describe the strongyloidiasis cases registered in a regional hospital of Alicante province (Spain) and to determine if they were autochthonous cases.Methods
Retrospective study of all diagnosed cases of strongyloidiasis in Vega Baja Hospital (Orihuela, Alicante) between January 1999 and March 2016.Results
A total of 10 cases were found, four of which were autochthonous cases. Two of them presented with a hyper-infection syndrome, with a fatal outcome. All autochthonous cases were in patients ≥ 69 years old with gastrointestinal, cutaneous, and/or respiratory symptoms. Serology was positive in the 8 cases studied. Larvae were found in histopathological samples of the gastrointestinal tract of three patients.Conclusions
We communicate the first autochthonous cases of strongyloidiasis in the region of Vega Baja. Screening programs should be implemented, especially in immunosuppressed patients or patients under chronic corticosteroid treatment. 相似文献10.
Francisco González-Vílchez José Luis Lambert Diego Rangel Luis Almenar José Luis de la Fuente Jesús Palomo Beatriz Díaz Molina Ernesto Lage Ignacio Sánchez Lázaro José A. Vázquez de Prada 《Revista espa?ola de cardiología》2018,71(1):18-25
Introduction and objectives
The extended-release formulation of tacrolimus (ERT) allows once-daily dosage, thus simplifying the immunosuppressive regimen. This study aimed to describe the safety and efficacy of the de novo and early use of ERT in heart transplantation.Methods
This was an observational, retrospective, multicenter study comparing the safety and efficacy of the de novo use of ERT (ERT group [n = 94]), standard-release tacrolimus (SRT group [n = 42]) and early conversion (EC) from SRT to ERT (EC group [n = 44]). Extended-release tacrolimus was used between 2007 and 2012. One-year incidence rates of acute rejection, infection, and cytomegalovirus infection were analyzed. Safety parameters were also evaluated.Results
There were no significant between-group differences in the daily dose or trough levels of tacrolimus during the first year after transplantation. The rejection incidence rates were 1.05 (95%CI, 0.51-1.54), 1.39 (95%CI, 1.00-1.78), and 1.11 (95%CI, 0.58-1.65) episodes per patient-years in the SRT group, ERT group, and EC group, respectively (P = .48). The infection incidence rates were 0.75 (95%CI, 0.60-0.86), 0.62 (95%CI, 0.52-0.71), and 0.55 (95%CI, 0.40-0.68) in the SRT group, ERT group, and EC group, respectively (P = .46). Cytomegalovirus infection occurred in 23.8%, 20.2%, and 18.2% of the patients, respectively (P = .86). No significant between-group differences were found in laboratory tests or in allograft function. There was 1 death in the SRT group and 2 in the ERT group.Conclusions
Both de novo and early use of ERT seem to have similar safety and efficacy profiles to conventional SRT-based immunosuppression.Full English text available from: www.revespcardiol.org/en 相似文献11.
Ana Dias Rita Gaio Pedro Sousa Marta Gomes Olena Oliveira Raquel Duarte 《Archivos de bronconeumología》2018,54(1):18-23
Introduction
Tuberculosis notification in Portugal has decreased in the last few years. As a consequence of the economic crisis, emigration has increased and immigration has decreased. Immigrants are a risk group for tuberculosis. Most emigrants are 20–44 years old and belong to the age group most affected by tuberculosis.Objective
To describe the decrease in tuberculosis notification in Portugal over the last years from a demographical point of view.Methods
Mathematical analysis was performed to quantify the effect of the migration movements (separately and simultaneously) on tuberculosis notification in Portugal from 2008 to 2014. We calculated the estimated tuberculosis notification for each year during the period of study: 1) fixing immigration rate and tuberculosis rate in immigrants at 2008 values; 2) fixing emigration rate and tuberculosis rate in emigrants at 2008 values; 3) fixing both phenomenons at 2008 values.Results
The differences between the observed and the estimated numbers were small (≤0.5 cases/100 000 inhabitants).Discussion
Impact of the migration movements on tuberculosis notification rate does not seem to be significant when analyzed for each phenomenon individually and simultaneously, by our model. This might mean that we have to concentrate our efforts in other risk factors for tuberculosis. 相似文献12.
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13.
Carmen Sánchez Perales Teresa Vázquez Sánchez Daniel Salas Bravo Sonia Ortega Anguiano Eduardo Vázquez Ruiz de Castroviejo 《Nefrología : publicación oficial de la Sociedad Espa?ola Nefrologia》2018,38(3):286-296
Atrial fibrillation (AF) represents an important social and healthcare problem. There is wide variability in the prevalence of this arrhythmia in studies analysing patients on haemodialysis (HD).
Objective
To investigate the prevalence, clinical profile and therapeutic management of patients with AF on HD in Andalusia.Methods
We asked the public healthcare system of Andalusia to provide us with the number of patients who were being treated with HD. We asked attending nephrologists from all hospital and outpatient centres in 5 of the 8 Andalusian provinces to perform an electrocardiogram and to fill out a questionnaire on patients selected by simple random sampling.Results
A total of 2,348 patients were being treated with HD in the 5 provinces included in the study. The estimated sample size was 285 patients. We obtained an electrocardiogram and information from 252 patients (88.4%); mean age 65.3 ± 16 years; 40.9% women. Sixty-three patients (25%) had AF. Of these, 36 (14.3%) had AF in the recorded ECG and in the rest it had been documented previously. In the multivariate analysis, older age (OR: 1.071; 95% CI: 1.036-1.107; P = 0.000) and greater time on HD (OR: 1.009; 95% CI: 1.004-1.014; P = 0.000) were independently associated with the presence of AF. Of the patients with AF, 41.3% were on anticoagulant treatment at the time of the study; and 41.2% were on antiplatelet agents.Conclusions
AF in dialysis units is an important finding. Establishing the risk-benefit ratio of anticoagulant treatment constitutes a real challenge. Well-designed clinical trials are pivotal in order to define the rational use of antithrombotic drugs. 相似文献14.
Ruth María Sánchez Soriano María Dolores Albero Molina Carlos Israel Chamorro Fernández Rocío Juliá-Sanchís Ramón López Menchero Carlos del Pozo Fernández Guillermo Grau Jornet Julio Núñez Villota 《Nefrología : publicación oficial de la Sociedad Espa?ola Nefrologia》2018,38(4):394-400
Introduction and objectives
Evidence for the efficacy and safety of oral anticoagulation with dicumarines in patients with atrial fibrillation (AF) on hemodialysis is controversial. The aim of our study is to evaluate the long-term prognostic implications of anticoagulation with dicumarines in a cohort of patients with non-valvular AF on a hemodialysis program due to end-stage renal disease.Methods
Retrospective, observational study with consecutive inclusion of 74 patients with AF on hemodialysis. The inclusion period was from January 2005 to October 2016. The primary variables were all-cause mortality, non-scheduled readmissions and bleeding during follow-up.Results
Mean age was 75 ± 10 years; 66.2% were men and 43 patients (58.1%) received acenocoumarol. During a median follow-up of 2.40 years (IQR = 0.88-4.15), acenocoumarol showed no survival benefit [HR = 0.76, 95% CI (0.35-1.66), p = 0.494]. However, anticoagulated patients were at increased risk of recurrent cardiovascular hospitalizations [IRR = 3.94, 95% CI (1.06-14.69), p = 0.041]. There was a trend towards an increase in repeated hospitalizations of ischemic cause in anticoagulated patients [IRR = 5.80, 95% CI (0.86-39.0), p = 0.071]. There was a statistical trend towards a higher risk of recurrent total bleeding in patients treated with acenocoumarol [IRR = 4.43, 95% CI (0.94-20.81), p = 0.059].Conclusions
In this study, oral anticoagulation with acenocoumarol in patients with AF on hemodialysis did not increase survival. However, it was associated with an increased risk of hospitalizations of cardiovascular causes and a tendency to an increased risk of total bleeding. 相似文献15.
16.
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17.
Filipa Aguiar Gabriela Fernandes Henrique Queiroga José Carlos Machado Luís Cirnes Conceição Souto Moura Venceslau Hespanhol 《Archivos de bronconeumología》2018,54(1):10-17
Background
Patients with activating somatic mutations in the Epidermal Growth Factor Receptor (EGFR) have better clinical outcomes when treated with Tyrosine Kinase Inhibitors (TKI) over chemotherapy. However, the impact of the use of TKIs on overall survival outside clinical trials is not well established.Objective
To characterize and analyze the overall survival of a Caucasian population with NSCLC and EGFR mutations.Methods
A retrospective cohort analysis of patients with NSCLC screened for EGFR mutations (exons 18–21) between October 2009 and July 2013 was conducted. Clinical and pathological characteristics, mutational EGFR status, treatment and overall survival were evaluated.Results
From the 285 patients which performed screening for EGFR mutations, 54 (18.9%) had mutations, 25 (46.3%) of which in exon 19 and 20 of which (37.0%) in exon 21. The occurrence of mutations was associated with female sex and non-smoking habits (both, P < .001). The median survival of the global population was 12.0 months, with a better overall survival in mutated than non-mutated patients (20.0 vs 11.0 months, respectively; P = .007).Conclusion
These data contribute for a better knowledge of our lung cancer population concerning the mutational status and clinical outcomes, confirming a better overall survival for the patients with EGFR TKI sensible mutations. 相似文献18.
19.
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20.
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》2018,41(3):153-162