Interferon-alpha and ribavirin therapy on chronic hepatitis C virus infection: the experience of Rio Grande do Sul State Health Department, Brazil

BACKGROUND: Chronic infection by hepatitis C virus is an important public health issue. AIMS: To assess the effectiveness of a combination therapy with interferon-alpha plus ribavirin and to identify predictive factors of response in adult patients with chronic hepatitis C in a public drug supply program. PATIENTS AND METHODS: A retrospective study of consecutive records of 400 patients with chronic hepatitis C treated with interferon-a plus ribavirin therapy, as part of a health program conducted by the Department of Health of the State of Rio Grande do Sul, Porto Alegre, RS, southern Brazil, between 1999 and 2000, was carried out. RESULTS: Sex distribution was similar, and the average age was 46.5 +/- 10.3 years. Response at the end of the treatment was observed in 49% of patients, and sustained response was observed in 32% of them. Sustained response was significantly higher in females and in patients infected by genotypes other than 1. We did not observe significant differences in terms of age or histological stage and activity score. CONCLUSION: In adult patients with chronic hepatitis C, combination therapy with interferon-alpha plus ribavirin was effective in one third of patients. Higher rates of response were observed in women and in patients infected by genotypes other than 1.     

EBV reactivation serological profile in primary Sjögren’s syndrome: an underlying trigger of active articular involvement?

Antibody to Epstein–Barr virus (EBV) early antigen diffuse (anti-EA-D) is associated with viral replication. However, their possible associations with clinical/therapeutic features in primary Sjögren’s syndrome (pSS) were not established. We evaluated 100 pSS patients (American–European Criteria) and 89 age/gender/ethnicity-matched healthy controls. Disease activity was measured by EULAR Sjögren’s Syndrome Disease Activity Index (ESSDAI). Antibodies to EBV (anti-VCA IgG/IgM, anti-EBNA-1 IgG, anti-EA-D IgG) were determined by ELISA. Patients and controls had comparable frequencies and mean levels of anti-VCA IgG (90 vs. 86.5 %, p = 0.501; 2.6 ± 1.1 vs. 2.5 ± 1.1 AU/mL, p = 0.737) and anti-EBNA-1 IgG (92 vs. 94.4 %, p = 0.576; 141.3 ± 69.8 vs. 135.6 ± 67.5 RU/mL, p = 0.464). Anti-VCA IgM was negative in all cases. Noteworthy, higher frequency and increased mean levels of anti-EA-D were observed in patients than controls (36 vs. 4.5 %, p < 0.0001; 38.6 ± 57.4 vs. 7.9 ± 26.3 RU/mL, p < 0.0001). Further analysis of patients with (n = 36) and without (n = 64) anti-EA-D revealed comparable age/gender/ethnicity (p ≥ 0.551), current prednisone dose (4.8 ± 6.9 vs. 5.1 ± 10.4 mg/day, p = 0.319), and current uses of prednisone (52.8 vs. 37.5 %, p = 0.148) and immunosuppressants (44.4 vs. 31.3 %, p = 0.201). ESSDAI values were comparable (p = 0.102), but joint activity was more frequent (25 vs. 9.4 %, p = 0.045) in anti-EA-D positive patients. Anti-EA-D antibodies were not associated with anti-Ro/SSA (p = 1.000), anti-La/SSB (p = 0.652), rheumatoid factor (p = 1.000), anti-α-fodrin (p = 0.390) or antiphospholipid antibodies (p = 0.573), not suggesting cross-reactivity. The higher anti-EA-D frequency associated with joint activity raises the possibility that a subclinical EBV reactivation may trigger or perpetuate the articular involvement in pSS.     

Incidence of root resorption after concussion,subluxation, lateral luxation,intrusion, and extrusion: a systematic review

Traumatic dental injuries often affect the dental hard tissues, periodontal tissues, and dental pulp. Root resorption (RR) is a significantly concerning ph     

Immunogenicity of hepatitis B vaccine in preterm and full term infants vaccinated within the first week of life

The immunogenicity of a Hepatitis B vaccine was evaluated in 110 neonates (57 full term and 53 preterm) born to Hepatitis B surface antigen (HBsAg) negative mothers. Three 10 microg doses of recombinant Hepatitis B vaccine were administered: the first dose within the first week of life; the second between 1 and 2 months; and the third at 5-7 months of age. Anti-HBs antibody titres were measured 3 months after the third dose. The seroconversion rate in preterm infants (77%; 95% CI=64.7-87.1) was significantly lower than in full term infants (98%; 95% CI=91.6-99.9) while the mean anti-HBs titres among those infants that did seroconvert was lower in preterm (186.6 mIU ml(-1)) than in full term infants (537.5 mIU ml(-1)). More full term than preterm infants showed titres greater than 100 mIU ml(-1) (71.9 and 41.5%, respectively). We conclude that the administration of a recombinant Hepatitis B vaccine shortly after birth is less immunogenic in preterm infants weighing <1800 g at birth than in full term infants. Currently accepted recommendations for post exposure perinatal prophylaxis may be inadequate to protect preterm infants.     

The effect of N-acetylcysteine supplementation upon viral load, CD4, CD8, total lymphocyte count and hematocrit in individuals undergoing antiretroviral treatment.

Individuals infected with the human immunodeficiency virus (HIV-1) present with decreased CD4, a progressive increase in viral load, compromised cell immune defense, and hematologic alterations. The aim of this study was to assess the serum viral load, CD4, CD8, lymphocyte count and hematocrit at the beginning of antiretroviral therapy in individuals who were supplemented with N-acetylcysteine (NAC). Twenty volunteers participated in this double-blind, placebo-controlled 180-day study. Ten participants received 600 mg of NAC per day (NAC group) and the other ten serving as a control group received placebo. The above mentioned parameters were determined before treatment, and after 60, 120 and 180 days. In NAC-treated patients hematocrit remained stable and an increase in CD4 cell count took place earlier than that in the control group.     

Enhancement of in-vitro activity of ofloxacin and gentamicin by rat serum

Normal rat serum shows antibacterial activity because of the presence of endogenous substances. The aim of this research was to study some aspects of the interaction between this biological fluid and some antibiotics, in order to demonstrate possible synergistic activity. Serum is able to lower the minimum inhibitory concentration of gentamicin and ofloxacin against some Gram-negative microorganisms. This can be explained by the presence of lysozyme, antibodies, beta-lysin and other complementary factors that are able to cooperate with these antibiotics.     

Reversibility of the inhibitory effect of salmon calcitonin on bone resorption in rats

Inhibition of osteoclastic bone resorption has been induced in growing rats with high doses of salmon calcitonin. This effect was evaluated by measuring the perichondria! ring height of the proximal tibial metaphysis. The aim was to assess whether osteoclastic activity resumed after a period of inhibition with high doses of calcitonin. 20 male Sprague-Daw-ley rats were treated for 21 days with 100 units/kg/day of salmon calcitonin subcutaneously and killed after 0-60 days, together with non-treated controls at 0 and 60 days.

Arrest of metaphyseal modeling and increased height of the perichondria! ring at the end of the period of therapy (P 0.002 versus controls) were observed. Recovery of bone resorption was evident 20 and 40 days after withdrawal of calcitonin.     

Influence of Access Cavity Design on Root Canal Detection,Instrumentation Efficacy,and Fracture Resistance Assessed in Maxillary Molars

Introduction

The aim of this study was to assess the influence of contracted endodontic cavities (CECs) on root canal detection, instrumentation efficacy, and fracture resistance assessed in maxillary molars. Traditional endodontic cavities (TECs) were used as a reference for comparison.