Efficiency of using cycloferon as part of combined therapy for chronic hepatitis C (a review of multicenter clinical trials)

The results of a study of the efficiency of treatment in patients with chronic hepatitis C conducted in a complex of multicenter clinical trials of the impact of various antiviral therapy regimens including the interferon genesis inductor cycloferon are reviewed. Four hundred and seventy-eight patients with hepatitis C virus infection were followed up. The study has demonstrated that the incorporation of cycloferon into the standard treatment regimen, which is manifested by the effect of drug synergism, by producing antiviral, immunomodulating, and antifibrotic effects, is a promising pharmacotherapy for chronic hepatitis C. This treatment is economically sound, reduces the incidence and degree of adverse reactions and increases the quality of life in the patients.     

Early and mid-term angiographic and clinical results after intracoronary duet stent placement.

The Duet stent (Guidant/Advanced Cardiovascular Systems) is a new stent with a corrugated ring design and very limited data on its short- and mid-term performance. Accordingly, in this study we sought to determine the early and mid-term clinical and angiographic outcomes in a moderate-sized series of 86 consecutive patients who underwent placement of 108 premounted Duet stents in 98 coronary lesions. Procedural success, accomplished in all patients, was accompanied by a significant reduction in lesion severity from 89% +/- 11% before to 5% +/- 3% diameter stenosis after the procedure (P = 0.0001) and a 0.9% incidence of subacute stent thrombosis. Angiographic restudy at 5.7 months in 89% of eligible patients revealed a binary in-stent restenosis rate of 26%. Coronary stenting with the new Duet stent confers a low risk of stent thrombosis and a favorable mid-term clinical and angiographic outcome despite the presence of a large proportion of patients at high risk of in-stent restenosis.     

Deletions in the Y-derived amelogenin gene fragment in the Indian population

Background  

Rare failures in amelogenin-based gender typing of individuals have been observed globally. In this study, we report the deletion of a large fragment of the amelogenin gene in 10 individuals out of 4,257 male samples analyzed from 104 different endogamous populations of India.     

Characteristics of the wound process in patients with burns treated by tube hyperalimentation

Time course of burn wound healing was studied in 32 patients with severe thermal trauma during tube hyperalimentation (TH). Similar study was conducted in 20 patients of the control group who did not receive TH. Early inclusion of TH in the complex of therapeutic measures stimulated some of the links of burn wound histogenesis: the formation of the demarcation swelling and rejection of the necrotic tissue occurred sooner, the leucocytic-macrophagal reaction was activated, and granulation and epithelialization processes were intensified. Thus, the use of the TH method in patients with burns makes it possible to conduct active surgical tactics for restoration of the lost skin area successfully as a result of which they recover within a shorter time than the patients of the control group.     

The management of extensive corrosive esophageal strictures: Do not dilate and procrastinate

Corrosive strictures of the esophagus are difficult to treat, however, prompt and appropriate management of corrosive burns to the esophagus can prevent the formation of strictures. In a developing country like India, where facilities for early treatment are not easily available, strictures are an ineviatable consequence. If the strictures are extensive, dilatational therapy proves ineffective and offers no substantial benefit to the patients. Twenty patients with extensive corrosive strictures of the esophagus were surgically managed; by esophageal bypass in 13 and esophagectomy in 7. Surgical treatment restored normal swallowing in all the patients. The common post-operative complications to occur were: pulmonary complications, anastomotic leak and stricture, gastric outlet obstruction and reflux esophagitis. For extensive corrosive strictures of the esophagus, we advocate early surgical treatment rather than prolonged dilatational therapy.     

Predictive ability of a predischarge hour-specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near-term newborns

OBJECTIVE: To assess the predictive ability of a universal predischarge serum bilirubin measurement to screen for risk of subsequent significant hyperbilirubinemia in the direct Coombs negative healthy term and near-term newborn during the first postnatal week. METHODS: Total serum bilirubin (TSB) levels were obtained at the time of the routine metabolic screen in all term and near-term newborns cared for in the Pennsylvania Hospital Well Baby Nursery (n = 13 003). Postnatal age (in hours) at the time of TSB measurement was recorded. A percentile-based bilirubin nomogram for the first week was constructed from hour-specific predischarge and postdischarge TSB values of newborns (n = 2840; median BW = 3230 g and median gestational age = 39 weeks) who met classification criteria for healthy newborns (excluding those with a positive direct Coombs test or those requiring phototherapy before age 60 hours) and who were enrolled in a hospital supervised home or outpatient follow-up program. The accuracy of the predischarge TSB as a predictor of subsequent degree of hyperbilirubinemia was determined. RESULTS: The study patients in the nomogram were racially diverse. Nearly 60% were breastfed. Predischarge, 6.1% of the study population (172/2840) had TSB values in the high-risk zone (>/=95th percentile) at 18 to 72 hours; of these, 39.5% (68/172) remained in that zone (likelihood ratio [LR] = 14.08, sensitivity = 54%; specificity = 96.2%, probability = 39.5%). Predischarge, 32.1% of the population (912/2840) had TSB values in the intermediate-risk zone. In a clinically significant minority of these newborns (58/912 or 6.4%), the postdischarge TSB moved into the high-risk zone (LR of this move: 3.2 from the upper-intermediate zone and.48 from the lower-intermediate risk zone). The predischarge TSB in 61.8% of the newborns (1756/2840) was in the low-risk zone (<40th percentile) and there was no measurable risk for significant hyperbilirubinemia (LR = 0, sensitivity = 100%; specificity = 64.7%; probability = 0%). CONCLUSIONS: An hour-specific TSB before hospital discharge can predict which newborn is at high, intermediate or low risk for developing clinically significant hyperbilirubinemia (specifically defined as TSB levels >/=95th percentile for age in hours). Risk designation and subsequent increases or decreases of in TSB can be easily monitored on an hour-specific percentile based predictive bilirubin nomogram. A predischarge TSB measured as a universal policy would facilitate targeted intervention and follow-up in a safe, cost-effective manner. In conjunction with bilirubin practice parameter of the American Academy of Pediatrics, it could reduce the potential risk for bilirubin-induced neurologic dysfunction.