Seroconversion to hepatitis C virus antibodies in patients with acute posttransfusion non-A,non-B hepatitis in Sweden

Summary Seventy-four patients in 1978 and 316 in 1986, all transfused during open-heart surgery in Stockholm, Sweden, were studied prospectively for the development of posttransfusion non-A, non-B (NANB) hepatitis, seroconversion to hepatitis C virus antibodies (anti-HCV) (C-100), time lag to seroconversion to anti-HCV and outcome of posttransfusion NANB/C hepatitis. Anti-HCV was tested up to six months after transfusions in patients from 1978 and up to one year after transfusions in patients from 1986. Fifty-four percent of the patients who developed posttransfusion NANB hepatitis seroconverted to anti-HCV, 7/15 (47%) in 1978 and 8/13 (62%) in 1986. Four (27%) of the 15 patients who seroconverted to anti-HCV were anti-HCV reactive within one week, 12 (80%) within eight weeks and all within 18 weeks after the onset of hepatitis. The ELISA optical density/cut-off (OD/CO) ratio was above 4.0 in all patients with hepatitis C who seroconverted. One transfused patient with normal serum aminotransferase levels throughout follow-up seroconverted after six months. He had a temporary positive anti-HCV reactivity with a maximal ELISA OD/CO ratio for anti-HCV of only 1.2, which became negative three years later. Development of chronic hepatitis was noticed in 9/15 (60%) patients who seroconverted to anti-HCV and in 5/13 (38%) patients with posttransfusion NANB hepatitis who did not seroconvert.

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Anti-HBC-Serokonversion bei Patienten mit akuter Non-A, Non-B-Hepatitis nach Transfusion in Schweden

Zusammenfassung 74 Patienten, die 1978, und 316 Patienten, die 1986 während offener Herzchirurgie in Stockholm, Schweden, Transfusionen erhielten, wurden in eine prospektive Studie aufgenommen und im Hinblick auf das Auftreten einer Non-A, Non-B-Posttransfusions-hepatitis, Serokonversion für Hepatitis C Virus-Antikörper (anti-HCV, C-100), Zeitspanne bis zur Serokonversion für anti-HCV und Verlauf der NANB/C-Posttransfusionshepatitis untersucht. Bei Patienten, die 1978 transfundiert worden waren, wurden Untersuchungen auf anti-HCV bis zu sechs Monate nach der Transfusion und bei 1986 Transfundierten bis zu einem Jahr nach Transfusion durchgeführt. Eine Serokonversion zu anti-HCV trat bei 54% der Patienten mit NANB-Posttransfusions-hepatitis ein, 7/15 (47%) der Patienten aus dem Jahr 1978 und 8/13 (62%) aus dem Jahr 1986. Die Serokonversion zu anti-HCV trat bei vier der 15 Patienten (27%) schon innerhalb einer Woche ein, bei 12 (80%) innerhalb acht Wochen und bei allen innerhalb 18 Wochen nach Beginn der Hepatitis. Bei den Patienten mit Hepatitis C, die eine Serokonversion entwickelten, lag der Quotient von ELISA Meßwert zu Grenzwert (Optical density/ Cut-off, OD/CO) in allen Fällen über 4,0. Ein Patient, bei dem nach der Transfusion stets normale Serum- Aminotransferase-Spiegel vorlagen, zeigte nach sechs Monaten eine Serokonversion. Er war vorübergehend anti-HCV positiv, der ELISA OD/CO- Quotient für anti-HCV betrug maximal 1,2; nach drei Jahren war er seronegativ. Bei neun der 15 Patienten (60%) war eine chronische Hepatitis nach Serokonversion für anti-HCV zu beobachten. Unter den 13 Patienten mit NANB-Posttransfusionshepatitis, die keine Serokonversion zeigten, entwickelten fünf eine chronische Hepatitis (38%).

     

The effect of pressure bandaging on complications and comfort in patients undergoing coronary angiography: A multicenter randomized trial

OBJECTIVES: To determine the effectiveness of pressure bandaging in reducing bleeding and bruising in patients undergoing coronary angiography and to investigate the contribution that pressure bandages make to patient discomfort after angiography.DESIGN: A prospective multicenter, randomized study.SETTING: Three university hospitals in Melbourne, Australia.PATIENTS: One thousand seventy-five patients undergoing coronary angiography were randomized to receive a pressure bandage (N = 556) or no bandage (N = 519) after manual compression of the right femoral artery puncture site.RESULTS: Patients without pressure bandages had a higher incidence of bleeding (P < 0.05) and bled earlier (mean 2.4 hours; SD 3.6 hours) after catheter removal (P < 0.001) than patients with bandages (mean 5.3 hours; SD 3.8 hours). The incidence of bleeding in patients without pressure bandages was 6.7%. The incidence and extent of bruising was the same for both groups. Patients with pressure bandages experienced a higher incidence of back (P < 0.05), groin (P < 0.001), and leg pain (P < 0.001), nausea (P < 0.05), and urinary difficulty (P < 0.01).CONCLUSIONS: In view of the associated increase in patient discomfort and the delay in time of onset of bleeding, pressure bandages should not be used routinely in the management of patients after coronary angiography, especially in the context of early discharge from the hospital.     

Mutations in mammalian target of rapamycin regulator DEPDC5 cause focal epilepsy with brain malformations

We recently identified DEPDC5 as the gene for familial focal epilepsy with variable foci and found mutations in >10% of small families with nonlesional focal epilepsy. Here we show that DEPDC5 mutations are associated with both lesional and nonlesional epilepsies, even within the same family. DEPDC5‐associated malformations include bottom‐of‐the‐sulcus dysplasia (3 members from 2 families), and focal band heterotopia (1 individual). DEPDC5 negatively regulates the mammalian target of rapamycin (mTOR) pathway, which plays a key role in cell growth. The clinicoradiological phenotypes associated with DEPDC5 mutations share features with the archetypal mTORopathy, tuberous sclerosis, raising the possibility of therapies targeted to this pathway. Ann Neurol 2014;75:782–787     

Bacampicillin in the treatment of pelvic inflammatory disease: A study of two dosage regimens

Summary In order to evaluate a twice daily dosage regimen of bacampicillin a multicenter clinical trial was performed in patients suffering from pelvic inflammatory disease (PID). A total of 75 patients were allocated at random to treatment with 800 mg bacampicillin twice daily or 400 mg three times daily for fourteen days (PID). The study was performed double-blind. The therapeutic effect was assessed in 70 patients. The therapeutic response was judged on the basis of clinical symptoms and bacteriology. There was no significant difference in the overall efficacy of the two dosages in the patient groups studied. Good response was obtained in 93% of the patients, and 7% were improved. Gastrointestinal side-effects were infrequent (three cases out of 75). Exanthema occurred in six patients.

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Die Verwendung von Bacampicillin bei entzündlichen Erkrankungen der Beckenorgane: Eine Studie mit zwei verschiedenen Dosierungen

Zusammenfassung Zur Beurteilung einer zweimal täglichen Dosierung von Bacampicillin wurde bei Patienten mit entzündlichen Erkrankungen der Organe des kleinen Beckens eine klinische multizentrische Studie durchgeführt. Insgesamt 75 Patienten wurden zufallsgemäß mit entweder 800 mg Bacampicillin zweimal täglich oder 400 mg dreimal täglich über vierzehn Tage behandelt. Die Studie wurde nach klinischen Symptomen und bakteriologischen Befunden bei insgesamt 70 Patienten beurteilt. Es konnte kein signifikanter Unterschied zwischen den beiden Dosierungen festgestellt werden. Gute Resultate wurden bei 93% der Patienten erreicht, 7% wurden gebessert. Zu gastrointestinalen Beschwerden kam es selten (bei drei von 75 Patienten). In sechs Fällen trat ein Exanthem auf.