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11.
Chronic hepatitis C in patients with persistently normal alanine transaminase levels. 总被引:2,自引:0,他引:2
Mitchell L Shiffman Moisés Diago Albert Tran Paul Pockros Robert Reindollar Daniele Prati Maribel Rodríguez-Torres Pilar Lardelli Steven Blotner Stefan Zeuzem 《Clinical gastroenterology and hepatology》2006,4(5):645-652
BACKGROUND & AIMS: Many patients with chronic hepatitis C virus (HCV) have persistently normal serum alanine transaminase (ALT) levels. We compared characteristics of chronic hepatitis C patients with patients with normal and elevated ALT levels using data from 3 randomized phase III trials of peginterferon alfa-2a (40 kDa). METHODS: The characteristics of 480 patients with normal ALT values (on >or=3 occasions without any increases in ALT level over a 6- to 18-month period) and 1993 patients with elevated ALT levels were compared. Sixty-eight of the 480 patients with normal ALT levels were randomized to no treatment and monitored for 72 weeks. RESULTS: More patients with normal ALT levels than patients with elevated ALT levels were women (59% vs 32%; P<.01). The serum HCV RNA titer was significantly lower in patients with normal ALT levels (P<.01 vs in patients with elevated ALT levels). Patients with normal ALT levels had significantly lower inflammation and fibrosis scores on liver biopsy examination than patients with elevated ALT levels, but almost two-thirds had portal fibrosis and 10% had bridging fibrosis. No correlation between baseline ALT activity, HCV RNA level, and liver histology was observed in patients with normal ALT levels. During the 72-week follow-up period, ALT activity elevated above the upper limit of normal in 53% of the untreated patients with normal levels of ALT. None became HCV RNA undetectable. CONCLUSIONS: Chronic hepatitis C patients with normal ALT levels should be evaluated in a similar manner as patients with elevated ALT levels because they are at risk for developing significant liver disease. The decision to treat with peginterferon alfa and ribavirin should be based on multiple factors, rather than on ALT levels alone. 相似文献
12.
13.
Pilar Nicolás 《Hereditary cancer in clinical practice》2007,5(3):144-152
The specific characteristics of genetic data lead to ethical-legal conflicts in the framework of genetic diagnosis. Several international organisations, including UNESCO and the Council of Europe, have enacted rules referring to the use of genetic information. This paper discusses possible legal and ethical criteria that could be used in genetic testing. 相似文献
14.
Esparza-Gordillo Jorge; Goicoechea de Jorge Elena; Buil Alfonso; Berges Luis Carreras; Lopez-Trascasa Margarita; Sanchez-Corral Pilar; Rodriguez de Cordoba Santiago 《Human molecular genetics》2005,14(8):1107
Some MCP SNP and aHUS-associated MCP mutation 相似文献
15.
Antonio Gómez Mercedes Salgado Manuel Valladares-Ayerbes Mónica Jorge Ana Carballo Sonia Candamio Pilar Izquierdo Paula Peleteiro Rafael López 《Clinical & translational oncology》2010,12(12):843-848
Objective
The aim of the project was to assess the effectiveness and safety of weekly epoetin-beta (EB) in patients with gastrointestinal cancer (GIC) subjected to concomitant chemoradiotherapy (CCTRT). 相似文献16.
Javier Garzón Almudena López-Fando Pilar Sánchez-Blázquez 《Neuropsychopharmacology》2003,28(11):1983-1990
Members of the R7 subfamily of regulators of G-protein signaling (RGS) proteins (RGS6, RGS7, RGS9-2, and RGS11) are found in the mouse CNS. The expression of these proteins was effectively reduced in different neural structures by blocking their mRNA with antisense oligodeoxynucleotides (ODNs). This was achieved without noticeable changes in the binding characteristics of labeled beta-endorphin to opioid receptors. Knockdown of R7 proteins enhanced the potency of antinociception promoted by morphine and [D-Ala(2), N-MePhe(4), Gly-ol(5)]-enkephalin (DAMGO)-both agonists at mu-opioid receptors. The duration of morphine analgesia was greatly increased in RGS9-2 and in RGS11 knockdown mice. The impairment of R7 proteins brought about different changes in the analgesic activity of selective delta agonists. Knockdown of RGS11 reduced [D-Ala(2)]deltorphin II analgesic effects. Those of RGS6 and RGS9-2 proteins caused [D-Ala(2)]deltorphin II to produce a smoothened time-course curve-the peak effect blunted and analgesia extended during the declining phase. RGS9-2 impairment also promoted a similar pattern of change for [D-Pen(2,5)]-enkephalin (DPDPE). RGS7-deficient mice showed an increased response to both [D-Ala(2)]deltorphin II and DPDPE analgesic effects. A single intracerebroventricular (i.c.v.) ED(80) analgesic dose of morphine gave rise to acute tolerance in control mice, but did not promote tolerance in RGS6, RGS7, RGS9-2, or RGS11 knockdown animals. Thus, R7 proteins play a critical role in agonist tachyphylaxis and acute tolerance at mu-opioid receptors, and show differences in their modulation of delta-opioid receptors. 相似文献
17.
18.
This study investigates whether tissue recoil or patient intrinsic factors influence the final position of the nipple areola
complex (NAC) after reduction mammoplasty.
The age, pre-operative ptosis, BMI and weight of the tissue resected were recorded as patient intrinsic factors in 37 patients
undergoing reduction mammoplasty. The “spring-back” value was defined as the distance from the sternal notch to a nipple landmark
on the breast meridian with the patient sitting up, minus the same measurement repeated with the patient recumbent to eliminate
the pull of gravity on the breast. Spring back was measured pre-operatively for the nipple and nipple mark then post-operative
for the nipple. The difference in centimeters between the final post-operative distance from the sternal notch to the nipple
and the level intended by the pre-operative nipple mark was termed the “judgment error.” The final position of the post-operative
nipple and the judgment error was compared to the spring-back values and patient intrinsic factors.
Pre-operative ptosis was statistically related to increasing patient BMI and mass of tissue resected per breast. Pre-operative
spring-back values for the nipple increased with increasing ptosis, BMI and decreasing age. Spring-back values were greater
in the lower pole of the breast than in the upper pole. The final position of the nipple was higher than the pre-operative
mark in 65% of cases, lower in 8% and as marked in 27% of cases. The post-operative NAC was, on average, 0.6 cm higher than
planned pre-operatively. The post-operative distance from the sternal notch to the nipple increased with increasing pre-operative
ptosis, mass of breast tissue resected per breast and all three spring-back values. The difference between the level of the
pre-operative mark and the final nipple position showed a weak correlation with post-operative spring-back values.
The parameters of ptosis, BMI, weight of tissue resected per breast and pre-operative nipple spring back reflect body habitus
and breast size. Spring-back values vary between the upper and lower pole of the breast. The final NAC position was higher
than that intended at pre-operative marking in the majority of cases. The surgeon instinctively marks the nipple lower in
patients with greater pre-operative ptosis and in whom a larger resection is anticipated. Judgment error did not relate to
intrinsic factors nor to pre-operative spring-back values; hence, these parameters cannot be applied as predictive tools for
more accurate pre-operative marking of the nipple position. This study suggests that the pre-operative nipple mark should
be placed, with the patient sitting up, at least 23 cm from the sternal notch and 0.6 cm lower than the final position estimated
using the inframammary crease as a landmark.
An invited commentary on this paper is available at . 相似文献
19.
Hyper-IgM syndrome with CHARGE association 总被引:1,自引:0,他引:1
Pilar Bahillo Teresa Cantero Pilar Solís Paz Aragón Samuel Gómez Rosario Cambronero 《Pediatric allergy and immunology》2003,14(6):487-489
A girl with coloboma of the iris, sensorineural deafness, growth delay, distinctive face, and cranial nerve dysfunction was diagnosed of CHARGE association in the first year of life. She presented with repeated otitis. At 3 yr of age, the patient suffered a septicemia ( Streptococcus pneumoniae , Corynebacterium sp.). The immunoglobulin G (IgG) and IgA serum levels were decreased, IgM increased and cellular immunity parameters were normal, supporting the diagnosis of hyper-IgM (HIM) syndrome. The sequence of CD40 ligand and cytidine deaminase genes were normal. From then on, she was receiving immunoglobulin intravenously with an excellent outcome . Here, we report the first case of CHARGE association and HIM syndrome in the same patient. Although the cause could not be identified, a non-random link is likely. 相似文献
20.
Carmen Guillén Ponce María Pilar Garrido López María José Molina Garrido Gema Muñoz Molina Alfredo Carrato 《Clinical & translational oncology》2007,9(1):53-55
Pituitary metastases of solid tumours are infrequent, specially as a first manifestation. When they happen, they are usually
due to breast or lung cancer and are asymptomatic or produce diabetes insipidus. It is very strange that they produce hormonal
deficiency.
We present a case report of a bronchogenic adenocarcinoma in a 65-year-old man which began with panhypopituitarism, diabetes
insipidus and visual alterations. Magnetic resonance imaging revealed a large sellar mass, with clivus infiltration and invading
the right cavernous sinus. The biopsy result was adenocarcinoma metastases from lung cancer. 相似文献