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1面向21世纪的卒中新定义:美国心脏病学会和美国卒中学会声明显示文摘尽管脑血管病有着全球性影响且对其病理生理学的认识有了很多进步,但是'卒中'这一术语在临床实践、临床研究或公共卫生评估中的定义却不一致。传统的定义依据于临床,却没有考虑到科学技术的进步。美国心脏协会(AHA)和美国卒中协会(ASA)卒中分会组织了写作小组,为21世纪卒中新定义撰写专家共识性声明。中枢神经系统(CNS)梗死,指由缺血所导致的脑、脊髓或视网膜的细胞死亡,是基于持续性损害的神经病理学、神经影像学和(或)临床证据。CNS梗死表现为一个临床谱:缺血性卒中特指伴有明显症状的CNS梗死,而静息性梗死根据定义指未引起已知的症状的梗死。卒中也还包括脑出血和蛛网膜下腔出血。新定义的卒中结合了临床和组织学标准,可被用于实践、研究和公共卫生评估。俞羚 董荃 宋叶平 江静雯 李卉 刘亮贤 苏爱萍 李焰生 Sacco RL Kasner SE Broderick JP Caplan LR Connors JJ Culebras A Elkind MS George MG Hamdan AD Higashida RT Hoh BL Janis LS Kase CS Kleindorfer DO Lee JM Moseley ME Peterson ED Turan TN Valderrama AL Vinters HV 2013神经病学与神经康复学杂志2013,10,2:188
2晚新生代岷江下蚀速率及其对青藏高原东缘山脉隆升机制和形成时限的定量约束显示文摘青藏高原东缘具有青藏高原地貌、龙门山高山地貌和山前冲积平原三个一级地貌单元 ,本文以岷江作为切入点 ,研究了该地区河流下蚀速率与山脉的隆升作用之间的相互关系。在建立岷江阶地序列的基础上 ,利用阶地高程和热释光年代学测年资料分别定量计算了岷江在川西高原、龙门山和成都盆地的下蚀速率 ,结果表明岷江各河段的下蚀速率明显不同 ,分别为 1.0 7~ 1.6 1mm / a、1.81m m/ a和 0 .5 9mm / a;在龙门山地区岷江的下蚀速率最高 ,约为川西高原地区的 1.5倍 ,约为成都平原地区的 3倍 ;而同一河段不同时期岷江的下蚀速率基本是连续的 ,具有很好的线性关系 ,可作为该河段整个河谷的下蚀速率。基于龙门山的表面隆升速率 (0 .3~ 0 .4 mm / a) ,在约束局部侵蚀基准面和气候变化对阶地形成的控制作用的基础上 ,本文建立了青藏高原东缘岷江下蚀速率与龙门山表面隆升速率之间的线性关系 ,结果表明河流下蚀速率约为山脉表面隆升速率的 5倍。根据龙门山表面在隆升速率和下切速率等方面均大于川西高原 ,并结合龙门山活动构造以走滑作用为主 ,笔者认为青藏高原东缘的边缘山脉以剥蚀隆升为主 ,兼有构造隆升作用。最后 ,根据岷江最大切割深度所需的时间 (3.4 8Ma)和成都盆地最古老的岷江冲积扇大邑砾岩的时间 (3.6李勇 曹叔尤 周荣军 AL DENSMORE M A ELLIS 2005地质学报2005,79,1:70
3Severe acute pancreatitis: Pathogenetic aspects and prognostic factors显示文摘Approximately 20% of patients with acute pancreatitis develop a severe disease associated with complications and high risk of mortality. The purpose of this study is to review pathogenesis and prognostic factors of severe acute pancreatitis (SAP). An extensive medline search was undertaken with focusing on pathogenesis, complications and prognostic evaluation of SAP. Cytokines and other inflammatory markers play a major role in the pathogenesis and course of SAP and can be used as prognostic markers in its early phase. Other markers such as simple prognostic scores have been found to be as effective as multifactorial scoring systems (MFSS) at 48 h with the advantage of simplicity, efficacy, low cost, accuracy and early prediction of SAP. Recently, several laboratory markers including hematocrit, blood urea nitrogen (BUN), creatinine, matrix metalloproteinase-9 (MMP-9) and serum amyloid A (SAA) have been used as early predictors of severity within the first 24 h. The last few years have witnessed a tremendous progress in understanding the pathogenesis and predicting the outcome of SAP. In this review we classified the prognostic markers into predictors of severity, pancreatic necrosis (PN), infected PN (IPN) and mortality.Ibrahim A Al Mofleh 2008World Journal of Gastroenterology2008,14,5:67
4Clinical trials on corticosteroids for diabetic macular edema显示文摘Diabetic macular edema(DME)is a common cause of visual impairment in diabetic patients.It is caused by an increase in the permeability of the perifoveal capillaries and a disruption of the blood retinal-barrier.The pathogenesis of DME is multifactorial.Several therapeutic modalities have been proposed for the treatment of DME.Corticosteroid treatments have emerged as an alternative therapy for persistent DME or refractory to conventional laser photocoagulation and other modalities,due to anti-inflammatory,anti-vascular endothelial growth factor and anti-proliferative effects.Many studies have demonstrated the beneficial therapeutic effect of corticosteroids with improvement to both retinal thickness and visual acuity in short-term on the treatment of DME.Peribulbar and intravitreal injections have been used to deliver steroids for DME with frequent injections due to the chronic and recurrent nature of the disease.Steroid-related side effects include elevated intraocular pressure,cataract,and injection related complications such as endophthalmitis,vitreous hemorrhage,and retinal detachment particularly with intravitreal steroid injections.In order to reduce the risks,complications and frequent dosing of intravitreal steroids,intravitreal implants have been developed recently to provide sustained release of corticosteroids and reduce repeated intravitreal injections for the management of DME.Hassan A Al Dhibi J Fernando Arevalo 2013World Journal of Diabetes2013,4,6:17
5Autologous CD34^+ and CD133^+ stem cells transplantation in patients with end stage liver disease显示文摘AIM:To assess the utility of an autologous CD34 + and CD133 + stem cells infusion as a possible therapeutic modality in patients with end-stage liver diseases.METHODS:One hundred and forty patients with endstage liver diseases were randomized into two groups.Group 1,comprising 90 patients,received granulocyte colony stimulating factor for five days followed by autologous CD34 + and CD133 + stem cell infusion in the portal vein.Group 2,comprising 50 patients,received regular liver treatment only and served as a control group.RESULTS:Near normalization of liver enzymes and improvement in synthetic function were observed in 54.5% of the group 1 patients;13.6% of the patients showed stable states in the infused group.None of the patients in the control group showed improvement.No adverse effects were noted.CONCLUSION:Our data showed that a CD34 + and CD133 + stem cells infusion can be used as supportive treatment for end-stage liver disease with satisfactory tolerability.Hosny Salama Abdel-Rahman N Zekri Abeer A Bahnassy Eman Medhat Hanan A Halim Ola S Ahmed Ghada Mohamed Sheren A Al Alim Ghada M Sherif 2010World Journal of Gastroenterology2010,16,42:16
6Management of gastroesophageal reflux disease: Patient and physician communication challenges and shared decision making显示文摘Gastroesophageal reflux disease(GERD) is a common upper esophageal condition and typical symptoms can include heartburn and sensation of regurgitation while atypical symptoms include chronic cough, asthma, hoarseness, dyspepsia and nausea. Typically, diag-nosis is presumptive given the presence of typical and atypical symptoms and is an indication for empiric therapy. Treatment management can include lifestyle modifications and/or medication therapy with proton pump inhibitor(PPI) class being the preferred and most effective. Complete symptom resolution is not always achieved and long-term PPI therapy can put patients at risk for serious side effects and needless expense. The brain-gut connection and hypervigilance plays an important role in symptom resolution and treatment success, especially in the case of non-PPI responders. Hypervigilance is a combination of increased esophageal sensory sensitivity in combination with exaggerated threat perception surrounding esophageal symptoms. Hypervigilance requires a different approach to GERD managements, where continued PPI therapy and surgery are usually not recommended. Rather, helping physicians and patients understand the brain-gut connection can guide and improve care.Education and reassurance should be the main pillars or treatment. However, it is important not to suggest the symptoms are due to anxiety alone, this often leads to patient dissatisfaction. Patient dissatisfaction with treatment reveals the need for a more patient-centered approach to GERD management and better communication between patients and providers. Shared decision making(SDM) with the incorporation of patient-reported outcomes(PRO) promotes patient adherence and satisfaction. SDM is a joint discussion between clinician and patient in which a mutually shared solution is explored for GERD symptoms. For SDM to work the physician needs to capture patients' perceptions which may not be obtained in the standard interview. This can be done through the use of PROs which promote a dialogue with patients about their symptoms and treatment priorities in the context of the SDM patient encounter. SDM could potentially help in the management of patient expectations for GERD treatment, ultimately positively impacting their health-related quality of life.Scott Klenzak Igor Danelisen Grace D Brannan Melissa A Holland Miranda AL van Tilburg 2018World Journal of Clinical Cases2018,6,15:10
7Safety and efficacy of ultrasound ciliary plasty as a primary intervention in glaucoma patients显示文摘AIM: To evaluate the safety and the efficacy of the ultrasound ciliary plasty(UCP) on the intraocular pressure(IOP) control in glaucomatous eyes without previous glaucoma surgery.METHODS: A retrospective study included patients with primary and secondary glaucoma who underwent UCP in Dar Al Shifa Hospital, Kuwait between January 2017 to June 2018. High-intensity focused ultrasound procedures were performed under peribulbar anesthesia using the 2^(nd) generation probe with 8 s duration of each of the 6 shots. Complete ophthalmologic examinations were scheduled pre-treatment, and at 1 d, 1 wk, 1, 3, 6 and 12 mo posttreatment. Primary outcomes were the IOP reduction and success rates at 12 mo, while the secondary outcomes were the occurrence of vision threatening complications and visual acuity.RESULTS: The records of 62 eyes of 62 patients were analyzed with mean age of 63.8 y(67.7% males). There was statistically significant reduction in the mean IOP from 35.2±8.3 mm Hg before treatment to 20.6±8.7 mm Hg at 12^(th) month(P<0.0005) with a mean percentage IOP reduction of 42.3% with significant reduction in the mean number of antiglaucomatous drugs from 3.2±0.4 before treatment to 2.1±1.02 at 12 mo(P<0.0005). Qualified success was achieved in 77.4% of eyes at 12 mo. No major intra-or posttreatment complications were reported.CONCLUSION: Second-generation UCP prove to be effective in reducing IOP in naive glaucoma patients with lower success rates in cases of neovascular and uveitic glaucomas.Magda A.Torky Yousif A Al Zafiri Sherein M.Hagras Abeer M.Khattab Rania M.Bassiouny Tharwat H.Mokbel 2019International Journal of Ophthalmology(English edition)2019,12,4:9
8Fatty liver without a large“belly”:Magnified review of nonalcoholic fatty liver disease in non-obese patients显示文摘Nonalcoholic fatty liver disease(NAFLD) is well described as a common cause of chronic liver disease, mostly in the obese population. It refers to a spectrum of chronic liver disease that starts with simple steatosis than progresses to nonalcoholic steatohepatitis and cirrhosis in patients without significant alcohol consumption. NAFLD in the non-obese population has been increasingly reported and studied recently. The pathogenesis of nonobese NAFLD is poorly understood and is related to genetic predisposition, most notably patatin-like phospholipase domain-containing 33 G allele polymorphism that leads to intrahepatic triglyceride accumulation and insulin resistance. Nonobese NAFLD is associated with components of metabolic syndrome and, especially, visceral obesity which seems to be an important etiological factor in this group. Dietary factors and, specifically, a high fructose diet seem to play a role. Cardiovascular events remain the main cause of mortality and morbidity in NAFLD, including in the nonobese population. There is not enough data regarding treatment in non-obese NAFLD patients, but similar to NAFLD in obese subjects, lifestyle changes that include dietary modification, physical activity, and weight loss remain the mainstay of treatment.Mohamad H Yousef Alhareth Al Juboori Abdulmajeed A Albarrak Jamal A Ibdah Veysel Tahan 2017World Journal of Gastrointestinal Pathophysiology2017,8,3:9
9Increased expression of tumor necrosis factor-a is associated with advanced colorectal cancer stages显示文摘AIM:To detect the expression of tumor necrosis factor-a(TNF-a)in colorectal cancer(CRC)cells among Saudi patients,and correlate its expression with clinical stages of cancer.METHODS:Archival tissue specimens were collected from 30 patients with CRC who had undergone surgical intervention at King Khalid University Hospital.Patient demographic information,including age and gender,tumor sites,and histological type of CRC,was recorded.To measure TNF-a m RNA expression in CRC,total RNA was extracted from tumor formalin-fixed,paraffinembedded,and adjacent normal tissues.Reverse transcription and reverse transcription polymerase chain reaction were performed.Colorectal tissue microarrays were constructed to investigate the protein expression of TNF-a by immunohistochemistry.RESULTS:The relative expression of TNF-a m RNA in colorectal cancer was significantly higher than that seen in adjacent normal colorectal tissue.High TNF-a gene expression was associated with StageⅢandⅣneoplasms when compared with earlier tumor stages(P=0.004).Eighty-three percent of patients(25/30)showed strong TNF-a positive staining,while only 10%(n=3/30)of patients showed weak staining,and 7%(n=2/30)were negative.We showed the presence of elevated TNF-a gene expression in cancer cells,which strongly correlated with advanced stages of tumor.CONCLUSION:High levels of TNF-a expression could be an independent diagnostic indicator of colorectal cancer,and targeting TNF-a might be a promising prognostic tool by assessment of the clinical stages of CRC.Omar A Al Obeed Khayal A Alkhayal Abdulmalik Al Sheikh Ahmad M Zubaidi Mansoor-Ali Vaali-Mohammed Robin Boushey James H Mckerrow Maha-Hamadien Abdulla 2014World Journal of Gastroenterology2014,20,48:8
10Aqueous suspension of anise “Pimpinella anisum” protects rats against chemically induced gastric ulcers显示文摘AIM: To substantiate the claims of Unani and Arabian traditional medicine practitioners on the gastroprotective potential effect of a popular spice anise, 'Pimpinella anisum L.' on experimentally-induced gastric ulceration and secretion in rats. METHODS: Acute gastric ulceration in rats was produced by various noxious chemicals including 80% ethanol, 0.2 mol/L NaOH, 25% NaCl and indomethacin. Anti-secretory studies were undertaken using pylorus- ligated Shay rat technique. Levels of gastric non-protein sulfhydryls (NP-SH) and wall mucus were estimated and gastric tissue was also examined histologically. Anise aqueous suspension was used in two doses (250 and 500 mg/kg body weight) in all experiments. RESULTS: Anise significantly inhibited gastric mu- cosal damage induced by necrotizing agents and indomethacin. The anti-ulcer effect was further confirmed histologically. In pylorus-ligated Shay rats, anise suspension significantly reduced the basal gastric acid secretion, acidity and completely inhibited the rumenal ulceration. On the other hand, the suspension significantly replenished ethanol-induced depleted levels of gastric mucosal NP-SH and gastric wall mucus concentration. CONCLUSION: Anise aqueous suspension possesses significant cytoprotective and anti-ulcer activities against experimentally-induced gastric lesions. The anti-ulcer effect of anise is possibly prostaglandin-mediated and/orthrough its anti-secretory and antioxidative properties.Ibrahim A Al Mofleh Abdulqader A Alhaider Jaber S Mossa Mohammed O Al-Soohaibani Syed Rafatullah 2007World Journal of Gastroenterology2007,13,7:7
11中心和外周动脉脉搏波传导速度测量的重复性:社区动脉粥样硬化风险研究显示文摘通过脉搏波传导速度(pulsewavevelocity,PwV)检测动脉硬化程度是当前对高血压和心血管病风险评估和分层所日渐常用的方式。颈股动脉脉搏波传导速度(catroidfemoralarteryPWV,cfPWV)是一项公认的测定中心动脉硬化程度的方式。Meyer ML Tanaka H Palta P Patel MD Camplain R Couper D Cheng S Al Qunaibet A Poon AK Heiss G 陈云 叶鹏 2016中华高血压杂志2016,24,5:6
12Vascular depression for radiology: A review of the construct,methodology,and diagnosis显示文摘Vascular depression(VD)as defined by magnetic resonance imaging(MRI)has been proposed as a unique subtype of late-life depression.The VD hypothesis posits that cerebrovascular disease,as characterized by the presence of MRIdefined white matter hyperintensities,contributes to and increases the risk for depression in older adults.VD is also accompanied by cognitive impairment and poor antidepressant treatment response.The VD diagnosis relies on MRI findings and yet this clinical entity is largely unfamiliar to neuroradiologists and is rarely,if ever,discussed in radiology journals.The primary purpose of this review is to introduce the MRI-defined VD construct to the neuroradiology community.Case reports are highlighted in order to illustrate the profile of VD in terms of radiological,clinical,and neuropsychological findings.A secondary purpose is to elucidate and elaborate on the measurement of cerebrovascular disease through visual rating scales and semi-and fully-automated volumetric methods.These methods are crucial for determining whether lesion burden or lesion severity is the dominant pathological contributor to VD.Additionally,these rating methods have implications for the growing field of computer assisted diagnosis.Since VD has been found to have a profile that is distinct from other types of late-life depression,neuroradiologists,in conjunction with psychiatrists and psychologists,should consider VD in diagnosis and treatment planning.Sara N Rushia Al Amira Safa Shehab Jeffrey N Motter Dakota A Egglefield Sophie Schiff Joel R Sneed Ernst Garcon 2020World Journal of Radiology2020,12,5:5
13Six Minute Walk Test to assess functional capacity in chronic liver disease patients显示文摘AIM: To examine the utility of Six Minute Walk Test (6MWT) in patients with chronic liver disease (CLD). METHODS: Two hundred and fifty subjects between the ages of 18 and 80 (mean 47) years performed 6MWT and the Six Minute Walk Distance (6MWD) was measured. RESULTS: The subjects were categorized into four groups. Group A (n = 45) healthy subjects (control); group B (n = 49) chronic hepatitis B patients; group C (n = 54) chronic hepatitis C patients; group D (n = 98) liver cirrhosis patients. The four groups differed in terms of 6MWDs (P < 0.001). The longest distance walked was 421 ± 47 m by group A, then group B (390 ± 53 m), group C (357 ± 72 m) and group D (306 ± 111 m). The 6MWD correlated with age (r = -0.482, P < 0.01), hemoglobin (r = +0.373, P < 0.001) and albumin (r = +0.311, P < 0.001) levels. The Child-Pugh classification was negatively correlated with the 6MWD in cirrhosis (group D) patients (r = -0.328, P < 0.01). At the end of a 12 mo follow-up period, 15 of the 98 cirrhosis patients had died from disease complications. The 6MWD for the surviving cirrhotic patients was longer than for non-survivors (317 ± 101 vs 245 ± 145 m, P = 0.021; 95% CI 11-132). The 6MWD was found to be an independent predictor of survival (P = 0.024). CONCLUSION: 6MWT is a useful tool for assessing physical function in CLD patients. We suggest that 6MWD may serve as a prognostic indicator in patients with liver cirrhosis.Hatem F Alameri Faisal M Sanai Manal Al Dukhayil Nahla A Azzam Khalid A Al-Swat Ahmad S Hersi Ayman A Abdo 2007World Journal of Gastroenterology2007,13,29:5
14Endoscopic ultrasound guided drainage of pancreatic fluid collections: Assessment of the procedure, technical details and review of the literature显示文摘Endoscopic ultrasound(EUS) guided drainage of pancreatic fluid collections(PFC) has become increasingly popular and become first line management option in many centers. Use of therapeutic echoendoscopes has greatly increased the applicability of EUS guided transmural drainage. Drainage is indicated in symptomatic PFCs, PFC related infection, bleed, luminal obstruction, fistulization and biliary obstruction. EUS guided transmural drainage of PFCs is preferred in patients with non bulging lesions, portal hypertension, bleeding tendency and in those whom conventional drainage has failed. In the present decade significant progress has been made in minimally invasive endoscopic techniques. There are newer stent designs, access devices and techniques for more efficient drainage of PFCs. In this review, we discuss the EUS guided drainage of PFCs in acute pancreatitis.Rajesh Puri Ragesh Babu Thandassery Abdulrahman A Alfadda Saad Al Kaabi 2015World Journal of Gastrointestinal Endoscopy2015,7,4:5
15中国南方人A型行为问卷测查结果的分析显示文摘本文采用张伯源主持编制的A型行为问卷对中国南方13,808名正常成人进行测查,其中男性7943例,女性5865例。结果表明:我国南方人较北方人行为节凑慢、竞争性强;南方人男性与女性A型行为特征无明显差异,与北方人测查结果一致;不同年龄组的A型行为特征与北方人测查结果相同:即:45~>25~>35~>55~>15~>65岁以上组;不同职业组的A型行为特征是:商业>科技>干部>工人,与北方人测查结果存在一定差异;不同地区(省)间存在较大差异。Guo Huimin et al, Thesurvey cooperative group of the question paper on Chinese Southerners’type A bebavior pattern 1995中国临床心理学杂志1995,3,4:4
16Agmatine induces gastric protection against ischemic injury by reducing vascular permeability in rats显示文摘AIM:To investigate the effect of administration of agmatine(AGM) on gastric protection against ischemia reperfusion(I/R) injury.METHODS:Three groups of rats(6/group);sham,gastric I/R injury,and gastric I/R + AGM(100 mg/kg,i.p.given 15 min prior to gastric ischemia) were recruited.Gastric injury was conducted by ligating celiac artery for 30 min and reperfusion for another 30 min.Gastric tissues were histologically studied and immunostained with angiopoietin 1(Ang-1) and Ang-2.Vascular endothelial growth factor(VEGF) and monocyte chemoattractant protein-1(MCP-1) were measured in gastric tissue homogenate.To assess whether AKt/phosphatidyl inositol-3-kinase(PI3K) mediated the effect of AGM,an additional group was pretreated with Wortmannin(WM)(inhibitor of Akt/PI3K,15 μg/kg,i.p.),prior to ischemic injury and AGM treatment,and examined histologically and immunostained.Another set of experiments was run to study vascular permeability of the stomach using Evan's blue dye.RESULTS:AGM markedly reduced Evan's blue dye extravasation(3.58 ± 0.975 μg/stomach vs 1.175 ± 0.374 μg/stomach,P < 0.05),VEGF(36.87 ± 2.71 pg/100 mg protein vs 48.4 ± 6.53 pg/100 mg protein,P < 0.05) and MCP-1 tissue level(29.5 ± 7 pg/100 mg protein vs 41.17 ± 10.4 pg/100 mg protein,P < 0.01).It preserved gastric histology and reduced congestion.Ang-1 and Ang-2 immunostaining were reduced in stomach sections of AGM-treated animals.The administration of WM abolished the protective effects of AGM and extensive hemorrhage and ulcerations were seen.CONCLUSION:AGM protects the stomach against I/R injury by reducing vascular permeability and inflammation.This protection is possibly mediated by Akt/PI3K.Abeer A Al Masri Eman El Eter 2012World Journal of Gastroenterology2012,18,18:4
17网膜成形术在预防结直肠吻合口漏中作用的前瞻性研究显示文摘Tocchi A et al 王汉涛 2001中国实用外科杂志2001,21,6:4
18Drainage vs. non-drainage after cholecystectomy for acute cholecystitis:a retrospective study显示文摘Many surgeons practice prophylactic drainage after cholecystectomy without reliable evidence,this study was conducted to answer the question whether to drain or not to drain after cholecystectomy for acute calculous cholecystitis.A retrospective review of all patients who had cholecystectomy for acute cholecystitis in Aseer Central Hospital,Abha,Saudi Arabia,was conducted from April 2010 to April 2012.Data were extracted from hospital case files.Preoperative data included clinical presentation,routine investigations and liver function tests.Operative data included excessive adhesions,bleeding,bile leak,and drain insertion.Complicated cases such as pericholecystic collections,mucocele and empyema were also reported.Patients who needed therapeutic drainage were excluded.Postoperative data included hospital stay,volume of drained fluid,time of drain removal,and drain site problems.The study included 103 patients allocated into two groups;group A(n = 38) for patients with operative drain insertion and group B(n = 65) for patients without drain insertion.The number of patients with preoperative diagnosis of acute non-complicated cholecystitis was significantly greater in group B(80%) than group A(36.8%)(P < 0.001).Operative time was significantly longer in group A.All patients who were converted from laparoscopic to open cholecystectomy were in group A.Multivariate analysis revealed that hospital stay was significantly(P < 0.001) longer in patients with preoperative complications.There was no added benefit for prophylactic drain insertion after cholecystectomy for acute calculous cholecystitis in non-complicated or in complicated cases.Mohammed A Bawahab Walid M Abd El Maksoud Saeed A Alsareii Fahad S Al Amri Hala F Ali Abdul Rahman Nimeri Abdul Rahman M Al Amri Adel A Assiri Mohammed I Abdul Aziz 2014The Journal of Biomedical Research2014,28,3:3
19Treatment of hepatitis C virus genotype 4 with peginterferon alfa-2a: Impact of bilharziasis and fibrosis stage显示文摘AIM: To evaluate pegylated interferon alpha2a (PegIFN- α2a) in Egyptian patients with HCV genotype 4, and the impact of pretreatment viral load, co-existent bilharziasis and histological liver changes on response rate. METHODS: A total of 73 na?ve patients (61 with history of bilharziasis) with compensated chronic HCV genotype 4 were enrolled into: group A (38 patients) who received 180 mg PegIFN-alpha2a subcutaneously once weekly for a year and group B (35 patients) received IFN alpha-2a 3 MU 3 times weekly. Ribavirin was added to each regimen at a dose of 1200 mg. Patients were followed for 72 wk and sustained response was assessed. RESULTS: Significant improvement in both end of treatment response (ETR) (P < 0.002) and sustained response (SR) (P < 0.05) was noted with pegylated interferon, where ETR was achieved in 29 (76.3%) and 14 patients (40%) in both groups respectively, and 25 patients in group A (65.8%) and 9 (25.7%) in group B could retain negative viraemia by the end of follow up period. Sustained virological response (SVR) showed a significant negative correlation with age and positive correlation with pretreatment inflammation in patients receiving PegIFN. Viral clearance after 3 mo of therapy was associated with high incidence of ETR and SR (P < 0.001), but without significant difference between both forms of interferon. Significant improvement in response was achieved in patients with high grade fibrosis (grade 3 and 4) with PegIFN-α2a, where SR was seen in 5 out of 13 patients in group A, but none in group B. There was no significant difference in response betweenbilharzial and non-bilharzial patients in both groups. In terms of safety and tolerability, neutropenia was the predominant side effect; both drugs were comparable. CONCLUSION: PegIFN-α2a combined with ribavirin results in improvement in sustained response in HCV genotype 4, irrespective of history of bilharzial infestation.MF Derbala SR Al Kaabi NZ El Dweik F Pasic MT Butt R Yakoob A Al-Marri AM Amer N Morad A Bener 2006World Journal of Gastroenterology2006,12,35:3
20Coronary plaque erosion without rupture into a lipid core: a frequent cause of coronary thrombosis in sudden coronary death显示文摘Farb A Burke AP Tang AL 1996Circulation1996,93,:3
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