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Overlap of concurrent extrahepatic autoimmune diseases is associated with milder disease severity of newly diagnosed autoimmune hepatitis

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Hepatobiliary & Pancreatic Diseases International 2021年第1期20卷 21-27页

作者： Tobias Mühling Helmut Rohrbach wolfgang schepp Felix Gundling Department of Gastroenterology Internal Medicine ⅡUniversity of WürzburgWürzburgGermany Department of Pathology Academic Teaching Hospital BogenhausenTechnical University of MunichMunich 81925Germany Department of Gastroenterology Hepatology and Gastrointestinal OncologyAcademic Teaching Hospital BogenhausenTechnical University of MunichMunich 81925Germany Department of Internal Medicine Division of GastroenterologyGastrointestinal Oncology and DiabetologyKemperhof KoblenzKoblenzGermany

Background:Concurrent extrahepatic autoimmune disorders(CEHAID)are frequently observed in autoimmune hepatitis(AIH).It is not clear whether there is any prognostic significance of CEHAID on *** aim of this study was to examine the prognostic impact of CEHAID and the correlation with the disease severity of ***:This study included 65 hospitalized subjects who fulfilled the accepted criteria for AIH during an 8-year period(2009–2016).All records were manually screened for presence of associated autoimmune *** severity of AIH was assessed by liver laboratory tests including the ratio of aspartate aminotransferase to alanine aminotransferase(AST/ALT)and liver ***:Among the enrolled patients,52(80%)were female(median age 61 years,IQR 45–75).Fifty-six(86.2%)were classified as type-1 *** 26(40%)patients at least one additional extrahepatic autoimmune disease was ***-four subjects were referred to our hospital because of acute presentation of AIH(supposed by an acute elevation of hepatic enzymes)for subsequent liver biopsy resulting in initial diagnosis of *** group was stratified into 3 subgroups:(A)AIH alone(n=14);(B)overlap with primary biliary cirrhosis(PBC)/primary sclerosing cholangitis(PSC)(n=11);and(C)with CEHAID(n=9).AST/ALT ratio was the lowest in subgroup C(median 0.64,IQR 0.51–0.94;P=0.023),compared to subgroup A(median 0.91,IQR 0.66–1.10)and subgroup B(median 1.10,IQR 0.89–1.36).Patients with AIH alone showed a trend to the highest grade of fibrosis(mean 2.3;95%CI:1.5–3.0)with no statistical significance compared to subjects with CEHAID(lowest grade of fibrosis;mean 1.5;95%CI:0.2–2.8;P=0.380)whereas the ongoing inflammation was ***:AST/ALT ratio and extent of fibrosis were lower in subjects with AIH and CEHAID,compared to subjects with only ***,the occurrence of CEHAID might be a predictor for lower disease severity of newly diagnosed acute onset AIH,possibly caused by an e

关键词： Autoimmune hepatitis Concurrent extrahepatic autoimmune disease Serum aminotransferase activities

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突发性口吃:心因性非癫痫发作的信号

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世界核心医学期刊文摘（神经病学分册） 2005年第1期1卷 53-54页

作者： Vossler D.G. Haltiner A.M. schepp S.K. 高方 Epilepsy Center Swedish Neuroscience Institute 801 Broadway # 901 Seattle WA 98122 United States Dr.

Objective: To determine if ictal stuttering (IS) is more common among patients with psychogenic nonepileptic seizures (PNES) than patients with epileptic seizures (ES). Methods: The authors prospectively reviewed the medical records, EEG video recordings, and Minnesota Multiphasic Personality Inventory 2 (MMPI- 2) scores of consecutive adults of normal intelligence diagnosed with either PNES or ES. Results: A total of 230 (117 PNES and 113 ES) patients were studied. PNES patients were older (p = 0.029), more likely to be female (p < 0.001), and had a shorter duration of seizure disorder (p < 0.001) than ES cases. Ten (8.5% ) PNES subjects and no ES cases demonstrated IS. The proportion of patients with IS in these two groups was significantly different (p = 0.004). PNES patients with IS were of similar age as but had an even shorter (p = 0.010) duration of seizure disorder (mean = 3.0 years) than those without IS. Scores on the hypochondriasis, depression (D), and hysteria scales of the MMPI 2 were significantly higher among PNES subjects than in ES patients (p≤ 0.002). However, seven PNES patients with IS had a lower mean score on the D scale than did 98 PNES cases without stuttering (p = 0.005). This produced a more sharply defined "conversion V" appearance on the MMPI 2 graph in the stutterers. Conclusions: Ictal stuttering was present in 8.5% of 117 consecutive patients with psychogenic nonepileptic seizures, but was not observed in a consecutive series of 113 adults with epileptic seizures. Patients with psychogenic nonepileptic seizures with ictal stuttering had a shorter duration of seizure disorder and a more prominent conversion profile on the Minnesota Multiphasic Personality Inventory than either patients with psychogenic nonepileptic seizures without stuttering or subjects with epileptic seizures.

关键词：心因性癫痫性癫痫病史医疗记录 MMPI 明尼苏达无口录像资料测试图中更

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阿斯匹林能预防大肠息肉和大肠癌吗？

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德国医学 1997年第2期14卷 92-92页

作者： schepp,W 张林

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