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Pyogenic liver abscess caused by Fusobacterium in a 21-year-old immunocompetent male

World Journal of Gastroenterology 2015年第12期21卷 3731-3735页

作者： Zohair Ahmed Saurabh K Bansal Sonu Dhillon Department of Internal Medicine University of Illinois Peoria Campus OSF Saint Francis Medical Center Department of Gastroenterology and Hepatology University of Illinois Peoria Campus OSF Saint Francis Medical Center

A 21-year-old male with no significant past medical history, presented with right upper quadrant(RUQ) abdominal pain along with fevers and chills. Lab work revealed leukocytosis, anemia, and slightly elevated alkaline phosphatase. Viral serology for hepatitis B virus, hepatitis C virus, and human immunodeficiency virus were negative and he was *** tomography imaging revealed hepatic abscesses, the largest measuring 9.5 cm. Empiric antibiotics were started and percutaneous drains were placed in the abscesses. Anaerobic cultures from the abscesses grew Fusobacterium nucleatum. This is a gram negative anaerobic bacteria; a normal flora of the oral cavity. Fusobacterium is most commonly seen in Lemiere's disease, which is translocation of oral bacteria to the internal jugular vein causing a thrombophlebitis and subsequent spread of abscesses. Our patient did not have Lemiere's, and is the first case described of fusobacterium pyogenic liver abscess in a young immunocompetent male with good oral hygiene. This case was complicated by sepsis, empyema, and subsequent abscesses located outside the liver. These abscesses' have the propensity to flare abruptly and can be fatal. This case not only illustrates fusobacterium as a rare entity for pyogenic liver abscess, but also the need for urgent diagnosis and treatment. It is incumbent on physicians to diagnose and drain any suspicious hepatic lesions. While uncommon, such infections may develop without any overt source and can progress rapidly. Prompt drainage with antibiotic therapy remains the cornerstone of therapy.

关键词： Hepatic abscess Pyogenic Fusobacterium Liver immun

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Virological response and resistance mutations to NS3/4A inhibitors in hepatitis C virus-human immunodeficiency virus coinfection

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World Journal of Hepatology 2015年第18期7卷 2177-2183页

作者： Alissa Naqvi Valérie Giordanengo Brigitte Dunais Francine de Salvador-Guillouet Isabelle Perbost Jacques Durant Pascal Pugliese Aline Joulié Pierre Marie Roger Eric Rosenthal Infectious Diseases Department Archet Hospital Centre Hospitalier Universitaire Virology Laboratory Archet Hospital Centre Hospitalier Universitaire Internal Medicine Department Archet Hospital Centre Hospitalier Universitaire

AIM: To evaluate virological response to telaprevir or boceprevir in combination with pegylated interferon and ribavirin and resistance mutations to NS3/4A inhibitors in hepatitis C virus-human immunodeficiency virus(HCV-HIV) coinfected patients in a real life setting. METHODS: Patients with HCV genotype 1-HIV coinfection followed in Nice University Hospital internal medicine and infectious diseases departments who initiated treatment including pegylated interferon and ribavirin(Peg IFN/RBV) + telaprevir or boceprevir, according to standard treatment protocols, between August 2011 and October 2013 entered this observational study. Patient data were extracted from an electronic database(Nadis®). Liver fibrosis was measured by elastometry(Fibroscan®) with the following cut-off values: F0-F1: < 7.1 k Pa, F2: 7.1-9.5 k Pa, F3: 9.5-14.5 k Pa, F4: ≥ 14.5 k Pa. The proportion of patients with sustained virological response(SVR) twelve weeks after completing treatment, frequency and type of adverse events, and NS3/4A protease inhibitor mutations were described. RESULTS: Forty-one patients were included: 13(31.7%) patients were HCV-treatment na?ve, 22(53.7%) had advanced liver fibrosis or cirrhosis(Fibroscan stage F3 and F4); none had decompensated cirrhosis or hepatocellular carcinoma; all were receiving antiretroviral treatment, consisting for most them(83%) in either a nucleoside reverse-transcriptase inhibitor/protease inhibitor or/integrase inhibitor combination; all patients had undetectable HIV-RNA. One patient was lost to follow-up. SVR was achieved by 52.5% of patients. Five patients experienced virological failure during treatment and four relapsed. Seven discontinued treatment due to adverse events. Main adverse events included severe anemia(88%) and rash(25%). NS3/4A protease mutations were analyzed at baseline and at the time of virological failure in the 9 patients experiencing non-response, breakthrough or relapse. No baseline resistance mutation cou

关键词： Telaprevir Boceprevir Hepatitis C virushuman immun

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Gastric cancer:The times they are a-changin'

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World Journal of Gastrointestinal Oncology 2015年第11期7卷 303-316页

作者： Maria Antonietta Satolli Lucio Buffoni Rosella Spadi Ilaria Roato Department of Oncology University of Turin Department of Onco-ematology Medical OncologyAOU Città della Salute e della ScienzaMolinette10126 TurinItaly CeRMS AOU Città della Salute e della Scienza di TorinoDepartment of Medical ScienceUniversity of Turin

Gastric cancer is the third leading cause of cancer death *** though during these last decades gastric cancer incidence decreased in Western countries,it remains endemic and with a high incidence in Eastern *** survival in advanced and metastatic stage of gastric cancer is still very *** the Cancer Genoma Atlas Research Network identified four subtypes with different molecular profiles to classify gastric cancer in order to offer the optimal targeted therapies for pre-selected ***,the key point is still the selection of patients for the right treatment,on basis of molecular tumor *** chemotherapy reached a plateau of efficacy for gastric cancer,the combination between cytotoxic therapy and biological agents gets a better prognosis and decreases chemotherapeutic ***,Trastuzumab in combination with platinum and fluorouracil is the only approved targeted therapy in the first line for c-erb B2 positive patients,whereas Ramucirumab is the only approved targeted agent for patients with metastatic gastric *** perspectives for an effective treatment derived from the immunotherapeutic ***,we report an overview on gastric cancer treatments,with particular attention to recent advances in targeted therapies and in immunotherapeutic approach.

关键词： Targeted therapy Chemotherapy Gastric cancer immun

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