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Effect of viral load on T-lymphocyte failure in patients with chronic hepatitis B

World Journal of Gastroenterology 2008年第7期14卷 1112-1119页

作者： Jing You Hutcha Sriplung Alan Geater Virasakdi Chongsuvivatwong Lin Zhuang Hong-Ying Chen Lan Yu Bao-Zhang Tang Jun-Hua Huang Epidemiology Unit Faculty of Medicine Prince of Songkhla University Hat Yai Songkhla 90110 Thailand department of Hepatopathy Third Municipal People's Hospital of Kunming Kunming 650041 Yunnan Province China department of Infectious Diseases First Affiliated Hospital of Kunming Medical University Kunming 650032 Yunnan Province China department of Infectious Diseases Yunnan General Hospital of the Chinese People's Armed Police Forces Kunming 650111 Yunnan Province China

AIM: To investigate peripheral T-lymphocyte sub-population profile and its correlation with hepatitis B virus (HBV) replication in patients with chronic hepatitis B (CHB).METHODS: Distribution of T-lymphocyte subpopulations in peripheral blood was measured by flow cytometry in 206 CHB patients. HBV markers were detected with ELISA. Serum HBV DNA load was assessed with quantitative real-time polymerase chain reaction (PCR). The relationship between HBV replication and variation in peripheral T-cell subsets was ***: CHB patients had significantly decreased CD3+ and CD4+ cells and CD4+/CD8+ ratio, and increased CD8+ cells compared with uninfected controls (55.44 ± 12.39 vs 71.07 ± 4.76, 30.92 ± 7.48 vs 38.94 ± 3.39, 1.01 ± 0.49 vs 1.67 ± 0.33, and 34.39 ± 9.22 vs 24.02 ± 4.35; P hepatitis B e antigen (HBeAg) expression, liver disease severity, history of maternal HBV infection, and young age at HBV infection, all with P < 0.01. There was a significant linear relationship between viral load and these parameters of T-lymphocyte subpopulations (linear trend test P < 0.001). There was a negative correlation between the levels of CD3+ and CD4+ cells and CD4+/CD8+ ratio and serum level of viral load in CHB patients (r = -0.68, -0.65 and -0.75, all P < 0.0001), and a positive correlation between CD8+ cells and viral load (r = 0.70, P < 0.0001). There was a significant decreasing trend in CD3+ and CD4+ cells and CD4+/CD8+ ratio with increasing severity of hepatocyte damage and decreasing age at HBV infection (linear trend test P < 0.01). In multiple regression (after adjustment for age at HBV infection, maternal HBV infection status and hepatocyte damage severity) log copies of HBV DNA maintained a highly significant predictive coefficient on T-lymphocyte subpopulations, and was the strongest predictor of var

关键词：乙型肝炎病毒病毒感染 T淋巴细胞免疫机制

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Applying the WHO instead of CDC growth charts may double obesity rates

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Open Journal of Pediatrics 2013年第2期3卷 139-146页

作者： Abeer Yasin Guido Filler department of Paediatrics Division of Paediatric Nephrology Children’s Hospital London Health Sciences Centre London Canada

Aims: This study compares the WHO (2007) and the National Health Examination Survey (NHANES III) reference intervals and investigates the differences when applied on a Canadian cohort of older children and adolescents. Methods: We calculated height, weight and BMI z-scores of 4375 consecutive patients (1993 female, 45.6%) aged 5 - 20 years attending outpatient clinics at a single tertiary care centre using reference data of the latest NHANES (III) survey and the WHO (2007) growth charts. To address age dependency, data was stratified into age groups. Results: Using the NHANES III reference intervals, medians of weight (+0.46), height (+0.29) and BMI z-scores (+0.46) were significantly non-zero. The WHO (2007) growth charts yielded medians of +2.05, +0.32, +0.53 for weight, height and BMI z-scores respectively, all significantly non-zero. When comparing both growth charts, Canadian children had significantly different weight and BMI z-scores (p 95th percentile) doubled from 8.6% to 16.0%. A significant age dependency was observed with higher WHO (2007) weight z-scores (>7 years) and higher BMI z-scores (7 to 13 years) and no significant difference was observed for height z-scores across all age groups. Gender differences were observed for weight z-scores (>9 years) and BMI (males: 9 - 11 years, p = 0.0118;11 - 13 years, p = 0.0069) whereas no significant difference was found in height z-scores across all age groups. Conclusion: Our results reveal substantial differences between both reference populations and thus interpretation needs be done with caution, especially when labelling results as abnormal.

关键词： WHO NHANES Height z-Score Weight z-Score BMI z-Score Bland & Altman Agreement Obesity Rates

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Prevalence and Incidence of Metabolic Syndrome in a Cohort of Patients with Rheumatoid Arthritis: A Correlation between Body Mass Index and Disease Activity

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Open Journal of Rheumatology and Autoimmune Diseases 2020年第3期10卷 95-108页

作者： Susana Ferreira Krampe Nicole Pamplona Bueno de Andrade Letícia Guimarães da Silveira Claiton Viegas Brenol department of Rheumatology Hospital de Clínicas de Porto Alegre (HCPA)-UFRGS Porto Alegre Brazil

Rheumatoid Arthritis (RA) is an inflammatory disease associated with high morbidity and increased cardiovascular disease, and Metabolic Syndrome (MS) is understood as a set of metabolic disorders that correlates with obesity and sedentary lifestyle. The aim of this study is to evaluate the prevalence of MS in a cohort of patients with RA and its correlation to specific factors of the disease. A retrospective cohort study was conducted with 283 patients with RA, followed at the Rheumatology outpatient Clinic of the Hospital de Clínicas de Porto Alegre (HCPA) between 2008 and 2016;187 continued to be followed and agreed to be reevaluated between January and November 2016. MS was defined according to the National Cholesterol Education Program and disease activity was assessed using the Disease Activity Score (DAS28). Clinical, biochemical, and anthropometric evaluations were conducted. The prevalence of MS in the first evaluation was 43.9% and, after 8 years, 59.4%. Increased waist circumference and blood pressures, elevated triglycerides and low High-Density Lipoprotein were the most frequent features of MS. The DAS28 was significantly lower in the reevaluation (p = 0.006). The prevalence of MS was higher at the end of 8 years;disease activity, as well as blood pressure, decreased during this period. Steroid use had also decreased at the end of follow-up. There was an increase of 15% of cases with MS in an 8-year follow-up cohort of patients, which was in agreement with the current literature and showed how the inflammatory process in RA is correlated to MS. The parameters of MS that varied the most were blood pressure, cholesterol and triglycerides. Ultimately, these parameters and disease activity must be observed closely in order to improve the prognosis of patients with RA.

关键词： Rheumatoid Arthritis Metabolic Syndrome Medical Treatment Body Mass Index Disease Activity

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Updated Review on the Panorama of Liver Diseases in Benin

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Open Journal of Gastroenterology 2023年第1期13卷 33-42页

作者： Jean Sehonou Aboudou Raïmi Kpossou Celia Rosemonde Ablavi Mouzouvi Comlan N’déhougbèa Martin Sokpon Rodolph Koffi Vignon Hepato-Gastroenterology department National and University Hospital Hubert Koutoukou Maga (CNHU-HKM) Cotonou Benin Republic Faculty of Health Sciences University of Abomey-Calavi Cotonou Benin Republic Galenic Pharmacy and Pharmaceutical Technology Laboratory Pharmacy Teaching and Research Unit Faculty of Health Sciences Cotonou Benin Republic

Introduction: The aim of this work was to take stock of the epidemiological aspects of liver diseases in Benin. Methods: Two methods were used: documentary research and collection of the position of gastroenterologists on the subject. For the literature search, the sources interviewed were Medline, African Journal On Line (AJOL), Google and Google scholar. Additional searches were made on the websites of European gastroenterology societies (AFEF, EASL). A collection of the opinions of gastroenterologists, most of them members of the Beninese Society of Hepato-gastroenterology was made. Results: From a nosological point of view, the most frequent and serious liver diseases in Benin are mainly infectious: viral hepatitis B and C (9.9% and 4.12% of the general population in 2013). Bacterial liver diseases (ascites fluid infections and tuberculosis of the liver) come in 3rd position after cirrhosis and hepatocellular carcinoma. Amoebic abscesses of the liver tend to regress. The toxic causes are dominated, in addition to alcoholic liver diseases (steatosis, cirrhosis), by drug lesions: two fatal cases of hepatotoxicity by artesunate-amodiaquine combination and asymptomatic and transient cytolysis in 23.8% of 63 children less than 5 years old treated with arthemether-lumefantrine combination have been described. Phytotherapy, alone or in combination with modern drugs, can in some cases be hepatotoxic. Plants with recognized medicinal virtues (may be harmful to the liver (Senna, Moringa oleifera, tamarind). Chronic aflatoxicoses secondary to the consumption of contaminated food (maize, cassava or peanuts) are relatively under-documented. Overload diseases (in particular alcoholic or non-alcoholic fatty liver) are on the increase (3.19% of 662 ultrasounds in 1995 against 14.5% of 411 in 2011 in Cotonou) partly due to the demographic and nutritional transition underway in Benin. These diseases, often blamed on spells cast, lead to hospital deaths from cirrhosis or hepatocel

关键词： Viral hepatitis Drug-Induced hepatitis Benin Viral hepatitis Toxic hepatitis

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hepatitis B virus infection, diabetes mellitus, and their synergism for cholangiocarcinoma development: A casecontrol study in Korea

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World Journal of Gastroenterology 2015年第2期21卷 502-510页

作者： Ban Seok Lee Eun-Cheol Park Seung Woo Park Chung Mo Nam Jaehoon Roh department of Medicine Graduate SchoolYonsei University College of MedicineSeoul 120-752South Korea Digestive Disease Center and department of Internal Medicine Cheju Halla General HospitalJeju 690-766South Korea department of Preventive Medicine Yonsei University College of MedicineSeoul 120-752South Korea Institute of Health Services Research Yonsei University College of MedicineSeoul 120-752South Korea department of Internal Medicine Institute of GastroenterologyYonsei University College of MedicineSeoul 120-752South Korea

AIM: To identify possible risk factors and their synergism for cholangiocarcinoma ***: A hospital-based, case-control study in which we included 276 cholangiocarcinoma patients [193 extrahepatic cholangiocarcinoma(ECC) and 83 intrahepatic cholangiocarcinoma(ICC)], diagnosed at a training hospital in Korea between 2007 and 2013, and 552 healthy controls matched 2:1 for age, sex, and date of diagnosis. Risk factors for cholangiocarcinoma and possible synergism between those factors were evaluated using conditional logistic regression and synergism index, ***:There was an association between cholangiocarcinoma and hepatitis B virus(HBV) infection, diabetes mellitus(DM), cholecystolithiasis, choledocholithiasis, and hepatolithiasis, with the adjusted odds ratios(AORs) of 4.1, 2.6, 1.7, 12.4, and 39.9, respectively. Synergistic interaction on the additive model was investigated between HBV infection and DM(AOR = 12.2; 95%CI: 1.9-80.1). In the subgroup analyses, cholecystolithiasis, choledocholithiasis, hepatolithiasis, and DM were significant risk factors for ECC(AOR = 2.0, 18.1, 14.9, and 2.0, respectively), whereas choledocholithiasis, hepatolithiasis, HBV infection, and DM were risk factors for ICC(AOR = 8.6, 157.4, 5.3 and 4.9, respectively). Synergistic interaction was also observed between HBV infection and DM(OR = 22.7; 95%CI: 2.4-214.1). However, there was no synergistic interaction between other significant risk factors for ***: In this Korean study, HBV infection and DM were found to exert independent and synergistic effects on the risk for cholangiocarcinoma, including ICC. Exploring the underlying mechanismsfor such synergy may lead to the development of cholangiocarcinoma prevention strategies in high-risk individuals.

关键词： Cholangiocarcinoma Risk factor hepatitis Synergism

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Psychiatric Day Hospital and Its Impact on Patients Clinical Stability: The Reality of Faro (Portugal) Unit

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Open Journal of Psychiatry 2019年第1期9卷 15-22页

作者： Desiderio Duarte Luis Ramos Ana Cristina Trindade Eduardo Goncalves department of Psychiatry and Mental Health(DPSM)of the Centro Hospitalar Universitario do Algarve(CHUA) Faro CityPortugal

Psychiatric Day Hospitals are alternatives to classic hospitalization, staying in an intermediate position between full-time hospitalization and outpatient treatment. The main purpose of this work was to investigate the impact of the therapeutic program developed in a Psychiatric Day Hospital (of Faro-Portugal) on the clinical stability of the patients. It is a descriptive-correlational retrospective study, implemented through the consultation of the SCLINIC computer platform regarding the years 2015, 2016 and 2017. The records of 127 users were analysed. There was a predominance of mood disorders (n = 55;43.3%), followed by schizophrenia, schizotypal and delusional disorders (n = 43, 33.9%). The majority of patients had a structured occupational plan after discharge (n = 106, 83.46%). In the year following the frequency of Day Hospital, compared to the year prior to admission, there was a reduction in the number of full-time hospitalizations, outpatient visitations/consultations, prescribed drugs and emergency episodes, with statistically significant differences. The positive impact of the frequency of Day Hospital had on patients’ clinical stability was the improvement in all studied variables. The Psychiatric Day Hospital of Faro-Portugal contributes to decreasing the number of full time hospitalizations, outpatient visitations/consultations and emergency episodes, maintaining patients’ clinical stability and reducing the public financial costs related to their therapeutic intervention.

关键词： Psychiatric Day Hospital Therapeutic Program

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Liver histology in ICU patients dying from sepsis:A clinico-pathological study

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World Journal of Gastroenterology 2008年第9期14卷 1389-1393页

作者： John Koskinas Ilias P Gomatos Dina G Tiniakos Nikolaos Memos Maria Boutsikou Aspasia Garatzioti Athanasios Archimandritis Alexander Betrosian 2nd department of Internal Medicine Athens Medical SchoolAthens 11527Greece Laboratory of Surgical Research 1st Department of Propaedeutic SurgeryAthens Medical SchoolAthens 11527Greece Laboratory of Histology and Embryology Athens Medical School Athens 11527Greece Laboratory of Surgical Research 1st Department of Propaedeutic Surgery Athens Medical School Athens 11527Greece Intensive Care Unit Hippocration HospitalAthens 11527Greece

AIM:To determine end-stage pathologic changes in the liver of septic patients dying in the intensive care unit. METHODS: Needle liver biopsies obtained immediately after death from 15 consecutive patients with sepsis and no underlying liver disease were subjected to routine histological examination. Liver function tests and clinical monitoring measurements were also recorded. RESULTS: Liver biochemistries were increased in the majority of patients before death. Histology of liver bi- opsy specimens showed portal inflammation in 73.3%, centrilobular necrosis in 80%, lobular inflammation in 66.7%, hepatocellular apoptosis in 66.6% and cholan- gitis/cholangiolitis in 20% of patients. Mixed hepatitic/ cholestatic type of liver injury was observed in 6/15 (40%) patients and hepatitc in 9/15 (60%). Steatosis was ob- served in 11/15 (73.3%) patients affecting 5%-80% of liver parenchyma. Among the histological features, the presence of portal inflammation in liver biopsy was as- sociated with increased hospitalization in the ICU prior death (P = 0.026). CONCLUSION: Features of hepatitis and steatosis arethe main histological findings in the liver in the majority of patients dying from sepsis.

关键词：败血症肝脏组织学活组织切片检查临床研究

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Risks of Viral hepatitis B Transmission in Mother-to-Infant of Pregnant Women Carriers of Chronic Viral hepatitis B in Cote d’Ivoire

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Open Journal of Gastroenterology 2017年第7期7卷 206-215页

作者： Stanislas Adjéka Doffou Fulgence Bathaix Yao Aboubakar Demba Bangoura Dimitri Kouamé Henriette Kissi Anzouan-Kacou Aristide Tchimou Karidiatou Diallo Mahassadi Kouamé Alassan Alain Koffi Attia Thérèse Ndri Yoman department of Hepatology and Gastroenterology of the Centre Hospitalier Universitaire de Yopougon(CHU-Y) AbidjanCote d’Ivoire

The aim of this study was to identify the risk factors of mother-to-child transmission of HBV in positive Ag Hbs pregnant women in Cote d’Ivoire. Methods: This was a transversal prospective study that took place over a period of 7 months (from February 2016 to August 2016) in 2 university hospital and 2 private clinics. We consecutively recruited 91 pregnant women who were positive for HBs Ag in prenatal consultations. For each pregnant woman record included in the study, we provided Socio-demographic (Age, marital status, education level, social rank, gravidity, parity) and biological data (HBs Ag, Anti-HBc Total Ac, Hbe Ag, Ac anti-Hbe Ac, DNA-VHB, Ac anti-HCV Ac, retroviral serology, transaminases). All of these data were collected using a survey sheet developed for the study. Results: The age of our pregnant women HBs positive ranged from 18 years to 44 years with a mean age of 30.10 years. The age group from 20 to 39 years was the most represented with a frequency of 92.31%. Almost of all positive HBs Ag pregnant women was HBe Ag negative, only 3.3% was HBe Ag positive. The viral load above 2000 IU/ml was found in 21 (23.03%) patients. There were 4 co-infected patients, which 3 HBV-HIV and 1 HBV-HCV. Only 19 (20.88%) pregnant HBs Ag positive women were able to bring back the supplementary virological assessment within a period less than one month. Conclusion: According to our work the virologic profile of positive HBs Ag in pregnant women in Cote d’Ivoire is characterized by an important viral replication objectified by a high viral load in about 23% pregnant women, a negativity of HBe antigen in 96.6% of them.

关键词： Cote d’Ivoire hepatitis B Virus Surface Antigen Positive Risk Factors-Mother-to-Child Transmission

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Celiac Disease Knowledge and Practice of Dietitians in Rural New South Wales, Australia

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Food and Nutrition Sciences 2016年第10期7卷 874-883页

作者： Leah Goodyer Leanne J. Brown Elesa Crowley School of Health Sciences University of Newcastle Callaghan Australia department of Rural Health University of Newcastle Tamworth Australia

This study aimed to evaluate dietetic practices for patients with celiac disease and knowledge of celiac disease amongst rural dietitians. This study comprised of two parts: 1) a retrospective file audit of patients with celiac disease attending a rural dietetic outpatient clinic in NSW, Australia from 2007 to 2014 and 2) a cross-sectional survey of 25 dietitians within a rural Local Health District in NSW. Celiac disease related knowledge and diet therapy practices were assessed. Data were reported using descriptive statistics. The patient file audit (n = 17) indicated that the majority of patients (59%) had no follow-up with a dietitian. Education topics provided by dietitians included gluten-free food options (53%) and label reading (41%). Dietitians (n = 18, 72% response rate) achieved a mean score of 73% (range 48% - 90%) for celiac disease related food knowledge and 69% (range 50% - 90%) for screening and diagnosis knowledge. Perceived barriers for compliance with a gluten-free diet included limited access to dietitians, as well as limited availability and cost of gluten-free products. Current practices of rural-based dietitians in NSW are variable for patients with celiac disease, suggesting that evidence-based guidelines and continuing education are needed for rural-based dietitians in the specialized area of celiac disease.

关键词： Celiac Disease Dietitians Diet Therapy Evaluation Rural Health

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Image Findings and Common Musculoskeletal Disorders for Pediatrics in the Saudi Arabian Society

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Journal of Biosciences and Medicines 2016年第4期4卷 43-53页

作者： B. Z. Shakhreet department of Diagnostic Radiology Faculty of Applied Medical Sciences King Abdulaziz University Jeddah Kingdom of Saudi Arabia

Aim: To detect the most common musculoskeletal disorders and to explore the common injury and indication of different musculoskeletal systems, and then to obtain the causes of disorders by observing clinical indications via images. Methodology: The subjects in this project consisted of both genders—males and females and were investigated randomly by collecting data from the PACS unit that exists in the radiology department at KAUH. The participants had a mean age of 7.4 ± 0.3 years, a mean height of 118.2 ± 2.5 cm, a mean mass of 27.8 ± 1.5 kg, and a mean BMI of 19.6 ± 0.8 kg/m2. The author settled the study plan by building a special, appropriate questionnaire to be handed out to the patients and covered mainly the prospective studies of randomly selected patients who came to the emergency unit and the outpatient units from other departments at KAUH in Jeddah. Results: The ratio of injuries in male children (77%) against females (23%) is 3:1, and this ratio is considered significant between age groups for males when compared with females. The injuries existed most in the age groups of 4 to 6 years old and 8 to 10 years old with approximately the same percentage of the total subjects as about 21% for each age group. Trauma injury was significant (81%) compared to other types of causes in all age groups. There was a significant relationship between the causes of injuries and the age groups in pediatrics (p 0.05) between the site of injuries and age groups. The significant site that resulted from trauma was the knee (100%), out of the total traumas’ subject. There was a highly significant relationship between the site of injuries and its causes (p = 0.006, i.e. p < 0.05) that were expected. Conclusion: More awareness and understanding in the society are needed and we should concentrate on increasing the knowledge of such by providing them with more learning courses.

关键词： BMI Pediatric Injuries Musculoskeletal Age Groups Image Findings Trauma Sports Accidents

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