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Original Article
Effectiveness and tolerability of pegylated interferon alfa-2b in combination with ribavirin for treatment of chronic hepatitis C : the PegIntrust StudyPrice: €10,00 |
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Background and study aims : Large international clinical trials
conducted in the past 5 years rapidly improved the treatment of
chronic hepatitis C; however, it is unclear whether the advances
seen in clinical trials are being paralleled by similar improvements
in routine clinical practice. PegIntrust is a Belgian communitybased
trial evaluating the sustained virological response.
Patients and Methods : Observational study of 219 patients
receiving pegylated interferon alfa-2b (1.5 μg/kg/wk) and weightbased
ribavirin (800-1200 mg/day) for 48 weeks. Primary study end
point was sustained virological response (SVR), defined as undetectable
HCV RNA 6 months after the completion of treatment.
Results : In total, 108 patients (49.3 %) had undetectable
HCV RNA at the end of therapy, 91 (41.6%) attaining SVR. Of
the 111 patients without an end-of-treatment response, 28 were
non-responders, and 21 had virological breakthrough. In total,
134 patients attained early virological response (EVR); 88 (65.7%)
of those patients attained SVR. In contrast, 82 (96.5 %) of the
85 patients who did not attain EVR also did not attain SVR. Age,
fibrosis score and baseline viral load were identified as important
predictors of treatment outcome. The most frequently reported
serious adverse events resulting in treatment discontinuation were
anemia (n = 10), fatigue/asthenia/malaise (n = 6) and fever (n = 3).
Conclusion : Our data indicate that treatment of chronic hepatitis
C with PEG-IFN alfa-2b plus weight-based ribavirin results in
favourable treatment outcomes in a Belgian cohort of patients
treated in community-based clinical practice. (Acta gastro enterol.
belg., 2010, 73, 5-11). [Product Details...] |
Elevated serum uric acid is an independent risk factor for nonalcoholic fatty liver disease in Japanese undergoing a health checkupPrice: €10,00 |
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Background and study aims : The question of whether elevated
serum uric acid is an independent risk factor for nonalcoholic fatty
liver disease evident on ultrasonography was investigated by longitudinal
approach in Japanese undergoing a health checkup.
Patients and methods : A total of 1,386 male and 3,453 female
nondrinkers participating in health checkups in both 2000 and
2005 were included. Multiple logistic regression analyses were performed
for 1,042 men (51.4 ± 11.2 years old) and 3,076 women
(51.8 ± 9.2 years old) to identify independent factors for newly
developed nonalcoholic fatty liver disease in 2005. Adjustment was
made for age, body mass index, body mass index increase for 5
years, systolic blood pressure, triglyceridemia, fasting blood glucose,
and smoking.
Results: The prevalence of nonalcoholic fatty liver disease and
body mass index, systolic blood pressure, and triglyceride were significantly
higher in the participants with elevated serum uric acid,
with a significant increasing trend in relation to serum uric acid
quartiles. Nonalcoholic fatty liver disease was newly diagnosed in
17.4% of males and 8.2% of females, respectively, in 2005. Serum
uric acid adjusted for other factors was a risk factor for nonalcoholic
fatty liver disease in both sexes and quartiles 3 and 4 had significantly
elevated risks. The odds ratio and 95% confidence interval
for one increment of serum uric acid were 1.31 and 1.11-1.56 in
men and 1.30 and 1.10-1.53 in women, respectively.
Conclusions : Elevated serum uric acid is an independent risk
factor for nonalcoholic fatty liver disease in Japanese undergoing a
health checkup. (Acta gastro enterol. belg., 2010, 73, 12-17). [Product Details...] |
The first prospective endoscopic experience with the ePTFE-covered Viabil stent in patients with a distal malignant biliary stenosisPrice: €10,00 |
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Background and study aims. Endoscopic insertion of a biliary
stent is standard practice in the palliative treatment of malignant
biliary obstructions. Experience with the new ePTFE-covered
Viabil stent is mainly limited to the percutaneous approach. We
report our experience with its endoscopic application in patients
with distal malignant biliary obstructions.
Patients and methods. Eleven patients with an inoperable
tumour, without apparent metastatic disease, and with an ECOG
score of 0 to 1, were included. All patients received an ePTFE-covered
Viabil stent of 10 mm diameter, with transmural side-holes.
Primary endpoints were stent patency and patient survival.
Results. Overall median patient survival was 220 days; 10
patients died free of jaundice from non-stent related causes. Due to
malfunction of the prototype stents at insertion, the introduction of
2 Viabils was required in 3 patients to acquire complete bile duct
drainage. Thus, a total of 14 stents was needed in 11 patients. Stent
dysfunction occurred in 3/11 patients. It always resulted from massive
stone impaction needing stone removal with additional stenting
in two out of 3 patients. Stent patency was 80% at 3 and 6
months, and 63% at 9 and 12 months. Lifetime palliation was 73%.
Conclusions
Although the biliary Viabil device has been developed to minimize
bacterial adherence and sludge formation, stent dysfunctions
in this series always resulted from stone impaction. Moreover, malfunction
of the prototype stents needed the insertion of a second
stent in 3 patients. Overall life time palliation was 73%. Further
experience with newer versions of the device as well as comparative
studies versus other metallic stents are needed. (Acta gastro enterol.
belg., 2010, 73, 18-24). [Product Details...] |
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Acta Gastro-Enterologica Belgica is indexed in NCBI/PubMed.
Printed by Universa Press, Wetteren, Belgium. ©vzw/asbl Acta Gastro-Enterologica Belgica
Printed by Universa Press, Wetteren, Belgium. ©vzw/asbl Acta Gastro-Enterologica Belgica