Interferon (IFN) monotherapy significantly reduces the chronicity rate of acute hepatitis C (AHC) but optimal regimen and treatment timing remain undefined. The aim of this study was to assess the ...efficacy of a 6-month course of pegylated IFN (PEG-IFN) α-2b monotherapy in AHC patients and to investigate if IFN treatment initiated after 12 weeks from clinical presentation, still achieved a high response rate.
Sixteen AHC patients still viremic after 12 weeks from the onset were treated with PEG-IFN α-2b (1.5
mcg/kg once weekly) for 6 months and followed for at least 12 months. Response to therapy was defined as normal ALT values and undetectable HCV RNA (<50
IU/ml) at the end of therapy, after 6 (sustained response) and 12 months follow-up (long-term response).
At the end of treatment, HCV RNA was undetectable in 15/16 patients while ALT normalized in 14/16 patients. After 6 and 12 months follow-up, 15/16 patients (94%) showed virological and biochemical response.
A 6-month course of PEG-IFN α-2b is effective in inducing resolution of AHC in 94% of patients. Our results provide a rationale for delaying treatment for 12 weeks, targeting only patients who fail to clear the virus spontaneously and truly requiring therapy without loss of efficacy.
Research publication is a central to the scientific process and comprehensive bibliometric analysis is a leading way to better understand trends within research. Currently, there are limited ...bibliometric analyses of literature pertaining to foot and ankle surgery. This study aims to quantify the volume of research and investigate what may affect publication and citation. Journals associated with the 3 major orthopedic foot and ankle societies (Foot & Ankle InternationalFAI, Foot and Ankle Surgery, and The Foot) and one podiatric college (Journal of Foot and Ankle Surgery®) were evaluated from January 2009 to December 2018 using Scopus (Elsevier, Amsterdam, the Netherlands). Descriptive statistics were used to summarize article characteristics and regression modeling was used to determine factors associated with a country's current and future productivity and an article's citation rate. A total of 4994 articles were published over the 10-year period, with the largest contributor of publications being the United States of America (USA), who produced 2096 (41.8%) publications. Regression analysis found no association between a country's productivity and gross domestic product or population. There was no significant relationship between a country's baseline publication rate and future publication rate. The variables significantly associated with an increased citation count were; the number of years since publication, the number of authors, publication in FAI and if the article was a review. To our knowledge this is the largest bibliometric analysis of foot and ankle publications. The majority of research is being produced by the USA, but there are numerous complex factors associated with citation and publication rates. Further research is required to fully assess these factors and characterize the state of foot and ankle surgery research.
Chronic infection often develops in people who are infected with the hepatitis C virus (HCV). Such infection is difficult to eradicate and can eventually lead to end-stage liver disease. In this ...study, 44 patients with acute hepatitis C received 24 weeks of treatment with interferon alfa-2b in an attempt to prevent chronic infection. At the end of therapy, as well as 24 weeks later, 43 of the patients had undetectable levels of HCV RNA in serum.
Chronic infection with hepatitis C virus (HCV) is the leading cause of chronic liver disease in the United States and the most common indication for liver transplantation.
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Almost 4 million people in the United States and about 170 million people worldwide are estimated to be infected,
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,
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and cirrhosis will eventually develop in 10 to 30 percent of these people.
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Since the introduction of programs that screen blood products for HCV, less than 10 percent of new infections are caused by transfusions of contaminated blood. New infections continue to occur through such routes as intravenous drug abuse and . . .
Background: The present study aimed to investigate the role of stavudine in the onset of premature vascular lesions using
an ultrasound color Doppler evaluation of the carotid vessels. Patients and ...Methods: A total of 266 patients were evaluated:
149 were treated with stavudine (group I) and 117 without stavudine (group II). Results: Of the patients in group I, 41% exhibited
vascular lesions vs. 26% in group II (p=0.0103). The two groups were further divided into subgroups Ia (stavudine and proteinase
inhibitor, PI), Ib (stavudine and non-nucleotidic reverse transcriptase inhibitor, NNRTI), IIa (PI, without stavudine) and
IIb (NNRTI without stavudine). A higher prevalence of lesions emerged in group Ia, while group IIa were at higher risk of
developing vascular lesions than groups Ib and IIb. Conclusion: Although stavudine per se does not seem to determine damage
of the epiaortic vessels, the association of a PI with stavudine is related to a significantly higher rate of lesions.
Abstract
Aims
Diabetes is the most common comorbidity of HF patients. SGLT2 inhibitors has been shown to reduce hospitalization in patients with HF. The cardioprotective mechanisms of gliflozines ...have not been elucidated. The aim of our study was to evaluate the effect of SGLT2 inhibitors on right and left ventricular function in T2DM patients with HF.
Methods and results
One hundred and fifteen consecutive outpatients with CHF and T2DM were screened in the Daunia Heart Failure Registry. Seventy-eight of them were enrolled and followed up between May 2019 and September 2020. All patients underwent conventional, TDI and strain echocardiography in an ambulatory setting, at the beginning and after 3 months of therapy with SGLT2 inhibitors. Seventy-eight consecutive outpatients with CHF and T2DM (mean age 67.4 ± 8.4 years, male: 83%) were enrolled in the study. Thirty-eight of them started the treatment with SGLT2 inhibitors, while the remaining forty continued their original therapy. After 3 months of therapy, LVEF, LVEDD, and LVESD statistically improved (respectively, from 39.68 ± 7.78% to 45.08 ± 9.04%, P: 0.001 and 57.32 ± 9.76 mm to 54.16 ± 6.54 mm, P: 0.01 and from 47.51 ± 1.58 mm to 43.24 ± 8.12, P: 0.0008). Changes in left ventricular function and dimensions were not significant in patients who did not started a therapy with SGLT2 inhibitors. There was a statistically significant reduction of E/E′ (from 16.51 ± 22.55 to 9.73 ± 3.35, P: 0.0007) in patients with treatment with SGLT2i. Moreover, there was an improvement of right ventricular function, due to a statistically significant reduction of PAPs and increase of TAPSE (respectively, from 30.63 ± 8.80 to 24.00 ± 8.35, P: 0.008; from 19.16 ± 2.54 to 21.18 ± 2.84, P: 0.0003) and S′ (10.42 ± 2.09 to 12.91 ± 2.50, P: 0.000) 3 months after the administration of SGLT2 inhibitors therapy vs. the control group.
Conclusions
In a real-world scenario, our results showed that the treatment with SGLT-2 inhibitors in patients with CHF and diabetes is associated with an echocardiographic biventricular function improvement.
Therapy of acute hepatitis C (AHC) has not yet been standardized and several issues are still unresolved. This open, randomized, multicenter trial aimed to assess the efficacy and safety of a 24‐week ...course of pegylated IFN (Peg‐IFN) alpha‐2b versus a 12‐week course of Peg‐IFN alpha‐2b alone or with ribavirin (RBV) in AHC patients. One hundred and thirty HCV acutely infected patients who did not spontaneously resolve by week 12 after onset were consecutively enrolled and randomized to receive Peg‐IFN alpha‐2b monotherapy (1.5 μg/kg/week) for 24 or 12 weeks (arm 1, n = 44 and arm 2, n = 43, respectively) or in combination with RBV (10.6 mg/kg/day) for 12 weeks (arm 3, n = 43). The primary endpoint was undetectable HCV RNA at 6‐month posttreatment follow‐up (sustained virological response; SVR). All patients were followed for 48 weeks after therapy cessation. HCV RNA levels were determined by real‐time polymerase chain reaction (limit of detection: 15 IU/mL) at the central laboratory at baseline, week 4, end of treatment, and 6 and 12 months posttreatment. Using an intent‐to‐treat analysis, overall SVR rate was 71.5%. In particular, an SVR was achieved in 31 of 44 (70.5%), 31 of 43 (72.1%), and 31 of 43 (72.1%) patients in arms 1, 2, and 3, respectively (P = 0.898). Sixteen patients (12.3%) prematurely discontinued therapy or were lost to follow‐up; thus, sustained response rates with per‐protocol analysis were 81.6%, 81.6%, and 81.6% for patients in arms 1, 2, and 3 respectively. With multivariate analysis, virologic response at week 4 of treatment was an independent predictor of SVR. Peg‐IFN alpha‐2b was well tolerated. Conclusion: Peg‐IFN alpha‐2b induces a high SVR in chronically evolving AHC patients. Response rates were not influenced by combination therapy or treatment duration. (Hepatology 2014;59:2101‐2109)
Interferon (IFN) monotherapy significantly reduces the chronicity rate of acute hepatitis C (AHC) but optimal regimen and treatment timing remain undefined. The aim of this study was to assess the ...efficacy of a 6-month course of pegylated IFN (PEG-IFN) alpha-2b monotherapy in AHC patients and to investigate if IFN treatment initiated after 12 weeks from clinical presentation, still achieved a high response rate.
Sixteen AHC patients still viremic after 12 weeks from the onset were treated with PEG-IFN alpha-2b (1.5 mcg/kg once weekly) for 6 months and followed for at least 12 months. Response to therapy was defined as normal ALT values and undetectable HCV RNA (<50 IU/ml) at the end of therapy, after 6 (sustained response) and 12 months follow-up (long-term response).
At the end of treatment, HCV RNA was undetectable in 15/16 patients while ALT normalized in 14/16 patients. After 6 and 12 months follow-up, 15/16 patients (94%) showed virological and biochemical response.
A 6-month course of PEG-IFN alpha-2b is effective in inducing resolution of AHC in 94% of patients. Our results provide a rationale for delaying treatment for 12 weeks, targeting only patients who fail to clear the virus spontaneously and truly requiring therapy without loss of efficacy.
Background/Aims: Interferon alpha provides benefit in only a limited number of patients with chronic anti-HBe-positive hepatitis B. The aim of this study was to verify the long-term efficacy of ...lamivudine treatment of these patients and the incidence of lamivudine-resistant hepatitis B virus mutants.
Methods: Fifteen consecutive patients with chronic anti-HBe-positive hepatitis B were treated with lamivudine 100 mg once daily for 52 weeks. Levels of alanine aminotransferase, HBV DNA, hepatitis B surface antigen, and IgM antibodies to hepatitis B core antigen were monitored during therapy and 12-month follow up. The polymerase gene was amplified by polymerase chain reaction and the region coding for YMDD amino acid motif was directly sequenced.
Results: Only 2/15 patients (13%) had a sustained virological and biochemical response and improved histologically. Eleven out of 15 (74%) showed inhibition of viral replication and normalization of alanine aminotransferase levels during lamivudine treatment but relapsed 1–12 months after terminating therapy. In the two remaining patients (13%), HBV DNA initially became negative but reappeared in the serum after 24 weeks, and in both patients the emergence of YMDD mutants was demonstrated.
Conclusions: Our data confirm the antiviral efficacy of lamivudine in anti-HBe-positive patients, but response to a 1-year course was only transient as the majority of patients relapsed after therapy withdrawal. The lack of a sustained effect and the emergence of lamivudine-resistant mutants suggest that therapy for chronic hepatitis B should be based on a combination of several therapeutic agents.
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