ABSTRACT
Background/Aims@#Data on treatment efficacy and safety of glecaprevir/pibrentasvir (GLE/PIB) for chronic hepatitis C virus (HCV) infection in Asian patients with severe renal impairment are limited. This study aimed to study the treatment and side effects of GLE/PIB in these patients infected with non-1 genotype (GT) HCV. @*Methods@#We prospectively recruited patients with Child’s A cirrhosis and eGFR <30 mL/min/1.73 m2 in Hong Kong and Taiwan during 2017–2018 to receive GLE/PIB treatment. @*Results@#Twenty-one patients (GT2, n=7; GT3, n=6; and GT6, n=8) received GLE/PIB for 11.2±1.8 weeks. All except one were treatment-naïve. GLE/PIB was initiated in 16 patients while on dialysis (seven on peritoneal dialysis [PD] and nine on hemodialysis) and in five patients before dialysis. One patient died of PD-related peritonitis during treatment and two were lost to follow up. The SVR12 rate in the remaining 18 patients was 100%. All patients achieved undetectable levels at 4-, 12-, 24- and 48-week after treatment. Patients with deranged alanine aminotransferase showed normalization after 4 weeks and the response was sustained for 48 weeks. No significant adverse event was observed. @*Conclusions@#GLE/PIB treatment was associated with high efficacy and tolerability in HCV-infected patients with severe renal impairment.
ABSTRACT
Background: We used a MapCHECK software-based dimensional dose distribution comparison method capable of evaluating point-to-point geometrical dose differences in volume to determine whether doses obtained from an enhanced computed tomography [CT]-based treatment plan, which better defines the target regions and organs at risk, differs from doses obtained from plain CT and then evaluated the feasibility of treatment planning via enhanced CT
Materials and Methods: Forty-three randomly selected patients underwent plain and subsequent enhanced CT with the same settings. Treatment plans developed for the two scans were identical in terms of planning parameters [e.g., isocentre, gantry angle, segments] and monitor units [MU] used for dose calculation. Horizontal and vertical dose distribution planes across the same isocentre were selected from two types of plan; a two-dimensional dose distribution analysis was used to determine the Distance-To-Agree [DTA] pass ratios of corresponding dose distribution planes
Results: Obtained doses at the head and neck [H and N] and pelvic sites did not differ greatly between enhanced and plain CT. However, enhanced CT significantly influenced doses to the lower thoracic oesophagus. A corrected pass ratio that was achieved by non-pass points in lower isodose areas excluded from the statistical analysis had better clinical outcome
Conclusion: Radiation plans with multi-fields and multi-angles can reduce the influence of enhanced CT on torso cases and may even negate its influence on H and N cases. Enhanced CT can be directly used for planning unless the target region contains the lower oesophagus and its surrounding blood vessel whose high density requires correction
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Background: this study assessed the optimal timing of computed tomography for detection of metastatic disease in locoregional lymph nodes in patients with rectal cancer who have undergone chemoradiotherapy
Materials and Methods: this observational retrospective study was performed in a single institution. All patients with locally advanced rectal cancer treated with chemoradiotherapy, followed by a total mesorectum excision from January 1, 2003 to December 31, 2012, were included. Lymph node metastases evident on preoperative computed tomography were compared with postoperative pathologic lymph node status
Results: the study population consisted of 108 patients: Group A [nodal negative on preoperative computed tomography, n = 52] and Group B [nodal positive on preoperative computed tomography, n = 56]. Analysis of the computed tomography scans in Group A revealed a high ability [98.07%] to predict negative lymph nodes, compared to 58.92% for predicting positive lymph nodes in Group B
Conclusion: the results of this study suggest that the optimal timing of computed tomography for assessing lymph nodes after neoadjuvant chemoradiotherapy for rectal cancer is after 6 weeks; this timing might be key for prediction of complete clinical responses
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Chinese materia medica (CMM), including Chinese herbal, animal, and mineral medicine, has been widely researched in the past century for their biological and pharmacological activities. However, their mechanism and clinical efficacy studies did not always give expected results. For example, the most commonly used Chinese herb for menstrual disorders, Radix Angelicae sinensis, showed neither estrogenic nor progesteronic activity in laboratory and clinical studies. Its efficacy should not be denied simply based on such results, because it is mostly used together with other herbs in formulae. Moreover, its regulation on menstruation may take effect through other mechanisms, such as regulation of blood circulation. The key difference of Chinese medicine (CM) from conventional medicine is its unique holistic view on human body and diseases. CMM is mostly applied in clinic in the form of formulae. Study on individual CMM, simply using methods for development of conventional drugs, is unable to thoroughly reveal the power of CMM formulae. The reason may partly result from improper design due to the lack understanding about application principle of CMMs in CM, and/or to current lack of knowledge about the causes of some symptoms and diseases. This paper will introduce the importance of qi and blood in CM etiology and pathology, Zheng differentiation, formulation of CMMs, and explain why one formula can treat different diseases and one disease can be treated with different formulae. Examples in the paper will demonstrate that proper studies on Zheng and its corresponding clinically proven formulae could help scientists find new direction to explain and treat symptoms and diseases that so far modern medicine has been unable to, provided that the designer properly understands CM theories, etiology and pathology of CM, as well as modern medicine. Strategy suggestions about research methods for CMM and its formulae will be given at the end.
Subject(s)
Animals , Humans , Disease , Materia Medica , Medicine, Chinese TraditionalABSTRACT
The objective of the present investigation was to determine the seroprevalence of Coxiella burnetii infection in free-range yaks in China. A total of 552 serum samples were collected from yaks in Gansu province, northwest China between April 2013 and January 2014, and antibodies against C. burnetii were evaluated using enzyme-linked immunosorbent assay [ELISA]. Overall, 13.59% [75/552, 95% CI: 10.73-16.45] of the examined animals were positive for C. burnetii antibodies. There was no significant difference in C. burnetii seroprevalence between female yaks [13.78%, 95% CI: 10.36-17.19] and male yaks [13.13%, 95% CI: 7.89-18.36] [P>0.05]. Coxiella burnetii seroprevalence in yaks in different age groups ranged from 10.88% to 15.26%, but the difference was not statistically significant [P>0.05]. Coxiella burnetii seroprevalence in yaks sampled in different seasons ranged from 12.06% [autumn] to 18.33% [summer], but the difference was not statistically significant [P>0.05]. This is the first report of C. burnetii seroprevalence in free-range yaks in China, indicating the need for measures to be taken to control C. burnetii infection in free-range yaks in China