RESUMO
Aim: To evaluate the association between biochemical, virologic and histologic features in patients with HBeAg-negative chronic hepatitis B [CHB]
Background: Hepatitis-B e-antigen [HBeAg]-negative is common in Iran, is progressive with poor prognosis. Therefore, it seems necessary to perform a comprehensive evaluation of different spectrum of laboratory measurements accompanying histological findings
Methods: HBeAg- negative CHB patients referring to two university hospitals during two years were enrolled. Alcohol consumption, liver mass, fatty liver and positive results of Anti HDV, Anti HCV or Anti HIV were excluded. The relationship between viral loads, liver enzymes [old and new cutoffs] and histopathological features was analyzed using descriptive and analytic statistical methods
Results: A total of 150 HBeAg-negative CHB [males=110, mean age=38.44 +/- 11.34 years] were assessed. ALT had a significant relation with the logarithm of serum HBV-DNA [P<0.0001], grade and stage on liver biopsy [P<0.001, P=0.034, respectively]. Serum viral load, AST and ALT were independent predictors of histological grade, age was the only independent predictor of the stage of liver fibrosis. There was a significant relationship between serum ALT and stage of liver fibrosis [P<0.0001] when new cutoff values for ALT were considered. We found that age had a significant relation with histological grade but it showed a reverse relation with ALT levels [P=0.009]
Conclusion: In HBeAg-negative CHB, AST had a better prediction for liver necrosis and inflammation. Age could be an independent predictor for liver fibrosis. New cutoff values for ALT had superiority over conventional values to identify higher risk of liver fibrosis
RESUMO
Background: atherosclerosis is involved in inflammatory diseases, and inflammation can be a valuable predictor of cardiovascular disease. On the other hand, an increase in intima-media thickness [IMT] is usually considered as a primary marker of atherosclerotic lesions.Hence, measurement of IMT may be useful for early detection of atherosclerosis in patients with inflammatory bowel disease [IBD]. The aim of this study was to systematically review the literature in which the IMT had been evaluated as diagnostic marker for the detection of atherosclerosis in patients with IBD
Materials and Methods: a systematic literature search was performed in PubMed, Scopus, and Google scholar using the following search method [[inflammatory bowel disease OR IBD OR Crohn's disease OR ulcerative colitis]] AND [intima OR intima media thickness OR intimal medial thickness OR IMT OR carotid intima-media thickness OR CIMT] to evaluate the association between IBD and IMT. After collecting the eligible documents, the desired data were extracted and analyzed
Results: of total 278 collected documents, only 14 relevant articles with total 1333 participants including 720 patients with IBD and 613 healthy controls were included for data assessment. The results of the articles did not support significant association between IMT and IBD. However, in some studies it was shown that IMT was elevated in patients with IBD
Conclusion: the results of this survey showed that there was no significant difference in IMT between the patients with IBD and healthy control groups; therefore, IMT cannot be considered as a predictor of atherosclerosis and future cardiovascular events in patients with IBD
RESUMO
Splenic artery aneurysm [SAA] is a rare and potentially life-threatening clinical entity that carries a risk of rupture and peritoneal hemorrhage. When ruptured, it typically manifests as abdominal pain with hemodynamic instability. This is a report about a 29-year-old male admitted for evaluation of recent-onset ascites following the spontaneous resolution of a transient episode of severe epigastric and left upper quadrant pain with syncope the preceding day. Paracentesis revealed bloody fluid. Abdominal computed tomographic angiography [CTA] and magnetic resonance venography [MRV] showed a three centimeter SAA. During admission, prompt exploratory laparotomy was performed that revealed excessive intraperitoneal hemorrhage due to a ruptured SAA. The pathology report confirmed that the SAA had developed secondary to atherosclerosis. Careful history taking together with appropriate imaging tests and emergent surgical intervention led to a timely diagnosis and the patient's survival.