ABSTRACT
Data from 219 hemodyalized patients receiving attention in our Hospital and other private centers in our city are shown. Mean age was 46.9 (range: 14-85), and 132 were male; mean time under dialysis was 20 months, and subjects received an average of 5 transfusions per patient year. Serological reactivity to HBs Ag, Anti HBs and IgG anti HBc by ELISA were investigated in all of them, and anti HCV by second generation enzimo-immunoassay (EIA II) in 73 HBe Ag/anti HBe system were determined in HBs Ag positive patients and those reactive to anti HCV (EIA II) were confirmed by LIA (immunoblotting of synthetic peptides LIA-TEK Organos Teknica). Recombinant anti HBV vaccine 40 mcg at 0-1 and six month were received by 81 cases without HBV markers in their sera and a protective response was considered when anti HBs titration of 10 mU/ml or more were obtained two months later. Prevalence for anti HBc and anti HBs were 38.8% respectively and that for HBs Ag was 21% with 78% of them reactive for HBs Ag. True reactivity for anti HCV (confirmed by LIA) was present in 35.6%, but it was 9.7% in our Hospital and 54.8% in private units (p < 0.0002). Anti HBs titration was done in 69/81 patients who received anti HBV vaccine, and a protective response in 49% were obtained; the other 12 patients underwent acute hepatitis B during the vaccination period.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Hepatitis B Vaccines , Hepatitis B/prevention & control , Hepatitis C/prevention & control , Renal Dialysis/adverse effects , Adolescent , Adult , Aged , Aged, 80 and over , Female , Hepatitis B/epidemiology , Hepatitis B/transmission , Hepatitis B Antibodies/blood , Hepatitis B Antigens/blood , Hepatitis C/epidemiology , Hepatitis C/transmission , Humans , Male , Middle Aged , Prevalence , Transfusion ReactionABSTRACT
La infección por virus de hepatitis B (HBC) y C (HCV) en hemodializados es elevada, y genera problemas epidemiológicos, aumento de la morbilidad y menores expectativas de éxito para el transplante renal; de hecho, la vacunación anti HBV es una indicación racional para este grupo de pacientes, aunque su respuesta es variable. En esta comunciación se analiza el impacto de esta problemática en nuestro medio. Se presentan 219 pacientes (132 del sexo masculino) hemodializados en nuestro hospital y unidades privadas de nuestra ciudad, con edad media de 46,9 años (R=14-85); la media de permanencia en diálisis fue de 20 meses, y la de transfusiones de 5 por ciento/años. En todos los casos se investigó por enzimo-inmunoanálisis (EIA) la presencia en suero de HBs Ag, anti HBs y anti HBc, y en 73 pacientes anti HCV por EIA II; en los casos HBs Ag positivos confirmados se determinó HBe Ag y HBe, y los anti HCV reactivos fueron confirmados por immunobloting de Péptidos Sintéticos LIA-TEK Organon Teknika. Recibieron 40 mcg de vacuna anti HBC recombinante intra deltoidea a 0,1 y 6 meses, 81 pacientes sin marcadores HBC en suero; la respuesta anti HBstitulada dos meses depués de la última dosis fue considerada protectora con títulos superiores a 10µ/ml. La prevalencia de anti HBc y anti HBs fue de 38 por ciento y la de HBs Ag de 21 por ciento; 78 por ciento de los evaluados resultaron reactivos a HBe Ag. La reactividad anti HCV se presentó en 35.6 por ciento, confirmada por LIA (9,7 por ciento en nuestro hospital y 54,8 por unidades privadas con p=0.007). Se halló niveles superiores a 10 mu/ml de anti HBs en 49 por ciento vacunados en los que se tituló el mismo. Los 12 casos restantes (14,8 por ciento) experimentaron hepatitis aguda B durante el período de vacunación...
Subject(s)
Adolescent , Adult , Middle Aged , Humans , Male , Female , Renal Dialysis/adverse effects , Hepatitis B Vaccines/therapeutic use , Hepatitis B/prevention & control , Hepatitis C/prevention & control , Aged, 80 and over , Hepatitis B Antigens/blood , Epidemiologic Factors , Hepatitis B Antibodies/blood , Hepatitis B/epidemiology , Hepatitis B/transmission , Hepatitis C/epidemiology , Hepatitis C/transmission , Biomarkers/blood , Prevalence , Time Factors , Blood Transfusion/adverse effectsABSTRACT
Data from 219 hemodyalized patients receiving attention in our Hospital and other private centers in our city are shown. Mean age was 46.9 (range: 14-85), and 132 were male; mean time under dialysis was 20 months, and subjects received an average of 5 transfusions per patient year. Serological reactivity to HBs Ag, Anti HBs and IgG anti HBc by ELISA were investigated in all of them, and anti HCV by second generation enzimo-immunoassay (EIA II) in 73 HBe Ag/anti HBe system were determined in HBs Ag positive patients and those reactive to anti HCV (EIA II) were confirmed by LIA (immunoblotting of synthetic peptides LIA-TEK Organos Teknica). Recombinant anti HBV vaccine 40 mcg at 0-1 and six month were received by 81 cases without HBV markers in their sera and a protective response was considered when anti HBs titration of 10 mU/ml or more were obtained two months later. Prevalence for anti HBc and anti HBs were 38.8
respectively and that for HBs Ag was 21
of them reactive for HBs Ag. True reactivity for anti HCV (confirmed by LIA) was present in 35.6
in our Hospital and 54.8
in private units (p < 0.0002). Anti HBs titration was done in 69/81 patients who received anti HBV vaccine, and a protective response in 49
were obtained; the other 12 patients underwent acute hepatitis B during the vaccination period.(ABSTRACT TRUNCATED AT 250 WORDS)
ABSTRACT
Data from 219 hemodyalized patients receiving attention in our Hospital and other private centers in our city are shown. Mean age was 46.9 (range: 14-85), and 132 were male; mean time under dialysis was 20 months, and subjects received an average of 5 transfusions per patient year. Serological reactivity to HBs Ag, Anti HBs and IgG anti HBc by ELISA were investigated in all of them, and anti HCV by second generation enzimo-immunoassay (EIA II) in 73 HBe Ag/anti HBe system were determined in HBs Ag positive patients and those reactive to anti HCV (EIA II) were confirmed by LIA (immunoblotting of synthetic peptides LIA-TEK Organos Teknica). Recombinant anti HBV vaccine 40 mcg at 0-1 and six month were received by 81 cases without HBV markers in their sera and a protective response was considered when anti HBs titration of 10 mU/ml or more were obtained two months later. Prevalence for anti HBc and anti HBs were 38.8
respectively and that for HBs Ag was 21
with 78
of them reactive for HBs Ag. True reactivity for anti HCV (confirmed by LIA) was present in 35.6
, but it was 9.7
in our Hospital and 54.8
in private units (p < 0.0002). Anti HBs titration was done in 69/81 patients who received anti HBV vaccine, and a protective response in 49
were obtained; the other 12 patients underwent acute hepatitis B during the vaccination period.(ABSTRACT TRUNCATED AT 250 WORDS)
ABSTRACT
La infección por virus de hepatitis B (HBC) y C (HCV) en hemodializados es elevada, y genera problemas epidemiológicos, aumento de la morbilidad y menores expectativas de éxito para el transplante renal; de hecho, la vacunación anti HBV es una indicación racional para este grupo de pacientes, aunque su respuesta es variable. En esta comunciación se analiza el impacto de esta problemática en nuestro medio. Se presentan 219 pacientes (132 del sexo masculino) hemodializados en nuestro hospital y unidades privadas de nuestra ciudad, con edad media de 46,9 años (R=14-85); la media de permanencia en diálisis fue de 20 meses, y la de transfusiones de 5 por ciento/años. En todos los casos se investigó por enzimo-inmunoanálisis (EIA) la presencia en suero de HBs Ag, anti HBs y anti HBc, y en 73 pacientes anti HCV por EIA II; en los casos HBs Ag positivos confirmados se determinó HBe Ag y HBe, y los anti HCV reactivos fueron confirmados por immunobloting de Péptidos Sintéticos LIA-TEK Organon Teknika. Recibieron 40 mcg de vacuna anti HBC recombinante intra deltoidea a 0,1 y 6 meses, 81 pacientes sin marcadores HBC en suero; la respuesta anti HBstitulada dos meses depués de la última dosis fue considerada protectora con títulos superiores a 10A/ml. La prevalencia de anti HBc y anti HBs fue de 38 por ciento y la de HBs Ag de 21 por ciento; 78 por ciento de los evaluados resultaron reactivos a HBe Ag. La reactividad anti HCV se presentó en 35.6 por ciento, confirmada por LIA (9,7 por ciento en nuestro hospital y 54,8 por unidades privadas con p=0.007). Se halló niveles superiores a 10 mu/ml de anti HBs en 49 por ciento vacunados en los que se tituló el mismo. Los 12 casos restantes (14,8 por ciento) experimentaron hepatitis aguda B durante el período de vacunación...(AU)
Subject(s)
Adolescent , Adult , Middle Aged , Aged , Humans , Male , Female , Hepatitis B/prevention & control , Hepatitis C/prevention & control , Hepatitis B Vaccines/therapeutic use , Renal Dialysis/adverse effects , Hepatitis B/epidemiology , Hepatitis B/transmission , Hepatitis C/epidemiology , Hepatitis C/transmission , Blood Transfusion/adverse effects , Hepatitis B Antibodies/blood , Hepatitis B Antigens/blood , Biomarkers/blood , Epidemiologic Factors , Time Factors , Prevalence , Aged, 80 and overABSTRACT
1- La hepatitis aguda NANB representa en nuestro medio 31.2% de las hepatitis virales agudas; si bien estos porcentajes no son directamente transpolables a la población general, el especialista gastroenterólogo o hepatólogo, debe esperar que casi 1 de cada 3 pacientes de su consulta presente una hepatopatía con multitud de aspectos aun desconocidos, etiológicos, evolutivos, vinculación con el cáncer hepático, etc. 2- El predominio de la hepatitis aguda a HAV es neto en la infancia (0-9 años: 72.2%) y excepcional después de los 40 años, mientras que el HBV es etiología predominante por encima de los 50; los NANBV se presentan en todas las edades, con 77,6% de los casos entre 20-49. 3- Al no incluirse casos sub-clínicos post-transfusionales, generalmente provenientes de estudios de seguimiento, el porcentaje de forma agudas NANB presuntamente esporádicas es elevado (71.5%), aunque no debiera descartarse la posibilidad de acción en nuestro medio de formas de transmisión no-parenteral. 4- 25% de nuestra serie de hapatitis crónicas activas, es atribuido por exclusión a la etiología NANB, englobando posiblemente a otras causas aun no conocidas. 5- Estos aspectos epidemiológicos, así como otros clínico-evolutivos, variarán seguramente en los próximos años gracias a los esfuerzos realizados por investigadores de todo el mundo en la identificación etiológica y la puesta a punto de marcadores serológicos específicos de los hoy denominados virus de la hepatiti No A- No B
Subject(s)
Infant , Child, Preschool , Child , Adult , Humans , Male , Female , Hepatitis C/epidemiology , Hepatitis, Chronic/epidemiology , Argentina , Hepatitis A/epidemiology , Hepatitis B/epidemiology , Hepatitis C/etiologyABSTRACT
1- La hepatitis aguda NANB representa en nuestro medio 31.2% de las hepatitis virales agudas; si bien estos porcentajes no son directamente transpolables a la población general, el especialista gastroenterólogo o hepatólogo, debe esperar que casi 1 de cada 3 pacientes de su consulta presente una hepatopatía con multitud de aspectos aun desconocidos, etiológicos, evolutivos, vinculación con el cáncer hepático, etc. 2- El predominio de la hepatitis aguda a HAV es neto en la infancia (0-9 años: 72.2%) y excepcional después de los 40 años, mientras que el HBV es etiología predominante por encima de los 50; los NANBV se presentan en todas las edades, con 77,6% de los casos entre 20-49. 3- Al no incluirse casos sub-clínicos post-transfusionales, generalmente provenientes de estudios de seguimiento, el porcentaje de forma agudas NANB presuntamente esporádicas es elevado (71.5%), aunque no debiera descartarse la posibilidad de acción en nuestro medio de formas de transmisión no-parenteral. 4- 25% de nuestra serie de hapatitis crónicas activas, es atribuido por exclusión a la etiología NANB, englobando posiblemente a otras causas aun no conocidas. 5- Estos aspectos epidemiológicos, así como otros clínico-evolutivos, variarán seguramente en los próximos años gracias a los esfuerzos realizados por investigadores de todo el mundo en la identificación etiológica y la puesta a punto de marcadores serológicos específicos de los hoy denominados virus de la hepatiti No A- No B (AU)
Subject(s)
Infant , Child, Preschool , Child , Adult , Humans , Male , Female , Hepatitis, Chronic/epidemiology , Hepatitis C/epidemiology , Hepatitis A/epidemiology , Hepatitis B/epidemiology , Hepatitis C/etiology , ArgentinaABSTRACT
157 acute viral hepatitis and 60 chronic active ones have been analyzed focusing on NANB etiology. HAV was implicated in 36.3% of the hole acute viral hepatitis sample, HBV in 29.3%, and HNANBV was presumed as etiology in 31.2%, 5 patients (3.2%) had acute infection by HAV, on previous one by HBV, except for Epstein-Barr virus, no other test for viruses were determined (CMV, HSV, etc.). Male/female ratio was 1.4:1, 1.9:1, and 1.4:1 for HAV, HBV and HNANBV acute hepatitis respectively; HAV was the main etiology in the 0-9 age group (72.2%) although it only represents 11.5% of the sample; small occurrence of HAV hepatitis were found in patients over 40 (8.8%); HBV was clearly prevalent in patients over 50 (65.2%); the highest concentration of NANB etiology was found between 20-39 years old, but it was represented in all age-groups. Out of 49 NANB acute hepatitis, 12.2% had related transfusional antecedents, 12.2% belonged to health care worker group, and 4.1% had a close family NANB hepatitis contact; 71.5% had no reported antecedent. Viral source was presumably implicated in 75.0% of chronic active hepatitis, 25.0% attributable to HNANBV. Results seem not feasible to transfer to general population due to the facts that most patients were of specialized consult, and pediatric assistance is unusual to the authors practice.
Subject(s)
Hepatitis C/epidemiology , Hepatitis, Chronic/epidemiology , Hepatitis, Viral, Human/epidemiology , Argentina , Female , Hepatitis A/epidemiology , Hepatitis B/epidemiology , Hepatitis C/etiology , Humans , MaleABSTRACT
157 acute viral hepatitis and 60 chronic active ones have been analyzed focusing on NANB etiology. HAV was implicated in 36.3
of the hole acute viral hepatitis sample, HBV in 29.3
, and HNANBV was presumed as etiology in 31.2
, 5 patients (3.2
) had acute infection by HAV, on previous one by HBV, except for Epstein-Barr virus, no other test for viruses were determined (CMV, HSV, etc.). Male/female ratio was 1.4:1, 1.9:1, and 1.4:1 for HAV, HBV and HNANBV acute hepatitis respectively; HAV was the main etiology in the 0-9 age group (72.2
) although it only represents 11.5
of the sample; small occurrence of HAV hepatitis were found in patients over 40 (8.8
); HBV was clearly prevalent in patients over 50 (65.2
); the highest concentration of NANB etiology was found between 20-39 years old, but it was represented in all age-groups. Out of 49 NANB acute hepatitis, 12.2
had related transfusional antecedents, 12.2
belonged to health care worker group, and 4.1
had a close family NANB hepatitis contact; 71.5
had no reported antecedent. Viral source was presumably implicated in 75.0
of chronic active hepatitis, 25.0
attributable to HNANBV. Results seem not feasible to transfer to general population due to the facts that most patients were of specialized consult, and pediatric assistance is unusual to the authors practice.
ABSTRACT
Author's experience about 70 endoscopic polipectomy of high gastrointestinal tract, realized on 53 patients during 1978-1983 period was evaluated. Esophaguel polyps incidence was 0.06% among 7.900 endoscopic studies; gastric polyps was 0.8% and duodenal was 0.03%. Diagnosis was radiologically suspected in 58%. Gastric antrum was the predominant localization (45.7%) and macroscopic Yamada types IV (32.8%) and III (30.0%) were found more frequently. Most of patients presented solitary polips (86.7%). 63.2% of pieces were under 10 mm in size and 35.2% between 10 - 20 mm. High frecuency of adenomas (23.5%) and a low one of hyperplasiogenic (7.3%) was the prominent finding; only one case of early gastric cancer was founded (1.5%). Neither adenoms or hyperplasiogenic polyps were founded on gastric fundus, and no direct relation between size and histopatologic type was observed. Only one hemorragic complication (1.4%) was present. Polips incidence on 800 consecutive auptopsy protocols in adults was 0.12%.
Subject(s)
Duodenal Neoplasms/surgery , Esophageal Neoplasms/surgery , Intestinal Polyps/surgery , Polyps/surgery , Stomach Neoplasms/surgery , Adult , Aged , Duodenal Neoplasms/diagnostic imaging , Duodenal Neoplasms/pathology , Esophageal Neoplasms/diagnostic imaging , Esophageal Neoplasms/pathology , Female , Humans , Intestinal Polyps/diagnostic imaging , Intestinal Polyps/pathology , Male , Middle Aged , Polyps/diagnostic imaging , Polyps/pathology , Radiography , Stomach Neoplasms/diagnostic imaging , Stomach Neoplasms/pathologySubject(s)
Adult , Middle Aged , Humans , Male , Female , Esophageal Neoplasms , Intestinal Polyps , Polyps , Stomach NeoplasmsABSTRACT
Authors experience about 70 endoscopic polipectomy of high gastrointestinal tract, realized on 53 patients during 1978-1983 period was evaluated. Esophaguel polyps incidence was 0.06
among 7.900 endoscopic studies; gastric polyps was 0.8
and duodenal was 0.03
. Diagnosis was radiologically suspected in 58
. Gastric antrum was the predominant localization (45.7
) and macroscopic Yamada types IV (32.8
) and III (30.0
) were found more frequently. Most of patients presented solitary polips (86.7
). 63.2
of pieces were under 10 mm in size and 35.2
between 10 - 20 mm. High frecuency of adenomas (23.5
) and a low one of hyperplasiogenic (7.3
) was the prominent finding; only one case of early gastric cancer was founded (1.5
). Neither adenoms or hyperplasiogenic polyps were founded on gastric fundus, and no direct relation between size and histopatologic type was observed. Only one hemorragic complication (1.4
) was present. Polips incidence on 800 consecutive auptopsy protocols in adults was 0.12
.
