ABSTRACT
Seventy-seven consecutive HBeAg-positive chronic hepatitis patients were studied from 1971 to 1983 to establish the seroconversion rate in the e system. Patients with less than a year of follow-up were not included in the study. Fifty-six patients with chronic active hepatitis (CAH) received immunosuppressive treatment (corticosteroids combined with azathioprine). The remaining twenty-one patients received no treatment, nine of them with chronic persistent hepatitis (CPH) and 12 with CAH. A retrospective study was performed with stored sera samples: HBeAg and anti-HBe were determined by RIA, and results were correlated with alanine aminotransferase (ALAT) levels in the same samples. The linearized seroconversion rate from HBeAg to anti-HBe was expressed as percent per patient-year. It was 9.6% in CPH patients and 8.8% in CAH patients without treatment. In CAH patients under immunosuppressive drugs it was as low as 1.1% and increased to 28.7% when treatment was withdrawn. ALAT levels were significantly lower in total seroconverted patients when compared with nonseroconverted (NS) patients, but no difference was found between partial seroconverted (PS) and NS patients. The results suggest that although immunosuppressive drug withdrawal may enhance seroconversion rate in type B CAH, delayed seroconversion and reported side effects during treatment stand against protracted usage of these drugs.
Subject(s)
Hepatitis B Antibodies/analysis , Hepatitis B e Antigens/immunology , Hepatitis B/drug therapy , Hepatitis, Chronic/drug therapy , Immunosuppressive Agents/therapeutic use , Azathioprine/therapeutic use , Clinical Trials as Topic , Hepatitis B/immunology , Hepatitis B e Antigens/analysis , Hepatitis, Chronic/immunology , Humans , Prednisolone/therapeutic use , Time FactorsABSTRACT
In a retrospective study, we review here the clinical presentation of patients with the biphasic form of hepatitis A, a variant of viral hepatitis characterised by an increase in ALAT levels after an initial recovery in clinical condition and laboratory tests. Twenty-one patients were diagnosed as having a biphasic form; they represent about 10% of a selected population of hepatitis A cases. Six patients were asymptomatic. Eleven patients were jaundiced, nine of them showing a "cholestatic" pattern. The second phase of the disease had a more protracted course and displayed higher ALAT levels than the first phase. The total duration of the disease was 120 +/- 28 (mean +/- SD) days, and its course was benign.
Subject(s)
Hepatitis A/physiopathology , Adolescent , Adult , Alanine Transaminase/blood , Argentina , Bilirubin/blood , Child , Female , Humans , Male , Retrospective Studies , gamma-Globulins/bloodABSTRACT
We performed endoscopic sclerotherapy of esophageal varices (ESEV) as an outpatient procedure in a private setting in patients with portal hypertension and a least one previous episode of variceal hemorrhage. Twenty-six stable cirrhotic patients (child's class A, 11 patients; class B, 10 patients; class C, 5 patients) underwent 103 outpatient sessions of ESEV. There were two episodes of post-sclerotherapy bleeding (1.9% of total sessions) requiring hospitalisation. Fever (2.9%), dysphagia (6.8%), chest pains (14.6%) and one episode (1%) of respiratory depression due to sedation were also noted, but were managed with simple measures. One of 26 patients developed esophageal stricture. These preliminary results suggest that ESEV can be performed as a relatively safe ambulatory procedure.
Subject(s)
Ambulatory Care , Esophageal and Gastric Varices/therapy , Sclerosing Solutions/therapeutic use , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
We performed endoscopic sclerotherapy of esophageal varices (ESEV) as an outpatient procedure in a private setting in patients with portal hypertension and a least one previous episode of variceal hemorrhage. Twenty-six stable cirrhotic patients (childs class A, 11 patients; class B, 10 patients; class C, 5 patients) underwent 103 outpatient sessions of ESEV. There were two episodes of post-sclerotherapy bleeding (1.9
of total sessions) requiring hospitalisation. Fever (2.9
), dysphagia (6.8
), chest pains (14.6
) and one episode (1
) of respiratory depression due to sedation were also noted, but were managed with simple measures. One of 26 patients developed esophageal stricture. These preliminary results suggest that ESEV can be performed as a relatively safe ambulatory procedure.
ABSTRACT
We present six cases to illustrate the protean clinical and sigmoidoscopic features of the amebic colitis. Three cases presented with a clinical picture resembling ulcerative colitis. In one fatal case, diverticular disease, ischemic colitis and toxic megacolon of uncertain origin were considered before arriving at the proper diagnosis. Two cases were believed to have pseudomembranous colitis on sigmoidoscopic examination. Given the multiple expressions of this entity, amebic colitis should be considered a diagnostic possibility in any protracted inflammatory condition of the colon. From the cases summarized here, it is evident that the clinical and endoscopic features of amebic colitis are variable and may often mimic other illnesses.
Subject(s)
Dysentery, Amebic/diagnosis , Adult , Aged , Colitis, Ulcerative/diagnosis , Colon/diagnostic imaging , Diagnosis, Differential , Humans , Male , Middle Aged , Radiography , SigmoidoscopyABSTRACT
Presentamos seis casos que pretenden senalar las dificuldades diagnosticas planteadas por la colitis amebiana. En nuestros pacientes, un variado espectro clinico y sigmoidoscopico contribuyo a ocasionar considerable confusion diagnostica. Tres casos se presentaron con caracteristicas clinicas compatibles con colitis ulcerosa.En otro caso, colonopatia diverticular, colitis isquemica y megacolon toxico de origen desconocido fueron considerados antes de arribar, post mortem, al diagnostico correcto. En dos casos, las caracteristicas sigmoidoscopicas sugirieron colitis seudomembranosa. Cuatro casos provenian de una institucion siquiatrica para enfermos cronicos. Las multiples expresiones que puede asumir esta entidad sugieren que la posibilidad de colitis amebiana debe plantearse ante todo cuadro de colitis prolongada
Subject(s)
Adult , Middle Aged , Humans , Male , Dysentery, Amebic , Sigmoidoscopy , Colitis, Ulcerative , Diagnosis, DifferentialABSTRACT
We present six cases to illustrate the protean clinical and sigmoidoscopic features of the amebic colitis. Three cases presented with a clinical picture resembling ulcerative colitis. In one fatal case, diverticular disease, ischemic colitis and toxic megacolon of uncertain origin were considered before arriving at the proper diagnosis. Two cases were believed to have pseudomembranous colitis on sigmoidoscopic examination. Given the multiple expressions of this entity, amebic colitis should be considered a diagnostic possibility in any protracted inflammatory condition of the colon. From the cases summarized here, it is evident that the clinical and endoscopic features of amebic colitis are variable and may often mimic other illnesses.
ABSTRACT
Presentamos seis casos que pretenden senalar las dificuldades diagnosticas planteadas por la colitis amebiana. En nuestros pacientes, un variado espectro clinico y sigmoidoscopico contribuyo a ocasionar considerable confusion diagnostica. Tres casos se presentaron con caracteristicas clinicas compatibles con colitis ulcerosa.En otro caso, colonopatia diverticular, colitis isquemica y megacolon toxico de origen desconocido fueron considerados antes de arribar, post mortem, al diagnostico correcto. En dos casos, las caracteristicas sigmoidoscopicas sugirieron colitis seudomembranosa. Cuatro casos provenian de una institucion siquiatrica para enfermos cronicos. Las multiples expresiones que puede asumir esta entidad sugieren que la posibilidad de colitis amebiana debe plantearse ante todo cuadro de colitis prolongada
