Guia per a la prevenció i el control de l'hepatitis C

Hepatitis C; Prevenció; TractamentHepatitis C; Prevención; TratamientoHepatitis C; Prevention; TreatmentL'objectiu d'aquesta guia és posar a l'abast dels professionals mèdics de Catalunya un resum dels coneixements disponibles sobre l'agent causal, l'epidemiologia, la part clínica i especialment sobre el diagnòstic, el tractament i la prevenció de l'hepatitis C.El objetivo de esta guía es poner al alcance de los profesionales médicos de Cataluña un resumen de los conocimientos disponibles sobre el agente causal, la epidemiología, la parte clínica y especialmente sobre el diagnóstico, el tratamiento y la prevención de la hepatitis C.The purpose of this guide is to make available to medical professionals in Catalonia a summary of the knowledge available on the causative agent, the epidemiology, the clinical part and especially on the diagnosis, treatment and prevention of the disease hepatitis C

Hepatitis G virus infection in fulminant hepatic failure

Background¿RNA sequences of the recently identified hepatitis GB virus C (HGBV-C), also named hepatitis G virus (HGV), have been detected in patients with idiopathic fulminant hepatic failure (FHF) but the role of this agent in the disease remains controversial. Aims¿To investigate the presence and implications of HGV infection in a large series of Spanish patients with FHF. Patients¿Sixty eight patients with FHF, including 19 with idiopathic disease, were studied. In 28 cases, studies were performed before and after liver transplantation. For comparison 200 volunteer blood donors and 22 patients transplanted for chronic liver disease were also studied. Methods¿HGV RNA was measured in serum by reverse transcriptase polymerase chain reaction of the 5' non-coding region. Results¿Evidence of HGV infection was found in 3% (6/200) of blood donors and in 19% (13/68) of patients with FHF. HGV infection was more frequent in patients with hepatitis B (24%, 6/25) or hepatitis D (42%, 5/12), than in patients with idiopathic disease (11%, 2/19). Half of the patients with HGV infection used illicit intravenous drugs. Specific clinical features associated with HGV infection were not identified. A very high rate of infection with HGV was observed in patients who underwent liver transplantation, either for FHF (60%, 15/24) or chronic liver disease (45%, 9/20). Conclusions¿In our geographical area, HGV infection is relatively frequent in FHF, but it does not seem to play a major role in idiopathic cases

Revisión bibliográfica de ortodoncia de 1999

Se recogen los artículos publicados en las revistas de ortodoncia del año 1999 de habla inglesa, francesa y española. Se da especial énfasis al control de la erupción y diagóstico precoz de maloclusiones. Se observa que el futuro de la ortodoncia está cada vez más ligado al resto de las especialidade de odontología, siendo ya una realidad la odontología integral. Un tema destacado en los tratamiento multidisciplinarios es la utilización de implantes palatinos como fuente de anclaje. La distracción osteogénica ofrece una nueva vía de tratamiento para los pacientes que necesitan un alargamiento mandibular

Low dose alpha interferon therapy can be effective in chronic active hepatitis C. Results of a multicentre, randomised trial

BACKGROUND--There is some controversy concerning the efficacy of low dose alpha interferon therapy in chronic hepatitis C. AIMS--To evaluate the effectiveness of treatment with low doses of alpha interferon in chronic hepatitis C. PATIENTS--One hundred and forty one patients with anti-HCV positive chronic active hepatitis C from six hospitals were enrolled in the study. METHODS--Patients were randomised to treatment with 5 MU (group A) or 1.5 MU (group B) injections. The dose was reduced in responders from group A or increased in non-responders from group B to maintain treatment with the minimal effective dose. Patients were treated for 48 weeks and followed up for 24 additional weeks with no treatment. Normalisation of alanine aminotransferase (ALT) was used to evaluate response. RESULTS--A sustained response was seen in eight patients from group A (12%) and in 15 (21%) from group B. This difference was not statistically significant. Increasing the dose of interferon led to sustained response in only five of 58 patients (9%) from group B who did not respond to 1.5 MU injections. In contrast, 15 of 21 patients (71%) in whom ALT remained normal with 1.5 MU injections developed a sustained response. By multivariate analysis sustained response seemed associated with young age and was more frequent in patients with genotype 3 HCV infection. Sustained response was preceded by a rapid normalisation of ALT and was inversely related to the amount of alpha interferon necessary to maintain ALT at low values during treatment. CONCLUSIONS--Some patients with chronic hepatitis C are very sensitive to alpha interferon and can be successfully treated with low doses. Treatment with higher doses may be effective in a minority of patients who do not respond to low doses

Low dose alpha interferon therapy can be effective in chronic active hepatitis C. Results of a multicentre, randomised trial

BACKGROUND--There is some controversy concerning the efficacy of low dose alpha interferon therapy in chronic hepatitis C. AIMS--To evaluate the effectiveness of treatment with low doses of alpha interferon in chronic hepatitis C. PATIENTS--One hundred and forty one patients with anti-HCV positive chronic active hepatitis C from six hospitals were enrolled in the study. METHODS--Patients were randomised to treatment with 5 MU (group A) or 1.5 MU (group B) injections. The dose was reduced in responders from group A or increased in non-responders from group B to maintain treatment with the minimal effective dose. Patients were treated for 48 weeks and followed up for 24 additional weeks with no treatment. Normalisation of alanine aminotransferase (ALT) was used to evaluate response. RESULTS--A sustained response was seen in eight patients from group A (12%) and in 15 (21%) from group B. This difference was not statistically significant. Increasing the dose of interferon led to sustained response in only five of 58 patients (9%) from group B who did not respond to 1.5 MU injections. In contrast, 15 of 21 patients (71%) in whom ALT remained normal with 1.5 MU injections developed a sustained response. By multivariate analysis sustained response seemed associated with young age and was more frequent in patients with genotype 3 HCV infection. Sustained response was preceded by a rapid normalisation of ALT and was inversely related to the amount of alpha interferon necessary to maintain ALT at low values during treatment. CONCLUSIONS--Some patients with chronic hepatitis C are very sensitive to alpha interferon and can be successfully treated with low doses. Treatment with higher doses may be effective in a minority of patients who do not respond to low doses

Hepatitis G virus infection in fulminant hepatic failure

Background¿RNA sequences of the recently identified hepatitis GB virus C (HGBV-C), also named hepatitis G virus (HGV), have been detected in patients with idiopathic fulminant hepatic failure (FHF) but the role of this agent in the disease remains controversial. Aims¿To investigate the presence and implications of HGV infection in a large series of Spanish patients with FHF. Patients¿Sixty eight patients with FHF, including 19 with idiopathic disease, were studied. In 28 cases, studies were performed before and after liver transplantation. For comparison 200 volunteer blood donors and 22 patients transplanted for chronic liver disease were also studied. Methods¿HGV RNA was measured in serum by reverse transcriptase polymerase chain reaction of the 5' non-coding region. Results¿Evidence of HGV infection was found in 3% (6/200) of blood donors and in 19% (13/68) of patients with FHF. HGV infection was more frequent in patients with hepatitis B (24%, 6/25) or hepatitis D (42%, 5/12), than in patients with idiopathic disease (11%, 2/19). Half of the patients with HGV infection used illicit intravenous drugs. Specific clinical features associated with HGV infection were not identified. A very high rate of infection with HGV was observed in patients who underwent liver transplantation, either for FHF (60%, 15/24) or chronic liver disease (45%, 9/20). Conclusions¿In our geographical area, HGV infection is relatively frequent in FHF, but it does not seem to play a major role in idiopathic cases

Hepatitis G virus infection in fulminant hepatic failure

Background¿RNA sequences of the recently identified hepatitis GB virus C (HGBV-C), also named hepatitis G virus (HGV), have been detected in patients with idiopathic fulminant hepatic failure (FHF) but the role of this agent in the disease remains controversial. Aims¿To investigate the presence and implications of HGV infection in a large series of Spanish patients with FHF. Patients¿Sixty eight patients with FHF, including 19 with idiopathic disease, were studied. In 28 cases, studies were performed before and after liver transplantation. For comparison 200 volunteer blood donors and 22 patients transplanted for chronic liver disease were also studied. Methods¿HGV RNA was measured in serum by reverse transcriptase polymerase chain reaction of the 5' non-coding region. Results¿Evidence of HGV infection was found in 3% (6/200) of blood donors and in 19% (13/68) of patients with FHF. HGV infection was more frequent in patients with hepatitis B (24%, 6/25) or hepatitis D (42%, 5/12), than in patients with idiopathic disease (11%, 2/19). Half of the patients with HGV infection used illicit intravenous drugs. Specific clinical features associated with HGV infection were not identified. A very high rate of infection with HGV was observed in patients who underwent liver transplantation, either for FHF (60%, 15/24) or chronic liver disease (45%, 9/20). Conclusions¿In our geographical area, HGV infection is relatively frequent in FHF, but it does not seem to play a major role in idiopathic cases