Osteopontin as a marker for response to pegylated interferon Alpha-2b treatment in Chronic HCV Saudi patients

Background: Many recent studies support the idea that osteopontin (OPN) can be used to predict the success of pegylated interferon (PEG IFN) alpha-2b/ribavirin therapy in chronic HCV patients.Objective: Our aim was to investigate the role of plasma OPN and its gene polymorphism at nt – 443 in response to PEG IFN in Saudi patients with chronic HCV.Methods: Blood was collected from 87 patients with chronic hepatitis C before treatment, then patients received PEG IFN α2b plus ribavirin combination therapy. Another 25 healthy subjects, matched for age and sex to patients, were enrolled as controls. Single nucleotide polymorphism (SNP) in OPN at nt – 443 and its blood level were analyzed.Results: The frequency of patients who reached sustained virological response (SVR) was increased in patients with T/T at nt – 443 than in those with C/C or C/T. Also the frequency of T allele was increased in responders than in non-responders. However, this increase was not statistically significant. The blood level of OPN was significantly increased in non-responders (Mean±SD=37.21±3.9) in comparison to responders (Mean±SD=33.22±4.1).Conclusion: Osteopontin blood level can be considered as a reliable predictor to PEG IFN α2b plus ribavirin therapy in chronic HCV Saudi Patients.Keywords: OPN, PEG IFN, HCV, SVR, SNP, RT-PC

Osteopontin as a marker for response to pegylated interferon Alpha-2b treatment in Chronic HCV Saudi patients.

Background: Many recent studies support the idea that osteopontin (OPN) can be used to predict the success of pegylated interferon (PEG IFN) alpha-2b/ribavirin therapy in chronic HCV patients. Objective: Our aim was to investigate the role of plasma OPN and its gene polymorphism at nt \u2013 443 in response to PEG IFN in Saudi patients with chronic HCV. Methods: Blood was collected from 87 patients with chronic hepatitis C before treatment, then patients received PEG IFN \u3b12b plus ribavirin combination therapy. Another 25 healthy subjects, matched for age and sex to patients, were enrolled as controls. Single nucleotide polymorphism (SNP) in OPN at nt \u2013 443 and its blood level were analyzed. Results: The frequency of patients who reached sustained virological response (SVR) was increased in patients with T/T at nt \u2013 443 than in those with C/C or C/T. Also the frequency of T allele was increased in responders than in non-responders. However, this increase was not statistically significant. The blood level of OPN was significantly increased in non-responders (Mean\ub1SD=37.21\ub13.9) in comparison to responders (Mean\ub1SD=33.22\ub14.1). Conclusion: Osteopontin blood level can be considered as a reliable predictor to PEG IFN \u3b12b plus ribavirin therapy in chronic HCV Saudi Patients

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely