Molecular genetics testing has made several huge breakthroughs in the past two decades and many molecular technologies have been applied to our daily medical progress. However, the clinical utility has not reach a consensus by the medical and genetic peers as well as third party payers. The predictive value and clinical applications are variable from one condition to the other. Numerous questions remain including technology deficits, data interpretation and unpredicted phenotypes in complex disorders. In this commentary, the authors reviewed the historical perspective of genetic testing and summarized the current technical deficit, clinical dilemma and suggested a few critical threshold to overcome before the implementation of useful genetic information in standard health care can become a reality.
{"title":"Toward Best Practice in Using Molecular Diagnosis to Guide Medical Management, Are We There Yet?","authors":"Anne Chun-Hui Tsai, Xuezhong Liu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Molecular genetics testing has made several huge breakthroughs in the past two decades and many molecular technologies have been applied to our daily medical progress. However, the clinical utility has not reach a consensus by the medical and genetic peers as well as third party payers. The predictive value and clinical applications are variable from one condition to the other. Numerous questions remain including technology deficits, data interpretation and unpredicted phenotypes in complex disorders. In this commentary, the authors reviewed the historical perspective of genetic testing and summarized the current technical deficit, clinical dilemma and suggested a few critical threshold to overcome before the implementation of useful genetic information in standard health care can become a reality.</p>","PeriodicalId":19338,"journal":{"name":"North American journal of medicine & science","volume":"7 4","pages":"199-200"},"PeriodicalIF":0.0,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4505911/pdf/nihms706686.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34021302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-07-31DOI: 10.7156/NAJMS.2014.0701008
Jesse M Civan, H. Hann
Hepatocellular carcinoma (HCC) is a major cause of morbidity and mortality, accounting for approximately 600,000 deaths annually world-wide and 10,000 deaths annually in the United States. Chronic infection with the hepatitis C virus (HCV) is the leading risk factor for HCC in the United States, and the second leading risk factor for HCC world-wide. The addition to the anti-HCV treatment armamentarium of boceprevir and telaprevir in 2011, and of simeprevir and sofosbuvir in 2013, mark a transition to a new era. In this new era, treatment for HCV is becoming so highly effective and tolerable that for the first time eradication of chronic HCV on a population level is realistically foreseeable. A major reduction in the burden of chronic HCV is likely to translate into a substantial reduction in the incidence of HCC. Here, we review the epidemiology, pathogenesis, and treatment of HCC with a special focus on hepatocarcinogenesis associated with chronic HCV infection.
{"title":"Hepatitis C Virus Mediated Hepatocellular Carcinoma: A Focused Review for a Time of Changing Therapeutic Options","authors":"Jesse M Civan, H. Hann","doi":"10.7156/NAJMS.2014.0701008","DOIUrl":"https://doi.org/10.7156/NAJMS.2014.0701008","url":null,"abstract":"Hepatocellular carcinoma (HCC) is a major cause of morbidity and mortality, accounting for approximately 600,000 deaths annually world-wide and 10,000 deaths annually in the United States. Chronic infection with the hepatitis C virus (HCV) is the leading risk factor for HCC in the United States, and the second leading risk factor for HCC world-wide. The addition to the anti-HCV treatment armamentarium of boceprevir and telaprevir in 2011, and of simeprevir and sofosbuvir in 2013, mark a transition to a new era. In this new era, treatment for HCV is becoming so highly effective and tolerable that for the first time eradication of chronic HCV on a population level is realistically foreseeable. A major reduction in the burden of chronic HCV is likely to translate into a substantial reduction in the incidence of HCC. Here, we review the epidemiology, pathogenesis, and treatment of HCC with a special focus on hepatocarcinogenesis associated with chronic HCV infection.","PeriodicalId":19338,"journal":{"name":"North American journal of medicine & science","volume":"312 1","pages":"008"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80010351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-07-31DOI: 10.7156/NAJMS.2014.0702053
R. Frye, J. M. Sequeira, E. Quadros, D. Rossignol
The folate receptor alpha (FRα) is essential for folate transportation across the blood-brain barrier and is closely associated with cerebral folate deficiency, a syndrome that commonly presents with autism spectrum disorder (ASD) features. FRα autoantibodies (FRAAs) interrupt FRα function and have a high prevalence in children with ASD. Since the FRα is also located on the thyroid, FRAAs could also interfere with thyroid function. Interestingly, ASD has been inconsistently associated with hypothyroidism. The aim of this study was to determine if thyroid dysfunction in ASD could be related to FRAAs. To this end we investigated the relationship between serum FRAA titers (both blocking and binding) and thyroid stimulating hormone (TSH) in 32 children with ASD. Blocking, but not binding, FRAAs were found to be related to TSH levels. Higher FRAAs were significantly correlated with higher TSH concentrations (r = 0.36, p = 0.025), while ASD children who were positive for blocking FRAAs demonstrated a significantly higher serum concentration of TSH than children who were negative for FRAAs (t(31) = 2.07, p = 0.02). These results are consistent with the notion that blocking FRAAs are associated with reduced thyroid function and suggest that thyroid function should be examined in children with ASD who are positive for the blocking FRAAs.
叶酸受体α (FRα)对叶酸通过血脑屏障的运输至关重要，并且与脑叶酸缺乏密切相关，这是一种通常表现为自闭症谱系障碍(ASD)特征的综合征。FRα自身抗体(FRAAs)阻断FRα功能，在ASD儿童中具有很高的患病率。由于fra α也位于甲状腺上，因此fra也可能干扰甲状腺功能。有趣的是，ASD与甲状腺功能减退的关系并不一致。本研究的目的是确定ASD患者的甲状腺功能障碍是否与fraa有关。为此，我们研究了32例ASD患儿血清FRAA滴度(阻断和结合)与促甲状腺激素(TSH)的关系。阻断而非结合，发现fraa与TSH水平有关。较高的FRAAs与较高的TSH浓度显著相关(r = 0.36, p = 0.025)，而阻断FRAAs阳性的ASD儿童血清TSH浓度显著高于FRAAs阴性的儿童(t(31) = 2.07, p = 0.02)。这些结果与阻断性fraa与甲状腺功能下降相关的观点一致，并建议对阻断性fraa阳性的ASD儿童进行甲状腺功能检查。
{"title":"Folate Receptor Alpha Autoantibodies Modulate Thyroid Function in Autism Spectrum Disorder","authors":"R. Frye, J. M. Sequeira, E. Quadros, D. Rossignol","doi":"10.7156/NAJMS.2014.0702053","DOIUrl":"https://doi.org/10.7156/NAJMS.2014.0702053","url":null,"abstract":"The folate receptor alpha (FRα) is essential for folate transportation across the blood-brain barrier and is closely associated with cerebral folate deficiency, a syndrome that commonly presents with autism spectrum disorder (ASD) features. FRα autoantibodies (FRAAs) interrupt FRα function and have a high prevalence in children with ASD. Since the FRα is also located on the thyroid, FRAAs could also interfere with thyroid function. Interestingly, ASD has been inconsistently associated with hypothyroidism. The aim of this study was to determine if thyroid dysfunction in ASD could be related to FRAAs. To this end we investigated the relationship between serum FRAA titers (both blocking and binding) and thyroid stimulating hormone (TSH) in 32 children with ASD. Blocking, but not binding, FRAAs were found to be related to TSH levels. Higher FRAAs were significantly correlated with higher TSH concentrations (r = 0.36, p = 0.025), while ASD children who were positive for blocking FRAAs demonstrated a significantly higher serum concentration of TSH than children who were negative for FRAAs (t(31) = 2.07, p = 0.02). These results are consistent with the notion that blocking FRAAs are associated with reduced thyroid function and suggest that thyroid function should be examined in children with ASD who are positive for the blocking FRAAs.","PeriodicalId":19338,"journal":{"name":"North American journal of medicine & science","volume":"44 1","pages":"053"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78971235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-07-31DOI: 10.7156/NAJMS.2014.0702081
Kheng-Jim Lim, Lanjing Zhang, Anish Sheth
The diagnosis of eosinophilic esophagitis has been steadily increasing with the increase usage of endoscopy as a diagnostic tool. Here we present a case of complete esophageal desquamation visualized on endoscopy without any evidence of caustic ingestion or any other potential disease process that would cause a similar presentation. The diagnosis of eosinophilic esophagitis was established by significantly increased intraepithelial eosinophils, eosinphilic micro-abscess and partially detached squamous epithelium on the esophageal biopsy. There was complete resolution of symptoms with standard therapy for eosinophilic esophagitis. To the best our knowledge, this is the first reported case in the English literature of eosinophilic esophagitis that presents as complete esophageal desquamation.
{"title":"Eosinophilic Esophagitis Presenting as Complete Esophageal Desquamation: An Unusual Case of Chest Pain","authors":"Kheng-Jim Lim, Lanjing Zhang, Anish Sheth","doi":"10.7156/NAJMS.2014.0702081","DOIUrl":"https://doi.org/10.7156/NAJMS.2014.0702081","url":null,"abstract":"The diagnosis of eosinophilic esophagitis has been steadily increasing with the increase usage of endoscopy as a diagnostic tool. Here we present a case of complete esophageal desquamation visualized on endoscopy without any evidence of caustic ingestion or any other potential disease process that would cause a similar presentation. The diagnosis of eosinophilic esophagitis was established by significantly increased intraepithelial eosinophils, eosinphilic micro-abscess and partially detached squamous epithelium on the esophageal biopsy. There was complete resolution of symptoms with standard therapy for eosinophilic esophagitis. To the best our knowledge, this is the first reported case in the English literature of eosinophilic esophagitis that presents as complete esophageal desquamation.","PeriodicalId":19338,"journal":{"name":"North American journal of medicine & science","volume":"40 1","pages":"081"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74998301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-07-31DOI: 10.7156/NAJMS.2014.0702063
Zhe Xu, E. Qin, Min Zhao, Weimin Nie, Zhi-ping Zhou, B. Tu, Weiwei Chen, B. Wu, Fei Wang, Jin Li
In order to explore the clinical pathways that fit the actual situation of our country and department of infectious diseases, an analysis was performed to evaluate the effectiveness of clinical pathways for varicella, acute bacillary dysentery, measles, scarlet fever and rubella when compared with traditional standard medical care. Using a retrospective comparative study design, varicella, acute bacillary dysentery, measles, scarlet fever and rubella patients who were managed on a clinical pathway (clinical pathway group) were compared with a retrospective group of patients who received traditional medical care (control group) prior to the pathway's implementation. The following outcomes were measured: length of hospital stay, hospitalization costs. There was a significant reduction in the median hospitalization costs in the clinical pathway group patients in all five infectious diseases (P<0.05). The clinical pathway group's length of hospital stay for varicella, measles, acute bacillary dysentery and rubella were significantly shorter than the control group (P<0.05). The implementation of clinical pathways in varicella, acute bacillary dysentery, measles, scarlet fever and rubella might contribute to better quality of care and cost-effectiveness.
{"title":"Study of the Application of Clinical Pathways in Varicella, Acute Bacillary Dysentery, Measles, Scarlet Fever, and Rubella","authors":"Zhe Xu, E. Qin, Min Zhao, Weimin Nie, Zhi-ping Zhou, B. Tu, Weiwei Chen, B. Wu, Fei Wang, Jin Li","doi":"10.7156/NAJMS.2014.0702063","DOIUrl":"https://doi.org/10.7156/NAJMS.2014.0702063","url":null,"abstract":"In order to explore the clinical pathways that fit the actual situation of our country and department of infectious diseases, an analysis was performed to evaluate the effectiveness of clinical pathways for varicella, acute bacillary dysentery, measles, scarlet fever and rubella when compared with traditional standard medical care. Using a retrospective comparative study design, varicella, acute bacillary dysentery, measles, scarlet fever and rubella patients who were managed on a clinical pathway (clinical pathway group) were compared with a retrospective group of patients who received traditional medical care (control group) prior to the pathway's implementation. The following outcomes were measured: length of hospital stay, hospitalization costs. There was a significant reduction in the median hospitalization costs in the clinical pathway group patients in all five infectious diseases (P<0.05). The clinical pathway group's length of hospital stay for varicella, measles, acute bacillary dysentery and rubella were significantly shorter than the control group (P<0.05). The implementation of clinical pathways in varicella, acute bacillary dysentery, measles, scarlet fever and rubella might contribute to better quality of care and cost-effectiveness.","PeriodicalId":19338,"journal":{"name":"North American journal of medicine & science","volume":"100 1","pages":"063"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73623555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-07-31DOI: 10.7156/NAJMS.2014.0701001
Julius M. Wilder, K. Patel
The burden of chronic hepatitis C infection worldwide is significant. Approximately 4.1 million people in the United States have anti-HCV antibodies. The prevalence worldwide varies, but reaches greater than 3.5% in some regions (North African, East Asia). The burden of hepatitis C virus is reflected in the morbidity and mortality of this disease, as well as the societal costs. The morbidity and mortality associated with chronic hepatitis c infection is mostly related to the rate of fibrosis and associated progression to cirrhosis. The natural history of this progression is a complex and dynamic process related to individual characteristics (age, sex, race, genetics), viral characteristics (genotype), behavioral (smoking, alcohol), metabolic factors (insulin resistance, obesity), and co-infection (Hepatitis B and HIV). This review describes the current literature on how these factors interact with chronic hepatitis C infection and impact the natural history of this disease and progression to fibrosis and cirrhosis.
{"title":"A Review of the Natural History of Chronic Hepatitis C Infection","authors":"Julius M. Wilder, K. Patel","doi":"10.7156/NAJMS.2014.0701001","DOIUrl":"https://doi.org/10.7156/NAJMS.2014.0701001","url":null,"abstract":"The burden of chronic hepatitis C infection worldwide is significant. Approximately 4.1 million people in the United States have anti-HCV antibodies. The prevalence worldwide varies, but reaches greater than 3.5% in some regions (North African, East Asia). The burden of hepatitis C virus is reflected in the morbidity and mortality of this disease, as well as the societal costs. The morbidity and mortality associated with chronic hepatitis c infection is mostly related to the rate of fibrosis and associated progression to cirrhosis. The natural history of this progression is a complex and dynamic process related to individual characteristics (age, sex, race, genetics), viral characteristics (genotype), behavioral (smoking, alcohol), metabolic factors (insulin resistance, obesity), and co-infection (Hepatitis B and HIV). This review describes the current literature on how these factors interact with chronic hepatitis C infection and impact the natural history of this disease and progression to fibrosis and cirrhosis.","PeriodicalId":19338,"journal":{"name":"North American journal of medicine & science","volume":"34 1","pages":"001"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80548786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-07-31DOI: 10.7156/NAJMS.2014.0702072
Xiu-qiao Zhang, Jiachun Chen, Feng-jiao Huang, L. Tian, Y. Tu
We studied the effects of two xanthones compounds isolated from Swertia punicea Hemsl (from Geutianaceae), swertianolin (I) and bellidifolin (II), on Hepatitis B surface antigen (HBsAg) and e antigen (HBeAg) in cultured human hepatocellular carcinoma cell line (HepG 2 ). The HepG 2 cells were first cultured for 24h, various concentrations of these two xanthones were then added to the culture medium. The culture medium containing the two xanthones was exchanged once every 4 days. After 8 days, the cytotoxic activities of these two xanthones were assessed by cytopathic effect. The HepG 2 cells were then treated with the two compounds at a concentration of swertianolin (1.6, 3.1, 6.2, 12.5, 25 m g/ml) and bellidifolin (2.0, 3.9, 7.8, 25.5, 31.2 m g/ml). Four or eight days later, the culture medium was collected and the expression of HBsAg and HBeAg were determined by radioimmunoassay. Our results show that swertianolin can suppress the expression of HBeAg with IC 50 of 8.0 m g/ml, while bellidifolin can inhibit the expression of HBsAg with IC 50 of 13 m g/ml at the eighth days. The Therapeutic Index for swertianolin and bellidifolin are 6.2 and 6.8, respectively. Our findings suggest that swertianolin and bellidifolin have anti-HBV activities in vitro.
研究了从獐牙菜属植物獐牙菜中分离的两种口山酮化合物獐牙菜苷(I)和獐牙菜苷(II)对培养的人肝癌细胞株(HepG 2)乙型肝炎表面抗原(HBsAg)和e抗原(HBeAg)的影响。先将HepG 2细胞培养24h，然后在培养基中加入不同浓度的这两种口山酮。含两种山酮的培养基每4天更换一次。8 d后，用细胞病变效应评价两种克山酮的细胞毒活性。然后用这两种化合物分别以swertianolin(1.6、3.1、6.2、12.5、25 m g/ml)和bellidifolin(2.0、3.9、7.8、25.5、31.2 m g/ml)的浓度处理HepG 2细胞。4、8 d后，收集培养基，用放射免疫法检测HBsAg和HBeAg的表达。结果表明，在第8天，獐牙菜苷可以抑制HBeAg的表达，ic50为8.0 m g/ml，而贝利地福林可以抑制HBsAg的表达，ic50为13 m g/ml。獐牙菜苷和贝利地福林的治疗指数分别为6.2和6.8。我们的研究结果表明，獐牙菜苷和贝利地福林具有体外抗hbv活性。
{"title":"Anti-HBV Activities of Xanthones From Swertia Punicea Hemsl","authors":"Xiu-qiao Zhang, Jiachun Chen, Feng-jiao Huang, L. Tian, Y. Tu","doi":"10.7156/NAJMS.2014.0702072","DOIUrl":"https://doi.org/10.7156/NAJMS.2014.0702072","url":null,"abstract":"We studied the effects of two xanthones compounds isolated from Swertia punicea Hemsl (from Geutianaceae), swertianolin (I) and bellidifolin (II), on Hepatitis B surface antigen (HBsAg) and e antigen (HBeAg) in cultured human hepatocellular carcinoma cell line (HepG 2 ). The HepG 2 cells were first cultured for 24h, various concentrations of these two xanthones were then added to the culture medium. The culture medium containing the two xanthones was exchanged once every 4 days. After 8 days, the cytotoxic activities of these two xanthones were assessed by cytopathic effect. The HepG 2 cells were then treated with the two compounds at a concentration of swertianolin (1.6, 3.1, 6.2, 12.5, 25 m g/ml) and bellidifolin (2.0, 3.9, 7.8, 25.5, 31.2 m g/ml). Four or eight days later, the culture medium was collected and the expression of HBsAg and HBeAg were determined by radioimmunoassay. Our results show that swertianolin can suppress the expression of HBeAg with IC 50 of 8.0 m g/ml, while bellidifolin can inhibit the expression of HBsAg with IC 50 of 13 m g/ml at the eighth days. The Therapeutic Index for swertianolin and bellidifolin are 6.2 and 6.8, respectively. Our findings suggest that swertianolin and bellidifolin have anti-HBV activities in vitro.","PeriodicalId":19338,"journal":{"name":"North American journal of medicine & science","volume":"46 1","pages":"072"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87904639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-07-31DOI: 10.7156/NAJMS.2014.0702075
J. J. Thangaiah, K. Balachandran, U. Poothiode, S. Bhat
Prostate fine needle aspiration (FNA) is an easy-to-perform outpatient procedure requiring no expensive equipment or anesthesia. The aim of this study was to analyze the cytomorphology of prostatic lesions and to correlate the findings in cytology with that of the histopathological appearance. In doing so we also assessed the diagnostic accuracy of fine needle aspiration cytology and identified possible pitfalls. The study was carried out in 100 patients who underwent tru-cut biopsy in the department of Urology at Kottayam Medical College, India during the period spanning from March 2010 to March 2011. Fine needle aspiration cytology (FNAC) was done with Franzen needle and followed by tru-cut biopsy after which the results of both were compared. FNAC gave a benign diagnosis in 64 cases and identified a malignant pattern in 36 cases. The overall accuracy of FNAC in this series in diagnosing prostatic lesions was 97% with a sensitivity of 100% and specificity of 95.5%. This shows that FNAC prostate is a reliable, relatively painless tool, which can be used for the diagnosis of prostatic carcinoma, especially in patients with high risk complications such as bleeding and infections in whom a tru-cut biopsy is more invasive. In addition it is also cost-effective and may sample a larger area.
{"title":"Validity of Fine Needle Aspiration Cytology in Diagnosis of Prostatic Lesions and Correlation with Trucut Biopsy","authors":"J. J. Thangaiah, K. Balachandran, U. Poothiode, S. Bhat","doi":"10.7156/NAJMS.2014.0702075","DOIUrl":"https://doi.org/10.7156/NAJMS.2014.0702075","url":null,"abstract":"Prostate fine needle aspiration (FNA) is an easy-to-perform outpatient procedure requiring no expensive equipment or anesthesia. The aim of this study was to analyze the cytomorphology of prostatic lesions and to correlate the findings in cytology with that of the histopathological appearance. In doing so we also assessed the diagnostic accuracy of fine needle aspiration cytology and identified possible pitfalls. The study was carried out in 100 patients who underwent tru-cut biopsy in the department of Urology at Kottayam Medical College, India during the period spanning from March 2010 to March 2011. Fine needle aspiration cytology (FNAC) was done with Franzen needle and followed by tru-cut biopsy after which the results of both were compared. FNAC gave a benign diagnosis in 64 cases and identified a malignant pattern in 36 cases. The overall accuracy of FNAC in this series in diagnosing prostatic lesions was 97% with a sensitivity of 100% and specificity of 95.5%. This shows that FNAC prostate is a reliable, relatively painless tool, which can be used for the diagnosis of prostatic carcinoma, especially in patients with high risk complications such as bleeding and infections in whom a tru-cut biopsy is more invasive. In addition it is also cost-effective and may sample a larger area.","PeriodicalId":19338,"journal":{"name":"North American journal of medicine & science","volume":"63 1","pages":"075"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79685529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-07-31DOI: 10.7156/NAJMS.2014.0701033
PharmD Jenna K. Kawamoto, P. Smith, Agaf Steven-Huy B. Han
Direct-acting antiviral (DAA) protease inhibitors, boceprevir (BOC) and telaprevir (TVR) were FDA-approved in 2011 to be used in combination with pegylated interferon (peg-IFN) and ribavirin for the treatment of chronic hepatitis C virus infection (HCV) genotype 1. The addition of these new DAAs increased cure rates but also increased rates of adverse events and drug interactions. This review will evaluate HCV treatment-related side-effects, toxicity, and drug-interactions and management. Understanding and identifying adverse events and drug interactions will help enable the provider to minimize treatment discontinuation, prevent serious adverse events, and optimize treatment for patients.
{"title":"Management of HCV Treatment-related Side-effects, Toxicity, and Drug-interactions","authors":"PharmD Jenna K. Kawamoto, P. Smith, Agaf Steven-Huy B. Han","doi":"10.7156/NAJMS.2014.0701033","DOIUrl":"https://doi.org/10.7156/NAJMS.2014.0701033","url":null,"abstract":"Direct-acting antiviral (DAA) protease inhibitors, boceprevir (BOC) and telaprevir (TVR) were FDA-approved in 2011 to be used in combination with pegylated interferon (peg-IFN) and ribavirin for the treatment of chronic hepatitis C virus infection (HCV) genotype 1. The addition of these new DAAs increased cure rates but also increased rates of adverse events and drug interactions. This review will evaluate HCV treatment-related side-effects, toxicity, and drug-interactions and management. Understanding and identifying adverse events and drug interactions will help enable the provider to minimize treatment discontinuation, prevent serious adverse events, and optimize treatment for patients.","PeriodicalId":19338,"journal":{"name":"North American journal of medicine & science","volume":"6 1","pages":"033"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86121658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-07-31DOI: 10.7156/NAJMS.2014.0701017
V. Sundaram, T. Tran
Hepatitis C virus (HCV) is the most common cause of liver cirrhosis in the United States. If untreated, HCV can lead to death from complications of liver failure or hepatocellular carcinoma, making screening imperative in high-risk patients. Established risk factors for HCV infection include injection drug use, receipt of blood transfusion or organ transplantation prior to 1992, and hemodialysis. Recent evidence has demonstrated that those born between 1945-1965 are additionally at high risk for HCV acquisition and should undergo one time screening. Once diagnosed, consideration for treatment should be based on patient motivation, concurrent medical co-morbidities, degree of liver injury, and risk of progression to cirrhosis. Therapy may also be indicated in patients with extra-hepatic manifestations of HCV.
{"title":"Clinical Evaluation of Chronic Hepatitis C and Indications for HCV Treatment","authors":"V. Sundaram, T. Tran","doi":"10.7156/NAJMS.2014.0701017","DOIUrl":"https://doi.org/10.7156/NAJMS.2014.0701017","url":null,"abstract":"Hepatitis C virus (HCV) is the most common cause of liver cirrhosis in the United States. If untreated, HCV can lead to death from complications of liver failure or hepatocellular carcinoma, making screening imperative in high-risk patients. Established risk factors for HCV infection include injection drug use, receipt of blood transfusion or organ transplantation prior to 1992, and hemodialysis. Recent evidence has demonstrated that those born between 1945-1965 are additionally at high risk for HCV acquisition and should undergo one time screening. Once diagnosed, consideration for treatment should be based on patient motivation, concurrent medical co-morbidities, degree of liver injury, and risk of progression to cirrhosis. Therapy may also be indicated in patients with extra-hepatic manifestations of HCV.","PeriodicalId":19338,"journal":{"name":"North American journal of medicine & science","volume":"75 1","pages":"017"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86165486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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