J. Botha, C. Kassianides, H. Schneider, E. Song, C. Spearman, S. W. van der Merwe
{"title":"South African Hepatitis C management guidelines","authors":"J. Botha, C. Kassianides, H. Schneider, E. Song, C. Spearman, S. W. van der Merwe","doi":"10.4314/SAGR.V3I1.30725","DOIUrl":"https://doi.org/10.4314/SAGR.V3I1.30725","url":null,"abstract":"","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"3 1","pages":"18-21"},"PeriodicalIF":0.0,"publicationDate":"2006-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70615899","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}
Extracted from text ... CASE REPORT The South African Gastroenterology Review - March 2005 14 A Surgical Cure for Sarcoidosis. Fact of Fancy portal area and the retroperitoneum. Occasionally the spleen and liver may show multiple hypodensity without pulmonary involvement. This women had no abnormality on the chest radiograph with nodular disease in the spleen but not of the liver on imaging. Correspondence: Prof S Thomson email: thomson@ukzn.ac.za A 47 year old female presented with 3 month history of upper abdominal pain. She had no cardiovascular or respiratory symptoms. Endoscopy revealed a diffuse gastritis with erosions treated by eradication therapy. Two months later ..
{"title":"A surgical cure for sarcoidosis. Fact of fancy : case report","authors":"R. Wise, S. Thomson","doi":"10.4314/SAGR.V3I1.30724","DOIUrl":"https://doi.org/10.4314/SAGR.V3I1.30724","url":null,"abstract":"Extracted from text ... CASE REPORT \u0000The South African Gastroenterology Review - March 2005 14 \u0000A Surgical Cure for Sarcoidosis. \u0000Fact of Fancy \u0000portal area and the retroperitoneum. Occasionally the spleen \u0000and liver may show multiple hypodensity without pulmonary \u0000involvement. This women had no abnormality on the chest \u0000radiograph with nodular disease in the spleen but not of the \u0000liver on imaging. \u0000Correspondence: \u0000Prof S Thomson \u0000email: thomson@ukzn.ac.za \u0000A 47 year old female presented with 3 month history of upper \u0000abdominal pain. She had no cardiovascular or respiratory \u0000symptoms. Endoscopy revealed a diffuse gastritis with erosions \u0000treated by eradication therapy. Two months later ..","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"3 1","pages":"14-15"},"PeriodicalIF":0.0,"publicationDate":"2006-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70615842","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}
C. Rensburg, J. D. Villiers, C. Daniels, Wright Ca, M. Kidd, G. Jong, M. Kotze
Background : Barrett's esophagus is the precursor of esophageal adenocarcinoma with a 5-year survival rate of 25-30%. Objective : To define clinically useful biomarkers for transcriptional profiling in South African patients with Barrett's esophagus in order to identify those patients with an increased cancer risk necessitating intensified surveillance intervals. Materials and method : One-hundred and two patients were recruited for the study. COX-2, c-myb and c-myc mRNA expression were measured using a quantitative PCR method in endoscopically obtained specimens of Barrett's metaplasia (BM, n=26) or dysplasia (BD, n=14) and matching squamous esophageal tissue (n=40), squamous esophageal tissue of patients with erosive esophagitis (n=20), non-erosive esophagitis (n=20) and normal controls (n=20). Two patients with Barrett's adenocarcinoma (BAC) were also studied. Results : Demographic data of the groups were comparable. No significant differences in m-RNA expression levels were observed between ethnic groups for the genes analyzed. In the BD/BAC group 69% (11/16) showed increased c-myb m-RNA expression compared with 35% (9/26) in the BM group (p = 0.03). In the BD patients 19% (3/16) had increased c-myc m-RNA expression compared to none in those with BM and BAC. One patient each with BM and BAC had increased COX-2 m-RNA levels. No significant associations were observed for COX-2 in any of the other study groups. Conclusion : In the South African study cohort c-myb appears to be a clinically useful molecular marker for Barrett's esophagus and increased cancer risk, since m-RNA levels are progressively more over expressed in the metaplasia-dysplasia-adenocarcinoma sequence. Further studies are required to clarify the potential significance c-myc and COX-2 in South African patients with Barrett's esophagus. South African Gastroenterology Review Vol. 3(1) 2005: 5-9
{"title":"Identification of clinically-informative biomarkers for risk stratification within the spectrum of gastro-esophageal reflux disease in the South African population","authors":"C. Rensburg, J. D. Villiers, C. Daniels, Wright Ca, M. Kidd, G. Jong, M. Kotze","doi":"10.4314/SAGR.V3I1.30722","DOIUrl":"https://doi.org/10.4314/SAGR.V3I1.30722","url":null,"abstract":"Background : Barrett's esophagus is the precursor of esophageal adenocarcinoma with a 5-year survival rate of 25-30%. Objective : To define clinically useful biomarkers for transcriptional profiling in South African patients with Barrett's esophagus in order to identify those patients with an increased cancer risk necessitating intensified surveillance intervals. Materials and method : One-hundred and two patients were recruited for the study. COX-2, c-myb and c-myc mRNA expression were measured using a quantitative PCR method in endoscopically obtained specimens of Barrett's metaplasia (BM, n=26) or dysplasia (BD, n=14) and matching squamous esophageal tissue (n=40), squamous esophageal tissue of patients with erosive esophagitis (n=20), non-erosive esophagitis (n=20) and normal controls (n=20). Two patients with Barrett's adenocarcinoma (BAC) were also studied. Results : Demographic data of the groups were comparable. No significant differences in m-RNA expression levels were observed between ethnic groups for the genes analyzed. In the BD/BAC group 69% (11/16) showed increased c-myb m-RNA expression compared with 35% (9/26) in the BM group (p = 0.03). In the BD patients 19% (3/16) had increased c-myc m-RNA expression compared to none in those with BM and BAC. One patient each with BM and BAC had increased COX-2 m-RNA levels. No significant associations were observed for COX-2 in any of the other study groups. Conclusion : In the South African study cohort c-myb appears to be a clinically useful molecular marker for Barrett's esophagus and increased cancer risk, since m-RNA levels are progressively more over expressed in the metaplasia-dysplasia-adenocarcinoma sequence. Further studies are required to clarify the potential significance c-myc and COX-2 in South African patients with Barrett's esophagus. South African Gastroenterology Review Vol. 3(1) 2005: 5-9","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"3 1","pages":"5-9"},"PeriodicalIF":0.0,"publicationDate":"2006-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70615758","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}
{"title":"Colonoscopy and the management of lower gastrointestinal bleeding","authors":"K. Pettengell","doi":"10.4314/SAGR.V3I1.30723","DOIUrl":"https://doi.org/10.4314/SAGR.V3I1.30723","url":null,"abstract":"","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"3 1","pages":"11-13"},"PeriodicalIF":0.0,"publicationDate":"2006-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70615824","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}
Objectives : To verify the validity and reliability of two Afrikaans patient-reported outcomes instruments, a disease-specific and a health-related quality of life instrument in patients with reflux disease. Design : Psychometric validation study. Setting : South African, major referral gastroenterology clinic. Subjects : Consecutive patients with predominant symptoms of heartburn. Outcome measures : Patients completed the Afrikaans versions of the Gastrointestinal Symptom Rating Scale (GSRS), the Quality of Life in Reflux and Dyspepsia questionnaire (QOLRAD) and the Short Form Health-36 (SF-36). The frequency and severity of heartburn during the previous 7 days were recorded. Results : 125 patients (aged of 46.0 ±12.3 years, 74.4% female, 87% mixed race) completed the assessments. Most patients (62%) had severe symptoms and half (54%) had symptoms on more than 5 days in the previous week. Patients were most bothered by symptoms of reflux (mean GSRS score of 4.9), indigestion (4.0) and abdominal pain (4.0). These symptoms caused patients problems with food and drink (mean QOLRAD score of 3.5), emotional distress (3.6), impaired vitality (3.7) and sleep disturbance (3.8). The internal consistency of the GSRS symptom clusters was between 0.65 and 0.86 and, for QOLRAD dimensions, it was in the range 0.82 0.94. Test-retest reliability was 0.620.75 (GSRS) and 0.710.82 (QOLRAD). Relevant domains of GSRS and QOLRAD were significantly correlated. GSRS domains of abdominal pain and indigestion, and relevant QOLRAD domains, showed negative correlation with related SF-36 domains. Conclusions : The Afrikaans translations of GSRS and QOLRAD are valid and reliable instruments for use in clinical trials for the assessment of reflux symptoms and their impact on South African patients' healthrelated quality of life. South African Gastroenterology Review Vol. 4(1) 2006: 5-9
{"title":"Psychometric validation of the Afrikaans translation of two patient-reported outcomes instruments for reflux disease","authors":"C. Rensburg, K. Kulich, J. Carlsson, I. Wiklund","doi":"10.4314/SAGR.V4I1.30726","DOIUrl":"https://doi.org/10.4314/SAGR.V4I1.30726","url":null,"abstract":"Objectives : To verify the validity and reliability of two Afrikaans patient-reported outcomes instruments, a disease-specific and a health-related quality of life instrument in patients with reflux disease. Design : Psychometric validation study. Setting : South African, major referral gastroenterology clinic. Subjects : Consecutive patients with predominant symptoms of heartburn. Outcome measures : Patients completed the Afrikaans versions of the Gastrointestinal Symptom Rating Scale (GSRS), the Quality of Life in Reflux and Dyspepsia questionnaire (QOLRAD) and the Short Form Health-36 (SF-36). The frequency and severity of heartburn during the previous 7 days were recorded. Results : 125 patients (aged of 46.0 ±12.3 years, 74.4% female, 87% mixed race) completed the assessments. Most patients (62%) had severe symptoms and half (54%) had symptoms on more than 5 days in the previous week. Patients were most bothered by symptoms of reflux (mean GSRS score of 4.9), indigestion (4.0) and abdominal pain (4.0). These symptoms caused patients problems with food and drink (mean QOLRAD score of 3.5), emotional distress (3.6), impaired vitality (3.7) and sleep disturbance (3.8). The internal consistency of the GSRS symptom clusters was between 0.65 and 0.86 and, for QOLRAD dimensions, it was in the range 0.82 0.94. Test-retest reliability was 0.620.75 (GSRS) and 0.710.82 (QOLRAD). Relevant domains of GSRS and QOLRAD were significantly correlated. GSRS domains of abdominal pain and indigestion, and relevant QOLRAD domains, showed negative correlation with related SF-36 domains. Conclusions : The Afrikaans translations of GSRS and QOLRAD are valid and reliable instruments for use in clinical trials for the assessment of reflux symptoms and their impact on South African patients' healthrelated quality of life. South African Gastroenterology Review Vol. 4(1) 2006: 5-9","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"4 1","pages":"5-9"},"PeriodicalIF":0.0,"publicationDate":"2006-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70615911","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}
Background : Tegaserod is a promotility agent with proven efficacy and safety in patients with irritable bowel syndrome with constipation (IBS-C). AIM : Assess tegaserod's effect on quality of life (QOL) and symptom relief in South African patients. Methods : Women >18 years old meeting Rome II criteria for IBS-C were enrolled in a prospective, open-label, multi-center study in South Africa, consisting of a 2-week treatment-free baseline period, followed by a 4-week tegaserod 6 mg b.i.d. treatment period. QOL was assessed using the IBS-QOL questionnaire, at –2 weeks, baseline and 4 weeks; symptom relief was evaluated with daily diaries and weekly assessments of overall symptom relief. Results : Of the 242 women enrolled, 210 completed the study visits and questionnaires. Compared with baseline, tegaserod significantly improved overall QOL and domains at Week 4 (p values Conclusions : Tegaserod significantly improves QOL and relieves the multiple symptoms associated with IBS-C. Symptom improvement was observed early and was sustained through study end. South African Gastroenterology Review Vol. 4(1) 2006: 11-15
{"title":"Effect of tegaserod on quality of life and symptom relief in women with irritable bowel syndrome with constipation in South Africa","authors":"H. Schneider, Abofele Khoele","doi":"10.4314/SAGR.V4I1.30727","DOIUrl":"https://doi.org/10.4314/SAGR.V4I1.30727","url":null,"abstract":"Background : Tegaserod is a promotility agent with proven efficacy and safety in patients with irritable bowel syndrome with constipation (IBS-C). AIM : Assess tegaserod's effect on quality of life (QOL) and symptom relief in South African patients. Methods : Women >18 years old meeting Rome II criteria for IBS-C were enrolled in a prospective, open-label, multi-center study in South Africa, consisting of a 2-week treatment-free baseline period, followed by a 4-week tegaserod 6 mg b.i.d. treatment period. QOL was assessed using the IBS-QOL questionnaire, at –2 weeks, baseline and 4 weeks; symptom relief was evaluated with daily diaries and weekly assessments of overall symptom relief. Results : Of the 242 women enrolled, 210 completed the study visits and questionnaires. Compared with baseline, tegaserod significantly improved overall QOL and domains at Week 4 (p values Conclusions : Tegaserod significantly improves QOL and relieves the multiple symptoms associated with IBS-C. Symptom improvement was observed early and was sustained through study end. South African Gastroenterology Review Vol. 4(1) 2006: 11-15","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"4 1","pages":"11-15"},"PeriodicalIF":0.0,"publicationDate":"2006-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70616084","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}
Extracted from text ... The South African Gastroenterology Review ? November 2006 85 CASE REPORT One is often humbled when one has to deal with family members who have developed an illness. I would like to relate a story of one family member which was an ignobling experience. The member in question is Attila, she is a miniature schnauzer (Figure 1). She was and is a mature and feisty lady. In her 10th dog year (70 in human terms), she had a rather eventful year. She regularly goes to Greyville Racecourse, the home of the Durban July, where she gets walked with our ..
{"title":"Lessons from the vet","authors":"S. Thomson, M K. Thomson","doi":"10.4314/SAGR.V4I3.30730","DOIUrl":"https://doi.org/10.4314/SAGR.V4I3.30730","url":null,"abstract":"Extracted from text ... The South African Gastroenterology Review ? November 2006 85 CASE REPORT One is often humbled when one has to deal with family members who have developed an illness. I would like to relate a story of one family member which was an ignobling experience. The member in question is Attila, she is a miniature schnauzer (Figure 1). She was and is a mature and feisty lady. In her 10th dog year (70 in human terms), she had a rather eventful year. She regularly goes to Greyville Racecourse, the home of the Durban July, where she gets walked with our ..","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"4 1","pages":"85-86"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70615662","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}
Extracted from text ... REVIEW The 18 The medical management of ulcerative colitis stools per day and a CRP greater than 45mg/l came to colectomy. 6 Endoscopic evaluation of the patient with severe ulcerative colitis should be undertaken with caution. Colonoscopy, even in expert hands, is probably not warranted as most severe lesions (90%) are found in the rectosigmoid colon. The risk of colonoscopy includes perforation and acute traumatic dilatation of the colon. There does appear to be an increased risk of colectomy in patients with severe endoscopic lesions. These can be examined by careful sigmoidoscopy with minimal air inflation. The presence ..
{"title":"The medical management of ulcerative colitis : review","authors":"H. Schneider","doi":"10.4314/sagr.v2i3.30719","DOIUrl":"https://doi.org/10.4314/sagr.v2i3.30719","url":null,"abstract":"Extracted from text ... REVIEW \u0000The 18 \u0000The medical management of ulcerative \u0000colitis \u0000stools per day and a CRP greater than 45mg/l came to colectomy. \u00006 \u0000Endoscopic evaluation of the patient with severe ulcerative \u0000colitis should be undertaken with caution. Colonoscopy, even \u0000in expert hands, is probably not warranted as most severe lesions \u0000(90%) are found in the rectosigmoid colon. The risk of \u0000colonoscopy includes perforation and acute traumatic dilatation \u0000of the colon. There does appear to be an increased risk of \u0000colectomy in patients with severe endoscopic lesions. These \u0000can be examined by careful sigmoidoscopy with minimal air \u0000inflation. The presence ..","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"2 1","pages":"18-23"},"PeriodicalIF":0.0,"publicationDate":"2004-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70615363","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}
Introduction: Chronic liver diseases have become a significant cause of mortality in HIV patients. Few reports have assessed risk factors for HCV disease progression in HIV infected patients. Objectives: The aim of our study was to compare the progression rate of liver fibrosis in HIV-HCV coinfected patients with that of HCV-only infected patients. We sought to identify the risk factors associated with accelerated progression rates and higher fibrosis stage. Methods: Eighteen HCV/HIV coinfected patients were matched to fifty-four HCV patients in a 1 to 3 ratio. The matching variables included duration of HCV, alcohol use, age, gender and race. Both unmatched and matched analyses were performed on estimated fibrosis progression rate and fibrosis stage separately. An ordinal logistic regression analysis was used to identify risk factors. Results: Using Metavir unit system, the mean (+ standard deviation [SD]) estimated fibrosis rates were 0.26 (+ 0.17) and 0.11 (+ 0.09) for HIV-HCV coinfected and HCV-only patients respectively (unmatched analysis p=0.001). The mean (+ SD) duration of HCV infection was 22.05 (+ 1.10) and 15.50 (+ 2.20) for coinfected and HCV-only patients, respectively. There was a statistically significant difference in the proportion of patients with stage 4 liver fibrosis between both groups (HIV-HCV 33 %, HCV 9%, P =0.004). Ordinal Logistic Regression model (unmatched analysis) suggested that duration of HCV (Odds Ratio [OR]= 1.11, 95 % confidence interval [CI] 1.03 to 1.20, P = 0.01), HIV status (OR =9.49, CI 2.39 to 37.75, P = 0.001) (overall model R2= 0.16, F = 0.0002) and age (OR=1.14, CI 1.01 to 1.28, P = 0.03) are statistically significant independent predictors of accelerated progression rate and higher fibrosis stage. Conclusions: Duration of HCV infection, age, and HIV status are significant independent predictors of accelerated fibrosis in HIV-HCV coinfected patient population. HIV-HCV coinfected patients should be counseled and their providers informed regarding the risk factors for accelerated progression of liver fibrosis. Further studies are needed to investigate the underlying biological and immunological mechanisms of accelerated liver fibrosis in HCV patients coinfected with HIV. South African Gastroenterology Review Vol.2(3) 2004: 14-17
慢性肝病已成为HIV患者死亡的重要原因。很少有报告评估了HIV感染患者HCV疾病进展的危险因素。目的:本研究的目的是比较HIV-HCV合并感染患者与单纯hcv感染患者肝纤维化的进展率。我们试图确定与加速进展率和较高纤维化分期相关的危险因素。方法:18例HCV/HIV合并感染患者与54例HCV患者按1:3的比例配对。匹配变量包括HCV持续时间、酒精使用、年龄、性别和种族。对估计的纤维化进展率和纤维化分期分别进行了非匹配和匹配分析。采用有序逻辑回归分析确定危险因素。结果:使用Metavir单位系统，HIV-HCV合并感染和仅hcv患者的平均(+标准差[SD])估计纤维化率分别为0.26(+ 0.17)和0.11(+ 0.09)(未匹配分析p=0.001)。合并感染和单纯感染HCV的患者HCV感染的平均(+ SD)持续时间分别为22.05(+ 1.10)和15.50(+ 2.20)。两组患者发生4期肝纤维化的比例差异有统计学意义(HIV-HCV 33%， HCV 9%， P =0.004)。有序Logistic回归模型(未匹配分析)显示，HCV病程(比值比[OR]= 1.11, 95%可信区间[CI] 1.03 ~ 1.20, P = 0.01)、HIV状态(OR= 9.49, CI 2.39 ~ 37.75, P = 0.001)(总模型R2= 0.16, F = 0.0002)和年龄(OR=1.14, CI 1.01 ~ 1.28, P = 0.03)是加速进展率和较高纤维化分期的独立预测因子，具有统计学意义。结论:HCV感染持续时间、年龄和HIV状态是HIV-HCV合并感染患者纤维化加速的重要独立预测因素。应告知HIV-HCV合并感染患者，并告知其提供者肝纤维化加速进展的危险因素。HCV合并HIV患者加速肝纤维化的潜在生物学和免疫学机制有待进一步研究。南非胃肠病学评论Vol.2(3) 2004: 14-17
{"title":"Risk factors of accelerated liver fibrosis in HIV-HCV coinfection: a matched analysis: original","authors":"Ayman B. Ibrahim, A. Shpaner, J. Nieto, S. Saab","doi":"10.4314/SAGR.V2I3.30718","DOIUrl":"https://doi.org/10.4314/SAGR.V2I3.30718","url":null,"abstract":"Introduction: Chronic liver diseases have become a significant cause of mortality in HIV patients. Few reports have assessed risk factors for HCV disease progression in HIV infected patients. \u0000Objectives: The aim of our study was to compare the progression rate of liver fibrosis in HIV-HCV coinfected patients with that of HCV-only infected patients. We sought to identify the risk factors associated with accelerated progression rates and higher fibrosis stage. \u0000Methods: Eighteen HCV/HIV coinfected patients were matched to fifty-four HCV patients in a 1 to 3 ratio. The matching variables included duration of HCV, alcohol use, age, gender and race. Both unmatched and matched analyses were performed on estimated fibrosis progression rate and fibrosis stage separately. An ordinal logistic regression analysis was used to identify risk factors. \u0000Results: Using Metavir unit system, the mean (+ standard deviation [SD]) estimated fibrosis rates were 0.26 (+ 0.17) and 0.11 (+ 0.09) for HIV-HCV coinfected and HCV-only patients respectively (unmatched analysis p=0.001). The mean (+ SD) duration of HCV infection was 22.05 (+ 1.10) and 15.50 (+ 2.20) for coinfected and HCV-only patients, respectively. There was a statistically significant difference in the proportion of patients with stage 4 liver fibrosis between both groups (HIV-HCV 33 %, HCV 9%, P =0.004). Ordinal Logistic Regression model (unmatched analysis) suggested that duration of HCV (Odds Ratio [OR]= 1.11, 95 % confidence interval [CI] 1.03 to 1.20, P = 0.01), HIV status (OR =9.49, CI 2.39 to 37.75, P = 0.001) (overall model R2= 0.16, F = 0.0002) and age (OR=1.14, CI 1.01 to 1.28, P = 0.03) are statistically significant independent predictors of accelerated progression rate and higher fibrosis stage. \u0000Conclusions: Duration of HCV infection, age, and HIV status are significant independent predictors of accelerated fibrosis in HIV-HCV coinfected patient population. HIV-HCV coinfected patients should be counseled and their providers informed regarding the risk factors for accelerated progression of liver fibrosis. Further studies are needed to investigate the underlying biological and immunological mechanisms of accelerated liver fibrosis in HCV patients coinfected with HIV. South African Gastroenterology Review Vol.2(3) 2004: 14-17","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"2 1","pages":"14-17"},"PeriodicalIF":0.0,"publicationDate":"2004-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70615310","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}
Extracted from text ... GUIDELINES The South African Gastroenterology Review - November 2003 18 Reflux disease: Pathways to the best care if appropriate. If Hp negative, then appropriate PPI therapy. patients with non-ulcer dyspepsia should not routinely be treated with PPI longterm PPI therapy should normally be reserved for those with proven pathology the least expensive appropriate PPI should be used patients with "complicated oesophagitis" (stricture, ulcer, haemorrhage) should be maintained on the full healing dose of PPI patient with GORD should be stepped down form a healing dose to the lowest dose to control symptoms unless they ..
{"title":"Reflux disease : pathways to the best care : guidelines","authors":"J. Garisch","doi":"10.4314/SAGR.V1I2.30704","DOIUrl":"https://doi.org/10.4314/SAGR.V1I2.30704","url":null,"abstract":"Extracted from text ... GUIDELINES \u0000The South African Gastroenterology Review - November 2003 18 \u0000Reflux disease: \u0000Pathways to the best care \u0000if appropriate. If Hp negative, then appropriate PPI \u0000therapy. \u0000patients with non-ulcer dyspepsia should not routinely \u0000be treated with PPI \u0000longterm PPI therapy should normally be reserved \u0000for those with proven pathology \u0000the least expensive appropriate PPI should be used \u0000patients with \"complicated oesophagitis\" (stricture, \u0000ulcer, haemorrhage) should be maintained on the \u0000full healing dose of PPI \u0000patient with GORD should be stepped down form a \u0000healing dose to the lowest dose to control symptoms \u0000unless they ..","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"1 1","pages":"18-19"},"PeriodicalIF":0.0,"publicationDate":"2004-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70615589","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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