Search PubMed⌕ Search

Biomedical subjects

M Diago

Publications and source records attributed to M Diago.

29 records · Page 2Linked to original sources
PubMed1999

Retreatment of chronic hepatitis B e antigen-positive patients with recombinant interferon alfa-2a. The European Concerted Action on Viral Hepatitis (EUROHEP).

Fifty-seven patients with chronic hepatitis B, hepatitis B virus (HBV) e antigen (HBeAg) and HBV DNA positivity, and aminotransferase elevation despite a previous course of any type of adequate interferon alfa (IFN-alpha) therapy were included in a multicenter prospective randomized controlled trial. The objective of the study was to compare a second course of IFN-alpha therapy (9 million units [MU] of IFN-alpha-2a, Roferon-A, thrice weekly for 6 months) versus no therapy in terms of loss of HBV DNA and HBeAg. At the end of the study, a sustained clearance of HBV DNA and HBeAg was observed in 9 of the 27 (33.3%) patients who had received retreatment with IFN-alpha compared with 3/30 (10%) patients who spontaneously cleared these markers in the untreated control group (chi2 = 4.66, P =.031; odds ratio: 4.5, 95%; confidence interval: 1.1-18.9). None of the responders lost HBsAg. Patients retreated with IFN-alpha were more likely to have biochemical remission in association with HBV clearance (5/27, 18.5%) compared with untreated patients (1/30, 3. 3%; Fisher's exact test P =.09 ). Histological improvement in the liver necroinflammatory activity was observed among sustained responders to IFN-alpha retreatment, consisting of regression of the portal and periportal inflammation and of the piecemeal necrosis; there was no change in the degree of liver fibrosis. Side effects were similar to those previously reported during IFN-alpha treatment; these were mild and reversible on IFN-alpha discontinuation. None of the baseline features were associated with response by Cox's regression analysis. In summary, viremic patients with chronic HBeAg-positive hepatitis may experience disease remission following retreatment with IFN-alpha. Thus, retreatment with IFN-alpha may be considered a therapeutic option.

Adolescent↗
PubMed1998

Preliminary investigation of the association of oral lichen planus and hepatitis C.

OBJECTIVE: The aim of this investigation was to determine if an association exists between hepatitis C virus and oral lichen planus. STUDY DESIGN: Three groups of subjects were selected: 505 patients with hepatitis C virus infection (group 1), 100 patients with oral lichen planus (group 2), and a randomly selected control group (age- and gender-matched) of 100 healthy subjects (group 3). The prevalence of oral lichen planus was determined in groups 1 and 3, and the prevalence of hepatitis C virus infection was established in groups 2 and 3. RESULTS: The prevalence of oral lichen planus was 3.36% (n = 17) in group 1 and 1% (n = 1) in the control group; the prevalence of hepatitis C virus infection was 23% (n = 23) in group 2, and 5% (n = 5) in the control group. No significant differences were observed in the incidence of oral lichen planus in group 1 between those patients who received interferon and those who did not. The 17 patients in group 1 who manifested oral lichen planus and hepatitis C virus infection simultaneously exhibited a marked tendency to have only reticular lesions (70.6%), with involvement of the buccal mucosa in 88.2% of these patients, the tongue in 29.4%, and the gingiva in 11.8%. Analyzing a randomized subgroup of 143 patients from group 1 (subgroup 1) that was matched by age and gender with groups 2 and 3, we found that the incidence of oral lichen planus in patients with hepatitis C virus infection (subgroup 1) was greater than in the control group (5.59% vs 1%), though this was not statistically significant (chi2 = 0.119; p = 0.06). In contrast, group 2 exhibited a statistically significant higher incidence of hepatitis C virus infection (23%) than the controls (5%; chi2 = 0.259, p = 0.0002). CONCLUSIONS: The prevalence of hepatitis C virus infection in patients with oral lichen planus was greater than in the control series. In our opinion this observation warrants the investigation of potential concomitant hepatitis C virus infection in patients with oral lichen planus.

Candidiasis, Oral↗
PubMed1998

[Focal nodular liver hyperplasia of atypical presentation].

Focal nodular hyperplasia is a benign hepatic tumor that usually appears in young women. Diagnosis of focal nodular hyperplasia is often incidental when an ultrasonography or computed tomography is performed by other reasons, because its course is generally asymptomatic; the presence of a central fibrous scar is characteristic. Management in focal nodular hyperplasia must be conservative, with ultrasonographic follow-up, and it only must be treated when patients are symptomatics or in case of tumoral enlargement. We report a case of FNH in which symptomatic presentation and the absence of central stellate scar in ultrasonography, computed tomography and magnetic resonance leads to a misdiagnostic of hepatic adenoma, that conditioned a surgical resection. The later examination was diagnostic of focal nodular hyperplasia.

Adenoma↗
PubMed1997

Multicenter randomized, controlled study of intramuscular administration of interferon-beta for the treatment of chronic hepatitis C.

The intramuscular administration of interferon-beta (IFN-beta) at a dosage of 6 million units three times per week for 6 months has been evaluated in 90 patients included in a multicenter, randomized, controlled trial for the treatment of chronic hepatitis C. Transaminase levels were significantly reduced in IFN-beta-treated patients (p = 0.015) and were significantly lower with respect to those of the untreated controls (p = 0.040 at 6 months). Four treated (8%) and one untreated (2.5%) patients had normal transaminase values after 6 months. At study end (12 months), three quarters of the IFN-beta-treated patients had sustained transaminase normalization, whereas the untreated case had relapsed. Hepatitis C viremia was cleared in 6 (12%) treated patients but in none of the untreated controls (p = 0.058). Side effects of IFN-beta were infrequent (a mild flu-like syndrome in < 10%, asthenia in 16%, anorexia in 8%, headaches and weight loss in 8%, and hair loss in 4%). Leukocyte and platelet counts decreased during IFN-beta treatment, but no dose modifications were necessary. Such decreases were not statistically significant when compared with the levels in the untreated controls. Intramuscular IFN-beta at the dosage used has little efficacy in the treatment of chronic hepatitis C. Because of IFN-beta tolerance, higher doses and alternate routes of injection might prove beneficial for the treatment of this disease.

Adult↗
PubMed1997

Tolerance and efficacy of subcutaneous interferon-beta administered for treatment of chronic hepatitis C.

We studied tolerance to subcutaneous (s.c.) administration of 6 million units of interferon-beta (IFN-beta), given three times per week for 6 months, and its efficacy in the treatment of 15 patients with chronic hepatitis C. At the end of the treatment, alanine aminotransferase (ALT) levels were significantly reduced (p = 0.024) in all patients, and 4 (27%) had a normal ALT value. However, at the end of the study (12 months), only 1 of these 4 had a sustained response. No patient cleared hepatitis C virus (HCV) RNA completely, but the RNA could be detected only by polymerase chain reaction (PCR) in the sustained responder. Adverse side effects to the s.c. IFN-beta were infrequent. Leukocyte (p = 0.012) and platelet (p = 0.013) counts decreased significantly during treatment but did not necessitate dose modifications. Thus, although s.c. IFN-beta at the dosage used had little efficacy in the treatment of chronic hepatitis C, the excellent tolerance to the treatment suggests that the effects of higher doses should be explored.

Adult↗
PubMed1996

Intrafamily transmission of hepatitis C virus: sexual and non-sexual contacts.

BACKGROUND/METHODS: As a high number of patients with antibodies to hepatitis C (anti-HCV) do not have a known history of parenteral acquisition, other non-parenteral means of hepatitis C virus transmission must be studied. We investigated 1451 household contacts of 535 anti-HCV positive, human immunodeficiency virus-negative index patients. RESULTS: Overall, the prevalence of anti-HCV in household contacts was 4.5%. Thirty (7.6%) out of the 394 heterosexual stable partners were anti-HCV positive as compared to 35 (3.3%) out of 1057 non-sexual contacts (p < 0.01). The prevalence of anti-HCV was lowest in children of the index cases (1.8%). In this group, the prevalence of anti-HCV was 3% (10/330) when the mother was the index case, as opposed to 0.6% (2/328) when the father was the index case (p < 0.05). The prevalence of anti-HCV increased with age, being highest (18.6%) in family contacts older than 60 years. CONCLUSIONS: Transmission of hepatitis C virus may occur among household contacts of anti-HCV positive patients. Sexual contact or the use of non-disposable medical material in the past might explain the higher prevalence of anti-HCV found in sexual partners and in family contacts older than 60 years of age. Anti-HCV screening should be performed in family contacts of anti-HCV positive patients, particularly in those contacts older than 20.

Adolescent↗
PubMed1990

[Physical exercise and gastric acid secretion].

The effects of physical exercise on the basal acid secretion of the stomach has been investigated in 10 healthy individuals and 16 hypersecretors with duodenal ulcer. The gastric basal secretion was collected during 3 hours; during the first hour the patient was at rest, during the second he realized a training exercise, according to Roskamm's formula, and in the third was at rest. While normal subjects showed a significative reduction of the acid secretion during the period of exercise, in the hypersecretory patients with ulcer the acid secretion increased significantly during exercise, from 4.25 +/- 1.52 mEq/h to 7.79 +/- 3.49 mEq/h; these figures reverted to normal values (5.45 +/- 2.21) during the recovery period. We comment the potential mechanisms of these differences in both groups of patients.

Adult↗
PubMed1983

[Action of domperidone on dopamine-induced inhibition of gastric secretion].

The inhibitory action of dopamine on basal gastric secretion and that stimulated by pentagastrin with previous administration of domperidone in 26 male patients, between 18 and 48 years of age, suffering duodenal ulcer has been studied. The administration of domperidone (0.25 mg/kg) produces a significant reduction of the inhibitory action of dopamine on basal gastric secretion and that stimulated by pentagastrin at dose 0.15 microgram/kg/h. Besides dopamine shows a minor, non significant, inhibitory action on acid gastric secretion stimulated by maximal doses of pentagastrin, while showing no differences against the group without administration of domperidone.

Adolescent↗
PubMedDate not supplied

[Prevalence of anti-hepatitis A in patients with chronic liver disease].

The recent availability of an effective vaccine for preventing hepatitis A has led to the performance of a prevalence study of antibodies versus the hepatitis A virus (HAV) in our patients with chronic liver disease by hepatitis B and C, as a step prior to vaccination. The sera of 425 patients with a mean age of 40 years was studied, with the global antibodies versus HAV being determined (Abbott). The prevalence was to 75.2% varying from 20% at 19 years to 93% in those over the age of 40. The prevalence was not related to sex, previous parenteral history, or drug addiction or infection by hepatitis B or C. Due to previous cost-benefit studies and the high prevalence found, the determination of anti-HAV in patients with chronic viral liver diseases prior to vaccination against HAV is recommended.

Adolescent↗