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At least 235 records · Page 13Linked to original sources
PubMed1994

Hepatitis C virus genotypes among HCV-chronic liver disease patients in Egypt: a leading trial.

UNLABELLED: In this trial, we have checked 50 anti-HCV positive, HCV-RNA PCR positive chronic liver disease cases, 44 males, 6 females with a mean age of 51 years. HCV-RNA extraction and genotyping was carried out at the Department of Medical Microbiology, University of Edinburgh, U.K. results showed that 47 (94%) of patients were of genotype 4 and 3 (6%) were of genotype 1. Liver biopsies were performed in 22 only out of the 50 patients studied. The 3 genotype 1 patients were biopsied, 2 had cirrhotic profile and one had CAH. Of 47 genotype 4 patients, 19 were biopsied, 3 were CPH, 2 had CLH, 9 had CAH, 4 had cirrhosis and one patient had HCC. CONCLUSION: It appears that Egypt hosts predominantly HCV genotype 4 and less commonly genotype 1. This finding might have important implications concerning the epidemiological aspects, pathogenesis and response to antiviral therapy.

Chronic Disease↗
PubMed2000

Palliative chemotherapy for advanced colorectal cancer: systematic review and meta-analysis. Colorectal Cancer Collaborative Group.

OBJECTIVES: To determine the benefits and harms of palliative chemotherapy in patients with locally advanced or metastatic colorectal cancer and to compare the outcomes for elderly and younger patients. DESIGN: Meta-analysis of individual patient data and published summary statistics from trials for which individual patient data could not be obtained from the investigators. STUDIES: All randomised controlled trials comparing palliative chemotherapy with supportive care in patients with advanced colorectal cancer that were identified by computerised and hand searches of the literature, scanning references, and contacting investigators. MAIN OUTCOME MEASURES: Survival, disease progression, quality of life, and toxicity. RESULTS: 13 randomised controlled trials including a total of 1365 patients met the inclusion criteria. Meta-analysis of seven trials that provided individual patient data (866 patients) showed that palliative chemotherapy was associated with a 35% reduction in the risk of death (95% confidence interval 24% to 44%). This translates into an absolute improvement in survival of 16% at both six and 12 months and an improvement in median survival of 3.7 months. No age related differences were found in the effectiveness of chemotherapy, but elderly patients were under represented in trials. The overall quality of evidence relating to treatment toxicity, symptom control, and quality of life was poor. CONCLUSIONS: Chemotherapy is effective in prolonging time to disease progression and survival in patients with advanced colorectal cancer. The survival benefit may be underestimated in this analysis as some patients in the control arms received chemotherapy.

Aged↗
PubMed1992

Transdermal fentanyl: long-term analgesic studies.

Alternative routes of drug delivery have particular relevance for use in chronic pain. When the pain experience is constant or nearly constant, a continuous infusion of drug is an ideal way to achieve effective pain relief. Early experience with the transdermal application of fentanyl in chronic cancer pain suggests that it is a safe, noninvasive, effective method of managing pain. The first experience with the use of transdermal fentanyl in cancer pain was reported by Miser and colleagues in 5 patients. They demonstrated that steady-state blood concentrations of fentanyl were linearly related to the transdermal fentanyl dose. The terminal elimination half-life was approximately 34 hr. Zech and colleagues studied 13 patients with chronic cancer pain. Pain relief was obtained and was correlated with plasma fentanyl levels. The largest experience so far was reported in 39 patients in a multicenter trial conducted by Simmonds and colleagues. The median fentanyl dose was 100 micrograms/hr (range, 25-525 micrograms/hr). The initial dose of fentanyl from morphine conversion (6:1) was adequate in 50% of patients and titrated upward by 72 hr for the remaining 50%. Patients wore the system for a median of 84 days (range, 5-365 days). Median supplementary daily dose of morphine was 105 mg/day (range, 0-720 mg/day). The system was able to be maintained through a variety of concomitant events. This experience demonstrated the safety and clinical effectiveness of transdermal fentanyl. The transdermal therapeutic system (fentanyl) is a promising advance in achieving noninvasive, continuous drug administration for the management of chronic cancer pain.

Administration, Cutaneous↗
PubMed1984

Symptomatic malignant melanoma of the gastrointestinal tract. Operative treatment and survival.

Malignant melanoma involving the gastrointestinal tract is a common autopsy finding in patients who die with this disease. Melanoma metastatic to bowel infrequently causes symptoms. Some investigators suggest that survival following the onset of gastrointestinal symptoms is very poor and, as a result, surgical intervention to relieve symptoms should be avoided. We reviewed the clinical courses of 15 consecutive patients with symptomatic malignant melanoma of the bowel who underwent resection alone or in combination with bypass of symptomatic intestinal lesions. There were no deaths within 30 days of operation; 14 patients obtained relief of intestinal symptoms; 11 patients survived a mean of 7.9 months; and four patients are alive 2, 7, 22, and 23 months after operation. These results suggest that operations to treat symptomatic intestinal melanoma provide reasonable palliation and survival for patients with this disease.

Adult↗
PubMed2005

New DNA viruses identified in patients with acute viral infection syndrome.

A sequence-independent PCR amplification method was used to identify viral nucleic acids in the plasma samples of 25 individuals presenting with symptoms of acute viral infection following high-risk behavior for human immunodeficiency virus type 1 transmission. GB virus C/hepatitis G virus was identified in three individuals and hepatitis B virus in one individual. Three previously undescribed DNA viruses were also detected, a parvovirus and two viruses related to TT virus (TTV). Nucleic acids in human plasma that were distantly related to bacterial sequences or with no detectable similarities to known sequences were also found. Nearly complete viral genome sequencing and phylogenetic analysis confirmed the presence of a new parvovirus distinct from known human and animal parvoviruses and of two related TTV-like viruses highly divergent from both the TTV and TTV-like minivirus groups. The detection of two previously undescribed viral species in a small group of individuals presenting acute viral syndrome with unknown etiology indicates that a rich yield of new human viruses may be readily identifiable using simple methods of sequence-independent nucleic acid amplification and limited sequencing.

Acute Disease↗
PubMed1982

Intrapartum hypoxia: the association between neurological assessment of damage and abnormal excretion of ATP metabolites.

A series of 29 newborn infants had been studied after intrapartum hypoxia defined as meconium aspiration, an Apgar score of less than or equal to 6 at 5 min or a peripheral blood pH of 7.2 or less after resuscitation. Two independent sets of techniques were used; one concerned with the critical system in hypoxic damage, the central nervous system, the other assessing the central biochemical events in hypoxia. Both sets of data were assembled, then graded separately and only then combined. In this way detailed neurological assessment has been combined with measurement of urinary excretion of the ATP metabolites, hypoxanthine and xanthine. The essential metabolic consequence of hypoxia is a reduction in the synthesis of the energy currency of cells, ATP. This is associated with an outflow of ATP metabolites from cells. The extent of neurological damage was related to the magnitude of the hypoxanthine and xanthine excretion; neither were closely related to the initial blood pH. Infants who were normal neurologically had normal oxypurine excretion. Infants with neurological abnormalities for less than 48 h had lower excretion than those who were abnormal for more than 48 h. The duration of abnormal oxypurine excretion after an acute episode of hypoxia was studied in two infants with respiratory distress and in two other infants with apnoeic attacks. Severe hypoxia was followed by abnormal oxypurine excretion for at least 40 h after an acute episode. It is justifiable to suggest that abnormalities of oxypurine excretion should indicate intrapartum hypoxia in newborn infants. This excretion should also quantify the metabolic damage.

Adenosine Triphosphate↗
PubMed1996

Psychological factors in disabling low back pain: causes or consequences?

Low back pain (LBP) is a common problem that is costly in both financial and human terms. The impact of LBP on an individual varies greatly. For some, LBP is a minor inconvenience; but for others LBP is associated with significant disability and with psychosocial dysfunction for the individual and for the family. Whether psychosocial factors are causes or consequences has been the subject of debate. This paper is a review of psychosocial factors associated with disabling LBP. It addresses the question of whether these factors are causes or consequences of the disability due to LBP. Based on this review it was concluded that there is little evidence in support of the concept of a pain-prone personality. Once LBP has occurred, the impact of the LBP on the individual and the family is influenced by the health-beliefs and coping strategies of the individual and the family. Distress appears to be secondary to physical restriction rather than pain, but the distress may aggravate the pain and thus the disability. The paper concludes with a discussion of the impact of health practitioners on pain-related disability.

Chronic Disease↗
PubMed1994

Sequence variability of hepatitis C virus and its clinical relevance.

Chronic type C hepatitis is a potentially serious disease that can lead to cirrhosis and hepatocellular carcinoma. This complex disease is caused by the hepatitis C virus (HCV), a positive sense, single-stranded RNA virus. HCV has been assigned to a separate genus within the Flaviviridae, and shares a close relationship to the pestiviruses. Nucleotide sequence variation has been observed in genomes amplified from serum of patients with HCV infection, and cloning of RNA amplified from patients infected with HCV has confirmed the heterogeneity of the agent responsible for post-transfusion and sporadic hepatitis C. The variability of HCV is structured in a way that immediately suggests a two tiered classification: this nomenclature comprises 'types' corresponding to the major branches in a phylogenetic tree of sequences from genomic or subgenomic regions of the genome, and 'subtypes', corresponding to the more closely related sequences within some of the major groups. This genotyping designation has provided an epidemiological tool for studying geographical differences in hepatitis C infection. Clearly discernible patterns of genotype distribution have been found in those countries that have been studied so far. In many European countries genotype distributions vary with the age of patients, reflecting rapid changes in genotype distribution with time within a single geographical area. Unfortunately we know very little about modes of transmission within different communities. There is considerable interest in the clinical significance of different HCV genotypes, and the intriguing question of whether these differences may affect the spectrum of the disease associated with hepatitis C. These data also have implications for diagnosis and treatment of acute and chronic hepatitis C. A uniform typing scheme and nomenclature will facilitate our understanding of the disease caused by this virus worldwide.

Genotype↗
PubMed2005

Plectranthus: a review of ethnobotanical uses.

Plectranthus is a large and widespread genus with a diversity of ethnobotanical uses. The genus is plagued with numerous nomenclatural disharmonies that make it difficult to collate accurate data on the uses. The aim of this review is to gather together all ethnobotanical information on Plectranthus and to map the data onto the most up-to-date phylogenetic classification in order to see if there are similar uses among related species and hence provide a framework for the prediction and exploration of new uses of species. The uses of 62 species of Plectranthus were mapped onto a current phylogeny based on DNA sequence data. The phylogeny reveals two major Clades, 1 and 2. The members of Clade 1 (corresponding to the formally recognized genus Coleus) were richer in number and diversity of uses than members of Clade 2 (comprising the remaining species of Plectranthus). The high incidence of synonymy can lead to problems in uncovering a species' ethnobotanical profile. About 30% of all citations of Plectranthus use a synonym and most of the synonyms are attributed to 10 of the most used species, 9 of which are in Clade 1. Members of the 'Coleus' Clade are the most studied group both taxonomically and economically. The higher incidence of study may be as a result of the higher diversity of uses and the fact that species in Clade 1, such as Plectranthus barbatus, Plectranthus amboinicus and Plectranthus mollis, are geographically more widespread than those in Clade 2. Plectranthus species in Clade 1 are frequently used as medicines and are used to treat a range of ailments, particularly digestive, skin, infective and respiratory problems. Plectranthus used as foods, flavours, fodder and materials are also mostly found in Clade 1. Monoterpenoids, sesquiterpenoids, diterpenoids and phenolics have been reported in species of Plectranthus. The abietane diterpenoids are the most diverse of the diterpenoids isolated from species of Plectranthus. The labdane diterpenoid, forskolin, occurs in Plectranthus barbatus and could explain some of the traditional uses of this species. This review highlights the fact that not enough is known about the chemistry of other species of Plectranthus to explain their traditional uses.

Animals↗