Hepatic hydatidosis.
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Echinococcosis, Hepatic↗
Biomedical subjects
B Frider
Publications and source records attributed to B Frider.
Lichen planus, chronic hepatitis C and interferon.
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Alanine Transaminase↗
Prevalence of hepatitis C in health care workers investigated by 2nd generation enzyme-linked and line immunoassays.
The aim of this study was to evaluate the prevalence of antibodies to hepatitis C virus (anti-HCV) in health-care workers (HCW). Sera from 439 unselected HCW were assessed for anti-HCV by 2nd generation enzyme-linked immunoassay (ELISA) and anti-HBc by ELISA. Anti-HCV (+) sera were evaluated by line immunoassay (LIA) (LiaTeK, Organon). Anti-HCV proved positive by ELISA in 12 (2.73%) subjects, 6 of whom were reactive by LIA, one was indeterminate and 5 non reactive. The prevalence of anti-HCV confirmed by LIA was 1.59% (7 subjects). Positive anti-HCV results with an ELISA ratio greater than 3 were LIA reactive in 6/6 as compared with 5 LIA non reactive with an ELISA ratio less than 2, while in the indeterminate serum the ratio was 2.5. No differences in age, profession, seniority, history of hepatitis or transfusions were found between anti-HCV (+) and (-) subjects, but females predominate significantly. The areas of higher risk were hemodialysis, obstetrics, surgery and intensive care. Anti-HBc was (+) in 85.7% (6/7) of the anti-HCV (+) subjects. Follow-up of anti-HCV (+) subjects showed raised alaninoaminotransferase levels in 4 cases, while liver biopsies in 3 disclosed cirrhosis, chronic active hepatitis and chronic persistent hepatitis. The anti-HCV prevalence in HCW is low compared with other risk groups perhaps due to the peculiar epidemiological features of HCV. In low risk groups for HCV infection a positive ELISA result with a ratio lower than 3 should be confirmed by more specific tests.
Adult↗
[Porphyria cutanea tarda and kidney transplantation].
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Hepatitis B↗
HBV and HCV infection in kidney transplant recipients.
The risk of HBV and HCV liver infection in kidney graft recipients was evaluated in 35 patients. All were tested for anti-HBc, HBsAg, HBeAg, anti-HBs, Anti-HBe, anti-HCV (c-100-3 and c-100-3, c-22, 33-c), anti-HDV and anti-HIV by ELISA, and for HBV-DNA by hybridization. Liver biopsy, immunostaining for HBcAg and Knodell's hepatic inflammatory index were performed in 18. Mean time elapsing form transplant to inclusion was 20.7 months (range 1-108). HBsAg was the only marker searched for prior to transplant. Twenty six (74.2%) patients presented HBV and/or HCV markers, while 9 (25.8%) had none; 16 (45%) proved anti-HBc+, 6(17.1%) HBsAg+, (3 HBeAg+ and 3 anti-HBe+), 7 (20%) anti-HBs+ and 3 (8.5%) isolated anti-HBc. Anti-HCV (C-100-3) was positive in 9/32 (28.1%), while 2nd. generation anti-HCV was positive in 20/35 (57.1%) cases. No false positives for 1st. generation test were found. Both anti-HDV and anti-HIV were negative in all the sample. Raised aminotransferases were present in 13/30 (43.3%), 7 in anti-HCV+, one in HBsAg+ and 3 in HBsAg+/HCV+ cases, but normal in 17/30 (56.6%). History of Transfusion and Hemodialysis time showed no significant differences between anti-HCV+ and anti-HCV negative cases. Biopsy disclosed 10 chronic persistent hepatitis (CPH), one chronic active hepatitis (CAH) with cirrhosis, one inactive cirrhosis (Ci) 4 minimal lesions (MHL) and 2 normal. Seven CPH, 3 MHL. one normal and both cirrhosis cases proved anti-HCV+. HBsAg was positive in the single CAH, in 2 CPH and in one MHL.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
[Professional risk: hepatitis B. Vaccination strategies in a general hospital].
The risk of contracting hepatitis B: (HBV) by health workers is widely accepted. In 1989 our Hepatology Service started a voluntary anti-HBV vaccination program, employing recombinant vaccine (SKF) by intramuscular route with a 0-1-6 month schedule after screening with antibody against the anti-core HBV antigen (AntiHBc Elisa Abbott). Initially, it was planned to monitor antibody titers against superficial antigen (Anti-HBs) 30 days after the last dose. An epidemiological form listing personal data, working area, profession, seniority, written consent for blood extraction and tentative acceptance of vaccination, was completed by 357 hospital staff members. After serological screening, only 184 (51%) workers agreed to receive vaccination. Given the paucity of volunteers, an attempt was made to explain this degree of reluctance by a randomized blind voluntary survey, to which 349 hospital staff members and 40 medical students replied. Questions were related to knowledge concerning vaccination in general, hepatitis and particularly hepatitis B, and specific anti-HBV vaccination. An appraisal of data gathered disclosed a considerable lack of information not only on the risk of HBV infection and its complications, but also on the existence of a suitable vaccine. Non-existent adverse effects of vaccination were mentioned, including AIDS (Acquired Immuno-Deficiency Syndrome), hepatitis and cirrhosis, among others. To overcome this obstacle, we held a two-day workshop on hepatitis B prevention and prophylaxis intended for medical and ancillary staff. After the meeting, which were attended by 221 members, 48 individuals, comprising 25 physicians and 23 nurses, spontaneously requested to be vaccinated.(ABSTRACT TRUNCATED AT 250 WORDS)
Health Knowledge, Attitudes, Practice↗
[Prevalence of antibody against the hepatitis B core antigen (anti-HBc)among hospital personnel in Buenos Aires].
A group of 1,479 employees in 19 Buenos Aires hospitals were tested for antibody to hepatitis B core antigen (anti-HBc) to identify those who should be vaccinated against this infection. The average age of the subjects was 38.22 years; 70.86% of them were women and 85.5% were working in services where the risk of infection was high. The enzyme-linked immunosorbent assay (ELISA) was used, and the data were analyzed by the chi-square test. The results showed that 1,257 subjects (85.0%) did not have anti-HBc and thus were considered candidates for vaccination. The antibody was present in 222 individuals (15.0%). The prevalence of anti-HBc increased with age and with length of service, and it was greater in laboratory technicians, nurses, and those in high-risk services. These differences were statistically significant (P less than 0.01). A total of 23 carriers of hepatitis B surface antigen (AgHBs) were identified. In high-risk groups, vaccination against hepatitis B should be preceded by serological screening of susceptible individuals; the use of anti-HBc for this purpose allows carriers of AgHBs to be identified. The high prevalence of anti-HBc in laboratory technicians, nurses, and nurses' aides might justify their systematic vaccination.
Adult↗
[Echographic specificity in the early diagnosis of human hydatidosis].
Ultrasonography (US) were used for screening of hydatid disease in 1321 asymptomatic individuals fron Río Negro Province, Argentina. A total of 76 positive subjects were identified with possible hydatid disease. Surgery was performed in 30 patients, conforming in 28 of them sonographic diagnosis (93.34%).
Argentina↗
Risk factors for acute pancreatitis in patients with migrating gallstones.
Stool screening for gallstones and ultrasound monitoring of diameter changes of the biliary and pancreatic duct were performed in 129 patients with choledocholithiasis. Gallstone migration was found in 44 patients, all of whom were operated on electively. At surgery, acute pancreatic lesions were found in 16 patients; in the remaining 28 there was no evidence of pancreatic inflammation. There were no significant differences among patients in both groups regarding sex, age, stone size, shape or number found in stools, interval between admission and migration, or the presence of a dilated pancreatic duct before migration. Pancreatic duct reflux, however, was significantly more frequent in cholangiograms of patients with acute pancreatitis, implying that a common channel may be a major factor relating to acute pancreatitis in patients with migrating gallstones.
Acute Disease↗
Ultrasonographic diagnosis of portal vein cavernous transformation in children.
The aim of this work was to evaluate the efficiency, sensitivity, and specificity of ultrasonographic findings in the diagnosis of portal vein cavernous transformation and secondary splanchnic hypertension in children. Twenty patients with esophageal varices on endoscopic sclerotherapy, with ages ranging from 1 to 15 years (mean of 7.5), were compared with 20 age-matched normal asymptomatic controls. In 17 cases, diagnosis was confirmed by splenoportography. Ultrasonographic portal vein features, respiratory variations in splenic and superior mesenteric veins, lesser omentum to aorta diameter ratio and spleen size, as well as the presence of vessels in the lesser omentum and of spontaneous anastomoses, were analyzed in both groups. The efficiency of ultrasonography to establish a diagnosis of portal vein cavernous transformation reached 100%. Splenic and superior mesenteric vein respiratory variation was negligible in patients and inspiration versus expiration diameter differences ranged from 1 to 4 mm (mean of 2.4) in controls (p less than .001). Mean lesser omentum to aorta ratio was 2.07 in patients versus .9 in controls (p less than .001). Splenomegaly was found in all but two cases; lesser omentum vessels were visualized in nine cases; whereas five presented spontaneous splenorenal anastomoses and gallbladder varices were observed in five patients. Thus, ultrasonography allowed portal vein cavernous transformation to be diagnosed throughout; portal hypertension was also detected. It may be concluded that ultrasonography, either alone or associated with endoscopy, provides a reliable method for portal vein cavernous transformation diagnosis. Angiography should be reserved for preoperative or controlled hemodynamic studies.
Child↗
Biliary and pancreatic obstruction during gallstone migration.
A prospective study on biliary and pancreatic obstruction during gallstone migration was performed in patients without acute pancreatitis. From January to October 1986, 125 patients with upper abdominal pain due to cholelithiasis were admitted to the hospital. Ultrasonography performed in all patients at admission demonstrated a distal bile duct measuring 7 mm or more in 39 patients, who were monitored for diameter changes of the biliary and pancreatic duct every 24 h and their stools screened for gallstones. Patients underwent surgery at least 8 days after admission. Gallstone migration was found preoperatively in 10 patients, of whom 6 had total serum bilirubin values lower than 2 mg/100 ml. Migration time was accurately determined by the sudden decrease in bile duct caliber. Simultaneous dilatation of biliary and pancreatic duct was found in 4 out of 10 patients with migrating gallstones and in 7 out of 23 patients without gallstone migration, though differences proved non-significant. Acute pancreatitis developed in 2 patients with lithiasis of the distal bile duct who ingested a fatty meal against medical advice. Gallstone migration, even of small stones, was preceded by a period of biliary obstruction. Pain and jaundice before migration were not as frequent as expected.
Acute Disease↗
[An echographic, serologic and radiologic register of human hydatidosis. Contributions to a control program].
Between June and November 1984, 904 asymptomatic people from endemic areas of hydatidosis in Rio Negro, Argentina, were studied by means of ultrasonography (U.S.) and double diffusion for arc five (dd5). The population included 272 inhabitants from Pilcaniyeu, 55 patients from the Zonal Bariloche Hospital admitted for diseases other than hydatidosis and 577 recruits from different departments of the Rio Negro Province. A chest X-ray was performed in every recruits. 47 (5.20%) cases of hepatic hydatidosis were detected by U.S.; 11 (1.22%) were detected by dd5 (p 0.01); 2 (0.34%) were detected by chest X-ray. Due to the low sensitivity of dd5 a presumptive diagnosis of hydatidosis should be made in every patient proceeding from an endemic area with a liver cyst diagnosed by ultrasound, even if dd5 is negative. U.S. must be incorporated as an elective method associated with chest X-ray and dd5 in epidemiological yielding and monitoring of control programs for hydatidosis.
Adolescent↗
[Echography of non-lithiasic pathology of the gallbladder. Personal experience].
Ultrasonography offers rich information of the gallbladders wall and its contents. Its high sensibility and specificity depends of the type of pathology. Its impossible to pretend an echographic histologic diagnosis but the sensibility of this method to reveal macroscopic alterations that correspond with anatomic macroscopic pathology is of sufficient hierarchy to induce a precocious surgical exploration. 85 cases of non lithiasis pathology of the gallbladder is presented. They were found in a revision of 2831 hepatobiliary echographic studies. A correlation with surgery and other methods with the ultrasonographic finding is made.
Cholecystography↗
Development of cutaneous sarcoidosis in a patient with chronic hepatitis C treated with interferon alpha 2b.
BACKGROUND: Sarcoidosis is a multisystemic granulomatous disorder of unknown etiology that most commonly affects young adults. A probable induction of sarcoidosis by interferons (IFN) has been published. To this date, few cases of cutaneous sarcoidosis inpatients with chronic hepatitis C under interferon treatment have been reported. OBJECTIVE: We describe a 50-year-old woman with chronic hepatitis C who developed lesions of cutaneous sarcoidosis three months after IFN treatment. CONCLUSIONS: The possible role of INF therapy in the development of cutaneous sarcoidosis in a patient with chronic hepatitis C should be considered.
Antiviral Agents↗
[Human hydatidosis: field echography for the determination of groups at high risk in the evaluation of a control program].
The development of small ultrasonographic equipment has permitted to incorporate this technique to the methods of early detection of Human Hydatidosis. 689 echographies were carried out in this experience, and 5.51% of compatible images in the whole population, and 12.24% in groups of risk (those living together with the operated ones) were found. It was observed a significant decrease in the infection percentages in man in the whole population of areas under Control Program, using the echographic screening. In conclusion, echography might be incorporated to the epidemiologic surveillance system of human Hydatidosis.
Adolescent↗
[The diagnostic efficacy of ultrasonography-guided puncture cytology in hepatic masses].
The aim of this work was to evaluate the diagnostic reliability of fine needle cytology guided by ultrasonography in hepatic masses. One hundred and fifty nine patients underwent this procedure. The final diagnosis was confirmed by histology obtained by percutaneous biopsy, surgery, laparoscopy and necropsy or adequate clinical follow-up in 139 cases. Twenty cases were excluded since no final diagnosis was available. In 102 cases the method was applied on an outpatient basis, while the remainder were hospitalized. There were 9 (6.4%) false negatives, whose final diagnosis were hepatocarcinoma in 4, adenocarcinoma in 3, cholangiocarcinoma in 1 and in a non Hodgkin lymphoma. The global sensitivity of the method was 93.5%, the specificity 100% and the efficiency 93.5%. In hepatocarcinomas the sensitivity was 73.3%, the specificity 100% and the efficiency 73.3%. In metastatic adenocarcinomas the sensitivity was 96.2%, the specificity 100% and the efficiency 73.3%. Except for a single hepatocarcinoma patient who developed hemoperitoneum and 2 patients who required parenteral analgesics, complications were entirely lacking. Fine needle cytology guided by ultrasonography in hepatic masses is a highly efficient method to confirm, rule out and stage liver malignancy and benign lesions in a fast low-cost fashion. The low sensitivity in hepatocarcinomas is attributable to tumor size and histological differentiation.
Adult↗
[Propranolol and 5-isosorbide mononitrate in patients with cirrhosis: systemic and portal hemodynamic events].
AIM: To study the acute variations in portal and systemic hemodynamics after propranolol and 5-isosorbide mononitrate (IMN) administration in cirrhotic patients. PATIENTS AND METHODS: Seventeen cirrhotic patients with portal hypertension were studied with catheterization and Doppler duplex Ultrasound Systemic hemodynamics. Hepatic venous pressure gradient (HVPG), portal blood flow and resistance were evaluated in baseline, after intravenous propranolol (0.15 mg/kg), and after 20 mg p.o. of IMN. Patients who showed a decrease > or = 20% and/or < 12 mm/hg in HVPG were considered responders. RESULTS: There were no significant differences in clinical or portal hemodynamic baseline data between responders and non-responders to the drugs. After propranolol administration cardiac index decreased (p < 0.05) and pulmonary capillary pressure increased (p < 0.0001). Six patients (35%) were responders; lack of response was associated with an insufficient decrease in portal blood flow or with an increase in portal resistance. After IMN administration cardiac index decreased (p < 0.05) with normalization of pulmonary capillary pressure (p < 0.05). Seven patients were responders to the addition of IMN (5 non-responders to propranolol) and showed a decrease in HVPG associated with a reduction in portal blood flow and resistance; in the remaining 10 patients HVPG did not decrease despite a reduction in portal blood flow, with an increase in portal resistance. CONCLUSIONS: Addition of IMN increased the number of responders and reduced portal blood flow with a variable effect in portal resistance.
Antihypertensive Agents↗
Asymptomatic abdominal hydatidosis detected by ultrasonography.
Ultrasonography (US) and serology (double diffusion for antigen 5 (dd5] were used for the screening of hydatid disease in 1,418 asymptomatic individuals from two provinces in Argentina. A total of 122 positive subjects were identified and in 120 of them lesions consistent with hydatid disease were observed at US (98.4%) while only 19 had positive dd5 tests (15.8%). Chest radiography was performed in 647 of the subjects and an additional 4 lesions were found. Surgery was performed in 32 patients, confirming in all of them the sonographic diagnosis. It is suggested that US should be used in the screening for hydatidosis in high-risk populations as well as in follow-up programmes.
Adolescent↗