Kathleen Hansen | PubMed Health

PubMed2005

Septuplet placenta: a case report.

OBJECTIVE: On November 19, 1997, 7 liveborn infants (4 boys and 3 girls) were delivered by cesarean delivery at 30.5 weeks gestational age. The pregnancy was the result of artificial induction of ovulation. STUDY DESIGN: The septuplet placenta was evaluated with a standard and systematic procedure for placentas of multiple births that revealed a septamnionic, septchorionic architecture with 5 fused and 2 unfused placentas. RESULTS: Each of the 7 umbilical cords contained 3 vessels. Two cords were velamentous; the remaining 5 cords were inserted eccentrically. The ratio of combined birth weights of the 7 infants to total placental weight (7.52:1) correlated with normograms of singleton and twin gestations. CONCLUSION: This ratio and additional calculations were used for comparison and for additional clinicopathologic correlations.

Adult↗

PubMed2004

Treatment of recurrent hepatitis C infection after liver transplantation with combination of pegylated interferon alpha2b and ribavirin: an open-label series.

BACKGROUND: Hepatitis C virus (HCV) recurrence after orthotopic liver transplantation (OLT) is universal. We aimed to evaluate the efficacy and safety of pegylated interferon (PEG-IFN) and ribavirin (RIB) in the treatment of post-OLT HCV recurrence. METHODS: Thirty-seven patients with recurrent HCV after OLT were screened and began treatment. Nineteen patients have completed therapy. PEG-IFN was started at a dose of 0.5 microg/kg per week and titrated toward a maximum dose of 1.5 microg/kg per week. RIB was started at a dose of 400 mg per day and titrated toward a maximum of 1000 mg per day, as tolerated. Therapy continued for 1 year after HCV replication was undetectable by reverse transcriptase-polymerase chain reaction and was discontinued if there was no virologic clearance at 48 weeks. RESULTS: Twelve patients (63%) completed the combination regimen. Therapy was discontinued in seven (37%) patients. Seven patients (37%) had undetectable viral load at the end of treatment. Of those, five patients (26%) had sustained viral response 6 months after discontinuation of therapy. Five patients (26%) had no virologic response. Necro-inflammatory score declined from 5.22 to 2.89 (P=0.05) in nonresponders versus 6.8 to 2.6 (P<0.01) in responders. Fibrosis stage did not change in either group. Genotype 1-infected patients had a lower likelihood of attaining end of treatment or sustained viral response (P<0.05 for both). CONCLUSIONS: Post-OLT HCV recurrence can be safely treated with PEG-IFN and RIB. Bone marrow toxicity, depression, and rejection are limiting factors that require aggressive management. There was short-term histologic benefit to the use of this regimen, even in those patients without viral clearance.

Antiviral Agents↗