PubMed Health⌕ Search

Biomedical subjects

R Esteban Mur

Publications and source records attributed to R Esteban Mur.

6 recordsLinked to original sources

[The response of the hepatitis C and hepatitis G viruses to treatment with recombinant interferon alfa-2b].

OBJECTIVE: The efficacy of recombinant alfa-2b interferon therapy in C-virus (HCV) and G-virus (HGV) in children with chronic hepatitis C was evaluated. PATIENTS AND METHODS: Fifteen patients, between 6 and 16 years of age and positive for HCV of which four were also infected with HGV, were treated with interferon (3 M three times a week for 6 months). The responders were treated for 12 months. HCV RNA, antibodies to HCV, HVC viral genome (expressed as 1000 copy equivalents of HCV genome = 1 keq), HGV RNA (RT/PCR, 5'NCR-NS5), and E2-HGV antibodies were determined before treatment and at 3 and 6 months in all patients and at 12-24 months in the responders. RESULTS: Four HCV patients (27%) with low viral load (mean 36 keg/ml) showed good results after interferon treatment and two of them (13%) with genotypes 1b and 3 according to Simmond's classification showed a maintained response. The four HGV children also showed the same good results and the RNA was negative without sero-conversion to anti-E2 after 12 months of interferon treatment. In the post-interferon treatment period, the HGV RNA appeared again in the serum in 3 of the 4 children. In the child with a maintained response, serum conversion to anti-E2 was not detected. CONCLUSIONS: 1) The current results, with only 13% of the patients reaching a sustained response, question the systematic treatment of all children affected with hepatitis C virus. Since the cost-benefit ratio is not yielding the expected results, such therapy may be reserved for patients with genotype other than 1b and a low level of viral genome. 2) HGV is sensitive to treatment with interferon, although the infection frequently appears again once the treatment is over.

Adolescent↗

[Pyogenic liver abscess. Review of 33 cases].

Thirty three cases of pyogenic liver abscess, (24 single and 9 multiple), diagnosed in our department during the past 6 years, were reviewed. Mean patient age was 54 years with a male predominance over females (1.5:1). The most frequently encountered underlying pathology was bile duct disease (33%), followed by previous liver disease (21%). Causal pathology could not be found in 4 cases (12%). The most frequent sign was fever (76%). Diagnosis was made by clinical picture and complementary exam (echography, CT scan and hepatic gammagraphy) in 29 cases (88%). Blood and pus cultures were positive in 47 and 67% of cases respectively. Thirty nine per cent of microbial abscesses were polymicrobial. E. coli and S. milleri were the most frequently isolated. No micro-organism were identified in 5 cases (15%). Antibiotic treatment was given to 33 patients. Surgical drainage was performed in 24 cases and percutaneous drainage in 7 patients. Two patients received antibiotics exclusively. Five patients died (15%), three of whom had a multiple abscess (33%) and the other two had a single abscess (8%). The efficacy of percutaneous drainage for diagnosis and treatment is analyzed reviewing recent literature.

Adolescent↗