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1Anterior muscle sparing approach for total hip arthroplasty显示文摘The purpose of this review is to examine the validity of positive claims regarding the direct anterior approach(DAA) with a fracture table for total hip arthroplasty. Recent literature regarding the DAA was searched and specific claims investigated including improved early outcomes, speed of recovery, component placement, dislocation rates, and complication rates. Recent literature is positive regarding the effects of total hip arthroplasty with the anterior approach. While the data is not definitive at present, patients receiving the anterior approach for total hip arthroplasty tend to recover more quickly and have improved early outcomes. Component placement with the anterior approach is more often in the 'safe zone' than with other approaches. Dislocation rates tend to be less than 1% with the anterior approach. Complication rates vary widely in the published literature. A possible explanation is that the varianceis due to surgeon and institutional experience with the anterior approach procedure. Concerns remain regarding the 'learning curve' for both surgeons and institutions. In conclusion, it is not a matter of should this approach be used, but how should it be implemented.Joseph T Moskal Susan G Capps John A Scanelli 2013World Journal of Orthopedics2013,4,1:47
2Biliary wound healing, ductular reactions, and IL-6/gp130 signaling in the development of liver disease显示文摘在胆汁的树上的 Basic 和翻译创伤愈合研究在皮和胃肠道上在类似的研究后面显著地落后。这是至少对为学习的胆道的容易的存取的缺乏部分可归因。但是临床的关联,对胆汁的上皮的房间(BEC ) 的更多的兴趣 BEC 文化的病理生理学,和普遍可获得性是颠倒这个趋势的因素。在额外肝的胆汁的树上,徒劳的创伤愈合,结疤,苛评开发紧迫发出。在损害的最小的 intra 肝的胆汁管任何一个, BEC 增长或繁的回答能贡献肝疾病。在大、小的胆汁管的慢性炎和坚持的创伤愈合反应经常导致肝癌症。当他们适用于胆道,依赖于表明小径的 IL-6/gp130/STAT3 的细胞的过程的重要性,未答复的问题,和未来方向,愈合的创伤的一般概念被讨论。A J Demetris John G Lunz Ⅲ Susan Specht Isao Nozaki 2006World Journal of Gastroenterology2006,12,22:15
3Existing drugs as broad-spectrum and potent inhibitors for Zika virus by targeting NS2B-NS3 interaction显示文摘Zika 病毒(ZIKV ) 的最近的爆发为治疗学加亮迫切需要。朊酶建筑群 NS2B-NS3 在 flaviviral polyprotein 处理期间起必要作用,并且因此代表一个吸引人的药目标。这里,我们开发了裂口酶识别直接指向 flavivirus NS2B-NS3 相互作用的 orthosteric 禁止者的基于互补的高产量的屏蔽试金。由屏蔽一个总数 2 816 同意了并且 investigational 药,我们识别了三个有势力候选人, temoporfin, niclosamide,和 nitazoxanide,,有 nanomolar 力量的 flavivirus NS2B-NS3 相互作用禁止者。显著地,在老鼠的在人的胎盘、神经的祖先房间的大多数有势力化合物, temoporfin,不是仅仅禁止的 ZIKV 复制,而且阻止的导致 ZIKV 的 viremia 和死亡当模特儿。结构的停靠建议 temoporfin 潜在地绑保持批评 NS2B 残余的 NS3 衣袋,因此禁止以一种非竞争的方式处理的 flaviviral polyprotein。当这些药已经在 USA 或另外的国家在另外的指示任何一个为临床的使用被同意了,他们由 ZIKV 和另外的 flaviviruses 为感染的管理代表有希望、容易开发的治疗。Zhong Li Matthew Brecher Yong-Qiang Deng Jing Zhang Srilatha Sakamuru Binbin Liu Ruili Huang Cheri A Koetzner Christina A Allen Susan A Jones Haiying Chen Na-Na Zhang Min Tian Fengshan Gao Qishan Lin Nilesh Banavali Jia Zhou Nathan Boles Menghang Xia Laura D Kramer Cheng-Feng Qin Hongmin Li 2017Cell Research2017,27,8:11
4An acorn squash (Cucurbita pepo ssp. ovifera) fruit and seed transcriptome as a resource for the study of fruit traits in Cucurbita显示文摘Acorn squash(Cucurbita pepo)is an iconic fall vegetable in the United States,known for its unique fruit shape and also prized for its culinary properties.Little is known about the metabolism that underlies the development of fruit quality attributes such as color,sweetness,texture and nutritional qualities in acorn squash,or any other winter squash grown worldwide.To provide insight into winter squash fruit and seed development and add to the genomic resources in the Cucurbita genus,RNA sequencing was used to generate an acorn squash fruit and seed transcriptome from the cultivar Sweet REBA at critical points throughout fruit development.141838600 high-quality paired-end Illumina reads were assembled into 55949 unigenes.85%of unigenes with predicted open reading frames had homology with previously identified genes and over 62%could be functionally annotated.Comparison with the watermelon and cucumber genomes provided confirmation that the unigenes are full-length and comprehensive,covering an average of 90%of the coding sequence of their homologs and 72%of the cucumber and watermelon exomes.Key candidate genes associated with carotenoid and carbohydrate metabolism were identified toward a resource for winter squash fruit quality trait dissection.This transcriptome represents a major advance in C.pepo genomics,providing significant new sequence information and revealing the repertoire of genes expressed throughout winter squash fruit and seed development.Future studies on the genetic basis of fruit quality and future breeding efforts will be enhanced by tools and insights developed from this resource.Lindsay E Wyatt Susan R Strickler Lukas A Mueller Michael Mazourek 2015Horticulture Research2015,2,1:11
5Computed tomography overestimation of esophageal tumor length: Implications for radiotherapy planning显示文摘AIM:To assess the relationship between preoperative computed tomography(CT)and postoperative pathological measurements of esophageal tumor length and the prognostic significance of CT tumor length data.METHODS:A retrospective study was carried out in 56 patients who underwent curative esophagogastrectomy.Tumor lengths were measured on the immediate preoperative CT and on the post-operative resection specimens.Inter-and intra-observer variations in CT measurements were assessed.Survival data were collected.RESULTS:There was a weak correlation between CT and pathological tumor length(r=0.30,P=0.025).CT lengths were longer than pathological lengths in 68%(38/56)of patients with a mean difference of 1.67 cm(95%CI:1.18-2.97).The mean difference in measurements by two radiologists was 0.39 cm(95% CI:-0.59-1.44).The mean difference between repeat CT measured tumor length(intra-observer variation) were 0.04 cm(95%CI:-0.59-0.66)and 0.47 cm (95%CI:-0.53-1.47).When stratified,patients not receiving neoadjuvant chemotherapy showed a strong correlation between CT and pathological tumor length(r =0.69,P=0.0014,n=37)than patients that did(r= 0.13,P=0.43,n=19).Median survival with CT tumor length>5.6 cm was poorer than with smaller tumors,but the difference was not statistically significant.CONCLUSION:Esophageal tumor length assessed using CT does not reflect pathological tumor extent and should not be the only modality used for management decisions,particularly for planning radiotherapy.Karim Sillah Luke R Williams Hans-Ulrich Laasch Azeem Saleem Gillian Watkins Susan A Pritchard Patricia M Price Catharine M West Ian M Welch 2010World Journal of Gastrointestinal Oncology2010,2,4:10
6Constipation-predominant irritable bowel syndrome: A review of current and emerging drug therapies显示文摘Irritable bowel syndrome(IBS) is a highly prevalent medical condition that adversely affects patient quality of life and constitutes a significant economic burden on healthcare resources. A large proportion of patients suffer from the constipation subtype of IBS(IBS-C), most commonly afflicting older individuals and those with a lower socioeconomic status. Conventional pharmacologic and nonpharmacologic treatment options have limited efficacies and/or significant adverse events, which lead to increased long-term health care expenditures. Failure to effectively treat IBS-C patients over the past decades has largely been due to a poor understanding of disease pathophysiology, lack of a global view of the patient, and an inappropriate selection of patients and treatment endpoints in clinical trials. In recent years, however, more effective and safer drugs have been developed for the treatment of IBS-C. The advancement in the area of pharmacologic treatment is based on new knowledge of the pathophysiologic basis of IBS-C and the development of drugs with increased selectivity within pharmacologic classes with recognized efficacies. This narrative review covers the spectrum of available drugs and their mechanisms of action, as well as the efficacy and safety profiles of each as determined in relevant clinical trials that have investigated treatment options for IBS-C and chronic constipation. A brief summary of laxative-based treatment options is presented, followed by up-to-date assessments for three classes of drugs: prokinetics, prosecretory agents, and bile acid modulators.Khaled A Jadallah Susan M Kullab David S Sanders 2014World Journal of Gastroenterology2014,20,27:9
7改进医疗服务质量、确保病人安全的教学方法显示文摘提高医疗服务质量、确保病人安全是当前医学教育及培训面临的巨大挑战。今天的医生及医务工作者应具备良好的沟通能力,掌握如何在临床实践中鉴别、预防和处理不良事件及接近过失事件(nearmisses),如何使用当前获得的证据及相关信息,如何安全有效地在团队中工作,如何在实践中教授和学习病人安全知识,如何根据认可的伦理原则服务公众。Merrilyn M Walton Bruce H Barraclough Samantha A Van Staalduinen Susan L Elliott 段玉蓉(译) 张鸣明(审校) 2009中国循证医学杂志2009,9,9:7
8Comparative analysis of Cucurbita pepo metabolism throughout fruit development in acorn squash and oilseed pumpkin显示文摘Both the fruit mesocarp and the seeds of winter squash can be used for consumption,although the focus of breeding efforts varies by cultivar.Cultivars bred for fruit consumption are selected for fruit mesocarp quality traits such as carotenoid content,percent dry matter,and percent soluble solids,while these traits are essentially ignored in oilseed pumpkins.To compare fruit development in these two types of squash,we sequenced the fruit transcriptome of two cultivars bred for different purposes:an acorn squash,‘Sweet REBA’,and an oilseed pumpkin,‘Lady Godiva’.Putative metabolic pathways were developed for carotenoid,starch,and sucrose synthesis in winter squash fruit and squash homologs were identified for each of the structural genes in the pathways.Gene expression,especially of known rate-limiting and branch point genes,corresponded with metabolite accumulation both across development and between the two cultivars.Thus,developmental regulation of metabolite genes is an important factor in winter squash fruit quality.Lindsay E Wyatt Susan R Strickler Lukas A Mueller Michael Mazourek 2016Horticulture Research2016,3,1:7
9Gastroenterologist perceptions of faecal microbiota transplantation显示文摘AIM: To explore gastroenterologist perceptions towards and experience with faecal microbiota transplantation(FMT).METHODS: A questionnaire survey consisting of 17 questions was created to assess gastroenterologists' attitude towards and experience with FMT. This was anonymously distributed in hard copy format amongst attendees at gastroenterology meetings in Australia between October 2013 and April 2014. Basic descriptive statistical analyses were performed.RESULTS: Fifty-two clinicians participated. Twenty one percent had previously referred patients for FMT,8% more than once. Ninety percent would refer patients with Clostridium difficile infection(CDI) for FMT if easily available,37% for ulcerative colitis,13% for Crohn's disease and 6% for irritable bowel syndrome. Six percent would not refer any indication,including recurrent CDI. Eighty-six percent would enroll patients in FMT clinical trials. Thirty-seven percent considered the optimal mode of FMT administration transcolonoscopic,17% nasoduodenal,13% enema and 8% oral capsule. The greatest concerns regarding FMT were: 42% lack of evidence,12% infection risk,10% non infectious adverse effects/lack of safety data,10% aesthetic,10% lack of efficacy,4% disease exacerbation,and 2% inappropriate use; 6% had no concerns. Seventy seven percent believed there is a lack of accessibility while 52% had an interest in learning how to provide FMT. Only 6% offered FMT at their institution.CONCLUSION: Despite general enthusiasm,most gastroenterologists have limited experience with,or access to,FMT. The greatest concerns were lack of supportive evidence and safety issues. However a significant proportion would refer indications other than CDI for FMT despite insufficient evidence. These data provide guidance on where education and training are required.Sudarshan Paramsothy Alissa J Walsh Thomas Borody Douglas Samuel Johan van den Bogaerde Rupert WL Leong Susan Connor Watson Ng Hazel M Mitchell Nadeem O Kaakoush Michael A Kamm 2015World Journal of Gastroenterology2015,21,38:5
10Mental and physical symptoms associated with lower social support for patients with hepatitis C显示文摘AIM: To systematically examine the impact of the hepatitis C virus (HCV) diagnosis on patients' level of social support in a large-scale study. METHODS: Patients evaluated and treated for HCV in a tertiary referral center were enrolled in a cross-sectional study. Demographic data, functional and emotional status as measured by the Hospital Anxiety and Depression Scale (HAD) and the Sickness Impact Profile (SIP), severity of liver disease, mode of acquisition, and physical and psychiatric comorbidities were collected from patients or abstracted from the medical record. All participants completed a semi-structured interview, addressing questions of social support. RESULTS: A total of 342 patients (mean age 45.2 years; 37% women) were enrolled. Ninety-two (27%) patients described lower levels of support by family and friends. Nearly half of the participants (45%) noted the loss of at least one relationship due to the disease. Fears related to transmitting the disease (25%) were common and often associated with ignorance or even discrimination by others (19%). Nearly one fifth of the patients did not share information about their disease with others to avoid being stigmatized. Lower levels of social support were significantly associated with living alone, being unemployed, being excluded from antiviral therapy, having psychiatric comorbidities, contracting HCV through intravenous drug use, having high levels of anxiety and depression as measured by the HAD and negative mood state as measured by the SIP. Patients reporting lower levels of social support also noted more physical symptoms as measured by the SIP. CONCLUSION: Patients with hepatitis C often face significant social problems, ranging from social isolation to familial stress. The most common concerns reflect a limited insight of patients and their relatives and friends about the disease, the risk factors for its spread, and about potential consequences. Our data suggest that educational interventions targeting support persons and the stressors identified in our findings may lessen or alleviate the social strains patients with hepatitis C experience.Julie A Blasiole Laura Shinkunas Douglas R LaBrecque Robert M Arnold Susan L Zickmund 2006World Journal of Gastroenterology2006,12,29:5
11Inflammatory bowel disease associated neoplasia:Asurgeon's perspective显示文摘Inflammatory bowel disease(IBD) is associated with increased risk of colorectal cancer(CRC). The risk is known to increase with longer duration of the disease, family history of CRC, and history of primary sclerosing cholangitis. The diagnosis of the neoplastic changes associated with IBD is difficult owing to the heterogeneous endoscopic appearance and interobserver variability of the pathological diagnosis. Screening and surveillance guidelines have been established which aim for early detection of neoplasia. Several surgical options are available for the treatment of IBD-associated neoplasia. Patients' morbidities, risk factors for CRC, degree and the extent of neoplasia must be considered in choosing the surgical treatment. A multidisciplinary team including the surgeon, gastroenterologist, pathologist, and the patient who has a clear understanding of the nature of their disease is needed to optimize outcomes.Azah A Althumairi Mark G Lazarev Susan L Gearhart 2016World Journal of Gastroenterology2016,22,3:4
12Eosinophils and mast cells as therapeutic targets in pediatric functional dyspepsia显示文摘There is an increasing appreciation for the importance of inflammation as a pathophysiologic entity that contributes to functional gastrointestinal disorders including functional dyspepsia(FD).Importantly,inflammation may serve as a mediator between psychologic and physiologic functions.This manuscript reviews the literature implicating two inflammatory cell types,mast cells and eosinophils,in the generation of dyspeptic symptoms and explores their potential as targets for the treatment of FD.There are a number of inciting events which may initiate an inflammatory response,and the subsequent recruitment and activation of mast cells and eosinophils.These include internal triggers such as stress and anxiety,as well as external triggers such as microbes and allergens.Previous studies suggest that there may be efficacy in utilizing medications directed at mast cells and eosinophils.Evidence exists to suggest that combining 'anti-inflammatory' medications with other treatments targeting stress can improve the rate of symptom resolution in pediatric FD.Craig A Friesen Jennifer V Schurman Jennifer M Colombo Susan M Abdel-Rahman 2013World Journal of Gastrointestinal Pharmacology and Therapeutics2013,4,4:4
13伦理学与SARS:多伦多的教训显示文摘SARS的流行说明传染病在世界范围内流行是件多么容易的事,为了更好地应对下一次流行病,我们不仅要解决医学方面的问题,也同样需要解决伦理学方面的问题。Peter A Singer Solomon R Benatar Mark Bernstein Abdallah S Daar Bernard M Dickens Susan K MacRae Ross E G Upshur Linda Wright Randi Zlotnik Shaul 肖月 2004英国医学杂志中文版2004,7,4:3
14Shoot and root traits in drought tolerant maize(Zea mays L.) hybrids显示文摘This study aimed to investigate the differences in shoot and root traits, and water use and water use efficiency(WUE) in drought tolerant(DT) maize(Zea mays L.) hybrids under full and deficit irrigated conditions. A two-year greenhouse study was conducted with four hybrids(one conventional hybrid, 33D53AM, two commercial DT hybrids, P1151 AM, N75H, and an experimental hybrid, Exp HB) grown under two water regimes(I_(100) and I_(50), referring to 100 and 50% of evapotranspiration requirements). Under water stress, the hybids P1151 AM, N75, and Exp HB showed more drought tolerance and had either greater shoot dry weight or less dry weight reduction than the conventional hybrid(33 D53 AM). However, these three hybrids responded to water stress using different mechanisms. Compared with the conventional hybrid, the two commercial DT hybrids(P1151 AM and N75H) had a smaller leaf area, shoot dry weight, and root system per plant. As a result, these hybrids used less water but had a higher WUE compared with the conventional hybrid. In contrast, the experimental hybrid(ExpHB) produced more shoot biomass by silking stage at both irrigation levels than all other hybrids, but it had relatively lower WUE. The hybrids demonstrated different drought response mechanisms that may require different irrigation management strategies. More investigation and validation are needed under field conditions and in different soil types.ZHAO Jin XUE Qing-wu Kirk E Jessup HOU Xiao-bo HAO Bao-zhen Thomas H Marek XU Wen-wei Steven R Evett Susan A O'Shaughnessy David K Brauer 2018Journal of Integrative Agriculture2018,17,5:3
15Th1 cytokines promote T-cell binding to antigen-presenting cells via enhanced hyaluronan production and accumulation at the immune synapse显示文摘Hyaluronan(HA)production by dendritic cells(DCs)is known to promote antigen presentation and to augment T-cell activation and proliferation.We hypothesized that pericellular HA can function as intercellular‘glue’directly mediating T cell–DC binding.Using primary human cells,we observed HA-dependent binding between T cells and DCs,which was abrogated upon pre-treatment of the DCs with 4-methylumbelliferone(4-MU),an agent which blocks HA synthesis.Furthermore,T cells regulate HA production by DCs via T cell-derived cytokines in a T helper(Th)subset-specific manner,as demonstrated by the observation that cell-culture supernatants from Th1 but not Th2 clones promote HA production.Similar effects were seen upon the addition of exogenous Th1 cytokines,IL-2,interferon c(IFN-c)and tumor necrosis factor a(TNF-a).The critical factors which determined the extent of DC–T cell binding in this system were the nature of the pre-treatment the DCs received and their capacity to synthesize HA,as T-cell clones which were pre-treated with monensin,added to block cytokine secretion,bound equivalently irrespective of their Th subset.These data support the existence of a feedforward loop wherein T-cell cytokines influence DC production of HA,which in turn affects the extent of DC–T cell binding.We also document the presence of focal deposits of HA at the immune synapse between T-cells and APC and on dendritic processes thought to be important in antigen presentation.These data point to a pivotal role for HA in DC–T cell interactions at the IS.Paul L Bollyky Stephen P Evanko Rebecca P Wu Susan Potter-Perigo S Alice Long Brian Kinsella Helena Reijonen Kelly Guebtner Brandon Teng Christina K Chan Kathy R Braun John A Gebe Gerald T Nepom Thomas N Wight 2010Cellular & Molecular Immunology2010,7,3:3
16Ron receptor-dependent gene regulation in a mouse model of endotoxin-induced acute liver failure显示文摘BACKGROUND:Prior experimentation has shown that loss of the tyrosine kinase(TK) signaling domain of the Ron receptor leads to marked hepatocyte protection in a model of lipopolysaccharideinduced acute liver failure(ALF) in D-galactosamine(GalN)sensitized mice.The aim of this study was to identify the role of Ron in the regulation of hepatic gene expression.METHODS:Microarray analyses were performed on liver RNA isolated sequentially from wild-type(WT) and TK-/mice during the progression of ALF.Gene array data were validated using Western and immunohistochemistry analyses as well as with ex vivo culture systems.RESULTS:At baseline,101 genes were differentially expressed between WT and TK-/-livers,which regulate processes involved in hypoxia,proliferation,apoptosis and metabolism.One hour after ALF induction,WT livers exhibited increased cytokine expression compared to TK-/-livers,and after 4 hours,an induction of suppressor of cytokine signaling(SOCS) genes as well as JAK-STAT pathway activation were prominent in TK-/livers compared to controls.CONCLUSION:Our studies suggest a novel hepato-protective mechanism in Ron TK-/-mice wherein increased and sustained SOCS production and JAK-STAT activation in the hepatocyte may inhibit the destructive proinflammatory milieu and promote survival factors which blunt hepatic death and the ensuing development of ALF.Rishikesh M Kulkarni Louis W Kutcher William D Stuart Daniel J Carson Mike A Leonis Susan E Waltz 2012Hepatobiliary & Pancreatic Diseases International2012,11,4:3
17Present state and future challenges in pediatric abdominal pain therapeutics research: Looking beyond the forest显示文摘At the present time, it is nearly impossible to treat pediatric functional gastrointestinal disorders associated with pain in an evidence based fashion. This is due to the overall lack of controlled studies and, even more importantly, the complexity of the contributors to disease phenotype which are not controlled or accounted for in most therapeutic trials. In this manuscript, we review the challenges of defining entry criteria, controlling for the large number of biopsychosocial factors which may effect outcomes, and understanding pharmacokinetic and pharmacodynamic factors when designing therapeutic trials for abdominal pain in children. We also review the current state of pediatric abdominal pain therapeutics and discuss trial design considerations as we move forward.Craig A Friesen Jennifer V Schurman Susan M Abdel-Rahman 2015World Journal of Gastrointestinal Pharmacology and Therapeutics2015,6,4:3
18Patients undergoing infrainguinal bypass to treat atherosclerotic vascular disease are underprescribed cardioprotective medications: effect on graft patency, limb salvage, and mortality显示文摘Peter K Henke Susan Blackburn Mary C Proctor Jeri Stevens Debabrata Mukherjee Sanjay Rajagopalin Gilbert R Upchurch James C Stanley Kim A Eagle 2004Journal of Vascular Surgery2004,,:2
19Knowledge, perception and practices about malaria, climate change, livelihoods and food security among rural communities of central Tanzania显示文摘Background:Understanding the interactions between malaria and agriculture in Tanzania is of particular significance when considering that they are the major sources of illness and livelihoods.The objective of this study was to determine knowledge,perceptions and practices as regards to malaria,climate change,livelihoods and food insecurity in a rural farming community in central Tanzania.Methods:Using a cross-sectional design,heads of households were interviewed on their knowledge and perceptions on malaria transmission,symptoms and prevention and knowledge and practices as regards to climate change and food security.Results:A total of 399 individuals(mean age=39.8±15.5 years)were interviewed.Most(62.41%)of them had attained primary school education and majority(91.23%)were involved in crop farming activities.Nearly all(94.7%)knew that malaria is acquired through a mosquito bite.Three quarters(73%)reported that most people get sick from malaria during the rainy season.About 50%of the respondents felt that malaria had decreased during the last 10 years.The household coverage of insecticide treated mosquito nets(ITN)was high(95.5%).Ninety-six percent reported to have slept under a mosquito net the previous night.Only one in four understood the official Kiswahili term(Mabadiliko ya Tabia Nchi)for climate change.However,there was a general understanding that the rain patterns have changed in the past 10 years.Sixty-two percent believed that the temperature has increased during the same period.Three quarters of the respondents reported that they had no sufficient production from their own farms to guarantee food security in their household for the year.Three quarters(73.0%)reported to having food shortages in the past five years.About half said they most often experienced severe food shortage during the rainy season.Conclusion:Farming communities in Kilosa District have little knowledge on climate change and its impact on malaria burden.Food insecurity is common and community-based strategies to mitigate this need to be established.The findings call for an integrated control of malaria and food insecurity interventions.Benjamin K Mayala Carolyn A Fahey Dorothy Wei Maria M Zinga Venera M Bwana Tabitha Mlacha Susan F Rumisha Grades Stanley Elizabeth H Shayo Leonard EG Mboera 2015Infectious Diseases of Poverty2015,4,1:2
20Hepatitis B and C infection and liver disease trends among human immunodeficiency virus-infected individuals显示文摘AIM:To examine trends in and correlates of liver disease and viral hepatitis in an human immunodeficiency virus (HIV)-infected cohort. METHODS:The multi-site adult/adolescent spectrum of HIV-related diseases (ASD) followed 29 490 HIVinfected individuals receiving medical care in 11 U.S. metropolitan areas for an average of 2.4 years,and a total of 69 487 person-years,between 1998 and 2004. ASD collected data on the presentation,treatment,and outcomes of HIV,including liver disease,hepatitis screening,and hepatitis diagnoses. RESULTS:Incident liver disease,chronic hepatitis B virus (HBV),and hepatitis C virus (HCV) were diagnosed in 0.9,1.8,and 4.7 per 100 person-years. HBV and HCV screening increased from fewer than 20% to over 60% during this period of observation (P < 0.001). Deaths occurred in 57% of those diagnosed with liver disease relative to 15% overall (P < 0.001). Overall 10% of deaths occurred among individuals with a diagnosis of liver disease. Despite care guidelines promoting screening and vaccination for HBV and screening for HCV,screening and vaccination were not universally conducted or,if conducted,not documented. CONCLUSION:Due to high rates of incident liver disease,viral hepatitis screening,vaccination,and treatment among HIV-infected individuals should be a priority.Susan E Buskin Elizabeth A Barash John D Scott David M Aboulafia Robert W Wood 2011World Journal of Gastroenterology2011,17,14:2
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