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1.
Digestion ; 87(3): 196-203, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23689059

RESUMEN

BACKGROUND/AIMS: In patients with lamivudine (LAM)-resistant chronic hepatitis B (CHB) receiving adefovir (ADV) add-on LAM therapy, insufficient viral suppression or the appearance of additional ADV resistance has remained unresolved. This study determined the partial virological response (PVR) criteria to predict a virological response (VR) at week 96 in these patients. METHODS: 96 patients with LAM-resistant CHB (ADV add-on LAM therapy >2 years) were analyzed. For predicting VR at week 96, the area under the receiver operating characteristic curve values at different time points were compared to establish the optimal time point, and the maximal Youden index was calculated to determine the optimal cut-off hepatitis B virus (HBV) DNA level. RESULTS: 50 (52.1%) patients achieved VR at 2 years after ADV add-on LAM therapy. The optimal PVR criteria were determined to be HBV DNA 500 IU/ml at week 48. 44 (45.8%) patients who met optimal PVR criteria showed a significantly higher risk for detectable HBV DNA levels at week 96 than those with a favorable VR (HBV DNA <500 IU/ml) at week 48. CONCLUSIONS: This study suggested optimal PVR criteria in patients with LAM-resistant CHB receiving ADV add-on LAM therapy. Modification of the antiviral agent regimen should be considered if the serum HBV DNA level exceeds 500 IU/ml at week 48.


Asunto(s)
Adenina/análogos & derivados , ADN Viral/sangre , Farmacorresistencia Viral , Hepatitis B Crónica/tratamiento farmacológico , Lamivudine/administración & dosificación , Organofosfonatos/administración & dosificación , Inhibidores de la Transcriptasa Inversa/administración & dosificación , Adenina/administración & dosificación , Adulto , Área Bajo la Curva , Quimioterapia Combinada , Femenino , Hepatitis B Crónica/sangre , Hepatitis B Crónica/virología , Humanos , Masculino , Persona de Mediana Edad , Curva ROC , Resultado del Tratamiento
2.
Cancer Res Treat ; 45(2): 145-9, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23864848

RESUMEN

Humoral hypercalcemia of malignancy (HHM) is rarely associated with cholangiocarcinoma (CC), and represents dismal prognosis. A 63-year-old male was admitted for evaluation of an intrahepatic mass. He was diagnosed with HHM associated with locally advanced CC. As the tumor responded to the concurrent chemoradiotherapy with capecitabine and cisplatin, serum calcium level was normalized. However, according to the disease progression, he suffered recurrence of HHM and he expired approximately one year after initial diagnosis. A 68-year-old male who presented with abdominal pain was diagnosed with metastatic CC. After the eighth cycle of gemcitabine and cisplatin, progression of the disease was found with HHM. He was treated with the best supportive care, until his demise approximately one month after the diagnosis of HHM. We report on two cases of HHM associated with CC that demonstrate strong correlation between hypercalcemia and disease burden.

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