Assuntos
Fibrose/epidemiologia , Hepatite B/epidemiologia , Hepatite D/epidemiologia , Vírus Delta da Hepatite/isolamento & purificação , Hepatopatias/virologia , Adulto , Doença Crônica , Feminino , Fibrose/mortalidade , Carga Global da Doença , Antígenos de Superfície da Hepatite B/imunologia , Vírus da Hepatite B/isolamento & purificação , Hepatite D/complicações , Hepatite D/tratamento farmacológico , Hepatite D/mortalidade , Vírus Delta da Hepatite/imunologia , Humanos , Incidência , Interferon-alfa/economia , Interferon-alfa/uso terapêutico , Lipopeptídeos/uso terapêutico , Hepatopatias/epidemiologia , Hepatopatias/imunologia , Masculino , Pessoa de Meia-Idade , Piperidinas/uso terapêutico , Prevalência , Piridinas/uso terapêutico , Fatores de Risco , Superinfecção/complicações , Uzbequistão/epidemiologiaRESUMO
OBJECTIVES: Red blood cell autoantibodies (RBC autoAbs) of IgG class are found in the majority of patients with warm autoimmune hemolytic anemia (wAIHA) but sometimes also during the pretransfusion testing of patients with different diagnoses but without hemolysis. The aim of the study was to identify the main differences between these two groups of patients according to age, gender, subclass and titer of IgG RBC autoAbs and diagnosis. MATERIAL AND METHODS: In the 9-year retrospective study, data were collected from records of 291 patients with IgG RBC autoAbs detected by gel technique, from which 111 with wAIHA. RESULTS: More than 85% of patients in both groups were over 40 years old, with male to female ratio 1:1.9 in wAIHA vs 1:1.3 in patients without hemolysis (P=0.0916). The main characteristics of patients with wAIHA vs patients without hemolysis were: IgG only 38% vs 70%, IgG+Complement 62% vs 30%, total IgG1 79% vs 55%, IgG1+IgG3 35% vs 11%, titer of 100 for IgG1+IgG3 17% vs 3% (P<0.0001), respectively, while titer of 100 for IgG1 18% vs 9% (P=0.0241). The underlying diagnosis in wAIHA vs patients without hemolysis: hematologic disorders 41% vs 22% (P=0.0006), autoimmune disorders 12% vs 13% (P=0.8033), solid tumors 5% vs 14% (P=0.0154) and surgery procedures 6% vs 26% (P<0.0001). CONCLUSION: We observed more wAIHA patients with high titer of IgG1 and high prevalence of IgG1+IgG3 and consider that patients without hemolysis having identical results might be interesting to find out how they are protected from damage by RBC autoAbs.
Assuntos
Anemia Hemolítica Autoimune/imunologia , Autoanticorpos/sangue , Eritrócitos/imunologia , Imunoglobulina G/sangue , Idoso , Anemia Hemolítica Autoimune/sangue , Anemia Hemolítica Autoimune/etiologia , Grupos Diagnósticos Relacionados , Feminino , Cardiopatias/sangue , Cardiopatias/imunologia , Hemólise , Humanos , Falência Renal Crônica/sangue , Falência Renal Crônica/imunologia , Hepatopatias/sangue , Hepatopatias/imunologia , Masculino , Pessoa de Meia-Idade , Neoplasias/sangue , Neoplasias/imunologia , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/imunologia , Estudos RetrospectivosRESUMO
INTRODUCTION: This study examined pneumococcal vaccine coverage in adults aged 19-64 years newly diagnosed with diabetes, chronic heart, lung, or liver disease. These conditions are indicated for pneumococcal vaccination by the Advisory Committee on Immunization Practices. METHODS: A retrospective cohort analysis was conducted in 2016 using the Truven Health MarketScan® database. The study population was adults aged 19-64 years with at least one new chronic condition during 2009-2013 and continuous health plan enrolment for 2 years before and 1 year after the initial diagnosis. Vaccine coverage by length of follow-up since diagnosis (ranging from 1 to 5 years) was summarized. Multivariate analyses were performed to understand factors associated with vaccination. RESULTS: A total of 552,942 adults aged 19-64 years with chronic conditions were identified. There were 8% of adults newly diagnosed with one of four chronic conditions that received a pneumococcal vaccination after 1 year of follow-up; the proportion increased to 20.1% among those with 5 years of follow-up data. Adults aged 50-64 years were more likely to be vaccinated than those aged 19-49 years. Adults with diabetes were more likely to be vaccinated than adults with chronic heart, lung, or liver disease. Adults enrolled in HMO plans were more likely to be vaccinated than adults in other plan types. A higher number of healthcare encounters increased the likelihood of vaccination. Adults who received influenza vaccination were also more likely to receive a pneumococcal vaccination. CONCLUSIONS: Vaccine coverage remains well below Healthy People 2020 targets. A substantial number of adults with chronic conditions remain unvaccinated and at risk for pneumococcal disease.
Assuntos
Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/uso terapêutico , Cobertura Vacinal/estatística & dados numéricos , Adulto , Fatores Etários , Doença Crônica , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/imunologia , Feminino , Seguimentos , Cardiopatias/diagnóstico , Cardiopatias/imunologia , Humanos , Hepatopatias/diagnóstico , Hepatopatias/imunologia , Pneumopatias/diagnóstico , Pneumopatias/imunologia , Masculino , Pessoa de Meia-Idade , Infecções Pneumocócicas/economia , Infecções Pneumocócicas/imunologia , Estudos Retrospectivos , Adulto JovemRESUMO
Although classification criteria for systemic sclerosis (SSc) do not incorporate gastrointestinal tract (GIT) manifestations often present in this disease, the GIT is the most common internal organ involved. Pathophysiology of GIT involvement is thought to be similar to other organs in SSc with fibroproliferative vascular lesions of small arteries and arterioles, increased production of profibrotic growth factors, and alterations of innate, humoral, and cellular immunity. These processes result in neuropathy progressing to myopathy with eventual fibrosis. Proper diagnostics and therapeutics for SSc-GIT involvement require the treating physician to have an understanding of an integrated approach and potential medication adverse effects.
Assuntos
Gastroenteropatias , Hepatopatias , Conduta do Tratamento Medicamentoso , Escleroderma Sistêmico , Gastroenteropatias/complicações , Gastroenteropatias/imunologia , Humanos , Inflamação/imunologia , Hepatopatias/complicações , Hepatopatias/imunologia , Escleroderma Sistêmico/complicações , Escleroderma Sistêmico/tratamento farmacológico , Escleroderma Sistêmico/imunologiaRESUMO
Results of examination of 233 patients with hepatic tumors provided new criteria of the patients' selection for extended hepatic resections. Correlation between the degree of affection of porto-hepatic hemodynamics and the risk of hepatic failure was found. It is also demonstrated that an increase in the diameter of hepatic tumor leads to a decrease in the main hemodynamic parameters in the portal vein. The level of proinflammatory cytokines may be regarded not only as an indicator of tissue alteration but also as a significant prognostic criterion.
Assuntos
Interleucina-1beta/imunologia , Interleucina-6/imunologia , Hepatopatias , Hemodinâmica/fisiologia , Humanos , Hepatopatias/imunologia , Hepatopatias/fisiopatologia , Hepatopatias/cirurgiaAssuntos
Anticorpos/metabolismo , Biotecnologia/economia , Programas Governamentais/economia , Fígado/imunologia , Fígado/metabolismo , Proteômica/economia , Proteômica/métodos , Anticorpos/imunologia , Anticorpos/isolamento & purificação , Biotecnologia/métodos , Biotecnologia/organização & administração , China , Financiamento Governamental/economia , Financiamento Governamental/organização & administração , Programas Governamentais/métodos , Programas Governamentais/organização & administração , Humanos , Hepatopatias/imunologia , Hepatopatias/metabolismo , Mapeamento de Interação de Proteínas/economia , Mapeamento de Interação de Proteínas/métodos , Proteômica/organização & administração , Pesquisa/economia , Projetos de PesquisaAssuntos
Doenças Biliares/imunologia , Hepatopatias/imunologia , Pesquisa , Animais , Autoanticorpos/biossíntese , Criança , Colangite Esclerosante/genética , Colangite Esclerosante/imunologia , Modelos Animais de Doenças , Hepatite Autoimune/genética , Hepatite Autoimune/imunologia , Humanos , Pesquisa/economiaAssuntos
Hepatopatias/cirurgia , Transplante de Fígado , Pesquisa , Constituição Corporal , Criança , Humanos , Hospedeiro Imunocomprometido , Hepatopatias/imunologia , Transplante de Fígado/métodos , Transplante de Fígado/mortalidade , Qualidade de Vida , Pesquisa/economia , Análise de Sobrevida , Resultado do TratamentoAssuntos
Efeitos Psicossociais da Doença , Hepatopatias/epidemiologia , Adolescente , Adulto , Doenças Autoimunes/epidemiologia , Carcinoma Hepatocelular/economia , Carcinoma Hepatocelular/epidemiologia , Criança , Pré-Escolar , Colelitíase/economia , Colelitíase/epidemiologia , Fígado Gorduroso/economia , Fígado Gorduroso/epidemiologia , Feminino , Hepatite Viral Humana/economia , Hepatite Viral Humana/epidemiologia , Humanos , Hipertensão Portal/economia , Hipertensão Portal/epidemiologia , Lactente , Recém-Nascido , Hepatopatias/economia , Hepatopatias/imunologia , Hepatopatias Alcoólicas/economia , Hepatopatias Alcoólicas/epidemiologia , Neoplasias Hepáticas/economia , Neoplasias Hepáticas/epidemiologia , Transplante de Fígado , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: To investigate signs of liver disease, and biochemical and immunological markers in blood donors with isolated GBV-C/HGV viremia. METHODS: Eighteen donors with isolated GBV-C/HGV viremia were followed up 3-5 years after initial identification. Testing for GBV-C/HGV RNA, GBV-C/HGV-E2 antibodies and a range of biochemical and immunological tests was performed. Thirteen donors consented to liver biopsy. RESULTS: Twelve donors remained GBV-C/HGV viremic at follow-up. Five donors had developed E2 antibodies. Liver biopsies revealed mild portal inflammatory lesions in 6/11 individuals with persistent viremia, and steatosis in 10/13 biopsied donors. CONCLUSION: Steatosis and mild portal inflammatory lesions were found in liver biopsies from several blood donors with isolated GBV-C/HGV viremia.
Assuntos
Biomarcadores/sangue , Flaviviridae , Hepatite Viral Humana/complicações , Hepatopatias/virologia , Adulto , Alanina Transaminase/sangue , Anticorpos Antinucleares/sangue , Biópsia , Índice de Massa Corporal , Feminino , Flaviviridae/genética , Flaviviridae/imunologia , Citometria de Fluxo , Anticorpos Anti-Hepatite/sangue , Hepatite Viral Humana/sangue , Humanos , Fígado/patologia , Hepatopatias/sangue , Hepatopatias/imunologia , Subpopulações de Linfócitos/imunologia , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , RNA Viral/sangue , Medição de Risco , Suécia , Doadores de Tecidos , Viremia/sangue , Viremia/complicaçõesRESUMO
A new serological assay to detect antibodies against hepatitis C, based on a recombinant protein (BHC10) which incorporates structural and non-structural viral antigens, was tested in 67 healthy subjects and 409 patients with various forms of liver disease. Results were compared with the current assay based on the recombinant non-structural viral antigen c100 and with the recently introduced second-generation assay, Ortho2. None of the healthy subjects was positive by any of the assays. In patients with chronic non-A, non-B hepatitis the prevalence of anti-BHC10 was 96.8%, higher than anti-c100 (83.3%, p less than 0.001) and similar to Ortho2 (94.3%). False-positive results were less frequently found when BHC10 was used. These findings show that assays incorporating structural and non-structural antigens provide higher sensitivity to detect hepatitis C virus infection and they define an almost exclusive role of hepatitis C virus in the genesis of chronic non-A, non-B hepatitis.