Tumor necrosis factor receptor 1 expression is upregulated in dendritic cells in patients with chronic HCV who respond to therapy.

The present studies assessed the level of tumor necrosis factor receptor (TNFR) expression in peripheral blood mononuclear cells (PBMCs) subsets from patients with chronic HCV undergoing interferon α/ribavirin-based therapy (Ifn/R). Methods. TNFR family member mRNA expression was determined using quantitative real-time PCR assays (RTPCRs) in PBMC from 39 HCV+ patients and 21 control HCV- patients. Further subset analysis of HCV + patients (untreated (U), sustained virological responders (SVR), and nonresponders (NR)/relapsers (Rel)) PBMC was performed via staining with anti-CD123, anti-CD33, anti-TNFR1 or via RTPCR for TNFR1 mRNA. Results. A similar level of TNFR1 mRNA in PBMC from untreated HCV+ genotype 1 patients and controls was noted. TNFR1 and TNFR2 mRNA levels in PBMC from HCV+ patients with SVR were statistically different than levels in HCV(-) patients. A significant difference was noted between the peak values of TNFR1 of the CD123+ PBMC isolated from SVR and the NR/Rel. Conclusion. Upregulation of TNFR1 expression, occurring in a specific subset of CD123+ dendritic cells, appeared in HCV+ patients with SVR.

Effects of recognizing depression with a standardized questionnaire (CES-D) versus patient reporting of depression after a single-standardized question on the outcomes of treatment for hepatitis C with pegylated interferon-α-2b and ribavirin.

BACKGROUND: Depression may worsen during antiviral treatment for hepatitis C virus, resulting in noncompliance treatment. AIM: The aim was to compare the response and compliance rates between the groups of veteran patients using two different methods of identifying depression, either the Centers for Epidemiology Studies for Depression Scale (group A) questionnaire or the report of symptoms of depression after a single-standardized question by the health care provider (group B). METHODS: One hundred and twenty-nine patients were randomly assigned to the two groups before the treatment. RESULTS: No statistical differences were noted in baseline characteristics between the groups. Depression was common in both the groups. No difference between initial Centers for Epidemiologic Studies Depression Scale scores and diagnosis of depression between the two groups was noted. Furthermore, the number of patients diagnosed with depression during the treatment was similar in each group. There were no significant differences between the groups in rates of sustained viral response (30% group A, 35% group B) or in rates of overall compliance with patients receiving more than 90% of prescribed PegIntronA therapy (44% group A, 39% group B), and ribavirin (32% group A and 37% group B). CONCLUSION: The use of the Centers for Epidemiology Studies for Depression Scale questionnaire to recognize depression had no significant advantage over patient reporting of depression symptoms after a single-standardized question on the hepatitis C virus clearance and the treatment compliance rates in veteran populations.

Portal hypertensive gastropathy: a review.

Portal hypertensive gastropathy (PHG) occurs as a complication of cirrhotic or non-cirrhotic portal hypertension. Although the pathogenesis of PHG is not completely understood, evidence suggests that the key factor for the development of PHG is portal hypertension. PHG is clinically important because it may cause acute (and even) massive or insidious, blood loss. The diagnosis of PHG is (only) made endoscopically; it is most often characterized by an abnormality of the gastric mucosa described as a mosaic-like pattern resembling 'snake-skin', with or without red spots and the endoscopic pattern is key its diagnosis. Unfortunately, standardization of the endoscopic diagnostic criteria for PHG is poor and consensus is generally lacking, resulting in a wide range of reported prevalence. Pharmacological therapies, presumably reducing portal pressure and gastric blood flow, have been used to treat acute bleeding; propanolol, a non-selective beta-blocker (24-480 mg/day), has been used most frequently. Endoscopic treatment for PHG bleeding plays a small, if any, role in the treatment of PHG. TIPS and shunt surgery have not been extensively analysed as a treatment for acute or chronic PHG bleeding, but they appear to lessen the severity of PHG. Secondary prophylaxis of PHG bleeding with non-selective beta-blockers is recommended. There is not enough evidence to support the use of beta-blockers in primary prophylaxis of PHG bleeding, even in cases of severe PHG (however, non-selective beta-blockers are recommended if varices are present). Further studies are needed to clarify the role of PHG in suspected chronic gastrointestinal bleeding.

Prevalencia de anticuerpos anti-Toxoplasma gondii en gestantes del Hospital Cayetano Heredia (Lima) / Prevalence of antibodies anti-toxoplasma gondii in gestantes of the Hospital Cayetano Heredia (Lima)

Introducción: La toxoplasmosis es una zoonosis de etiología parasitaria ampliamente distribuída a nivel mundial, que adquiere importancia cuando la infección ocurre durante la gestación; por lo que es importante conocer la prevalencia de anticuerpos IgG e IgM anti-toxoplasma en esta población. Matarial y Métodos: el presente es un estudio prospectivo, en el se incluyeron 122 gestantes del Hospital Nacional Cayetano Heredia, y se recolectaron datos generales y epidemiológicos, así como una muestra de sangre venosa; en la cual se determinó anticuerpos IgG e IgM Anti-toxoplasma utilizando el método de Inmunofluorescencia Indirecta (IFI). Resultados: La media de la edad fue de 25.72 +- 6.28 años. Fueron seropositivas para IgG y/o IgM el 58.9 por ciento (71); para IgG el 54,9 por ciento (66) y para Igm el 4,9 por ciento (6) de gestantes. Un 4,6 por ciento tuvo sospecha de infección aguda. No se encontró asociación entre seropositividad y los datos epidemiológicos analizados. Conclusiones: Se evidenció que la presencia de anticuerpos anti-Toxoplasma gondii es frecuente en la población de gestantes, sin embargo hay una elevada proporción de gestantes (cerca al 40 por ciento) susceptibles a adquirir la infección durante la gestación. Estos hallazgos ameritan una mayor investigación con respecto a la prevalencia e incidencia de la infección por toxoplasma gondii durante la gestación para sí planificar programas de prevención.