Positive and Negative Predictive Factors for Treatment Response in Patients with Chronic Viral C Hepatitis.

More than 200 million people worldwide are infected with hepatitis C virus. In the United States, suggested estimates are that more than 5 million people live with HCV. The purpose of this paper is to identify, within the Southwestern Romanian population, host factors associated with the response to Pegylated Interferon and Ribavirin treatment for Hepatitis C virus infection. We investigated several factors and their correlation to sustained virological response. The study included 267 patients diagnosed with chronic Hepatitis C between 2013 and 2016, treated with Pegylated Interferon and Ribavirin in the 2nd Medical Department of the Emergency County Hospital Craiova. From the 267 patients included in this study, 149 (55,81%) achieved sustained virological response during the 48 weeks of treatment. Several factors were taken in consideration regarding the treatment response. Positive predictive factors for achieving sustained virological response were: the female gender (35,96%), Low Viral Load at the beginning of treatment, Early Virological Response 75 (28,09%), Rapid Virologic Response133 (49,81%), and stage of fibrosis, with Stage F1 having the highest rate of Sustained Virological Response during double therapy 81 (30,34%). Although at the present time a number of more effective antiviral products have been approved for the treatment of viral hepatitis C, in our country the standard of treatment remains with PegInterferon and Ribavirin therapy. Multiple clinical and paraclinical tools can identify patients with a high chance of responding to treatment, or those who, during treatment, do not meet the criteria for prolonging therapy.

Pegylated Interferon-Induced Sarcoidosis Presenting With Anterior Uveitis in a Patient with Chronic Hepatitis C - Case Report.

Sarcoidosis is a chronic inflammatory systemic disorder of unknown etiology. It is known to be triggered by an autoimmune process, and is currently recognized as a rare adverse event to interferon therapy for Hepatitis C Virus Infection. Clinical presentation of interferon-triggered sarcoidosis is varied, but ocular manifestation as a first symptom was only once, previously reported. We report the case of a 32 year old woman, infected with hepatitis C, for whom antiviral therapy was initiated. Prior to treatment, the patient had outstanding medical history. Three months from the initiation, patient accused pain and redness of the left eye and mild visual loss. The diagnosis of Interferon induced sarcoidosis was established. We are presenting this case because it illustrates the possibility of sudden and severe complications and we want to emphasize the importance of performing ophthalmological examination in patients treated with pegylated interferon α.

A Case of Bilateral Aseptic Necrosis of the Femoral Head.

Aseptic necrosis of the femoral head is a disease whose etiology is not completely elucidated and generally affects young adults aged between 30 and 50 years. In a significant number of patients bilateral disease occurs, which makes detection in its early stages constitute an important objective. We present the case of a male patient, aged 23 years, with the following risk factors: smoking and chronic alcohol consumption, who is diagnosed with aseptic necrosis of the left femoral head, ARCO stage IV, and in just six months after the diagnosis and hip arthroplasty, he suffers an injury which leads to the same diagnosis in the contralateral hip. We want to emphasize that for all patients with a high index of suspicion there should be an MRI examination, because the plane radiographs or CT are most often not relevant in detecting early signs of this condition. Diagnosis of aseptic necrosis of the femoral head in the early stages is a necessity in order to obtain an optimal result of conservative treatment.

Morphometric findings in avascular necrosis of the femoral head.

Avascular necrosis of the femoral head is an illness with a controversial etiology, the trigger event being the suppression of blood flow to the femoral head. The disease affects mostly young adults within their third and fifth decade, the majority of the patients being men. The main risk factors are trauma, chronic alcohol consumption, smoking, corticotherapy. The main goal of our study is to describe the morphometric changes found in the bone tissue of patients diagnosed with avascular necrosis of the femoral head, with different risk factors, by comparing the area of bone trabeculae inside the area of necrosis with that from the adjacent viable tissue. The morphometric study used biological material from 16 patients with ages between 29 and 57 years, who underwent surgery for avascular necrosis of the femoral head. They were admitted in the Orthopedics Department at the Emergency County Hospital in Craiova between 2010 and 2011 and were split into four groups. Group I presented trauma as the main risk factor, Group II had corticotherapy as the defining risk factor, Group III presented chronic alcohol consumption and Group IV was represented by the patients who smoked and exhibited chronic alcohol consumption. There was not a significant statistical difference between the areas of bone trabeculae of the four groups when we compared viable bone tissue to the necrotized one. Knowing the risk factors of the avascular necrosis of the femoral head is critical to the management of the disease, because diagnosing it in an early stage is a necessity for obtaining a good result for conservative treatment.

P53 and Ki67 immunoexpression in mucinous malignant ovarian tumors.

Ovarian cancer is the fourth cause of death by cancer among women and the first mortality cause in gynecological neoplasia. Our goal was to evaluate p53 and Ki67 immunoexpression and also the correlations with tumor stage and type. The study included 45 primary ovarian malignant mucinous tumors, diagnosed in patients in the IV and VI decade. From the standpoint of histopathology, there were 28 cases of borderline mucinous tumors and 17 mucinous carcinomas, predominantly stage I of the disease. The immunostaining for Ki67 was positive in all the cases, the highest levels being recorded in mucinous carcinomas (22.2% medium index) compared to the borderline tumors (9.5% medium index). Opposed to Ki67, the immunoreaction for p53 was present in 37.7% of all the tumors, predominantly in mucinous carcinomas where the stain has high values (52.3% medium index) in contrast with borderline lesions (15.5% medium index). The study indicated significant differences in p53 and Ki67 immunostain in relation to the tumor stage and histological type, there being a direct correlation of the expression of both proteins, in the studied tumors. P53 and Ki67 are useful markers for evaluating aggressive tumoral behavior and differentiating between mucinous carcinomas and borderline mucinous tumors.

Macroscopic and microscopic findings in avascular necrosis of the femoral head.

UNLABELLED: The avascular necrosis of the femoral head is an illness induced by the cutoff of blood flow to the femoral head and it affects mostly young adults between the ages of 30 and 50 years, raising therapeutic and diagnostic issues. Many risk factors are incriminated in the development of avascular necrosis of the femoral head like: trauma, chronic alcohol consumption, smoking, administration of corticosteroid drugs, most of the cases are considered to be idiopathic. The main goal of our paper is to describe the macroscopic and microscopic variations of the bone structure, which occur in patients with avascular necrosis of the femoral head. MATERIALS AND METHODS: The biological material needed for our study was obtained following hip arthroplasty surgery in 26 patients between the ages of 29 and 59 years, which previously were diagnosed with avascular necrosis of the femoral head and admitted in the Orthopedics Department of the Emergency County Hospital of Craiova (Romania) between 2010 and 2011. From a macroscopic point of view, we found well defined areas of necrosis, most of which were neatly demarcated of the adjacent viable tissue by hyperemic areas, loss of shape and contour of the femoral head and transformations of the articular cartilage above the area of necrosis. When examined under the microscope, we found vast areas of fibrosis, narrow bone trabeculae, obstructed blood vessels or blood vessels with clots inside, hypertrophic fat cells, bone sequestration but also small cells and pyknotic nuclei. The microscopic and macroscopic findings on the femoral head sections varied with the patients and the stage of the disease.