AIM: To assess systematically the spectrum and extent of depressive symptoms comparing patient groups receiving peginterferon or conventional interferon.METHODS: Ninety-eight patients with chronic hepatitis C and inte...AIM: To assess systematically the spectrum and extent of depressive symptoms comparing patient groups receiving peginterferon or conventional interferon.METHODS: Ninety-eight patients with chronic hepatitis C and interferon-based therapy (+ribavirin) were consecutively enrolled in a longitudinal study. Patients were treated with conventional interferon alfa-2b (48/98patients; 5 MIU interferon alfa-2b thrice weekly) or peginterferon alfa-2b (50/98 patients; 80-150 μgpeginterferon alfa-2b) in combination with weight-adapted ribavirin (800-1 200 mg/d). Repeated psychometric testing was performed before, three times during and once after antiviral therapy: Depression was evaluated by the Hospital Anxiety and Depression Scale (HADS), anger/hostility by the Symptom Checklist-90 Items Revised (SCL-90-R).RESULTS: Therapy with pegylated interferon alfa-2bproduces comparable scores for depression (ANOVA:P = 0.875) as compared to conventional interferon.Maximums of depression scores were even higher and cases of clinically relevant depression were frequent during therapy with peginterferon. Scores for anger/hostility were comparable for both therapy subgroups.CONCLUSION: Our findings suggest that the extent and frequency of depressive symptoms in total are not reduced by peginterferon. Monitoring and management of neuropsychiatric toxicity especially depression have to be considered as much as in antiviral therapy with unmodified interferon.展开更多
Aims: Cardiac magnetic resonance perfusion imaging(CMRI) is a promising technique for non-invasive measurement of myocardial perfusion reserve. Fractional flowreserve(FFR) is an established invasive method for functio...Aims: Cardiac magnetic resonance perfusion imaging(CMRI) is a promising technique for non-invasive measurement of myocardial perfusion reserve. Fractional flowreserve(FFR) is an established invasive method for functional assessment of coronary artery disease(CAD). To prospectively assess the diagnostic value of CMRI for the detection of haemodynamically significant coronary lesions, compared with coronary angiography(CA) and FFR. Methods and results: Forty-three patients with suspected or known CAD underwent CA, CMRI, and FFR measurement. First pass magnetic resonance perfusion examination was performed during hyperaemia(140 μg/kg/min adenosine over 6 min) and at rest. One hundred and twenty-nine perfusion territories were assessed by semi-quantitative evaluation of signal intensity-time curves using the myocardial perfusion reserve index(MPRI)[upslopestress(corrected)/ upsloperest(corrected)]. Perfusion territories were categorized as normal(coronary stenosis≤50%), intermediate(stenosis >50%and FFR >0.75), or severe(stenosis >50%and FFR≤0.75 or total occlusion). MPRI values(±SD) were significantly different between the three categories[normal, 2.2±0.5 vs. intermediate, 1.8±0.5(P=0.005) and intermediate vs. severe, 1.2±0.3(P< 0.001)]. An MPRI cut-off value of 1.5(derived from receiver operating characteristics analysis) distinguished haemodynamically relevant(severe) from non-relevant(normal and intermediate) stenoses with a sensitivity of 88%(CI 74-100%)and a specificity of 90%(CI 84-96%). Conclusion: In contrast to earlier studies that compared CMRI with morphological examination(CA) alone, the present study compared CMRI with CA plus a standard invasive functional assessment(FFR) and demonstrated that CMRI is able to distinguish haemodynamically relevant from non-relevant coronary lesions with a high sensitivity and specificity and may therefore contribute to clinical decision-making.展开更多
Introduction: Various disease- specific serum antibodies were described in patients with inflammatory bowel disease and their yet healthy first- degree relatives. In the latter, serum antibodies are commonly regarded ...Introduction: Various disease- specific serum antibodies were described in patients with inflammatory bowel disease and their yet healthy first- degree relatives. In the latter, serum antibodies are commonly regarded as potential markers of disease susceptibility. The present long- term follow- up study evaluated the fate of antibody- positive first- degree relatives. Patients and Methods: 25 patients with Crohn s disease, 19 patients with ulcerative colitis and 102 first- degree relatives in whom presence of ASCA, pANCA, pancreatic- and goblet- cell antibodies had been assessed were enrolled. The number of incident cases with inflammatory bowel disease was compared between antibody- positive and antibody- negative first- degree relatives 7 years after storage of serum samples. Results: 34 of 102 (33% ) first- degree relatives were positive for at least one of the studied serum antibodies. In the group of first- degree relatives, one case of Crohn s disease and one case of ulcerative colitis were diagnosed during the follow- up period. However, both relatives did not display any of the investigated serum antibodies (p = 1). Discussion: The findings of our pilot study argue against a role of serum antibodies as a marker of disease susceptibility in first- degree relatives of patients with inflammatory bowel disease. However, these data have to await confirmation in larger ideally prospective multicenter studies before definite conclusions can be drawn.展开更多
基金Supported by an Unrestricted Grant From Essex Pharma (Munich, Germany), a subsidiary of Schering-Plough (Kenilworth NJ, USA)
文摘AIM: To assess systematically the spectrum and extent of depressive symptoms comparing patient groups receiving peginterferon or conventional interferon.METHODS: Ninety-eight patients with chronic hepatitis C and interferon-based therapy (+ribavirin) were consecutively enrolled in a longitudinal study. Patients were treated with conventional interferon alfa-2b (48/98patients; 5 MIU interferon alfa-2b thrice weekly) or peginterferon alfa-2b (50/98 patients; 80-150 μgpeginterferon alfa-2b) in combination with weight-adapted ribavirin (800-1 200 mg/d). Repeated psychometric testing was performed before, three times during and once after antiviral therapy: Depression was evaluated by the Hospital Anxiety and Depression Scale (HADS), anger/hostility by the Symptom Checklist-90 Items Revised (SCL-90-R).RESULTS: Therapy with pegylated interferon alfa-2bproduces comparable scores for depression (ANOVA:P = 0.875) as compared to conventional interferon.Maximums of depression scores were even higher and cases of clinically relevant depression were frequent during therapy with peginterferon. Scores for anger/hostility were comparable for both therapy subgroups.CONCLUSION: Our findings suggest that the extent and frequency of depressive symptoms in total are not reduced by peginterferon. Monitoring and management of neuropsychiatric toxicity especially depression have to be considered as much as in antiviral therapy with unmodified interferon.
文摘Aims: Cardiac magnetic resonance perfusion imaging(CMRI) is a promising technique for non-invasive measurement of myocardial perfusion reserve. Fractional flowreserve(FFR) is an established invasive method for functional assessment of coronary artery disease(CAD). To prospectively assess the diagnostic value of CMRI for the detection of haemodynamically significant coronary lesions, compared with coronary angiography(CA) and FFR. Methods and results: Forty-three patients with suspected or known CAD underwent CA, CMRI, and FFR measurement. First pass magnetic resonance perfusion examination was performed during hyperaemia(140 μg/kg/min adenosine over 6 min) and at rest. One hundred and twenty-nine perfusion territories were assessed by semi-quantitative evaluation of signal intensity-time curves using the myocardial perfusion reserve index(MPRI)[upslopestress(corrected)/ upsloperest(corrected)]. Perfusion territories were categorized as normal(coronary stenosis≤50%), intermediate(stenosis >50%and FFR >0.75), or severe(stenosis >50%and FFR≤0.75 or total occlusion). MPRI values(±SD) were significantly different between the three categories[normal, 2.2±0.5 vs. intermediate, 1.8±0.5(P=0.005) and intermediate vs. severe, 1.2±0.3(P< 0.001)]. An MPRI cut-off value of 1.5(derived from receiver operating characteristics analysis) distinguished haemodynamically relevant(severe) from non-relevant(normal and intermediate) stenoses with a sensitivity of 88%(CI 74-100%)and a specificity of 90%(CI 84-96%). Conclusion: In contrast to earlier studies that compared CMRI with morphological examination(CA) alone, the present study compared CMRI with CA plus a standard invasive functional assessment(FFR) and demonstrated that CMRI is able to distinguish haemodynamically relevant from non-relevant coronary lesions with a high sensitivity and specificity and may therefore contribute to clinical decision-making.
文摘Introduction: Various disease- specific serum antibodies were described in patients with inflammatory bowel disease and their yet healthy first- degree relatives. In the latter, serum antibodies are commonly regarded as potential markers of disease susceptibility. The present long- term follow- up study evaluated the fate of antibody- positive first- degree relatives. Patients and Methods: 25 patients with Crohn s disease, 19 patients with ulcerative colitis and 102 first- degree relatives in whom presence of ASCA, pANCA, pancreatic- and goblet- cell antibodies had been assessed were enrolled. The number of incident cases with inflammatory bowel disease was compared between antibody- positive and antibody- negative first- degree relatives 7 years after storage of serum samples. Results: 34 of 102 (33% ) first- degree relatives were positive for at least one of the studied serum antibodies. In the group of first- degree relatives, one case of Crohn s disease and one case of ulcerative colitis were diagnosed during the follow- up period. However, both relatives did not display any of the investigated serum antibodies (p = 1). Discussion: The findings of our pilot study argue against a role of serum antibodies as a marker of disease susceptibility in first- degree relatives of patients with inflammatory bowel disease. However, these data have to await confirmation in larger ideally prospective multicenter studies before definite conclusions can be drawn.
