1.

Chan HL, Kwan AC, To KF, Lai ST, Chan PK, Leung WK, Lee N, Wu A, Sung JJ. Clinical significance of hepatic derangement in severe acute respiratory syndrome. World J Gastroenterol. 2005 Apr 14;11(14):2148-53.

Department of Medicine and Therapeutics, Chinese University of Hong Kong, China.

AIM: Elevation of alanine aminotransferase (ALT) level is commonly seen among patients suffering from severe acute respiratory syndrome (SARS). We report the progression and clinical significance of liver derangement in a large cohort of SARS patient. METHODS: Serial assay of serum ALT was followed in patients who fulfilled the WHO criteria of SARS. Those with elevated ALT were compared with those with normal liver functions for clinical outcome. Serology for hepatitis B virus (HBV) infection was checked. Adverse outcomes were defined as oxygen desaturation, need of intensive care unit (ICU) and mechanical ventilation and death. RESULTS: Two hundred and ninety-four patients were included in this study. Seventy (24%) patients had elevated serum ALT on admission and 204 (69%) patients had elevated ALT during the subsequent course of illness. Using peak ALT >5XULN as a cut-off and after adjusting for potential confounding factors, the odds ratio of peak ALT >5X ULN for oxygen desaturation was 3.24 (95%CI 1.23-8.59, P = 0.018), ICU care was 3.70 (95%CI 1.38-9.89, P = 0.009), mechanical ventilation was 6.64 (95%CI 2.22-19.81, P = 0.001) and death was 7.34 (95%CI 2.28-24.89, P = 0.001). Ninety-three percent of the survived patients had ALT levels normalized or were on the improving trend during follow-up. Chronic hepatitis B was not associated with worse clinical outcomes. CONCLUSION: Reactive hepatitis is a common complication of SARS-coronavirus infection. Those patients with severe hepatitis had worse clinical outcome.

2.

Ding HG, Shan J, Zhang B, Ma HB, Zhou L, Jin R, Tan YF, He LX Combined human growth hormone and lactulose for prevention and treatment of multiple organ dysfunction in patients with severe chronic hepatitis B. World J Gastroenterol. 2005 May 21;11(19):2981-3.

Department of Gastroenterology and Hepatology, Beijing Youan Hospital, Capital University of Medical Sciences, Beijing 100054, China. dinghuiguo@medmail.com.cn

AIM: To evaluate the efficiency and safety of combined recombinant human growth hormone (rhGH) and lactulose for treatment and/or prevention of multiple organ dysfunction in patients with chronic severe hepatitis B. METHODS: Forty-eight inpatients with chronic severe hepatitis B were randomly divided into rhGH group (n=28) and control group (n=20). In rhGH group, 4-4.5 IU of rhGH was injected intramuscularly once daily for 2-4 wk, and 100 mL of enema containing 30 mL of lactulose, 2 g of metronidazole and 0.9% saline was administered every 2 d for 2-4 wk. Their symptoms and complications were noted. Liver and kidney functions were analyzed by an Olympus analyzer. Serum GH, IGF-1, IGFBP1 and IGFBP3 were measured by ELISA. RESULTS: Clinical symptoms of 90% of these patients in rhGH group were obviously improved. The total effectiveness in rhGH group was better than that in control group (75% vs 40%, P<0.05). After 2- and 4-wk treatment of rhGH respectively, serum albumin (26.1+/-4.1 vs 30.2+/-5.3, 31.9+/-5.1 g/L), prealbumin (79.6+/-28.0 vs 106.6+/-54.4, 108.4+/-55.0 g/L), cholesterol (76.3+/-16.7 vs 85.6+/-32.3, 96.1+/-38.7 mg/dL), and IGFBP1 (56.8+/-47.2 vs 89.7+/-50.3 ng/mL after 2 wk) were significantly increased compared to control group (P<0.05). However, serum GH was decreased. The increase of serum IGF1 and IGFBP3 after rhGH treatment was also observed. CONCLUSION: rhGH in combination with lactulose may be beneficial to the prevention and treatment of multiple organ dysfunction in patients with chronic severe hepatitis.

3.

Maddrey WC. Drug-induced hepatotoxicity: 2005. J Clin Gastroenterol. 2005 Apr;39(4 Suppl 2):S83-9.

University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-8570, USA. wcmaddrey@utsouthwestern.edu

The removal from the marketplace of several widely prescribed drugs due to hepatotoxicity has attracted considerable attention. Now under extensive review are means by which we can better identify hepatic risk prior to federal approval. Assessment of risk-to-benefit ratios regarding a novel agent with hepatotoxicity issues (especially one for a life-threatening condition) requires considerable judgment and education on the part of prescribers and patients. The spectrum of drug-induced liver injury is broad with simulation of almost all unknown liver disorders. Drug-induced liver injuries often have a somewhat characteristic signature, as regards type of injury (hepatocellular vs cholestatic) and time of onset. The diagnosis of drug-induced liver injury is often one of exclusion with initial suspicion based on circumstantial evidence. Factors affecting susceptibility to drug-induced injury include age, sex, concomitant use of other drugs, and genetic polymorphism in metabolic pathways involved in activation or disposition of therapeutic drugs. Drug-drug interactions present particular problems in patients, often elderly, who are receiving several drugs simultaneously. Mechanisms of drug-induced liver injury are many and varied. With many drugs, intermediary products produced during metabolism are highly reactive and toxic. In these situations, the balance between the rate of production of the metabolite and the effectiveness of the drug may determine whether or not hepatic injury occurs.

4.

Sharp GB, Lagarde F, Mizuno T, Sauvaget C, Fukuhara T, Allen N, Suzuki G, Tokuoka S. Relationship of hepatocellular carcinoma to soya food consumption: a cohort-based, case-control study in Japan. Int J Cancer. 2005 Jun 10;115(2):290-5

Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima, Japan. gsharp@niaid.nih.gov

To determine if the risk of hepatocellular carcinoma (HCC) is reduced by consumption of soya foods, we conducted a case-control study within a cohort of Japanese A-bomb survivors. We compared the prediagnosis consumption of isoflavone-rich miso soup and tofu to HCC risk, adjusting for hepatitis B (HBV) and C (HCV) viral infections, the major HCC risk factors in this population. The study included 176 pathologist-confirmed cases of HCC diagnosed in 1964-1988 and 560 controls who died of diseases other than liver cancer. We examined dietary information collected at least 2 years before diagnosis or death and tissue-based measures of viral hepatitis. Using logistic regression, crude ORs were 0.5 (95% CI 0.29-0.95) and 0.5 (95% CI 0.20-0.99) for high vs. low miso soup and tofu intake, respectively. Adjusting for year of birth, sex, HBV, HCV and other factors, the OR for miso soup was unchanged at 0.5 (95% CI 0.14-1.55), and miso results were similar when ORs were recalculated separately for earlier and later birth cohorts to assess consistency of results. The adjusted OR for tofu was 0.9 (95% CI 0.20-3.51). We also found a statistically significant (p < 0.0001) interaction between sex and HCV, with risk of HCC being substantially higher for women. We conclude that consumption of miso soup and other soya foods may reduce HCC risk. Copyright 2005 Wiley-Liss, Inc

5.

 Sooriakumaran P, McAndrew HF, Kiely EM, Spitz L, Pierro A. Peritoneovenous shunting is an effective treatment for intractable ascites. Postgrad Med J. 2005 Apr;81(954):259-61.

Great Osmond Street Hospital for Children, London, UK. p.s@doctors.org.uk

AIM AND METHODS: A retrospective review was carried out of children undergoing peritoneovenous shunting for intractable ascites. RESULTS: 11 children, aged 3 months to 12 years (median 31 months) underwent peritoneovenous shunting over the past 17 years. The duration of ascites ranged from one month to 2.5 years (median two months). The primary pathology consisted of previous surgery in eight (three neuroblastoma, one renal carcinoma, one hepatoblastoma, one adrenal teratoma, one renal artery stenosis, and one diaphragmatic hernia), and cytomegalovirus hepatitis, lymphatic hypoplasia, and lymphohistiocytosis in one patient each. All patients had failed to respond to previous treatment including peritoneal drainage in six patients, diuretics in five, and parenteral nutrition in five. There were no intraoperative problems. Postoperative complications included pulmonary oedema in three patients, shunt occlusion in three, infection in two, and wound leakage in one. Ascites resolved after shunting in 10 patients. Five shunts were removed one to three years after insertion without recurrence of ascites. Three others are free of ascites with shunts in place for less than one year postoperatively. Three children died from their underlying disease: two after resolution of ascites (neuroblastoma) and one in whom the ascites failed to resolve (lymphohisticytosis). CONCLUSIONS: Peritoneovenous shunting is an effective treatment for symptomatic intractable ascites in children (10 of 11 successful cases in this series). Elective removal of the shunt after one year is recommended.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:  

12677.  Assy N, Schlesinger S, Hussein O. Elevated plasma protein C levels correlate with the presence of fatty liver (NASH and NAFLD). Gut. 2005 May;54(5):729.

12678.  Becker-Merok A, Nossent H. Antiphospholipid antibody syndrome in autoimmune hepatitis. Isr Med Assoc J. 2005 Apr;7(4):268-9.

12679.  Chan HL, Kwan AC, To KF, Lai ST, Chan PK, Leung WK, Lee N, Wu A, Sung JJ. Clinical significance of hepatic derangement in severe acute respiratory syndrome. World J Gastroenterol. 2005 Apr 14;11(14):2148-53.

12680.  Chua R, Keogh A, Miyashita M. Novel use of sildenafil in the treatment of portopulmonary hypertension. J Heart Lung Transplant. 2005 Apr;24(4):498-500.

12681.  Colli A, Massironi S, Faccioli P, Conte D. "Pseudotumoral" hepatic areas in acute alcoholic hepatitis: a computed tomography and histological study. Am J Gastroenterol. 2005 Apr;100(4):831-6.

12682.  Craxi A, Camma C. Prevention of hepatocellular carcinoma. Clin Liver Dis. 2005 May;9(2):329-46, viii. Review.

12683.  Davila JA, Morgan RO, Shaib Y, McGlynn KA, El-Serag HB. Diabetes increases the risk of hepatocellular carcinoma in the United States: a population based case control study. Gut. 2005 Apr;54(4):533-9.

12684.  Desbois D, Grangeot-Keros L, Roquebert B, Roque-Afonso AM, Mackiewicz V, Poveda JD, Dussaix E. Usefulness of specific IgG avidity for diagnosis of hepatitis A infection. Gastroenterol Clin Biol. 2005 May;29(5):573-6.

12685.  Ding HG, Shan J, Zhang B, Ma HB, Zhou L, Jin R, Tan YF, He LX. Combined human growth hormone and lactulose for prevention and treatment of multiple organ dysfunction in patients with severe chronic hepatitis B. World J Gastroenterol. 2005 May 21;11(19):2981-3.

12686.  Foster GR. Apoptotic cell death: the caspase-cleavage "gold rush". Lancet. 2005 Apr 9-15;365(9467):1293-4.

12687.  Genova NJ. A fresh look at clinical excellence. JAAPA. 2005 Apr;18(4):55-6.

12688.  Hirota M, Kaneko T, Sugimoto H, Kure S, Inoue S, Takeda S, Nakao A.  Intrahepatic circulatory time analysis of an ultrasound contrast agent in liver cirrhosis. Liver Int. 2005 Apr;25(2):337-42.

12689.  Irshad M. Serum lipoprotein (a) levels in liver diseases caused by hepatitis. Indian J Med Res 2004;120(6):542-5.

12690.  Ito K, Shiraki K, Sakai T, Yoshimura H, Nakano T. Portal hypertensive colopathy in patients with liver cirrhosis. World J Gastroenterol. 2005 May 28;11(20):3127-30.

12691.  Javor ED, Ghany MG, Cochran EK, Oral EA, DePaoli AM, Premkumar A, Kleiner DE, Gorden P. Leptin reverses nonalcoholic steatohepatitis in patients with severe lipodystrophy. Hepatology. 2005 Apr;41(4):753-60.

12692.  Josephsen G. Images in clinical medicine. Mixed cryoglobulinemia. N Engl J Med. 2005 Jun 23;352(25):2627.

12693.  Kirkham C, Harris S, Grzybowski S. Evidence-based prenatal care: part II. Third-trimester care and prevention of infectious diseases. Am Fam Physician. 2005 Apr 15;71(8):1555-60. Review.

12694.  Lim AK, Patel N, Eckersley RJ, Kuo YT, Goldin RD, Thomas HC, Cosgrove DO, Taylor-Robinson SD, Blomley MJ. Can Doppler sonography grade the severity of hepatitis C-related liver disease? AJR Am J Roentgenol. 2005 Jun;184(6):1848-53.

12695.  Maddrey WC. Drug-induced hepatotoxicity: 2005. J Clin Gastroenterol. 2005 Apr;39(4 Suppl 2):S83-9. Review.

12696.  Makwana N, Riordan FA. Prospective study of community needlestick injuries. Arch Dis Child. 2005 May;90(5):523-4.

12697.  Malde AD. Viral Hepatitis and anaesthesiologist. Indian J Anaesth 2004; 48(4):264-75.

12698.  Manukyan MN, Demirkalem P, Gulluoglu BM, Tuney D, Yegen C, Yalin R, Aktan AO. Retained abdominal gallstones during laparoscopic cholecystectomy. Am J Surg. 2005 Apr;189(4):450-2.

12699.  McGillis JP. White adipose tissue, inert no more! Endocrinology. 2005 May;146(5):2154-6.

12700.  Meier M, Woywodt A, Hoeper MM, Schneider A, Manns MP, Strassburg CP.  Acute liver failure: a message found under the skin. Postgrad Med J. 2005 Apr;81(954):269-70.

12701. Myers JP. New recommendations for the treatment of tuberculosis. Curr Opin Infect Dis. 2005 Apr;18(2):133-40. Review.

12702.  Nahon P, Ganne-Carrie N, Degos F, Nahon K, Paries J, Grando V, Chaffaut C, Njapoum C, Christidis C, Trinchet JC, Chevret S, Beaugrand M. Serum albumin and platelet count but not portal pressure are predictive of death in patients with Child-Pugh A hepatitis C virus-related cirrhosis. Gastroenterol Clin Biol. 2005 Apr;29(4):347-52.

12703.  Narbey A. Update on viral hepatitis. Nurs Times. 2005 May 17-23;101(20):55-7. Review.

12704.  Padda M. Malarial hepatitis simulating fulminant hepatic failure. Mayo Clin Proc. 2005 Jun;80(6):828;

12705.  Pan L, Jia ZS, Chen L, Fu EQ, Li GY. Effect of anti-tuberculosis therapy on liver function of pulmonary tuberculosis patients infected with hepatitis B virus. World J Gastroenterol. 2005 Apr 28;11(16):2518-21.

12706.  Pendino GM, Mariano A, Surace P, Caserta CA, Fiorillo MT, Amante A, Bruno S, Mangano C, Polito I, Amato F, Cotichini R, Stroffolini T, Mele A; ACE Collaborating Group. Prevalence and etiology of altered liver tests: a population-based survey in a Mediterranean town. Hepatology. 2005 May;41(5):1151-9.

12707.  Quiroga JA, Carreno V. HCV-indeterminate blood donors or occult HCV infection? Lancet. 2005 Apr 30-May 6;365(9470):1540-1.

12708.  Saffar MJ, Rezai MS. Long-term antibody response and immunologic memory in children immunized with hepatitis B vaccine at birth. Indian J Pediat 2004; 41(12): 232-7.

12709.   Sargent S. The aetiology, management and complications of alcoholic hepatitis. Br J Nurs. 2005 May 26-Jun 8;14(10):556-62. Review.

12710.  Sharp GB, Lagarde F, Mizuno T, Sauvaget C, Fukuhara T, Allen N, Suzuki G, Tokuoka S. Relationship of hepatocellular carcinoma to soya food consumption: a cohort-based, case-control study in Japan. Int J Cancer. 2005 Jun 10;115(2):290-5.

12711.  Singh V, Katyal R, Kochhar RK, Basin DK, Aggarwal RP. Study of Hepatitis B and C viral markers in patients of chronic liver disease. Indian J Med Microbiol 2004;22(4): 269-70(sc).

12712.  Sooriakumaran P, McAndrew HF, Kiely EM, Spitz L, Pierro A. Peritoneovenous shunting is an effective treatment for intractable ascites. Postgrad Med J. 2005 Apr;81(954):259-61.

12713.  Strazzabosco M, Fabris L, Spirli C. Pathophysiology of cholangiopathies. J Clin Gastroenterol. 2005 Apr;39(4 Suppl 2):S90-S102. Review.

12714.  Terrault NA. Sex and hepatitis C. Am J Gastroenterol. 2005 Apr;100(4):825-6.

Pathogenesis:

12715.  Hernandez B, Shiramizu B. Viruses and cancer. Hawaii Med J. 2005 Apr;64(4):106-8. Review.

12716.  Jahani MR, Alavian SM, Shirzad H, Kabir A, Hajarizadeh B. Distribution and risk factors of hepatitis B, hepatitis C, and HIV infection in a female population with "illegal social behaviour". Sex Transm Infect. 2005 Apr;81(2):185.

12717.  Katzberg RW. Contrast medium-induced nephrotoxicity: which pathway? Radiology. 2005 Jun;235(3):752-5. Review.

12718.  Stine SW, Song I, Choi CY, Gerba CP. Application of microbial risk assessment to the development of standards for enteric pathogens in water used to irrigate fresh produce. J Food Prot. 2005 May;68(5):913-8.

Vaccines:

12719.  Tabor E. Persistence of antibody after hepatitis B vaccine and the question of boosters. Hepatology. 2005 Apr;41(4):940; author reply 941.

Therapy:

12720.  Aslam F, Syed JA. Seeking a safer blood supply. Lancet. 2005 Apr 23-29;365(9469):1464.

12721.  Burke J. Breastfeeding. Am J Nurs. 2005 May;105(5):15.

12722.  Chan CY, Lee SD. More on the need for boosters 15 years after neonatal vaccination. Hepatology. 2005 Apr;41(4):940-1;

12723.  Das Gupta A, Mania RN, Sahu GN. Treatment of HIV related tuberculosis: experience from a tertiary care hospital in eastern India. Lung India. 2005 Jan-Mar; 22(1): 5-11.

12724. Fioredda F, Giacchino M, Castagnola E. Assessment of humoral immunity to poliomyelitis, tetanus, hepatitis B, measles, rubella, and mumps in children after chemotherapy. Cancer. 2005 Apr 15;103(8):1758-9; author reply 1760.

12725.  Fonseca MO, Pang LW, de Paula Cavalheiro N, Barone AA, Heloisa Lopes M. Randomized trial of recombinant hepatitis B vaccine in HIV-infected adult patients comparing a standard dose to a double dose. Vaccine. 2005 Apr 22;23(22):2902-8.

12726.  Kurugol Z, Mutlubas F, Ozacar T. A two-dose schedule for combined hepatitis A and B vaccination in children aged 6-15 years. Vaccine. 2005 Apr 22;23(22):2876-80.

12727.  Lobato MN, Reves RR, Jasmer RM, Grabau JC, Bock NN, Shang N; 2RZ Study Group. Adverse events and treatment completion for latent tuberculosis in jail inmates and homeless persons. Chest. 2005 Apr;127(4):1296-303.

12728.  Lok AS. The maze of treatments for hepatitis B. N Engl J Med. 2005 Jun 30;352(26):2743-6.

12729.  Owens DK, Black M. Assessing the benefits and costs of new therapies for hepatitis B virus infection. Ann Intern Med. 2005 May 17;142(10):863-4.

12730.  Rivest P, Grenier L, Lonergan G, Bedard L. Varicella vaccination for grades 4 and 5 students: from theory to practice. Can J Public Health. 2005 May-Jun;96(3):197-200.

12731.  Thakur V, Sarin SK, Rehman S, Guptan RC, Kazim SN, Kumar S. Role of HBV genotype in predicting response to lamivudine therapy in patients with chronic hepatitis B. Indian Journal of Gastroenterology. 2005 Jan-Feb; 24(1): 12-15.

12732.  Wenzel RP, Edmond MB.  Patient-to-patient transmission of hepatitis C virus. Ann Intern Med. 2005 Jun 7;142(11):940-1.