Role of steroid priming in the treatment of chronic hepatitis B

The influence of bio-behavioural factors on tumour biology: pathways and mechanisms

Epidemiological studies indicate that stress, chronic depression and lack of social support might serve as risk factors for cancer development and progression. Recent cellular and molecular studies have identified biological processes that could potentially mediate such effects. This review integrates clinical, cellular and molecular studies to provide a mechanistic understanding of the interface between biological and behavioural influences in cancer, and identifies novel behavioural or pharmacological interventions that might help improve cancer outcomes.

Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2005 update

BACKGROUND/AIMS

A large amount of new data on the treatment of chronic hepatitis B has become available such that the 2003 consensus statement requires revision and update.

METHODS

New data were presented, discussed and debated in an expert pre-meeting to draft a revision. The revised contents were finalized after discussion in a general meeting of APASL.

RESULTS

Conceptual background, including the efficacy and safety profile of currently available and emerging drugs, was reviewed. Nineteen recommendations were formed and unresolved issues and areas for further study were suggested.

CONCLUSION

The current therapy of chronic hepatitis B is modestly effective but not satisfactory. The development of new drugs and new strategies is required to further improve the outcomes of treatment.

Symptom clustering in subjects with and without diabetes mellitus: a population-based study of 15,000 Australian adults

OBJECTIVES

GI symptoms form distinct symptom clusters in community samples when factor and cluster analysis is applied. However, this has not been studied in diabetic populations, despite clear evidence that GI complaints are common in patients with diabetes mellitus (DM). This study aimed to describe clustering of GI symptoms among individuals with and without diabetes mellitus, and to describe associations of symptom clustering in diabetes mellitus, with self-reported glucose control and treatment.

METHODS

A large population survey (n = 15,000) was used to identify a cohort with diabetes mellitus. Items assessing therapy and quality of glycemic control were included, as were those assessing 16 common GI symptoms. Latent GI symptom factors were extracted by factor analysis and used in a k-means cluster analysis. The latter serves to group individuals according to commonalities in symptom profiles. The association of cluster group membership to glycemic control and diabetic treatment was described by logistic regression.

RESULTS

Factor analysis identified four latent symptom factors, which accounted for 69.3% of the total variance. These were labeled Upper GI/Dysmotility, Diarrhea, Constipation, and Vomiting/Nausea. The k-means analysis produced a five-cluster solution, which included a "health" group and four "diseased" groups, each identified by a predominant symptom: Upper GI/Dysmotility symptoms, Nausea/Vomiting, Diarrhea, and Constipation. After adjustment for age and gender, poor glycemic control predicted membership in all disease clusters, when compared separately with the health group. Oral hypoglycemic drugs predicted membership in the Nausea/Vomiting cluster (OR = 5.13) when used alone, and membership in the Nausea/Vomiting (OR = 10.12) and Upper GI/Dysmotility cluster (OR = 10.12) when used in combination with insulin.

CONCLUSION

Diabetes can be grouped according to common GI symptoms. Glycemic control and treatment for DM predict membership of symptom clusters.