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Bach N, Schäfer S. Ultrafast strain propagation and acoustic resonances in nanoscale bilayer systems. Struct Dyn 2021; 8:035101. [PMID: 34169119 PMCID: PMC8214470 DOI: 10.1063/4.0000079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/21/2021] [Indexed: 06/13/2023]
Abstract
Ultrafast structural probing has greatly enhanced our understanding of the coupling of atomic motion to electronic and phononic degrees-of-freedom in quasi-bulk materials. In bi- and multilayer model systems, additionally, spatially inhomogeneous relaxation channels are accessible, often governed by pronounced interfacial couplings and local excitations in confined geometries. Here, we systematically explore the key dependencies of the low-frequency acoustic phonon spectrum in an elastically mismatched metal/semiconductor bilayer system optically excited by femtosecond laser pulses. We track the spatiotemporal strain wave propagation in the heterostructure employing a discrete numerical linear chain simulation and access acoustic wave reflections and interfacial couplings with a phonon mode description based on a continuum mechanics model. Due to the interplay of elastic properties and mass densities of the two materials, acoustic resonance frequencies of the heterostructure significantly differ from breathing modes in monolayer films. For large acoustic mismatch, the spatial localization of phonon eigenmodes is derived from analytical approximations and can be interpreted as harmonic oscillations in decoupled mechanical resonators.
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Affiliation(s)
- N. Bach
- Institute of Physics, University of Oldenburg, 26129 Oldenburg, Germany
| | - S. Schäfer
- Institute of Physics, University of Oldenburg, 26129 Oldenburg, Germany
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Aubart M, Gitiaux C, Roux CJ, Levy R, Schuffenecker I, Mirand A, Bach N, Moulin F, Bergounioux J, Leruez-Ville M, Rozenberg F, Sterlin D, Musset L, Antona D, Boddaert N, Zhang SY, Kossorotoff M, Desguerre I. Severe Acute Flaccid Myelitis Associated With Enterovirus in Children: Two Phenotypes for Two Evolution Profiles? Front Neurol 2020; 11:343. [PMID: 32411086 PMCID: PMC7198806 DOI: 10.3389/fneur.2020.00343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/07/2020] [Indexed: 12/19/2022] Open
Abstract
Acute flaccid myelitis (AFM) is an acute paralysis syndrome defined by a specific inflammation of the anterior horn cells of the spinal cord. From 2014, worrying waves of life-threatening AFM consecutive to enterovirus infection (EV-D68 and EV-A71) have been reported. We describe 10 children displaying an AFM with an EV infection, the treatments performed and the 1 to 3-years follow-up. Two groups of patients were distinguished: 6 children (“polio-like group”) had severe motor disability whereas 4 other children (“brainstem group”) displayed severe brainstem weakness requiring ventilation support. Electrodiagnostic studies (n = 8) support the presence of a motor neuronopathy associated to myelitis. The best prognosis factor seems to be the motor recovery after the first 4 weeks of the disease.
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Affiliation(s)
- Melodie Aubart
- Department of Paediatric Neurology, Necker-Enfants malades Hospital, University of Paris, AP-HP, Paris, France.,INSERM 1163, Imagine Institute, Paris, France
| | - Cyril Gitiaux
- Department of Paediatric Neurophysiology, Necker-Enfants malades Hospital, University of Paris, AP-HP, Paris, France.,INSERM U955-Team 10, Department of Neurosciences, Mondor Biomedical Research Institute, Paris-Est University, Créteil, France
| | - Charles Joris Roux
- Department of Paediatric Radiology, Necker-Enfants malades Hospital, University of Paris, AP-HP, Paris, France
| | - Raphael Levy
- Department of Paediatric Radiology, Necker-Enfants malades Hospital, University of Paris, AP-HP, Paris, France
| | - Isabelle Schuffenecker
- Laboratory of Virology, National Reference Center for Enterovirus, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Audrey Mirand
- Laboratory of Virology, National Reference Center for Enterovirus Associated Laboratory, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Nathalie Bach
- Paediatric Department, CHU Caen-Normandie, Caen, France
| | - Florence Moulin
- Intensive Care Unit, Necker-Enfants malades Hospital, University of Paris, AP-HP, Paris, France
| | - Jean Bergounioux
- Intensive Care Unit, CHU Raymond Poincaré, Paris Saclay University, AP-HP, Garches, France
| | - Marianne Leruez-Ville
- Laboratory of Virology, Necker-Enfants malades Hospital, University of Paris, AP-HP, Paris, France
| | - Flore Rozenberg
- Laboratory of Virology, Cochin Hospital, University of Paris, AP-HP, Paris, France
| | - Delphine Sterlin
- Laboratory of Immunology, Pitié-Salpétrière Hospital, Sorbonne University, AP-HP, Paris, France
| | - Lucile Musset
- Laboratory of Immunology, Pitié-Salpétrière Hospital, Sorbonne University, AP-HP, Paris, France
| | - Denise Antona
- Direction des maladies infectieuses, Santé publique France, Saint-Maurice, France
| | - Nathalie Boddaert
- INSERM U955-Team 10, Department of Neurosciences, Mondor Biomedical Research Institute, Paris-Est University, Créteil, France.,Department of Paediatric Radiology, Necker-Enfants malades Hospital, University of Paris, AP-HP, Paris, France
| | | | - Manoelle Kossorotoff
- Department of Paediatric Neurology, Necker-Enfants malades Hospital, University of Paris, AP-HP, Paris, France
| | - Isabelle Desguerre
- Department of Paediatric Neurology, Necker-Enfants malades Hospital, University of Paris, AP-HP, Paris, France
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Lagrue E, Dogan C, De Antonio M, Audic F, Bach N, Barnerias C, Bellance R, Cances C, Chabrol B, Cuisset JM, Desguerre I, Durigneux J, Espil C, Fradin M, Héron D, Isapof A, Jacquin-Piques A, Journel H, Laroche-Raynaud C, Laugel V, Magot A, Manel V, Mayer M, Péréon Y, Perrier-Boeswillald J, Peudenier S, Quijano-Roy S, Ragot-Mandry S, Richelme C, Rivier F, Sabouraud P, Sarret C, Testard H, Vanhulle C, Walther-Louvier U, Gherardi R, Hamroun D, Bassez G. A large multicenter study of pediatric myotonic dystrophy type 1 for evidence-based management. Neurology 2019; 92:e852-e865. [DOI: 10.1212/wnl.0000000000006948] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 10/18/2018] [Indexed: 12/18/2022] Open
Abstract
ObjectiveTo genotypically and phenotypically characterize a large pediatric myotonic dystrophy type 1 (DM1) cohort to provide a solid frame of data for future evidence-based health management.MethodsAmong the 2,697 patients with genetically confirmed DM1 included in the French DM-Scope registry, children were enrolled between January 2010 and February 2016 from 24 centers. Comprehensive cross-sectional analysis of most relevant qualitative and quantitative variables was performed.ResultsWe studied 314 children (52% females, with 55% congenital, 31% infantile, 14% juvenile form). The age at inclusion was inversely correlated with the CTG repeat length. The paternal transmission rate was higher than expected, especially in the congenital form (13%). A continuum of highly prevalent neurodevelopmental alterations was observed, including cognitive slowing (83%), attention deficit (64%), written language (64%), and spoken language (63%) disorders. Five percent exhibited autism spectrum disorders. Overall, musculoskeletal impairment was mild. Despite low prevalence, cardiorespiratory impairment could be life-threatening, and frequently occurred early in the first decade (25.9%). Gastrointestinal symptoms (27%) and cataracts (7%) were more frequent than expected, while endocrine or metabolic disorders were scarce.ConclusionsThe pedDM-Scope study details the main genotype and phenotype characteristics of the 3 DM1 pediatric subgroups. It highlights striking profiles that could be useful in health care management (including transition into adulthood) and health policy planning.
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Coco L, Dahmen K, Bach N, Fischer H, Albanese V, Dylewski L, Muñoz E. Use of fibrin sealant in a horse with an intratracheal dorsal laceration. EQUINE VET EDUC 2018. [DOI: 10.1111/eve.13006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- L. Coco
- Tierärztliches Kompetenzzentrum für Pferde Grosswallstadt Altano GmbH Grosswallstadt Germany
| | - K. Dahmen
- Tierärztliches Kompetenzzentrum für Pferde Grosswallstadt Altano GmbH Grosswallstadt Germany
| | - N. Bach
- Tierärztliches Kompetenzzentrum für Pferde Grosswallstadt Altano GmbH Grosswallstadt Germany
| | - H. Fischer
- Tierärztliches Kompetenzzentrum für Pferde Grosswallstadt Altano GmbH Grosswallstadt Germany
| | - V. Albanese
- Tierärztliches Kompetenzzentrum für Pferde Grosswallstadt Altano GmbH Grosswallstadt Germany
| | - L. Dylewski
- Tierärztliches Kompetenzzentrum für Pferde Grosswallstadt Altano GmbH Grosswallstadt Germany
| | - E. Muñoz
- Tierärztliches Kompetenzzentrum für Pferde Grosswallstadt Altano GmbH Grosswallstadt Germany
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Guénolé F, Spiers S, Madigand-Tordjman MA, Bach N, Rébillard C. [Not Available]. Soins Pediatr Pueric 2017; 38:36-40. [PMID: 28705568 DOI: 10.1016/j.spp.2017.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Hyperactivity disorder in children is the most commonly found syndrome in paedo-psychiatric clinics. Children's professionals need to have clinical data on the subject. The diagnostic process includes several components which allow care to be tailored to each child.
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Affiliation(s)
- Fabian Guénolé
- Service de psychiatrie de l'enfant et de l'adolescent, CHU de Caen, Avenue Georges-Clemenceau, 14033 Caen cedex 9, France; Université de Caen Normandie, Esplanade de la Paix, 14032 Caen, France; Inserm U1077,Pôle des formations et de recherche en santé, 2 rue des Rochambelles, CS 14032, 14032 Caen cedex, France; Service de pédiatrie du Centre hospitalier universitaire de Caen, Pôle femme-enfant, Avenue de la Côte de Nacre, CS 30001, 14033 Caen cedex 9, France.
| | - Solène Spiers
- Service de psychiatrie de l'enfant et de l'adolescent, CHU de Caen, Avenue Georges-Clemenceau, 14033 Caen cedex 9, France
| | - Marie-Amélie Madigand-Tordjman
- Service de psychiatrie de l'enfant et de l'adolescent, CHU de Caen, Avenue Georges-Clemenceau, 14033 Caen cedex 9, France; Inserm U1077,Pôle des formations et de recherche en santé, 2 rue des Rochambelles, CS 14032, 14032 Caen cedex, France
| | - Nathalie Bach
- Service de psychiatrie de l'enfant et de l'adolescent, CHU de Caen, Avenue Georges-Clemenceau, 14033 Caen cedex 9, France; Service de pédiatrie du Centre hospitalier universitaire de Caen, Pôle femme-enfant, Avenue de la Côte de Nacre, CS 30001, 14033 Caen cedex 9, France
| | - Camille Rébillard
- Service de psychiatrie de l'enfant et de l'adolescent, CHU de Caen, Avenue Georges-Clemenceau, 14033 Caen cedex 9, France; Université de Caen Normandie, Esplanade de la Paix, 14032 Caen, France; Inserm U1077,Pôle des formations et de recherche en santé, 2 rue des Rochambelles, CS 14032, 14032 Caen cedex, France
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Zapf S, Stingl C, Post KW, Maiwald J, Bach N, Pietsch I, Neubauer D, Löhle A, Clauss C, Jiang S, Jeevan HS, Basov DN, Gegenwart P, Dressel M. Persistent Detwinning of Iron-Pnictide EuFe_{2}As_{2} Crystals by Small External Magnetic Fields. Phys Rev Lett 2014; 113:227001. [PMID: 25494081 DOI: 10.1103/physrevlett.113.227001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Indexed: 06/04/2023]
Abstract
Our comprehensive study on EuFe_{2}As_{2} reveals a dramatic reduction of magnetic detwinning fields compared to other AFe_{2}As_{2} (A=Ba, Sr, Ca) iron pnictides by indirect magnetoelastic coupling of the Eu^{2+} ions. We find that only ∼0.1 T are sufficient for persistent detwinning below the local Eu^{2+} ordering; above T_{Eu}=19 K, higher fields are necessary. Even after the field is switched off, a significant imbalance of twin domains remains constant up to the structural and electronic phase transition (190 K). This persistent detwinning provides the unique possibility to study the low temperature electronic in-plane anisotropy of iron pnictides without applying any symmetry-breaking external force.
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Affiliation(s)
- S Zapf
- 1. Physikalisches Institut, Universität Stuttgart, Pfaffenwaldring 57, 70550 Stuttgart, Germany
| | - C Stingl
- I. Physikalisches Institut, Universität Göttingen, Friedrich-Hund-Platz 1, 37077 Göttingen, Germany
| | - K W Post
- Department of Physics, University of California, San Diego, La Jolla, California 92093, USA
| | - J Maiwald
- I. Physikalisches Institut, Universität Göttingen, Friedrich-Hund-Platz 1, 37077 Göttingen, Germany and Experimentalphysik VI, Universität Augsburg, Universitätsstraße 1, 86135 Augsburg, Germany
| | - N Bach
- I. Physikalisches Institut, Universität Göttingen, Friedrich-Hund-Platz 1, 37077 Göttingen, Germany
| | - I Pietsch
- I. Physikalisches Institut, Universität Göttingen, Friedrich-Hund-Platz 1, 37077 Göttingen, Germany
| | - D Neubauer
- 1. Physikalisches Institut, Universität Stuttgart, Pfaffenwaldring 57, 70550 Stuttgart, Germany
| | - A Löhle
- 1. Physikalisches Institut, Universität Stuttgart, Pfaffenwaldring 57, 70550 Stuttgart, Germany
| | - C Clauss
- 1. Physikalisches Institut, Universität Stuttgart, Pfaffenwaldring 57, 70550 Stuttgart, Germany
| | - S Jiang
- 1. Physikalisches Institut, Universität Stuttgart, Pfaffenwaldring 57, 70550 Stuttgart, Germany
| | - H S Jeevan
- I. Physikalisches Institut, Universität Göttingen, Friedrich-Hund-Platz 1, 37077 Göttingen, Germany and Department of Physics, PESITM, Sagar Road, 577204 Shimoga, India
| | - D N Basov
- Department of Physics, University of California, San Diego, La Jolla, California 92093, USA
| | - P Gegenwart
- I. Physikalisches Institut, Universität Göttingen, Friedrich-Hund-Platz 1, 37077 Göttingen, Germany and Experimentalphysik VI, Universität Augsburg, Universitätsstraße 1, 86135 Augsburg, Germany
| | - M Dressel
- 1. Physikalisches Institut, Universität Stuttgart, Pfaffenwaldring 57, 70550 Stuttgart, Germany
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Bach N, Tuomilehto H, Gauthier C, Papadakis A, Remise C, Lavigne F, Lavigne GJ, Huynh N. The effect of surgically assisted rapid maxillary expansion on sleep architecture: an exploratory risk study in healthy young adults. J Oral Rehabil 2013; 40:818-25. [DOI: 10.1111/joor.12102] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2013] [Indexed: 11/27/2022]
Affiliation(s)
- N. Bach
- Faculty of Dental Medicine; Université de Montréal; Montreal QC Canada
| | - H. Tuomilehto
- Faculty of Dental Medicine; Université de Montréal; Montreal QC Canada
- Kuopio University Hospital; Kuopio Finland
| | - C. Gauthier
- Faculty of Dental Medicine; Université de Montréal; Montreal QC Canada
| | - A. Papadakis
- Faculty of Dental Medicine; Université de Montréal; Montreal QC Canada
| | - C. Remise
- Faculty of Dental Medicine; Université de Montréal; Montreal QC Canada
| | - F. Lavigne
- Faculty of Medicine; Université de Montréal; Montreal QC Canada
- Institut ORL de Montréal; Montreal QC Canada
| | - G. J. Lavigne
- Faculties of Dental Medicine and Medicine; Université de Montréal; Montreal QC Canada
- Sacré Coeur Hospital; Montreal QC Canada
| | - N. Huynh
- Faculty of Dental Medicine and CHU Sainte-Justine; Université de Montréal; Montreal QC Canada
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Arca M, Bellot A, Dupont C, Bach N, Eckart P, Penniello-Valette MJ, Brouard J. [Two uncommon extrapulmonary forms of Mycoplasma pneumoniae infection]. Arch Pediatr 2013; 20:378-81. [PMID: 23453717 DOI: 10.1016/j.arcped.2013.01.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 09/11/2012] [Accepted: 01/22/2013] [Indexed: 11/25/2022]
Abstract
Mycoplasma pneumonia is the second most frequent bacterium in pneumonia and the leading intracellular type. M. pneumoniae pulmonary infection is characterized by a slower onset profile and a lower biological inflammatory picture than pneumococcal infection. Both upper and lower respiratory tracts are often affected and sometimes a Kawasaki-like syndrome can be associated, with conjunctivitis or cheilitis. Extrapulmonary forms of the disease can occur, whether or not it is associated with pulmonary infection. We report two cases: in the first case, a renal form of M. pneumoniae disease developed in a 6-year-old girl, with membranous proliferative glomerulonephritis expressed as a picture of impure nephritic syndrome with decreased serum complement concentration, following an upper respiratory infection. Diagnosis was obtained by means of a kidney biopsy. The second case occurred in an 8-year-old girl who expressed, after a respiratory tract infection, neurological symptoms such as ocular flutter, perception disorder, and ataxia. This onset is typical of post-infectious rhombencephalitis. Biological investigations and imaging were normal. In both cases, M. pneumoniae infection was diagnosed on the basis of immunoglobulin M-positive serology. Direct exploration of the bacterium was negative, due to its fragility and delayed diagnostic hypothesis. Several forms of M. pneumoniae infection are either the direct effect of the bacterium or are secondary to a cross-immunological reaction. As its frequency is increasing, M. pneumoniae infection should be raised as a cause of atypical, less well-known extrapulmonary forms of the disease.
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Affiliation(s)
- M Arca
- Service de pédiatrie, pôle femme-enfant-hématologie, CHU de Caen, avenue de la Côte-de-Nacre, 14000 Caen, France.
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Abstract
Las infecciones infantiles afectan con frecuencia al aparato respiratorio inferior. Las clasificaciones convencionales, basadas en el tipo de afección anatómica, radiológica y etiopatogénica, permiten definir entidades clínicas (bronquitis, bronquiolitis, neumopatía); sin embargo, la evaluación de la gravedad del proceso es lo más útil para decidir el tipo y la rapidez del tratamiento. Aunque la etiología viral es la más frecuente, la estrategia fundamental para reducir la morbilidad e incluso la mortalidad de las infecciones respiratorias bajas se basa en el tratamiento adecuado de las neumonías bacterianas. Ante la ausencia de especificidad, es indispensable, cuando esté indicado, recurrir a una antibioticoterapia inicial probabilística que incluya el neumococo. En el niño, las muestras no suelen proceder del parénquima pulmonar y, además, la recogida de las secreciones bronquiales durante los primeros años de vida no es de buena calidad. Al contrario de lo que ocurre con los virus, el examen bacteriológico de las secreciones de las vías respiratorias altas es poco útil, porque los niños suelen ser portadores de gérmenes que pueden causar neumopatías. Los datos clínicos y radiológicos sólo pueden sugerir el diagnóstico. El desarrollo de técnicas que detectan antígenos microbianos o la búsqueda de material genético por biología molecular han permitido mejorar de manera significativa la identificación del patógeno responsable y la elección del tratamiento adecuado. Algunos grupos particulares de pacientes pueden padecer una afección respiratoria por agentes infecciosos inusuales o, incluso, oportunistas. Una proporción importante de la afectación respiratoria del adulto puede atribuirse a las agresiones pulmonares sufridas durante su infancia. La aplicación de vacunas, en especial, la antigripal y la antineumocócica, es fundamental para la prevención de estas afecciones respiratorias.
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Affiliation(s)
- J. Brouard
- Service de pédiatrie, Centre hospitalier universitaire de Caen, avenue Clemenceau, BP 95182, 14033 Caen cedex 5, France
| | - A. Vabret
- Laboratoire de virologie, Centre hospitalier universitaire de Caen, avenue Clemenceau, BP 95182, 14033 Caen cedex 5, France
| | - D. Nimal-Cuvillon
- Service de pédiatrie, Centre hospitalier universitaire de Caen, avenue Clemenceau, BP 95182, 14033 Caen cedex 5, France
| | - N. Bach
- Service de pédiatrie, Centre hospitalier universitaire de Caen, avenue Clemenceau, BP 95182, 14033 Caen cedex 5, France
| | - A. Bessière
- Service de pédiatrie, Centre hospitalier universitaire de Caen, avenue Clemenceau, BP 95182, 14033 Caen cedex 5, France
| | - A. Arion
- Service de pédiatrie, Centre hospitalier universitaire de Caen, avenue Clemenceau, BP 95182, 14033 Caen cedex 5, France
| | - F. Freymuth
- Laboratoire de virologie, Centre hospitalier universitaire de Caen, avenue Clemenceau, BP 95182, 14033 Caen cedex 5, France
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Singal AK, Stanca CM, Clark V, Dixon L, Levy C, Odin JA, Fiel MI, Friedman SL, Bach N. Natural history of small duct primary sclerosing cholangitis: a case series with review of the literature. Hepatol Int 2011; 5:808-13. [PMID: 21484124 DOI: 10.1007/s12072-011-9260-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2010] [Accepted: 02/04/2011] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Information about the natural history of small duct primary sclerosing cholangitis (SDPSC) remains scant despite literature suggesting that it constitutes 6-16% of all cases of primary sclerosing cholangitis (PSC). We combined clinical data on SDPSC cases from two tertiary care institutions with liver transplantation programs with the aim of studying the natural history of SDPSC. METHODS Medical records of 25 individuals with SDPSC were reviewed. Diagnosis of SDPSC was based on liver biopsy findings consistent with PSC, a normal cholangiogram, and elimination of known causes of secondary sclerosing cholangitis. Demographic information, symptoms, past medical history, laboratory values, and histologic data were evaluated. Our primary outcome measure was liver transplantation or death. Secondary outcome measures included evidence of end-stage liver disease, development of cholangiocarcinoma, and/or the development of classic PSC on a repeat cholangiogram. RESULTS Data on 25 individuals (13 males, 12 females; mean age 40 ± 15 years) diagnosed with SDPSC were analyzed. Upon presentation, 11 patients had symptoms including abdominal pain, fatigue, and pruritus. Inflammatory bowel disease was present in 14 patients (56%) at diagnosis. On initial liver biopsy, 60% had early-stage disease (I or II) and none had cirrhosis. On follow-up (1-168 months, median 17 months), malignancy or progression to classic large duct PSC was not noted. Two (8%) patients had evidence of varices and one of the two also developed ascites; one of these patients underwent liver transplantation and the other one died due to sepsis. CONCLUSIONS SDPSC, a mild disease at presentation typically runs a benign course and likely is not an early stage of classic PSC. Further studies with a control group of classic PSC and longer follow-up are needed to study the natural history of SDPSC.
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Affiliation(s)
- A K Singal
- Department of Gastroenterology, University of Texas Medical Branch, Galveston, TX, USA
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Brouard J, Vabret A, Bach N, Toutain F, Duhamel JF, Freymuth F. [Adenoviral respiratory diseases in healthy children: a study of 116 hospital cases]. ACTA ACUST UNITED AC 2008; 6:97-102. [PMID: 32288527 PMCID: PMC7146831 DOI: 10.1016/s1294-5501(04)94248-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Adenoviruses most commonly cause respiratory illness; however, depending on the infecting serotype, they may also cause various other diseases. Diagnosis may be difficult to achieve.The clinical findings for 116 children hospitalised with adenoviral infection were studied retrospectively. In 71 children, the diagnosis was based on detection of adenovirus antigen in the nasopharyngeal specimens and in 71 children on viral culture. The clinical picture of adenoviral infection was characterised by high-grade (mean 39°1C) and prolonged fever (mean duration 4,3 days). Upper respiratory and lower respiratory symptoms were the most common infections. Twelve had been admitted to the hospital due to febrile convulsions, 6 had meningitis. Laboratory findings varied from normal values to values seen in bacterial infections. Thus it was difficult to distinguish adenoviral disease from a bacterial disease. Fifty-nine children were referred to the hospital due to infection unresponsive to antimicrobial therapy.Symptoms of respiratory infection caused by adenovirus may range from the common cold syndrome to pneumonia, croup and bronchiolitis. Adenoviruses can be responsible for severe consequences, even in previously healthy children. Studies of the molecular mechanisms of viral infections of the airways could provide important insights into the nature of the inflammatory process involved in asthma and chronic obstructive pulmonary disease. Most infections are mild and require no therapy or only symptomatic treatment. There are at present time no recognised antiviral agents that are effective in treating serious adenovirus disease. The rapid detection of adenovirus antigen in nasopharygeal specimens proved to have a great clinical value in the diagnosis.
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Affiliation(s)
- J Brouard
- Service de Pédiatrie A, CHU de Caen avenue Georges Clémenceau, 14033 Caen cedex
| | - A Vabret
- Laboratoire de Virologie Humaine et Moléculaire, CHU de Caen avenue Georges Clémenceau, 14033 Caen cedex
| | - N Bach
- Service de Pédiatrie A, CHU de Caen avenue Georges Clémenceau, 14033 Caen cedex
| | - F Toutain
- Service de Pédiatrie A, CHU de Caen avenue Georges Clémenceau, 14033 Caen cedex
| | - J F Duhamel
- Service de Pédiatrie A, CHU de Caen avenue Georges Clémenceau, 14033 Caen cedex
| | - F Freymuth
- Laboratoire de Virologie Humaine et Moléculaire, CHU de Caen avenue Georges Clémenceau, 14033 Caen cedex
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Freymuth F, Vabret A, Tripey V, Bach N, Nimal D, Legrand L, Dina J, Brouard J. [A new virus: the human metapneumovirus]. Rev Prat 2007; 57:1909-1911. [PMID: 18095627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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14
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Brouard J, Vabret A, Nimal-Cuvillon D, Bach N, Bessière A, Arion A, Freymuth F. [Epidemiology of acute upper and lower respiratory tract infections in children]. Rev Prat 2007; 57:1759-1766. [PMID: 18092718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
More than 200 antigenically distinct viruses have been documented as causes of sporadic or epidemic respiratory infections in infants and children. The lung itself is rarely sampled directly, and sputum representing lower-airway secretions can rarely be obtained from children. In addition culture of secretions from upper respiratory tract is not useful since the normal flora includes the bacteria commonly responsible for pneumonia. Clinical and radiology data only suggest the diagnosis. The development of techniques to detect antigens of the causative agent in nasopharyngeal secretions, nucleic acid by means of the polymerise-chain reaction assays has significantly improved the identification of the responsible pathogen and the choice of appropriate treatment. Since more 30 years rhinovirus, coronavirus, enterovirus, parainfluenza virus and respiratory syncytial virus were added to influenza, adenovirus and measles virus as causes of respiratory tract infections. This list of pathogens was extended last years with the discovery of human metapneumovirus, bocavirus, polyomavirus. In restricted patient groups, such as the immunocompromised, members of the family of herpesvirus have also been associated with respiratory disease.
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15
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Bahi-Buisson N, Eisermann M, Nivot S, Bellanné-Chantelot C, Dulac O, Bach N, Plouin P, Chiron C, de Lonlay P. Infantile spasms as an epileptic feature of DEND syndrome associated with an activating mutation in the potassium adenosine triphosphate (ATP) channel, Kir6.2. J Child Neurol 2007; 22:1147-50. [PMID: 17890419 DOI: 10.1177/0883073807306272] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Activating mutations in the Kir6.2 subunit of the adenosine triphosphate-sensitive potassium (KATP) channel is a cause of neonatal diabetes associated with various neurological disorders that include developmental delay, epilepsy, and neonatal diabetes (known together as DEND syndrome). This article reports a girl who developed infantile spasms and early onset diabetes mellitus at the age of 3 months and revealed DEND syndrome with a heterozygous activating mutation in Kir6.2. Infantile spasms with hypsarrhythmia on the electroencephalogram were severe and refractory to steroids. Steroids combined with oral sulfonylurea, a drug that closes the ATP-sensitive potassium channel by an independent mechanism, allowed partial and transitory control of the epilepsy. However, the child still exhibited severe encephalopathy and died of aspiration pneumonia. The role of oral sulfonylurea as an anticonvulsant in DEND syndrome associated with Kir6.2 mutation is discussed.
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MESH Headings
- Anticonvulsants/therapeutic use
- Brain Chemistry/genetics
- Brain Diseases, Metabolic/genetics
- Brain Diseases, Metabolic/metabolism
- Brain Diseases, Metabolic/physiopathology
- DNA Mutational Analysis
- Developmental Disabilities/genetics
- Developmental Disabilities/metabolism
- Developmental Disabilities/physiopathology
- Diabetes Mellitus, Type 1/genetics
- Diabetes Mellitus, Type 1/metabolism
- Diabetes Mellitus, Type 1/physiopathology
- Electroencephalography
- Epilepsy/genetics
- Epilepsy/metabolism
- Epilepsy/physiopathology
- Fatal Outcome
- Female
- Genetic Predisposition to Disease/genetics
- Humans
- Hypoglycemic Agents/therapeutic use
- Infant
- Mutation/genetics
- Pneumonia, Aspiration/etiology
- Potassium Channel Blockers/therapeutic use
- Potassium Channels, Inwardly Rectifying/genetics
- Spasms, Infantile/genetics
- Spasms, Infantile/metabolism
- Spasms, Infantile/physiopathology
- Steroids/therapeutic use
- Sulfonylurea Compounds/therapeutic use
- Syndrome
- Treatment Outcome
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Affiliation(s)
- Nadia Bahi-Buisson
- Department of Paediatric Neurology and Metabolic Disease, Hôpital Necker Enfants Malades, Paris, France.
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16
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Affiliation(s)
- J Brouard
- Service de pédiatrie, avenue Clémenceau, CHU de Caen, 14033 Caen cedex, France.
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17
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Brouard J, Nimal D, Vabret A, Arion A, Bach N, Duhamel JF, Freymuth F. [Infant asthma: sole role of respiratory syncytial virus?]. Arch Pediatr 2006; 13:801-3. [PMID: 16690281 PMCID: PMC7118867 DOI: 10.1016/j.arcped.2006.03.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- J Brouard
- Service de pédiatrie, CHU de Caen, avenue Clémenceau, 14033 Caen cedex, France.
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18
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Tischendorf JJ, Crede S, Herrmann P, Bach N, Bömeke C, Manns MP, Schaefer O, Trautwein C. Diagnosenverschlüsselung durch Medizinische Dokumentationsassistentin oder Stationsarzt. Dtsch Med Wochenschr 2004; 129:1731-5. [PMID: 15295683 DOI: 10.1055/s-2004-829024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Starting in 2004 the patient budget in Germany will be calculated according to the Diagnosis Related Group (DRG) system, by which system the monetary reward of a unit will be directly related to the quality of documentation e. g. diagnosis and procedures. The aim of this study was to compare the quality of documentation by a medical documentation assistant (MDA) with the usual practice of documentation by the ward physician (WP). Additionally, the effect of introducing a completely changed organizational process was tested. METHODS In a prospective study on the ward of a gastroenterology unit two different approaches of medical documentation were compared. In a first six-month period diagnosis and procedures were encoded by WP. In the following six months an MDA was introduced and involved in the encoding process. RESULTS In the first six months 221 patients (mean age 55 +/- 16,2 years, 55,7 % males) were evaluated, whereas in the following six months 305 patients (mean age 53 +/- 15,4 years, 59,9 % males) were included. The introduction of an MDA improved medical documentation and economical reference numbers: with an increase of diagnosis per case to 7,43 (in first six months 5,53), patient complexity and comorbidity level (PCCL) to 2,5 (in first six months 2,13), case-mix index to 1,04 (in first six months 0,98). Additionally the medial hospitalization time decreased from 11,2 to 8,1 days. The average daily reimbursement increased in the MDA group from 423 Euro to 603 Euro. This was calculated on the basis of a basic case factor of 2900 Euro. CONCLUSION Introduction of an MDA in a gastroenterology ward increases the quality of documentation and results in an improved presentation of DRG-relevant efforts with a better reimbursement of medical costs.
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Affiliation(s)
- J J Tischendorf
- Abteilung für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover
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19
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Bach N, Cuvillon D, Brouard J, Lafay F, Freymuth F, Legrand L, Guillois B, Duhamel J. [Acute respiratory tract infections due to a human metapneumovirus in children: descriptive study and comparison with respiratory syncytial virus infections]. Arch Pediatr 2004; 11:212-5. [PMID: 14992767 PMCID: PMC7133263 DOI: 10.1016/j.arcped.2003.12.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2003] [Accepted: 12/06/2003] [Indexed: 11/20/2022]
Abstract
BACKGROUND A new paramyxovirus, the human metapneumovirus was recently isolated. We report the first French cases collected between 2000 and 2002. MATERIAL AND METHODS Samples were obtained from nasopharyngeal aspirates from children hospitalised for acute respiratory tract infection in hospitals of Caen and Flers in Basse-Normandie. Human metapneumovirus was studied by polymerase chain reaction on negative samples for respiratory syncytial virus, influenza A and B virus, parainfluenza (1, 2 and 3) virus, adenovirus, coronavirus and rhinovirus. Comparison between metapneumovirus virus and respiratory syncytial virus infections was done after matching sex, age and infection month. RESULTS Twenty-six human metapneumovirus infections were identified. A comparative study of a matched group of children infected by respiratory syncytial virus found no significative difference for hospitalisation motive, clinical criteria and treatment. CONCLUSION The human metapneumovirus is responsible for typical acute bronchiolitis in children.
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Affiliation(s)
- N Bach
- Service de pédiatrie, CHU Clémenceau, avenue Clémenceau,14033 Caen, France
| | - D Cuvillon
- Service de pédiatrie, CHU Clémenceau, avenue Clémenceau,14033 Caen, France
| | - J Brouard
- Service de pédiatrie, CHU Clémenceau, avenue Clémenceau,14033 Caen, France
| | - F Lafay
- Service de pédiatrie, centre hospitalier Jacques-Monod, 61100 Flers, France
| | - F Freymuth
- Laboratoire de virologie humaine et moléculaire, CHU Clémenceau, avenue Clémenceau, 14033 Caen, France
| | - L Legrand
- Laboratoire de virologie humaine et moléculaire, CHU Clémenceau, avenue Clémenceau, 14033 Caen, France
| | - B Guillois
- Service de pédiatrie, CHU Clémenceau, avenue Clémenceau,14033 Caen, France
| | - J.F Duhamel
- Service de pédiatrie, CHU Clémenceau, avenue Clémenceau,14033 Caen, France
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20
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Brouard J, Freymuth F, Bach N, Duhamel JF. [Viruses increase the risk of asthma]. Arch Pediatr 2003; 10 Suppl 1:94s-95s. [PMID: 14509756 DOI: 10.1016/s0929-693x(03)90396-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- J Brouard
- Service de pédiatrie A, CHU de Caen, avenue Clemenceau, 14033 Caen, France.
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21
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Brouard J, Freymuth F, Toutain F, Bach N, Vabret A, Gouarin S, Petitjean J, Duhamel JF. [Role of viral infections and Chlamydia pneumoniae and Mycoplasma pneumoniae infections in asthma in infants and young children. Epidemiologic study of 118 children]. Arch Pediatr 2002; 9 Suppl 3:365s-371s. [PMID: 12205810 DOI: 10.1016/s0929-693x(02)00145-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Wheezing associated with upper respiratory tract infections is common in children. Using conventional techniques (viral culture and immunofluorescence) and molecular techniques (PCR), we studied the prevalence of viral, Chlamydia pneumoniae (CP) and Mycoplasma pneumoniae (MP) infections in 118 children hospitalised for acute asthma exacerbation. A virus was identified by conventional techniques in 40 of the 118 nasal swabs (34%), while PCR allowed identification of virus CP and MP in 80 samples (68%). Combination of both techniques allowed identification of an infectious agent in 91 cases (77%). More than one agent was isolated in 15 cases (23%). Rhinovirus (RV) (45%) were prevalent, followed by respiratory syncytial virus (RSV) (28%) and enterovirus (8.5%). RV and RSV have a similar prevalence (42% and 36% respectively) before two years of age, as compared with 66% and 27% respectively in older children. CP and MP were identified by PCR in only 6 cases. Molecular techniques of identification demonstrated a clear advantage in sensitivity compared with conventional techniques. The high prevalence of RV and RSV infections is remarkable, while CP and MP do not seem particularly involved in children acute asthma exacerbation.
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Affiliation(s)
- J Brouard
- Service de pédiatrie A, hôpital universitaire, avenue G. Clemenceau, 14033 Caen, France.
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22
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Sofia MJ, Floreancig P, Bach N, Baker SR, Nelson K, Sawyer JS, Baldwin R, Cockerham SL, Fleisch JH, Froelich LL, Jackson WT, Marder P, Roman CR, Saussy DL, Silbaugh SA, Spaethe SM, Stengel PW. The discovery of LY293111, a novel, potent and orally active leukotriene B4 receptor antagonist of the biphenylphenol class. Adv Exp Med Biol 2001; 400A:381-6. [PMID: 9547580 DOI: 10.1007/978-1-4615-5325-0_51] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- M J Sofia
- Lilly Research Labs, Eli Lilly and Co., Indianapolis, IN 46285, USA
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23
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Bach N, Koff RS, Maddrey W. When and how to screen for liver disease. MLO Med Lab Obs 2000; 32:58-64, 66; quiz 67-8. [PMID: 11066401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- N Bach
- Mount Sinai School of Medicine, City University of New York, NY, USA
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24
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Blatt LM, Mutchnick MG, Tong MJ, Klion FM, Lebovics E, Freilich B, Bach N, Smith C, Herrera J, Tobias H, Conrad A, Schmid P, McHutchison JG. Assessment of hepatitis C virus RNA and genotype from 6807 patients with chronic hepatitis C in the United States. J Viral Hepat 2000; 7:196-202. [PMID: 10849261 DOI: 10.1046/j.1365-2893.2000.00221.x] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Hepatitis C virus (HCV) RNA status and HCV genotype have become important tools in the diagnosis and monitoring of therapy in chronic HCV infection. To establish a database with respect to HCV genotype and serum HCV RNA concentrations in chronic hepatitis C patients in the United States, we analysed 6807 chronic hepatitis C patients who had HCV RNA and HCV genotype tests conducted at a central laboratory. The HCV RNA concentration cut-off for the lower 25th percentile of this population (low titre) was 0.9 x 106 copies ml-1. The median HCV RNA concentration was 3.5 x 106 copies ml-1 and the cut-off for the upper 25th percentile (high titre) was 5 x 106 copies ml-1. Male patients had a median HCV RNA concentration of 3.9 x 106 copies ml-1, which was significantly higher than the median HCV RNA level for females (2.75 x 106 copies ml-1; P < 0.001). HCV genotype 1 was detected in 73% of patients; genotype 2 in 14%; genotype 3 in 8%; mixed genotype in 4%; and genotypes 4, 5 and 6 with a frequency of < 1%. Patients from the Northeast, Southeast and Midwest had significantly (P < 0.001) more infections with genotype 1 than patients from the Western and Southern regions. African-American patients were more likely to be infected with genotype 1 when compared with Caucasian, Hispanic or Asian Pacific Islanders (P < 0.001). Patients infected with HCV genotype 1 and mixed HCV genotypes had significantly higher serum HCV RNA concentrations when compared with HCV genotypes 2 and 3 (P < 0.001 for all comparisons).
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Affiliation(s)
- L M Blatt
- National Genetics Institute, Los Angeles, CA, USA
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25
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Bach N. Industrial postdocs at risk. Nat Biotechnol 1998; 16:1295. [PMID: 9853594 DOI: 10.1038/4246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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26
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Bach N, Thung SN, Schaffner F. The histologic effects of low-dose methotrexate therapy for primary biliary cirrhosis. Arch Pathol Lab Med 1998; 122:342-5. [PMID: 9648903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Primary biliary cirrhosis is a progressive liver disease that is believed to be autoimmune in nature. Treatment, at best, may slow the progression of the disease, although no therapy has been able to halt its progression. Preliminary data suggest a beneficial effect of methotrexate in the treatment of primary biliary cirrhosis. We evaluated the histologic effect of 2 years of treatment with methotrexate. DESIGN Liver biopsies were obtained before methotrexate was started and after 2 years of therapy. Ninety-six paired biopsies from 48 patients with primary biliary cirrhosis were reviewed by a pathologist who was blinded to all clinical history and sequence of the biopsies. Variables examined included stage of the disease, degree of portal fibrosis, portal inflammation and piecemeal necrosis, bile duct injury or loss, bile ductular proliferation, lobular inflammation and necrosis, steatosis, granulomas, cholestasis, and nuclear pleomorphism of hepatocytes. RESULTS In most categories, pretreatment and posttreatment biopsies did not reflect a change over the 2-year period of treatment. There was a trend toward progression of the stage of the disease, portal fibrosis, bile duct loss, fat, and pleomorphism over the 2 years and toward regression in piecemeal necrosis, bile duct injury, ductular proliferation, granulomas, and lobular inflammation and necrosis. CONCLUSION After 2 years of treatment with methotrexate, the stage of disease and fibrosis of primary biliary cirrhosis continue to progress, although overall, inflammation and bile duct injury decrease with methotrexate treatment.
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Affiliation(s)
- N Bach
- Department of Medicine, The Mount Sinai Medical Center of the City University of New York, NY, USA
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27
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Melero I, Bach N, Hellström KE, Aruffo A, Mittler RS, Chen L. Amplification of tumor immunity by gene transfer of the co-stimulatory 4-1BB ligand: synergy with the CD28 co-stimulatory pathway. Eur J Immunol 1998; 28:1116-21. [PMID: 9541607 DOI: 10.1002/(sici)1521-4141(199803)28:03<1116::aid-immu1116>3.0.co;2-a] [Citation(s) in RCA: 157] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We have explored the role of an activation-induced T cell molecule, 4-1BB (CDw137), in the amplification of tumor immunity by retrovirus-mediated transduction of the 4-1BB ligand (4-1BBL) into tumor cells. Mice inoculated with P815 tumor cells expressing 4-1BBL developed a strong cytotoxic T lymphocyte (CTL) response and long-term immunity against wild-type tumor. The optimal effect of 4-1BBL in CTL stimulation required B7-CD28 interaction since blockade of this interaction by antibodies down-regulated the expression of 4-1BB on T cells and decreased CTL activity. Furthermore, co-expression of 4-1BBL and B7-1 in the poorly immunogenic AG104A sarcoma enhanced the induction of effector CTL and the rejection of the wild-type tumor while neither 4-1BBL nor B7-1 single transfectants were effective, suggesting a synergistic effect between the 4-1BB and the CD28 co-stimulatory pathways. Our results underscore the importance of the 4-1BB T cell stimulation pathway in the amplification of an antitumor immune response.
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MESH Headings
- Animals
- Antigens, CD
- Antigens, Neoplasm/immunology
- CD28 Antigens/administration & dosage
- CD4-Positive T-Lymphocytes/immunology
- Cytotoxicity, Immunologic
- Gene Transfer Techniques
- Lymphocyte Activation
- Mice
- Mice, Inbred C3H
- Mice, Inbred DBA
- Neoplasms, Experimental/immunology
- Receptors, Nerve Growth Factor/administration & dosage
- Receptors, Nerve Growth Factor/physiology
- Receptors, Tumor Necrosis Factor/administration & dosage
- Receptors, Tumor Necrosis Factor/physiology
- T-Lymphocytes, Cytotoxic/immunology
- Tumor Necrosis Factor Receptor Superfamily, Member 9
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Affiliation(s)
- I Melero
- Bristol-Myers Squibb Pharmaceutical Research Institute, Seattle, USA
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28
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Abstract
Despite the fact that many tumors express MHC class I molecules presenting "foreign" peptide antigens, a vigorous tumor-destructing immune response is seldom detected. A possible explanation is that tumors cannot provide adequate costimulatory signals as provided by professional antigen presenting cells. CD28, upon interacting with B7, triggers costimulatory signals critical for the T-cell response. Transfection of tumor cells with B7 augments the immunogenicity of the tumor so that an anti-tumor immune response can be amplified. When B7-CD28 costimulation is provided CTL specific for otherwise silent epitopes can be activated. Therefore, unresponsiveness of T cells to many tumor antigens should be considered as ignorance rather than tolerance. Immunological ignorance may thus contribute to the failure of the immune system to respond against the tumor antigens.
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Affiliation(s)
- I Melero
- Bristol-Myers Squibb Pharmaceutical Research Institute, Seattle, WA 98121, USA
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29
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Bach N. The significance of alcoholic liver disease to contemporary clinical hepatology. Hepatology 1996; 24:959-60. [PMID: 8855205 DOI: 10.1053/jhep.1996.v24.ajhep0240959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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30
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Eshhar Z, Bach N, Fitzer-Attas CJ, Gross G, Lustgarten J, Waks T, Schindler DG. The T-body approach: potential for cancer immunotherapy. Springer Semin Immunopathol 1996; 18:199-209. [PMID: 8908700 DOI: 10.1007/bf00820666] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Z Eshhar
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
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31
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Bach N. [Enalapril treatment of a pre-eclamptic woman]. Ugeskr Laeger 1995; 157:1203-4. [PMID: 7701668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A case is reported describing severe pre-eclampsia, treated firstly with antihypertensive drugs and Caesarean section. Contrary to expectation blood pressure did not fall and proteinuria still remained. Blood pressure reducing drugs had no effect at all. The patient was then treated with Renitec (enalapril), an ACE-inhibitor, with good result--even when given in a small dosis. No influence on lactation was documented for five weeks. Teratogenicy has been reported using ACE-inhibitors, and only a little is known about their effect on lactation. We found Renitec to have a good effect on reducing blood pressure postpartum and no effect on lactation at all.
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Affiliation(s)
- N Bach
- Gynaekologisk afdeling G., Sønderborg Sygehus
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32
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Abstract
To estimate the prevalence of primary biliary cirrhosis in family members with this disease and determine if a family history of primary biliary cirrhosis predisposes to the development of this disease, we performed a retrospective review of charts and a prospective mail survey of patients with primary biliary cirrhosis. Prevalence of primary biliary cirrhosis in family members of 405 patients with disease was compared to known prevalence of disease in the general population. Twenty-six patients with primary biliary cirrhosis had at least one family member with primary biliary cirrhosis. The estimated prevalence per 100,000 was 6420 or 6.4%. Exclusion of family members with primary biliary cirrhosis who were patients in our practice, in order to avoid duplication, changed the prevalence to 4282 per 100,000 or 4.3%. Affected family members included mothers, daughters, sisters, brothers, aunts and cousins. Estimates of prevalence of primary biliary cirrhosis are between 0.7 and 7.5 cases per 100,000. Therefore, compared to estimates in the general population, the prevalence of primary biliary cirrhosis in family members of patients with this disease is markedly increased. A family history of primary biliary cirrhosis is therefore a predisposing factor for the development of this disease.
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Affiliation(s)
- N Bach
- Samuel Bronfman Department of Medicine, Mount Sinai School of Medicine, City University of New York, New York
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33
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Danque PO, Bach N, Schaffner F, Gerber MA, Thung SN. HLA-DR expression in bile duct damage in hepatitis C. Mod Pathol 1993; 6:327-32. [PMID: 8346181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Several investigations have demonstrated aberrant expression of HLA-DR on damaged bile duct epithelium of patients with primary biliary cirrhosis, liver allograft rejection, graft versus host disease, and AIDS. Since bile duct damage is a prominent feature of chronic hepatitis C, it may also be associated with HLA-DR induction. Therefore, we examined the expression of HLA-DR antigen in formalin-fixed, paraffin-embedded liver biopsy sections of 30 patients with chronic hepatitis C by the avidin-biotin peroxidase complex method using a monoclonal antibody to HLA-DR. HLA-DR was not detected on bile duct epithelium in any of the cases, although bile duct damage of varying degree was observed in 90% of the cases. HLA-DR was expressed by Kupffer cells; inflammatory infiltrates in portal tracts, and in areas of piecemeal necrosis and lobular necrosis; dendritic cells in portal and periportal areas; and occasionally hepatocytes. These observations suggest that the mechanism of bile duct injury in chronic hepatitis C may be different from that of other conditions such as primary biliary cirrhosis, liver allograft rejection, and graft versus host disease.
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Affiliation(s)
- P O Danque
- Lillian and Henry M. Stratton-Hans Popper Department of Pathology, Mount Sinai Medical Center, City University of New York, New York
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34
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Affiliation(s)
- N Bach
- Department of Medicine, Mount Sinai Medical Center, New York, New York 10029
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35
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Abstract
Involvement of the liver with the same opportunistic organisms and neoplasms affecting other organs has been recognized since the beginning of the AIDS epidemic. In this overview of hepatic histopathologic features in AIDS, we review the range of opportunistic infections and neoplasms accompanying HIV infection. Hepatic disease may result from viral, bacterial, protozoal, or fungal infection, or secondary to drugs and neoplasms. Liver involvement in AIDS usually reflects disseminated rather than primary disease. CMV and mycobacteria are the most common organisms in liver identified in biopsy and autopsy studies. A variety of nonspecific features, including steatosis, granulomas, and sinusoidal abnormalities may also be seen. HIV-1 itself was recently identified in the liver. Speculation regarding the significance of this finding has been discussed in this review. Hepatitis B, C, and D may also complicate the course of disease in patients with AIDS. Hepatitis B behaves differently in the population with AIDS than in immunocompetent patients. We concluded our review with a discussion of the present recommendations regarding the use of liver biopsies in these patients. This topic continues to be widely debated in the literature.
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Affiliation(s)
- N Bach
- Samuel Bronfman Department of Medicine (Division of Liver Diseases), Mount Sinai School of Medicine, City University of New York, NY 10029
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36
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Abstract
Before the availability of serological markers for hepatitis C, the morphological features of this diagnosis, which represents most non-A, non-B hepatitis, could not be confirmed. We examined biopsy specimens from 50 patients with chronic hepatitis C and 21 patients with autoimmune chronic hepatitis. Each biopsy specimen was graded on 19 different histological features. The results indicated that at the time of biopsy, the average age of patients with chronic hepatitis C was 46 yr vs. 36 yr for autoimmune chronic hepatitis. Cirrhosis was seen more frequently in autoimmune chronic hepatitis (90%) than in hepatitis C (58%). Features more commonly observed in chronic hepatitis C were bile duct damage (91% vs. 40%), bile duct loss (91% vs. 20%), steatosis (72% vs. 19%) and lymphoid cell aggregation (follicles) within portal tracts (49% vs. 10%). Severe lobular necrosis and inflammation (76% vs. 38%), piecemeal necrosis (81% vs. 10%), multinucleated hepatocytes (29% vs. 6%) and broad areas of parenchymal collapse (76% vs. 6%) were seen more often in autoimmune chronic hepatitis. Exclusion of five patients with autoimmune chronic hepatitis who received immunosuppression before biopsy accentuated these differences. In conclusion, morphological criteria, in addition to serological data, may be useful for differentiating chronic hepatitis C from autoimmune chronic hepatitis, which histologically is a more aggressive disease.
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Affiliation(s)
- N Bach
- Samuel Bronfman Department of Medicine, Mount Sinai School of Medicine, City University of New York, New York 10029
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Bach N, Kahn H, Thung SN, Schaffner F, Klion FM, Miller CM. Hepatocellular carcinoma in a long-term survivor of intrahepatic biliary duct hypoplasia. Am J Gastroenterol 1991; 86:1527-30. [PMID: 1656729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We describe the development of hepatocellular carcinoma (HCC) in a 46-yr-old woman with intrahepatic biliary duct hypoplasia. Her underlying liver disease was quiescent for many years until a dramatic rise in serum bilirubin was seen. Orthotopic liver transplantation was performed, and a large tumor was found during surgery. A bile-producing HCC was identified, infiltrating about 50% of an otherwise noncirrhotic liver which had a paucity of intrahepatic ducts. The findings of HCC in this long-term survivor of intrahepatic biliary duct hypoplasia indicates HCC may occur in patients with long-standing disease.
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Affiliation(s)
- N Bach
- Samuel Bronfman Department of Medicine, Mount Sinai School of Medicine, City University of New York
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Bach N, Glabman S, Lewis BS. Prostaglandin analogues and reversal of hepatorenal syndrome: fact or fiction? Am J Gastroenterol 1991; 86:1271-2. [PMID: 1909087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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39
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Thung SN, Bach N, Fasy TM, Jordon D, Schaffner F. Hepatocellular carcinoma associated with autoimmune chronic active hepatitis. Mt Sinai J Med 1990; 57:165-8. [PMID: 2164643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Primary hepatocellular carcinoma, one of the most common malignancies in the world, develops in chronic liver diseases of different etiologies. Hepatitis B and non-A, non-B infections, alcoholic cirrhosis, hemochromatosis, contamination with aflatoxins, and oral contraceptives are just a few of the conditions that have been associated with this carcinoma. To our knowledge, few cases of autoimmune chronic active hepatitis and hepatocellular carcinoma have been reported in the literature. We describe a patient who developed hepatocellular carcinoma 21 years after the onset of the autoimmune hepatitis.
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Affiliation(s)
- S N Thung
- Lillian and Henry M. Stratton-Hans Popper Department of Pathology, New York
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40
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Abstract
As part of the protocol on the Development of the Child's Arch, foot growth studies were monitored prospectively in 107 children from 1 year of age till 5 years of age. Under 15 months of age, growth necessitated a 1/2 size footwear change in less than 2 months; from 15 months to 2 years of age, 1/2 size increase occurred every 2 to 3 months; from 2 to 3 years of age, 1/2 size change every 3 to 4 months; and from 3 to 5 years of age, 1/2 size change every 4 months. Although foot growth in boys and girls is parallel, boys' feet tend to average one size longer and one size wider. Width growth remained proportional to length growth throughout the study.
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Affiliation(s)
- N Gould
- Department of Orthopaedic Surgery and Rehabilitation, University of Vermont College of Medicine
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Bach N, Schultz BL, Cohen LB, Squire A, Gordon R, Thung SN, Schaffner F. Amiodarone hepatotoxicity: progression from steatosis to cirrhosis. Mt Sinai J Med 1989; 56:293-6. [PMID: 2797021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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42
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Bach N, Thung SN, Schaffner F, Tobias H. Exaggerated cholestasis and hepatic fibrosis following simultaneous administration of chlorpromazine and sodium valproate. Dig Dis Sci 1989; 34:1303-7. [PMID: 2502367 DOI: 10.1007/bf01537284] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- N Bach
- Department of Medicine, Mount Sinai School of Medicine, City University of New York 10029
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Affiliation(s)
- N Bach
- Department of Medicine, Mount Sinai School of Medicine, New York, New York 10029
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Abstract
Sexual behavior in women with liver disease was examined in 150 women to determine whether liver disease influenced sexual desire, frequency or performance. The average age of women studied was 53 years (range: 26 to 76 years), and a wide variety of liver diseases were represented. Sexual desire was reduced in 33%. Difficulty in becoming sexually aroused was noted by 18%. Orgasm during intercourse was not experienced by 25%. The frequency of sexual intercourse decreased since onset of disease in 27%. Dyspareunia was a complaint by 21%, most often attributed to decreased vaginal lubrication. Liver disease was considered a significant factor interfering with sexual function in 17%. No statistical difference was found between sexual desire or function in our study and in large studies of sexual behavior in women. Each category was subdivided by presence or absence of cirrhosis, pre- or postmenopausal state, laboratory values and duration of disease. Except for a greater number of postmenopausal women with complaints of painful intercourse, no statistical differences or trends were found. Nonalcoholic liver disease does not affect sexual desire, function or performance. Variables other than liver disease influence sexuality. Women with liver disease can thus be reassured that they can maintain normal sexual relations.
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Affiliation(s)
- N Bach
- Department of Medicine, Mount Sinai School of Medicine, City University of New York, New York 10029
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Novick DM, Farci P, Croxson TS, Taylor MB, Schneebaum CW, Lai ME, Bach N, Senie RT, Gelb AM, Kreek MJ. Hepatitis D virus and human immunodeficiency virus antibodies in parenteral drug abusers who are hepatitis B surface antigen positive. J Infect Dis 1988; 158:795-803. [PMID: 3171227 DOI: 10.1093/infdis/158.4.795] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
We studied unselected, hepatitis B surface antigen (HBsAg)-positive parenteral drug abusers for antibody to hepatitis D virus (anti-HD) and antibody to human immunodeficiency virus (HIV). The prevalences of anti-HD and antibody to HIV were 67% and 58%, respectively, and there was no association between positivity for these two markers. In a logistic regression model, anti-HD was associated with older age (P = .001), longer duration of drug abuse (P = .045), and the presence of liver disease (P = .002). Antibody to HIV was associated with a younger age (P = .003) and increased serum globulin levels (P less than .001). In patients infected with HIV, the severity of hepatic dysfunction remained correlated with anti-HD. In anti-HD-positive patients, most indices of hepatic dysfunction were similar whether or not antibody to HIV was present, but serum aspartate aminotransferase levels were significantly higher in patients with both anti-HD and antibody to HIV. (124 +/- 16 vs. 74 +/- 11, P less than .05).
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Affiliation(s)
- D M Novick
- Department of Medicine, Beth Israel Medical Center, New York, New York 10003
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Affiliation(s)
- F Schaffner
- Department of Medicine, Mount Sinai School of Medicine, City University of New York, NY 10029
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Abstract
In 7 healthy subjects (3 males and 4 females), the kinetics of nadolol was investigated after oral doses of 60 and 120 mg. The t 1/2 was 14.0 +/- 1.8 h. The peak plasma level was doubled on doubling the dose (from 69 +/- 15 to 132 +/- 27 ng/ml, respectively) and the urinary excretion (13.5%) rose similarly. The half-life of elimination was longer at night than in the day, probably because of the slower nocturnal flow of urine.
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Affiliation(s)
- L. Matthew
- From the Division of Physiology of the University of California Medical School, Berkeley
| | - N. Bach
- From the Division of Physiology of the University of California Medical School, Berkeley
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Affiliation(s)
- L. Matthew
- From the Division of Physiology of the University of California Medical School, Berkeley
| | - N. Bach
- From the Division of Physiology of the University of California Medical School, Berkeley
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