The United States Food and Drug Administration recently warned that the direct acting antiviral (DAA) combination hepatitis C virus (HCV) treatment of Paritaprevir, Ombitasvir, Dasabuvir, Ritonavir, and Ribavirin (PODr + R) can cause severe liver injury in patients with advanced liver disease. Drug induced liver injury was observed in a small number of patients with decompensated cirrhosis treated with other DAAs, but has not been reported in patients with compensated cirrhosis. We report a case of a 74-year-old woman with chronic HCV and Child-Pugh class A cirrhosis (compensated cirrhosis) treated with PODr + R. The patient presented on day 14 of PODr + R therapy with jaundice and new-onset ascites. Her total bilirubin level increased to 23 mg/dL and international normalized ratio rose to 1.65, while aminotransferase levels remained relatively stable. Hepatitis C treatment was discontinued on day 24 and she gradually recovered. Follow-up testing showed that she achieved a sustained virologic response. In conclusion, hepatic decompensation developed within two weeks of starting treatment with Hasin Y et al . HCV cures after DAA-related drug-induced liver injury PODr + R in a patient with Child-Pugh class A cirrhosis and was characterized by jaundice and ascites with stable aminotransferase levels. Careful monitoring is warranted in patients with HCV-related cirrhosis treated with PODr + R.
The element content of ossified auricles in two patients with Addison's disease was determined by X-ray microanalysis. The results showed a similar element content of the ossified auricles of the Addison's patients and control bone specimens. The calcium and phosphorus content of the petrified auricles was, however, slightly decreased compared with the iliac bone biopsies of the patients. The sulfur content of the ossified auricles was higher than that of their bones, but markedly lower than control auricular cartilage. Iron, sodium, and chloride contents were similar in the ossified auricles and in the normal auricular cartilage, whereas only trace amounts of these elements were detected in the bone. The auricles of the patients with Addison's disease possessed relatively high aluminium content compared with both control bone and cartilage. The element content of the bone biopsies from Addison patients was comparable to control bone. The presence of trace amounts of aluminium in the petrified auricles of Addison's patients is probably attributed to a long period of aluminium hydroxide consumption.
A group of 34 physically healthy young patients, aged 18-27 years at their first psychotic attack, before neuroleptic treatment and admission, were tested simultaneously with 24 age- and sex-matched controls for levels of serum interferon. No statistically significant differences were found between patients and controls. Therefore, no correlation between acute viral infection and schizophrenia was demonstrated.
The aim of this study was to assess life satisfaction and adjustment of lithium-treated affective patients in remission. Scores of life satisfaction and adjustment in four areas were obtained for two experimental groups of 50 unipolars and 50 bipolars and for two control groups of 50 healthy individuals and 50 patients with personality disorders. Subjects' self-assessments and psychiatrists' evaluation were rated using a modification of Cantril's ladder device. No significant differences were found between affective patients and healthy controls regarding life satisfaction and adjustment, whereas psychiatric controls scored significantly less on most indices. Moreover, the treating psychiatrists rated affective patients significantly higher than psychiatric controls and perceived them as actualizing their potential to a greater degree. Thus, it is concluded that neither the affective illness nor lithium as a prophylactic agent interfered with the patients' feelings of satisfaction or with manifest functioning while in remission.
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