Both occult and non-occult forms of HCV infection are more prevalent than HBV infection in hemodialysis patients. Especially the patients with isolated anti-HBc positivity should be tested for probable occult hepatitis B infection.
The present study indicates significant adverse effects of chronic diseases and psychological distress on HRQL in adults, the effect of psychological distress being the most important. Our results lead us to suggest that in the management of comorbidities, the detection of the presence and severity of associated psychological distress and its treatment, besides the specific treatment of comorbidities, may provide dramatic improvement in HRQL of the patients.
Objective: The aim was to evaluate the validity of current remission criteria in acromegaly, a random GH level of ,2.5 mg/l, a glucose-suppressed GH level of , 1 mg/l and a normal IGF-I level. Design: In forty-one patients treated for acromegaly (23 males and 18 females, 20-69 years) and 94 healthy subjects (50 males and 44 females, 20-78 years), basal GH and IGF-I levels and nadir GH levels after 75 g oral glucose were evaluated in decade blocks; these were assayed by sensitive immunoradiometric assays. Results: Basal GH levels varied widely from 0.022 to 10.4 in healthy subjects and were .2.5 mg/l in 19%. The mean post-glucose GH nadir was 0.067^0.009 mg/l (range 0.003 -0.4 mg/l) and the upper limit of the GH nadir was 0.26 mg/l (means þ 2 S.D.) in healthy subjects. Thirty-five patients with acromegaly had high-for-age IGF-I levels in relation to our healthy subjects. In this group, 15 (42.9%) patients had basal GH levels of , 2.5 mg/l, 14 (40%) patients had nadir GH levels of , 1 mg/l, and three (8.6%) patients had GH suppression to , 0.26 mg/l which was defined as normal GH suppression in our healthy subjects. Only six patients with acromegaly had normal-forage IGF-I levels and all of these patients had basal GH levels of , 2.5 mg/l and all but one had nadir GH levels of ,0.26 mg/l. Conclusions: A basal or random GH level of ,2.5 mg/l is not a reliable criterion for remission in acromegaly and the currently accepted normal upper limit of 1 mg/l for post-glucose GH suppression is too high. Post-glucose nadir GH levels, measured with sensitive assays, can be , 1.0 mg/l in 40% and basal GH levels can be , 2.5 mg/l in 43% of the active acromegalic patients. IGF-I levels appeared to correlate better with a nadir GH cut-off of 0.26 mg/l rather than 1 mg/l in the determination of disease activity. European Journal of Endocrinology 150 465-471
The aim of this study was to evaluate the effect of negative mood states at the moment of questionnaire, and other patient and disease characteristics on quality of life (QoL) in patients with asthma. The study groups were composed of 116 stable adult asthmatic patients and 116 age and sex matched healthy subjects. We used Short-Form Health Survey-36 (SF-36) for the assessment of general QoL in all participants, and the Asthma Quality of Life Questionnaire (AQLQ) for the assessment of disease specific QoL in patients with asthma. We evaluated negative mood in all subjects with a questionnaire including six mood subscales in three categories (nervous-anxious, hostile-angry and fearful-panicky). Negative mood scores were not different between asthmatic and comparison groups (p=0.4), but both SF-36 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were significantly lower in asthmatic group (p=0.003 and p=0.001, respectively). Multiple linear regression analysis in all study population indicated that both reduced PCS and MCS scores of SF-36 were associated with negative mood score (beta=-0.28, p<0.001 and beta=-0.37, p<0.001, respectively) and with FEV(1)% (beta=0.19, p=0.001 and beta=0.25, p<0.001, respectively) after adjusting for age, female sex, and the presence of asthma. On the other hand, multiple linear regression analysis in patients with asthma revealed that negative mood score and disease severity score were significant predictors for overall score of AQLQ after adjusting for other patient and disease characteristics (beta=-0.17, p=0.008 and beta=-0.64, p<0.001, respectively). The level of negative mood and disease severity in asthmatics significantly impair QoL. Thus, considering that one of the main objectives of health care should be preserving a satisfactory QoL in asthmatics, the presence and seriousness of negative mood and their effects on QoL should be taken into account as part of the clinical evaluation in asthmatics.
Infection with Helicobacter pylori (H. pylori) strains secreting cytotoxin-associated gene A (CagA) and vacuolating cytotoxin A (VacA) proteins is associated with more severe gastroduodenal pathologies. However, this association varies among geographical regions and ethnic groups. We investigated the frequencies of antibodies to CagA and VacA proteins in 131 H. pylori-infected dyspeptic patients [40 duodenal ulcer (DU), 19 gastric ulcer (GU), 28 gastric cancer (GC), and 44 non-ulcer dyspepsia (NUD)] across 30 H. pylori-infected and endoscopically normal asymptomatic subjects (AS). Anti-CagA and anti-VacA antibodies were detected by Western blotting. The positivity rates of anti-CagA and anti-VacA antibodies were higher in patients with DU (92.5 and 75%), GU (89.5 and 84.2%) and GC (96.4 and 85.7%) than patients with NUD (70.5 and 50%) and AS (50 and 23.3%) (p < 0.05). CagA+ VacA+ phenotype was more frequent in patients with DU, GU and GC than patients with NUD and AS (75, 84.2, 85.7 vs. 47.7 and 20%, respectively) (p < 0.01). Our results showed that there is a significantly positive association between the presence of anti-CagA and anti-VacA antibodies and DU, GU and GC in our region.
This study aimed to investigate the predictive role of grip strength on bone mineral density (BMD) of different sites in males. Two hundred thirty-four male patients were included in the study. BMD of lumbar spine, femoral neck, proximal radius-ulna (PRU) and distal radius-ulna (DRU) sites were measured by dual-energy X-ray absorptiometry and grip strength by using a hand dynamometer. Grip strength and BMD values of PRU and DRU at forearms were significantly higher on the dominant sides (P = 0.001, P = 0.001, P = 0.001, respectively). Stepwise linear regression analysis revealed that only the grip strength of the same side was the best predictor of the BMD of the dominant and non-dominant PRU with a ratio of 8.5 and 10.2%, respectively, whereas grip strength of the same side, age and weight were the best predictors of the BMD of the dominant and non-dominant DRU with a ratio of 25 and 24.6%, respectively. There was no predictive value of grip strength for BMD of lumbar spine and femoral neck. In conclusion, grip strength appears to be predictive of site specific rather than systemic BMD.
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