Residual HCV-RNA can persist in liver tissue and peripheral blood mononuclear cells (PBMCs) long after antiviral therapy of chronic hepatitis C in patients repeatedly negative for viral RNA in serum. This occult infection associates with impaired immune response and the risk of lymphoproliferative disorders or progressive liver disease. There are currently no monitoring strategies for patients after treatment. We investigated if serum inflammation markers and interferon lambda ( IFNL ) genotype can be predictors of the presence of HCV-RNA and the replicative HCV-RNA (−) strand in patients who reached sustained virological response after interferon-free therapy. Forty-two consecutive patients who remained HCV-RNA negative in serum 24 weeks after the end of treatment (EOT) and during the follow-up were enrolled. Total HCV-RNA and HCV-RNA (−) strand were detected using ultrasensitive RT-PCR in PBMCs collected 12–15 months after EOT. Polymorphisms within IFNL3 – IFNL4 region (rs12979860 and ss469415590) were genotyped with allele-specific PCR. Viral RNA was found in PBMCs from 31 (74%) patients, and of those 29 (69%) were also positive for HCV-RNA (−). Neither normalization of alanine aminotransferase nor IFNL genotype predicted the presence of residual HCV-RNA. A significantly higher neutrocyte-to-lymphocyte ratio (NLR) 24 weeks after the start of treatment predicted elimination of replicative HCV-RNA strand (OR 0.23; 95% CI 0.10–0.86; P = 0.019). Patients with no HCV-RNA (−) in PBMCs showed a greater increase in neutrocyte count between EOT and baseline ( P = 0.028). Lack of significant elevation of NLR after therapy with direct-acting antivirals could predict the presence of residual replicative HCV-RNA strand in PBMCs. Electronic supplementary material The online version of this article (10.1007/s10238-019-00561-y) contains supplementary material, which is available to authorized users.
Introduction. Sudden onset of aphasia due to stroke deprives man of communication with the environment, as well as eliminates of family, social and professional life. Difficulties in communication with patients with aphasia are important issues in ensuring the proper care and improve the quality of patients' life. Therefore, it is important to have the nursing staff knowledge and skills in communication with a patient with aphasia. Aim. The aim of the study was to evaluate the difficulty of communication with a patient with aphasia, to determine the possibility of communication and the factors contributing to the improvement of the situation of the patient in the opinion of the nursing staff. Material and Methods. The survey was conducted among 100 nurses working on the neurological wards in six specialized hospitals in the Pomerania region, between August 2012 to August 2013. Research material was collected by the author's questionnaire. Results. Statistical analysis revealed that age, education and work experience of nurses are related to owned by nurses the knowledge and skills to overcome communication difficulties. Conclusion. Better educated nurses with long work experience, often declare their readiness to therapeutic cooperate with patient with aphasia. Most respondents indicated that no therapeutic action by nurses result of external causes that relate to exess duties. (JNNN 2014;3(2):75-80
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.