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Chirino-Sprung RA, Dehesa M, Wolpert E, Corona-Lau C, García-Juarez I, Sánchez-Ávila JF, Moctezuma-Velázquez C, Kershenobich D. Chronic Hepatitis C Treatment with Direct-Acting Antiviral Agents in a Real-Life Setting. Rev Invest Clin 2016; 68:203-212. [PMID: 27623039] [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: 06/06/2023]
Abstract
BACKGROUND In clinical trials, new oral direct-acting antiviral agent therapies have demonstrated a high sustained virological response rate in patients with hepatitis C virus infection. We aimed to analyze the efficacy and safety data from direct-acting antiviral agent interferon-free therapy in hepatitis C virus infection in a study performed in five different clinical settings in Mexico City; four private practice sites and one academic medical center in a real-world scenario. METHODS Eighty-one patients were treated with seven different direct-acting antiviral agent regimens, in which the end of treatment, sustained virological response at 12 weeks post-treatment, and adverse effects were evaluated. At their discretion, attending physicians selected the treatment regimens and durations. RESULTS In total, 70.4% of the patients were female and the mean age was 60.7 years; 74.1% had blood transfusion as a risk factor. The most common genotype was 1b (70.4%). The fibrosis stage was F3 or F4 in 55.5% of patients; liver cirrhosis was present in 44%. The overall end of treatment response was 98.8%, and the rate of sustained virological response was 96%, independent of the regimen. Three patients did not achieve sustained virological response; they had cirrhosis and were treatment-experienced, and two had hepatocarcinoma. Non-significant adverse effects during treatment were documented. CONCLUSIONS In this real-life setting in Mexico, a rate of 96% of sustained virological response to direct-acting antiviral agents was achieved in an older population of patients with advanced fibrosis. This study provides data that may be useful in guiding health professionals and authorities in the development of health policies.
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Affiliation(s)
| | | | | | | | - Ignacio García-Juarez
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | | | - David Kershenobich
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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2
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Corona-Lau C, Muñoz L, Wolpert E, Aguilar LM, Dehesa M, Gutiérrez C, Kershenobich D. Hepatitis C screening in the general population. Rev Invest Clin 2015; 67:104-108. [PMID: 25938843] [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: 06/04/2023]
Abstract
BACKGROUND A significant number of patients infected with hepatitis C virus remain unaware of their infection, as this is a silent disease for many years. Patients are frequently detected at advance stages of the disease. OBJECTIVE To identify the prevalence and viremic stage of hepatitis C among a general population cohort. METHODS Anti-hepatitis C virus detection and viral RNA were offered without cost to individuals who voluntarily considered it relevant to be examined, as part of the World Hepatitis Day annually from 2007-2014. RESULTS A total of 32,945 individuals were analyzed; 57% were female and 43% male. Of them, 75.7% were between 21-50 years old. In 59%, the sample was obtained at their work place and in 41% at the facilities of 12 private laboratories. Anti-hepatitis C virus was positive in 194 patients (0.58%), of which 129 (66%) were confirmed positive by polymerase chain reaction. The overall prevalence of viremic cases in the sample was 0.39%. CONCLUSIONS Adequate estimation of the prevalence of anti-hepatitis C virus and viremic population, not only among high-risk groups but also in the general population, is central to the allocation of resources in an effort to reduce the consequences of the disease.
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Affiliation(s)
| | - Linda Muñoz
- Liver Unit, Hospital Universitario, Universidad Autónoma de Nuevo León, Monterrey, N.L., Mexico
| | - Enrique Wolpert
- Fundación Mexicana para la Salud Hepática, México, D.F., Mexico
| | - Luz Ma Aguilar
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., Mexico
| | | | | | - David Kershenobich
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F., Mexico
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3
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Moran S, Gallardo-Wong I, Rodriguez-Leal G, McCollough P, Mendez J, Castaneda B, Milke P, Jacobo J, Dehesa M. L-[1-13C]phenylalanine breath test in patients with chronic liver disease of different etiologies. Isotopes Environ Health Stud 2009; 45:192-197. [PMID: 20183232 DOI: 10.1080/10256010903083995] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The aim of this study was to compare the oxidation of L-[1-(13)C]phenylalanine ((13)C-PheOx) in patients with chronic liver failure due to different etiologies using L-[1-(13)C]phenylalanine breath test. Breath samples were collected before the administration of 100 mg L-[1-(13)C]phenylalanine, and every 10 min thereafter until completion of 1 h. Control subjects (n=9) presented a larger cumulative percentage of (13)C dose recovery (CPDR) than patients (n=124) with chronic liver disease, regardless of the etiology (7.5+/-0.7 vs. 4.2+/-0.2, p=0.001). No differences in CPDR were found considering the Child-Pugh (CP) class or etiology: alcoholic (CP A=7.7+/-0.7, CP B=4.1+/-0.5, CP C=2.0+/-0.3), hepatitis C virus (CP A=5.4+/-0.5, CP B=4.0+/-0.2, CP C=2.2+/-0.3), hepatocellular carcinoma (CP A=5.5+/-1.6, CP B=3.6+/-1.8, CP C=2.2+/-1.0); or cryptogenic cirrhotic patients (CP A=7.4+/-1.5, CP B=4.4+/-0.4, CP C=2.1+/-0.7). Results confirm that (13)C-PheOx decreases in patients with cirrhosis with respect to controls, notwithstanding the etiology.
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Affiliation(s)
- Segundo Moran
- Medical Center Siglo XXI, Mexican Institute of Social Security, Mexico, D.F., Mexico.
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4
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Gallardo-Wong I, Morán S, Rodríguez-Leal G, Castañeda-Romero B, Mera R, Poo J, Uribe M, Dehesa M. Prognostic value of 13C-phenylalanine breath test on predicting survival in patients with chronic liver failure. World J Gastroenterol 2007; 13:4579-85. [PMID: 17729409 PMCID: PMC4611830 DOI: 10.3748/wjg.v13.i34.4579] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the prognostic value of percentage of 13C-phenylalanine oxidation (13C-PheOx) obtained by 13C-phenylalanine breath test (13C-PheBT) on the survival of patients with chronic liver failure.
METHODS: The hepatic function was determined by standard liver blood tests and the percentage of 13C-PheOx in 118 chronic liver failure patients. The follow-up period was of 64 mo. Survival analysis was performed by the Kaplan-Meier method and variables that were significant (P < 0.10) in univariate analysis and subsequently introduced in a multivariate analysis according to the hazard model proposed by Cox.
RESULTS: Forty-one patients died due to progressive liver failure during the follow-up period. The probability of survival at 12, 24, 36, 48 and 64 mo was 0.88, 0.78, 0.66, 0.57 and 0.19, respectively. Multivariate analysis demonstrated that Child-Pugh classes, age, creatinine and the percentage of 13C-PheOx (HR 0.338, 95% CI: 0.150-0.762, P = 0.009) were independent predictors of survival. When Child-Pugh classes were replaced by all the parameters of the score, only albumin, bilirubin, creatinine, age and the percentage of 13C-PheOx (HR 0.449, 95% CI: 0.206-0.979, P = 0.034) were found to be independent predictors of survival.
CONCLUSION: Percentage of 13C-PheOx obtained by 13C-PheBT is a strong predictor of survival in patients with chronic liver disease.
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Affiliation(s)
- I Gallardo-Wong
- Laboratory of Gastrohepatology Research, Hospital de Pediatria, CMN, Siglo XXI, IMSS. Av Cuauhtemoc 330, Colonia Doctores, Delegacion Cuauhtemoc, Mexico
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5
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Méndez-Sánchez N, Aguilar-Ramírez JR, Reyes A, Dehesa M, Juórez A, Castñeda B, Sánchez-Avila F, Poo JL, Guevara González L, Lizardi J, Valdovinos MA, Uribe M, Contreras AM, Tirado P, Aguirre J, Rivera-Benítez C, Santiago-Santiago R, Bosques-Padilla F, Muñoz L, Guerroro A, Ramos M, Rodríguez-Hernández H, Jacobo-Karam J. Etiology of liver cirrhosis in Mexico. Ann Hepatol 2004; 3:30-3. [PMID: 15118577] [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] [Received: 01/02/2004] [Indexed: 12/11/2022]
Abstract
BACKGROUND In the last decades it has been suggested that the main cause of liver cirrhosis in Mexico is alcohol. Currently in Western countries hepatitis C virus stage liver disease and liver transplantation. In Mexico, we have no data relative to the etiology of liver cirrhosis. The aim of this study was to investigate the main causes of liver cirrhosis in Mexico. METHODS Eight hospitals located in different areas of the country were invited to participate in this study. Those hospitals provide health care to different social classes of the country. The inclusion criteria were the presence of either an histological or a clinical and biochemical diagnosis of liver cirrhosis. RESULTS A total 1,486 cases were included in this study. The etiology of liver cirrhosis was alcohol in 587 (39.5%), HCV 544 (36.6%), cryptogenic 154 (10.4%), PBC 84 (5.7%), HBV 75 (5.0%) and other 42 (2.8%). There was no statistical difference between alcohol and HCV. CONCLUSIONS We conclude that the main causes of liver cirrhosis in Mexico are alcohol and HCV.
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Affiliation(s)
- Nahum Méndez-Sánchez
- Department of Biomedical Research, Medica Sur Clinic and Foundation, Col. Toriello Guerra, Mexico City, Mexico.
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6
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Dehesa M, Larisch J, Dibildox M, Di Silvio M, Lopez L, Ramirez-Barba E, Torres J. Comparison of Three 7-Day Pantoprazole-Based Helicobacter pylori Eradication Regimens in a Mexican Population with High Metronidazole Resistance. Clin Drug Investig 2002; 22:75-85. [DOI: 10.2165/00044011-200222020-00002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Torres J, Camorlinga-Ponce M, Pérez-Pérez G, Madrazo-De la Garza A, Dehesa M, González-Valencia G, Muñoz O. Increasing multidrug resistance in Helicobacter pylori strains isolated from children and adults in Mexico. J Clin Microbiol 2001; 39:2677-80. [PMID: 11427594 PMCID: PMC88210 DOI: 10.1128/jcm.39.7.2677-2680.2001] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.7] [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: 12/14/2022] Open
Abstract
The susceptibilities to three antimicrobials of 195 Helicobacter pylori strains isolated from Mexican patients is reported; 80% of the strains were resistant to metronidazole, 24% were resistant to clarithromycin, and 18% presented a transient resistance to amoxicillin. Resistance to two or more antimicrobials increased significantly from 1995 to 1997.
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Affiliation(s)
- J Torres
- Unidad de Investigación Médica en Enfermedades Infecciosas, Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Mexico City, Mexico.
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González-Valencia G, Atherton JC, Muñoz O, Dehesa M, la Garza AM, Torres J. Helicobacter pylori vacA and cagA genotypes in Mexican adults and children. J Infect Dis 2000; 182:1450-4. [PMID: 11023467 DOI: 10.1086/315864] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2000] [Revised: 07/19/2000] [Indexed: 11/03/2022] Open
Abstract
Studies examining associations between Helicobacter pylori virulence markers and disease have concentrated on adults in developed countries. This study assessed adults and children in Mexico. Ninety patients were recruited, 56 adults (37 with active peptic ulceration and 19 with no ulcers) and 34 children (all with recurrent abdominal pain and no ulcers). H. pylori was cultured from gastric biopsy specimens, and vacA alleles and cagA were typed by use of polymerase chain reaction from multiple colony sweeps. Multiple vacA types were common in single-biopsy isolates and were more frequent in adults with ulcers (95%) than in adults without ulcers (37%; P<.001) or in children (52%; P<.01). vacA s1b and cagA+ strains were more frequent in adults than in children. vacA s1 and cagA+ strains had similar frequencies in adults with and without ulcers. In conclusion, infection with multiple H. pylori strains, defined by different vacA genotypes, is common in Mexico. Such mixed infection is associated with ulcer disease. Strain populations infecting Mexican adults and children differ.
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Affiliation(s)
- G González-Valencia
- Unidad de Investigación Medica en Enfermedades Infecciosas y Parasitarias, Instituto Mexicano del Seguro Social, México City, México
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Di Silvio M, Larisch J, Dibildox M, Almaguer I, Gitler R, Dehesa M, Ramírez-Barba EJ. [Breath tests as a noninvasive diagnostic method in Helicobacter pylori infection]. Rev Gastroenterol Mex 1998; 63:135-42. [PMID: 10068759] [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: 02/11/2023]
Abstract
There are several diagnostic methods for Helicobacter pylori infection, some of them need an endoscopic procedure and biopsy to be performed (invasive) like the rapid urease test, culture and histology. Recently non invasive, specific, sensible, easy to perform and patient's well accepted methods had been developed known as breath test, based on the hydrolysis of labelled urea by Helicobacter pylori urease enzyme, to release ammonia and bicarbonate. Labelled CO2 reaches the bloodstream and the lungs, from where can be collected into the breath for quantification. Labelled urea has to options: 13C stable, non-radioactive and 14C unstable, radioactive. Breath test with 13C is based on the atomic mass difference between 12C and 13C and it is necessary a mass spectrometer and 40 minutes to perform it. Breath test with 14C has 1 uCi (one micro-curie) of radioactivity (1/300 of total radiation received in one year from the environment); the test takes 10 minutes and the samples are read in a beta counter. Both non-invasive tests had demonstrated sensitivity and specificity comparable to established "gold standards" for Helicobacter pylori infection diagnosis.
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Affiliation(s)
- M Di Silvio
- Centro Médico Nacional 20 de Noviembre, Universidad Anáhuac, Escuela de Medicina.
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10
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Dehesa M, Larisch J, Dibildox M, Vega B, Di Silvio M, Rodríguez L, Camorlinga M, Almaguer I, Ramírez-Barba E, Torres J. [Comparison of 2 schedules based on pantoprazole for eradication of Helicobacter pylori in patients with active duodenal ulcer]. Rev Gastroenterol Mex 1998; 63:66-71. [PMID: 10068730] [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: 02/11/2023]
Abstract
OBJECTIVE To compare the efficacy and tolerability of a triple vs dual pantoprazole based therapy to eradicate Helicobacter pylori (H. pylori) in mexican patients with florid duodenal ulcer. BACKGROUND The treatment of peptic ulcer disease was revolutionized by the fact that H. pylori generally induces chronic gastritis and peptic ulcer disease and that the cure of the infection prevents ulcer relapses. MATERIAL AND METHODS 74 H. pylori positive patients with florid duodenal ulcer were randomized to receive either pantoprazole 40 mg bid in combination with clarithromycin 500 mg tid and amoxicillin 1 g bid (triple regimen PAC) or pantoprazole in combination with clarithromycin and placebo (dual regimen PC) during 14 days. To ensure complete ulcer healing all patients received an additional 2 weeks treatment with pantoprazole 40 mg od. 14C Urea Breath test (UBT) was the main criteria used to determine eradication rate with < 150 disintegrations per minute (DPM) to consider a patient eradicated. In all patients culture, antibiotic susceptibility (E-test) and histology were performed. RESULTS In the per protocol analysis (n = 66) the eradication rate was: PAC 93.5% vs PC 54.3% (p < 0.001). 76% of H. pylori strains were resistant to metronidazole. Tolerance and compliance were excellent in both groups. CONCLUSIONS Triple therapy (PAC) was shown to be superior to dual therapy (PC) for H. pylori eradication in mexican patients with florid duodenal ulcer.
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Affiliation(s)
- M Dehesa
- Hospital Especialidades, Centro Médico Nacional (CMN) Siglo XXI IMSS, México, D.F
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11
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Morán S, Uribe M, Prado ME, de la Mora G, Muñoz RM, Pérez MF, Milke P, Blancas JM, Dehesa M. [Effects of fiber administration in the prevention of gallstones in obese patients on a reducing diet. A clinical trial]. Rev Gastroenterol Mex 1997; 62:266-72. [PMID: 9580234] [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: 02/07/2023]
Abstract
Nearly 30% of the obese patients treated with hypoenergetic diets for weight reduction develop gallstone disease (GD). Until the present time, the use of ursodeoxycholic acid (UDA) is the only available therapeutic measure to avoid the development of GD. Dietary fiber induce a bile acid synthesis. A double-blind clinical trial was conducted to compare the effect of rational diet plus UDA vs a rational diet supplemented with Psyllium plantago (Pp) for the prevention of GD in obese subjects undergoing a weight-reduction diet. Patients with a body mass index (BMI = weight in Kg/square height in m) of 30 Kg/m2 or more and with normal gallbladder and biliary tree ultrasound (GBUS) were included. Weight-reduction diets were individually calculated for each patient according to their energy expenditure (EE). Patients were randomly and blindly assigned either to group I (diet + 750 mg UDA + fiber placebo) or group II (diet + 15 g Pp+ UDA placebo). An anthropometric evaluation was performed to each patient before and after the two-month treatment, as well as resting EE by indirect calorimetry, GBUS and endoscopy for the determination of cholesterol crystals in duodenal bile. Weight reduction was similar in both groups (group I = 6 +/- 2 Kg vs group II = 6 +/- 3 Kg). GD development was observed in one patient of group I (5.5%) and two patients of group II (p > 0.05). All patients with GD lost a minimum of 4 Kg during the study period. GD development did not correlate with the presence of crystals in the duodenal bile at the beginning of the study. Our results suggest a beneficial effect of a rational diet with fiber supplementation to prevent GD development in obese patients included in a weight reduction program.
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Affiliation(s)
- S Morán
- Departamentos de Gastroenterología, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F
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12
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Antonio Olivera M, Zapata L, Kaplan M, Bobadilla J, Corte G, de la Mora G, Uribe M, Cabiedes J, Dehesa M, Kershenobich D. [Prevalence of antinuclear antibodies in primary biliary cirrhosis, with negative antimitochondrial antibodies]. Rev Gastroenterol Mex 1993; 58:220-2. [PMID: 8165399] [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: 01/29/2023]
Abstract
Recently it has been described in the literature a subpopulation of PBC patients with negative AMA that might represent patients with ANA positive autoimmune cholangitis. We review 25 cases of PBC (23 females) with AMA negative. Our aim was to determine the frequency of ANA(+) in this group. We studied serum transaminases, total bilirubin, AMA and ANA by indirect immunofluorescence considering positive dilutions of 1:40. All patients had elevated alkaline phosphatase (641 +/- 389 U/l). Total bilirubin was below 2.5 in 59%. Thirteen patients had esophageal varices. The histologic stage was I-II in eleven and III-IV in 14 cases. Fourteen patients (56%) has ANA(+) (dilution 1:40), 44% had lower dilutions. We confirm the presence of a subpopulation of PBC AMA negative, ANA positive patients and the observations of different and diverse immune alterations in PBC patients.
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Affiliation(s)
- M Antonio Olivera
- Departamento de Gastroenterología, Instituto Nacional de la Nutrición Salvador Zubirán, México, DF
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Abstract
Evidence indicates that a link between peptic ulcer disease (PUD) and selected psychosomatic factors may exist. A series of 70 consecutive male and female adult patients were categorized by peptic symptoms and divided into four groups: a) controls; b) gastric ulcer (GU); c) duodenal ulcer (DU); and d) chronic non-ulcer dyspepsia (CNUD). All patients were interviewed and asked to answer a questionnaire that included demographics, medical history and the incidence of negative life events. A decreased level of activity was a predominant finding in GU, DU and CNUD patients. Family history of PUD may be correlated with CNUD. Of interest was the finding that DU and CNUD patients presented a higher incidence of negative life events when compared to the other study groups. Negative life events that produce considerable stress may predispose to peptic symptoms in certain patients.
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Affiliation(s)
- D E Hernandez
- Department of Medicine, Los Angeles County-University of Southern California School of Medicine 90033
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14
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Dehesa M, Dooley CP, Cohen H, Fitzgibbons PL, Perez-Perez GI, Blaser MJ. High prevalence of Helicobacter pylori infection and histologic gastritis in asymptomatic Hispanics. J Clin Microbiol 1991; 29:1128-31. [PMID: 1864929 PMCID: PMC269956 DOI: 10.1128/jcm.29.6.1128-1131.1991] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.1] [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: 12/29/2022] Open
Abstract
In this study, we estimated the prevalence of Helicobacter pylori infection and histologic gastritis in 58 asymptomatic Hispanic adult volunteers (mean age, 41 years; 59% male) by endoscopic biopsy of the upper gastrointestinal tract. Forty-six subjects (79%) were found to harbor H. pylori in gastric biopsies, and all had histologic gastritis. Four other subjects were found to have gastritis in the absence of H. pylori. Similar prevalences of H. pylori and gastritis were noted in all age groups and also in American-born and immigrant Hispanics. Biopsy data and serologic studies of H. pylori antibodies correlated well. We conclude that H. pylori infection is an almost universal finding in the gastric mucosa of asymptomatic adult Hispanics, regardless of age. The clinical significance of these findings is unknown, but we speculate that H. pylori and its associated gastritis could have a role in the high incidence of gastric carcinoma in Hispanic populations.
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Affiliation(s)
- M Dehesa
- Department of Medicine, University of Southern California School of Medicine, Los Angeles 90033
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15
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Rodríguez H, Dehesa M, Aguirre García J, Blasco JM. [Primary sclerosing cholangitis. A report of 4 cases]. Rev Gastroenterol Mex 1991; 56:71-5. [PMID: 1947618] [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: 12/29/2022]
Abstract
We informed four cases of primary sclerosing cholangitis associated with chronic ulcerative colitis, diagnosed in the Gastroenterology Department, Hospital de Especialidades del CM Siglo XXI Mexico City, during 1987 to 1988. The mean age was 30.2 years and the evolution of colitis was 6.6 years. Two patients were females and two males, all presented active colitis and three presented hepatic symptoms. The laboratory abnormalities were hypertransaminasemia, increased alkaline phosphatase and hyperbilirubinemia. In three patients endoscopic retrograde cholangiopancreatography was done, in all cases diagnosis was established by histology. The frequency of primary sclerosing cholangitis associated with chronic ulcerative colitis was 13.3%.
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Affiliation(s)
- H Rodríguez
- Servicio de Gastroenterología, Hospital de Especialidades del CM Siglo XXI IMSS, México, D.F
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16
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Fong TL, Dooley CP, Dehesa M, Cohen H, Carmel R, Fitzgibbons PL, Perez-Perez GI, Blaser MJ. Helicobacter pylori infection in pernicious anemia: a prospective controlled study. Gastroenterology 1991; 100:328-32. [PMID: 1985031 DOI: 10.1016/0016-5085(91)90199-u] [Citation(s) in RCA: 103] [Impact Index Per Article: 3.1] [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] [Indexed: 12/29/2022]
Abstract
Although some authors believe that Helicobacter pylori is the etiologic agent in chronic nonspecific gastritis, it has also been suggested that the bacterium colonizes inflamed mucosa as a secondary event. This study documents the prevalence of H. pylori in 28 patients with pernicious anemia and compares the findings with those of a group of 28 age-, race-, and sex-matched asymptomatic control subjects. All subjects underwent endoscopy with biopsy of the gastric antrum and corpus. A sample of serum was obtained before endoscopy for determination of antibodies (immunoglobulin A and immunoglobulin G) to H. pylori. The prevalence of H. pylori (by biopsy) in patients with pernicious anemia was significantly less than that in controls (11% vs. 71%, P less than 0.0001). All patients with pernicious anemia had abnormalities of corpus histology (inflammation and/or atrophy). In addition, 50% of patients with pernicious anemia had a lymphocytic infiltration of the antrum. All controls with H. pylori had gastritis, 50% having active chronic gastritis. Atrophic changes of the corpus were more commonly found in patients with pernicious anemia (75% vs. 7%, P less than 0.0001). Serology and biopsy results correlated poorly in the patients with pernicious anemia: all 5 patients with positive serology results had negative biopsy results, whereas all 3 patients with positive cultures on biopsy had negative serological studies. In conclusion, patients with pernicious anemia are protected from infection with H. pylori, and H. pylori does not passively colonize mucosa inflamed by an unrelated process.
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Affiliation(s)
- T L Fong
- Department of Medicine, University of Southern California School of Medicine, Los Angeles
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17
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Dehesa M, Robles-Díaz G. [Primary biliary cirrhosis]. Rev Gastroenterol Mex 1988; 53:207-18. [PMID: 3057579] [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: 01/03/2023]
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18
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Dehesa M. [Chronic active hepatitis caused by non-A, non-B virus]. Rev Gastroenterol Mex 1988; 53:169-76. [PMID: 2848306] [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]
MESH Headings
- Carcinoma, Hepatocellular/etiology
- Hepatitis C/complications
- Hepatitis C/epidemiology
- Hepatitis C/etiology
- Hepatitis C/therapy
- Hepatitis, Chronic/complications
- Hepatitis, Chronic/etiology
- Hepatitis, Chronic/therapy
- Hepatitis, Viral, Human/complications
- Hepatitis, Viral, Human/epidemiology
- Hepatitis, Viral, Human/etiology
- Hepatitis, Viral, Human/therapy
- Humans
- Liver Neoplasms/etiology
- Transfusion Reaction
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19
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Aguirre García J, Mendoza Rodríguez A, Dehesa M. [Acute fatty liver in pregnancy: report of 2 patients with unusual histologic disorders]. Rev Gastroenterol Mex 1987; 52:187-91. [PMID: 3432904] [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: 01/05/2023]
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20
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Dehesa M. [Current status of chronic liver diseases]. Rev Gastroenterol Mex 1987; 52:141-5. [PMID: 3324274] [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: 01/05/2023]
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21
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Robles-Díaz G, Chávez M, López M, Dehesa M, Centeno F, Wolpert E. [Critical analysis of 1263 percutaneous hepatic biopsies carried out over a 12-year period (1970-1981) in the Salvador Zubirán National Institute of Nutrition]. Rev Gastroenterol Mex 1985; 50:13-7. [PMID: 4089438] [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: 01/08/2023]
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22
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Segovia E, Cervera J, Dehesa M. [Chronic active hepatitis: clinical evolution of 38 patients]. Rev Gastroenterol Mex 1983; 48:19-21. [PMID: 6410493] [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: 01/20/2023]
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23
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Conte G, Aviles A, Dehesa M, Ambriz R, Sinco A, Pizzuto J. Ascitic fluid triggering disseminated intravascular coagulation. Rev Invest Clin 1982; 34:223-8. [PMID: 7146666] [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: 01/23/2023]
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24
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Dehesa M, Landa L. [Treatment of vesicular lithiasis with chenodesoxycholic acid. Report of 50 cases]. Rev Gastroenterol Mex 1981; 46:163-6. [PMID: 7336065] [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: 01/24/2023]
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25
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Uribe M, Berthier JM, Lewis H, Mata JM, Sierra JG, García-Ramos G, Ramírez Acosta J, Dehesa M. Lactose enemas plus placebo tablets vs. neomycin tablets plus starch enemas in acute portal systemic encephalopathy. A double-blind randomized controlled study. Gastroenterology 1981; 81:101-6. [PMID: 7239110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
A randomized, double-blind comparison of lactose enemas plus placebo tablets vs. starch enemas plus neomycin tablets was performed on 18 patients with acute portal systemic encephalopathy. Ten patients received starch enemas (10%; 1000 ml t.i.d.) plus neomycin tablets and 8 patients received lactose enemas (20%; 1000 ml t.i.d.) plus placebo tablets. A significant mental state improvement was demonstrated in the group of patients treated with starch enemas-neomycin tablets (p less than 0.05) and in the group of patients treated with lactose enemas-placebo tablets (p less than 0.025). Both treatments significantly improved the frequency of asterixis, ammonia blood levels, and electroencephalograms. In addition, patients treated with lactose enemas showed significant improvement in number-connection test times (p less than 0.02), and their stools showed a more acid pH (p less than 0.05). No side effects were evident with either treatment. Lactose enemas are a safe and effective treatment for acute portal systemic encephalopathy.
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Stoopen M, Dehesa M, Kimura K, Ramos-Martínez E. [Secondary sclerosing cholangitis. Radiologic diagnosis and anatomoclinical correlation. Report of a case]. Rev Gastroenterol Mex 1980; 45:193-203. [PMID: 7466146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Radiological diagnosis of secondary sclerosing cholangits was made in a patient who presented changes in morphology of the biliary tree in two consecutive post-operatory T-tube cholangiograms. The main change was a diffuse narrowness of the intrahepatic branches. Anatomical changes in post mortem examination had a good correlation with radiological images. The importance of this entity and experience from other authors in the current literature are discussed.
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27
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Dehesa M, Segovia E. [Amylase test in the diagnosis of acute pancreatitis]. Rev Gastroenterol Mex 1979; 44:57-62. [PMID: 462067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The determination of serum and urinary amylase are methods used in the diagnosis of acute pancreatitis, however there are many abdominal problems that can cause hyperamylasemia, in the absence of pancreatic disease, for this reason in 1969 Levitt and col. signaled the possible advantages of amylase/creatinine clearence ratio, in the clinical diagnosis of acute pancreatitis. This test was used in cases with acute pancreatitis, as in other diseases, in correlation with levels in normal subjects, with the objective of evaluating its clinica utility, in relation to the formentioned paragraph. Results concluded that the amylase/creatinine ratio is not of greater diagnostic utility than the determination of urinary amylase, in acute pancreatitis.
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Stoopen M, Kimura K, Touma M, Aguilar Arce K, Eguez Mogro H, Rodríguez J, Dehesa M, Luis Valle R. [Percutaneus cholangiography with the Chiba needle. Results in 220 studies]. Rev Gastroenterol Mex 1979; 44:77-87. [PMID: 462069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The authors employed this new technique of thin needle percutaneous cholangiography in 220 patients with the following results: 99.3% (146/147) success with previous biliary tract dilatation and 79.4% (53/73) success in patients with normal caliber bile ducts. The overall result of 92.7% (204/228) emphasizes that radiological opacification is the best way to study the icteric patient. Only 1.8% of patients with serious complications is less than in other instrumentation methods. By not requiring specialized equipment and being accessible in the majority of hospitals, study cost is reduced. In conclusion, this new technique of percutaneous cholangiography is preferable for accessibility, efficacy, cost and risk in the study of the icteric patient.
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Dehesa M, Carió A, Wolpert E. [Amebic abcess of the liver: retrospective study of 125 patients (author's transl)]. Rev Invest Clin 1975; 27:129-33. [PMID: 1179071] [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: 12/26/2022]
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Wolpert E, Fernández E, Lisker R, Suárez GI, Dehesa M, Robles G. Rotor syndrome, a family study. Rev Invest Clin 1974; 26:363-71. [PMID: 4456510] [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: 01/10/2023]
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