RESUMO
As part of a multicenter V.A. Cooperative Study, 437 male veterans with varying stages of alcoholic liver injury were followed over a 4.5 year period. Their ethnic distribution consisted of 256 Caucasians, 109 black Afro-Americans, 63 Puerto Rican Hispanics, and 9 Native American Indians. Survival analyses revealed significant differences between groups (P = 0.0002): 66% of Afro-Americans were still living at 42 months; Caucasians were intermediate with 40% survival; and only 28% of Hispanics were alive. The number of Native American Indians enrolled was too small to draw conclusions but none of those enrolled survived beyond 24 months. Survival regression analysis of 30 clinical, laboratory, histologic and nutritional parameters, revealed the following significant risk factors: clinical severity (P less than 0.0001), histologic severity (P less than 0.0001), race (P = 0.001), age (P = 0.002), BUN (P = 0.01) and ALT (P = 0.02). These analyses indicated that ethnicity, independent of other variables, is significantly associated with outcome from the disease.
Assuntos
Alcoolismo/complicações , Etnicidade , Hepatopatias Alcoólicas/mortalidade , Longevidade , Adulto , Idoso , População Negra , Seguimentos , Hispânico ou Latino , Humanos , Indígenas Norte-Americanos , Hepatopatias Alcoólicas/etnologia , Hepatopatias Alcoólicas/patologia , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto , Cooperação do Paciente , Porto Rico/etnologia , Análise de Regressão , Fatores de Risco , Estados Unidos , United States Department of Veterans Affairs , População BrancaRESUMO
Although single-dose amphotericin B therapy appears to be immunostimulatory in mice, no data are available regarding the effects of chronic anti-fungal drug therapy on the immune system. We studied the effects on the guinea-pig cellular immune system of 4 weeks of treatment with amphotericin B, 5-fluorocytosine, or the combination of both drugs. The in vitro lymphocyte response to phytohaemagglutinin and the specific antigen, picryl human serum albumin (picHSA), were not affected by anti-fungal drug treatment. At 1.5 weeks of therapy with amphotericin B, skin test reactivity to picHSA was significantly reduced but returned toward normal by the end of 3.5 weeks of drug therapy. Macrophage migration inhibitory factor production by guinea-pig peripheral blood lymphocytes was significantly reduced after 4 weeks of amphotericin B therapy. No immunostimulatory properties could be ascribed to amphotericin B. 5-fluorocytosine had no effect on cellular immunity.