RESUMO
Preventive measures, and particularly screening for anti-HCV donors, have diminished the incidence of HCV infections, however, a vaccine against the disease is necessary for an effective prevention. The most active treatment at this time, seems to be alpha-interferon, at the dosage of 3 MU during 6 months. Possibly larger doses during longer periods of time might improve response and recurrence indexes, but not sufficiently as to give indiscriminate treatment to all patients at great cost and with many adverse reactions. While waiting for better predictive factors, the most convenient therapy remains the indicated dosage during 6 months, followed by periodic assessment during 2-3 months of transaminase levels: if they remain normal, the patient should be reassessed later on, if there is a recurrence, another course of treatment should be tried; non-responders should not be treated again with single interferon; other combinations or different treatments should be tried.
Assuntos
Hepatite C/terapia , Protocolos Clínicos , Relação Dose-Resposta a Droga , Humanos , Interferons/uso terapêutico , Transplante de Fígado , Recidiva , Fatores de TempoRESUMO
BACKGROUND: The epidemiology of primary biliary cirrhosis (PBC) in Spain is still poorly known. In fact, remarkable differences between areas have been found. METHODS: The epidemiology of PBC was investigated in the South area of the city and the province of Granada from 1976 through 1989. Several clinical and epidemiological data were collected from 25 patients who met the criteria for PBC and the yearly incidence and prevalence were calculated. RESULTS: The ages of patients which PBC ranged from 31 to 74 years (mean age 50 +/- 10.5); 88% were females and 28% were diagnosed in the asymptomatic phase of the disease. The incidence for the study period was variable, with a maximum of 6.8 cases/million and an overall yearly incidence rate of 4.1 +/- 2.3 cases/million (7.1 +/- 4.3 cases/million for females). When the risk population was considered (people over 25 years) the respective values were 11.5 and 6.9 +/- 3.7 cases/million (12.1 +/- 7.2 cases/million for females). The prevalence showed a progressive increase, being 36.4 cases/million at the end of the study; for the "risk" population it was 61.5/million (100 cases/million for females). CONCLUSIONS: Incidence and prevalence of PBC in the area of study are within medium and medium-high values for Spain and Europe. As in other studies, personal environmental or social factors with epidemiological significance were not identified.
Assuntos
Cirrose Hepática Biliar/epidemiologia , Adulto , Fatores Etários , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Espanha/epidemiologiaRESUMO
Acute partial obstruction of the colon is a frequent complaint among elderly patients, this being the reason for the increase in incidence. 5 cases which were medically treated successfully are presented. The proper terminology is briefly discussed, describing the typical clinical features and the associated diseases which appear in 80-90% of cases. The diagnosis is basically clinical and plain abdominal X-Ray, barium enema and/or colonoscopy are the most helpful tests to make a differential diagnosis between mechanical and nonmechanical obstruction. An in-depth view on colonoscopy as a diagnostic and therapeutic method is presented.