Prognostic Value of Peak Exercise Systolic Pulmonary Arterial Pressure in Asymptomatic Primary Mitral Valve Regurgitation.

Background: The contribution of exercise echocardiography in primary asymptomatic mitral regurgitation (MR) remains debated. The aim of this study was to gain evidence regarding its usefulness in this setting and to investigate the prognostic value of peak exercise systolic pulmonary artery pressure (SPAP).

Methods: One hundred seventy-seven patients (mean age, 56 ± 13 years; 69% men) with moderate to severe (grade 3+) or severe (grade 4+) degenerative MR and preserved left ventricular ejection fraction, in sinus rhythm, referred for clinically indicated exercise echocardiography were identified.

[Alcohol, steatohepatitis, insulin resistance and hepatitis C].

Patients with chronic hepatitis C have frequently other morbidities, either because they are frequent in the general population (metabolic syndrome) and/or because the route of contamination (chronic alcohol consumption succeeding to drug abuse). These co-morbidities have a harmfull impact on fibrosis progression during the natural history of HCV infection and reduce the efficacy of antiviral treatments. Thus, it is crucial to diagnose early and treat these different diseases which may be combined.

HEPACOM: multicenter, observational prospective study of outcome and monitoring of HCV positive antiviral-naïve patients managed in the French health care system.

Objective: To study management practices in the French health care system for antiviral-naïve patients with chronic hepatitis C virus (HCV) infection.

Methods And Patients: Two groups of general practitioners, group I (special training and experience in drug addiction) and group II (other general practitioners) enrolled untreated HCV positive patients and noted management practices for a 12-month period.

Results: Among 4660 enrolled patients, 2038 enrolled by 462 general practitioners in group I and 1756 enrolled by 588 general practitioners in group II were retained for analysis.

Comparison of prescriber evaluations and patient-directed self-reports in office-based practice for buprenorphine treatment of opiate-dependent individuals in France, 2002.

The objective of this cross-sectional evaluation study was to compare data generated through prescriber assessments, and data generated from independent direct contact with opiate-dependent patients in office-based practice to evaluate buprenorphine treatment for modality of buprenorphine absorption, benzodiazepine use, and depressive symptoms. A group of buprenorphine office-based practice prescribers was selected to participate in this study. They were asked to screen for inclusion all their patients coming for a visit from February to August 2002.

[Evaluation of the fluoride concentration and consumption of mineral water].

Objective: Considering that water is an importance source of fluoride intake, and that the consumption of mineral water and prevalence of dental fluorosis have been increasing, the aim of this study was to evaluate the consumption of mineral water and its fluoride concentration.

Methods: The study was performed in residential districts of the municipality of Bauru, State of São Paulo, by means of stratified sampling via clusters. Each cluster corresponded to one residential block.

[A pluridisciplinary point of view of hepatitis C virus infections].

Various complementary actors are implied in the management of HCV infections: virologists, general practitioners, hepato-gastroenterologists and hospital residents, and they should all cooperate together. The role of biologist is crucial in assisting the practitioners in the choice of examinations to be prescribed for the diagnosis of HCV infections (search for RNA HCV), in establishing a prognosis and in deciding on the therapeutic strategy (genotyping, Fibrotest and Actitest). The role of the general practitioner is important at all stages of the management.

[The prognostic tools of hepatitis C virus infections].

INCREASE IN ALANINE AMINOTRANSFERASE (ALAT): Used for many Years in the diagnosis and follow-up of chronic hepatic diseases related to HCV, the determination of ALAT presents various limits: variation from one patient to the other and in the same patient over time, absence of specificity and inconstant increase. HISTOLOGICAL ASSESSMENT OF THE INVOLVEMENT OF THE LIVER: The hepatic needle-biopsy remains the best means of assessing precisely the hepatic impact. Several scores of hepatic involvement exist, the most frequently used is the Metavir score that takes into account not only the necrotic-inflammatory activity but also the fibrosis.

[The diagnostic tools of hepatitis C virus infections].

SERIOLOGICAL TESTS IN FIRST INTENTION: Aimed at revealing antibodies demonstrating the contact of the patient with the hepatitis C virus. There are two types of serological tests: ELISA for the global screening of various antibodies and immunoblot for the isolation of the various antibodies. QUALITATIVE RNA OF HCV: The positive qualitative detection of RNA of the hepatitis C virus in a patient exhibiting anti-HCV antibodies confirms an active infection.