A Latin American survey on demographic aspects of hospitalized, decompensated cirrhotic patients and the resources for their management.

Introduction & Objectives: Liver cirrhosis is a major cause of mortality worldwide. Adequate diagnosis and treatment of decompensating events requires of both medical skills and updated technical resources. The objectives of this study were to search the demographic profile of hospitalized cirrhotic patients in a group of Latin American hospitals and the availability of expertise/facilities for the diagnosis and therapy of decompensation episodes.

Genotype F prevails in Venezuelan urban patients with chronic hepatitis B.

Hepatitis B virus (HBV) has been classified into 8 genotypes (A-H). Genotypes A, D and F have been identified in some South American countries, but in Venezuela studies have been more restricted to aboriginal communities where genotype F is predominant. The aim of the present study was to identify the prevalence of HBV genotypes among native HBsAg carriers in Venezuelan urban areas.

Schistosomiasis mansoni in low transmission areas: abdominal ultrasound.

In endemic areas with low prevalence and low intensity of infection, the diagnosis of hepatic pathology due to the Schistosoma mansoni infection is very difficult. In order to establish the hepatic morbidity, a double-blind study was achieved in Venezuelan endemic areas, with one group of patients with schistosomiasis and the other one of non-infected people, that were evaluated clinically and by abdominal ultrasound using the Cairo classification. Schistosomiasis diagnosis was established based on parasitologic and serological tests.

[Hepatitis caused by virus C. Risk factors].

To establish the risk factors to hepatitis C virus (HCV) infection, we studied 120 patients divided in 2 groups: A first group of 40 patients with HCV infection, 24 (60%) with past medical history of blood transfusion, 14 (35%) of them also had hemodialysis and 3 Kidney transplant. 10 patients (25%) had mayor surgery without transfusion, 3 had frequent visits to the dentist and 3 month baby whose mother was HCV positive. In 4 patients we found no risk factors.

[Hepatobiliary complications detected by ultrasonography in patients undergoing total parenteral nutrition].

We studied 8 adult patients who received total parenteral nutrition (TPN). An abdominal ultrasound and liver functions test were done weekly looking for biliary sludge, thickening of the gallbladder wall, changes en bile ducts and liver parenchyma. Seven patients developed biliary sludge at week four.

[Clinical, laboratory, and ultrasonography features of acute viral hepatitis].

We review the charts of the hospital with diagnostic of acute viral hepatitis. We classified them using serologic markers in hepatitis B (60 patients), hepatitis A (27 patients) and C (4 patients). Fatigue, anorexia, fever, chills and lymphadenopathy where more common in hepatitis A.

[Glucose-6-phosphate dehydrogenase deficiency: report of 2 cases].

Glucose 6 phosphate dehydrogenase (G6PD) is an enzyme related to the metabolism of glutation, an antioxidant agent. Its deficiency causes hemolisis, generally well tolerated. However there are some factors including, exercise, infections and oxidants drugs that stimulate the hemolisis of the older red blood cells.

[Esophageal varices sclerosis in portal hypertension caused by portal thrombosis secondary to protein C deficiency].

Portal thrombosis is a rare entity classified as idiopathic in 50% of the cases, being protein C deficiency a known cause. We present two cases complicated with portal hypertension diagnosed through sonography and protein C determined though laboratory technics. Complicating esophageal varices sclerosed and follow up at seven months and ten years respectively, satisfactory clinical evolution observed.

[Gastric emptying of fluids and gallbladder contraction in non-ulcer dyspepsia].

Non-ulcer dyspepsia is a frequent clinical entity characterized by chronic upper gastrointestinal symptoms without organic lesions by radiology, sonography or endoscopy. We studied simultaneously the rate of gastric emptying and gallbladder contraction in 10 patients with non-ulcer dyspepsia and in 10 healthy controls after ingestion of 500 cc of isotonic saline, and 500 cc of a liquid mixed meal, hypercaloric and hyperosmotic. The measurements were done by direct real-time ultrasonic imaging in fasting and were repeated at regular intervals (15-30 minutes) after the liquid meal, until complete gastric emptying was established.

[Antibodies against hepatitis C virus. Experience with a second generation test].

A second generation recombinant immunoblot assay to detect antibodies against Hepatitis C virus (RIBA II, Ortho Diagnostic Systems) was applied to 30 serum samples repeatedly reactive to ELISA anti-HCV c100-3, 11 from hemodialysis patients, 11 from patients with chronic hepatitis and 8 from patients with cirrhosis. The assay detects individual antibodies directed to 4 antigenic components of the C virus, 2 antigens, c100 and 5-1-1 contained in the original ELISA assay and 2 new antigens, c33c and c22-3 the latter structural in nature. From the total of 30 samples, 23 (77%) were reactive, 4 (13%) indeterminate and 3 (10%) non reactive to the RIBA II assay.

[Antibodies against hepatitis C virus in patients with liver diseases and in risk subjects. Preliminary report].

The recent discovery of an antigenic component of the causative agent of Non-A, Non-B hepatitis, has led to the characterization of this virus--Hepatitis C Virus (HCV)--and to the identification of an antibody present in infected subjects (anti-HCV) detected by means of the C-100 antigen derived from a nonstructural region of the viral genome. Using a commercial Kit (Ortho Diagnostic Inc.), the incidence of anti-HCV antibody was studied in the Military Hospital "Dr.

[Malignant thymoma with myasthenia gravis and hepatic metastasis. Report of a case and review of the literature].

This paper reports a case of an histological non aggressive thymoma with myasthenic symptoms as the first clinical manifestation. Three years after its complete surgical resection liver metastases appeared without evidence of intrathoracic neoplastic disease. The extrathoracic metastases are uncommon and the thymomatous myasthenia gravis is present in 25 to 50% of cases.