European echinococcosis registry: human alveolar echinococcosis, Europe, 1982-2000.

Surveillance for alveolar echinococcosis in central Europe was initiated in 1998. On a voluntary basis, 559 patients were reported to the registry. Most cases originated from rural communities in regions from eastern France to western Austria; single cases were reported far away from the disease-"endemic" zone throughout central Europe.

Cognitive behavioral therapy and aerobic exercise for Gulf War veterans' illnesses: a randomized controlled trial.

Context: Gulf War veterans' illnesses (GWVI), multisymptom illnesses characterized by persistent pain, fatigue, and cognitive symptoms, have been reported by many Gulf War veterans. There are currently no effective therapies available to treat GWVI.

Objective: To compare the effectiveness of cognitive behavioral therapy (CBT), exercise, and the combination of both for improving physical functioning and reducing the symptoms of GWVI.

Living donor liver transplantation in patients with portal vein thrombosis: a survey and review of technical issues.

Background: Unlike cadaveric liver transplantation, current attitudes in living donor liver transplantation (LDLT) quote increased risk factors in the potential recipient such as retransplantation, multiple previous surgeries, or preexisting recipient portal vein thrombosis (PVT) as absolute or relative contraindications to this procedure.

Methods: An international survey was performed to examine the attitude of transplant teams relative to LDLT in the setting of preexisting PVT in the potential recipient. A questionnaire was sent to a total of 80 transplant centers performing LDLT in the United States, Europe, Canada, Japan, Southeast Asia, and Australia.

First clinical experience with Molecular Adsorbent Recirculating System (MARS) in six patients with severe acute on chronic liver failure.

Unlabelled: Despite recent advances in general supportive care, the mortality rate of patients with severe liver insufficiency remains high. Recently a new artificial liver support system MARS has been used for selective removal of albumin-bound toxins.

Aim: To assess the safety and efficacy of MARS treatment in patients with acute on chronic liver disease (n = 5) or liver failure after extended hepatic resection (n = 1).

The Black Triangle area--fit for Europe? Numerical air quality studies for the Black Triangle area.

The "Black Triangle" area (covering northern Bohemia, southern Saxony and part of lower Silesia) has been one of the most polluted areas in Central Europe. The area was named mainly because of high emissions of sulfur and dust. After the political changes at the end of the 1980s a significant improvement in air quality has been achieved.

Expression of the hepatocyte canalicular multidrug resistance protein (MRP2) in primary biliary cirrhosis.

The canalicular multidrug resistance protein 2 (MRP2; gene symbol: ABCC2) mediates ATP-dependent biliary excretion of organic anions such as bilirubin diglucuronide, glutathione conjugates and sulfated and glucuronidated bile salts. In chronic cholestatic liver diseases, the biliary excretion of cholephilic organic anions is impaired. While the underlying transport defects have been studied in rat models of cholestasis, little is known about the molecular basis of impaired organic anion excretion in human cholestatic liver disease.

Cost-effectiveness of cadaveric and living-donor liver transplantation.

Background: Cadaveric liver transplantation (5-year survival >80%) represents the standard of care for end-stage liver disease (ESLD). Because the demand for cadaveric organs exceeds their availability, living-donor liver transplantation has gained increasing acceptance. Our aim was to assess the marginal cost-effectiveness of cadaveric and living-donor orthotopic liver transplantation (OLT) in adults with ESLD.

Interferon and amantadine in naive chronic hepatitis C: a double-blind, randomized, placebo-controlled trial.

Recent controlled trials on the efficacy of an amantadine/interferon combination in treatment-naive patients with chronic hepatitis C yielded contradictory results. We therefore conducted a large, double-blind, placebo-controlled, multicenter trial in naive patients with chronic hepatitis C: 246 patients were randomized to receive interferon alfa-2a (6 MIU sc thrice weekly for 20 weeks, then 3 MIU sc thrice weekly) and either amantadine sulphate (2 x 100 mg p.o.

Simulation of hepatitis C based on a mandatory reporting system.

Objective: Hepatitis C is a major cause of liver disease in European countries. We aimed to assess the current and future disease burden of hepatitis C.

Setting: A representative data set of hepatitis C was applied to a validated computer model.

Pilot study of interferon-alpha with and without amantadine for the treatment of hepatitis C in HIV coinfected individuals on antiretroviral therapy.

Background: Concurrent potent therapy of hepatitis C (HCV) and HIV includes at least five antiviral drugs. Drug interactions, toxicity, tolerance and acceptance by patients of such treatment regimens are unknown.

Study Design: A prospective open randomized pilot trial was conducted to test interferon-alpha (6 million units/day for the 1st month followed by 6 million thrice weekly) and amantadine versus interferon-alpha monotherapy for tolerability and feasibility among HIV and HCV co-infected patients on stable antiretroviral combination therapy.

Fatal hepatoxicity secondary to nimesulide.

This report describes a 57-year-old female patient with chronic lumbago, who died from the sequelae of acute liver failure induced by nimesulide medication. Nimesulide is a non-steroidal anti-inflammatory drug (NSAID) which preferentially inhibits cyclo-oxygenase 2 and has been associated with a total of 13 reported cases of severe liver injury including our case. On the basis of the literature reports, the following features of nimesulide-associated hepatotoxicity were identified: female sex (84% of cases), age (mean age 62 years), jaundice as a primary manifestation (90%) and the absence of peripheral blood eosinophilia.

Transplant legislation: ethical and practical issues in liver allocation--The case of Switzerland.

Ethical and practical issues relating to liver allocation have been discussed in many countries. Several governments, including the United States, have attempted over the past few years to impose new legislation, which has resulted in virulent debates among individual centers, organ procurement agencies, states, and various groups of interest. This report discusses the current ongoing legislative process in Switzerland.

A pragmatic and cost-effective strategy of a combination therapy of interferon alpha-2b and ribavirin for the treatment of chronic hepatitis C.

Background: Combination of interferon (IFN) alpha and ribavirin is considered the standard treatment for patients with chronic hepatitis C. While combination therapy is more effective than IFN alone, the optimal management of combination treatment remains uncertain.

Objective: To assess a pragmatic and cost-effective strategy for the therapy of treatment-naive patients with chronic hepatitis C.

[Hepatitis C virus infection. Overview. SEVHEP (Swiss Experts on Viral Hepatitis)].

The hepatitis C virus (HCV) shows a pronounced polymorphism with six genotypes and many subtypes. The virus is generally not cytopathogenic. Immunological defence mechanisms are probably essential for the pathogenecity.

Helicobacter pylori and gastric erosions. Results of a prevalence study in asymptomatic volunteers.

Background/aims: Helicobacter pylori is considered to be the primary cause of most forms of gastritis, but its role as a causative agent in gastric erosions is unclear. The aim of this study was to estimate the prevalence of gastric erosions and H. pylori infection in asymptomatic volunteers.

[Liver transplantation and tumors: risk and chance].

Liver transplantation is the established therapy of choice for endstages of acute and chronic liver diseases of various aetiologies. The place of liver transplantation in the treatment of malignant liver disease, in particular hepatocellular carcinoma, remains, however, debated: liver transplantation for hepatocellular carcinoma achieves 5-year survival similar to that for other indications, and 5-year disease-free survival better than that following "curative" resection, provided certain criteria are fulfilled (one node max. 5 cm in diameter or max.

[Epidemiology of chronic hepatitis B and C among dialysis patients in Switzerland].

Background: Among patients with renal insufficiency undergoing chronic dialysis treatment, chronic hepatitis due to infection with viruses of the hepatitis B (HBV) or hepatitis C (HCV) type represents a serious medical problem. In contrast to other countries, detailed statistics on the prevalence of HBV and HCV infection are not available for dialysed patients in Switzerland.

Methods: The present study is based on a nationwide survey among the Swiss dialysis population which evaluated the prevalence of patients positive for either the HBs antigen (reflecting HBV infection) or anti-HCV antibodies (reflecting HCV infection) in 1999.

Genetic linkage of hyper-IgE syndrome to chromosome 4.

The hyper-IgE syndrome (HIES) is a rare primary immunodeficiency characterized by recurrent skin abscesses, pneumonia, and highly elevated levels of serum IgE. HIES is now recognized as a multisystem disorder, with nonimmunologic abnormalities of the dentition, bones, and connective tissue. HIES can be transmitted as an autosomal dominant trait with variable expressivity.

Primary liver disease as a determinant for acute rejection after liver transplantation.

Background: Graft rejection and infection remain major problems following liver transplantation; both are heavily influenced by the immunosuppressive regimen. Despite the disparity in the primary disease leading to transplantation, all patients receive the same posttransplant immunosuppressive treatment in a given center. The aim of this study is to detect a possible effect of the underlying disease on the incidence of early acute rejection episodes after orthotopic liver transplantation (OLT).

Early acute cellular rejection: no effect on late hepatic allograft function in man.

Whereas early acute cellular rejection, even if successfully treated, seems to have an impact on late function and survival of kidney and heart transplants, little quantitative data are available on its effect(s) on liver transplants. Routine liver function tests, the functioning liver cell mass (galactose elimination capacity) and microsomal metabolic capacity (aminopyrine breath test) were determined prospectively in 37 consecutive patients 1 year after liver transplantation. Of these, 19 (7 females and 12 males, 32-69 years of age) had previously required treatment for at least one biopsy proven acute cellular rejection episode occuring a median 7 days after grafting, while 18 (6 females and 12 males, 30-67 years of age) had not.

Anti-TNF antibody in Crohn's disease--status of information, comments and recommendations of an international working group.

The chimeric anti-TNF antibody Remicade (Infliximab) has recently been approved for human use by the FDA and is now available on the market. Since there is considerable interest in this kind of treatment among patients with Crohn's disease, an international working group has summarized the presently available information about efficacy, side effects and possible problems of this treatment. Studies show that Remicade is effective in the treatment of active Crohn's disease, maintaining remission and fistulae.