Survey of aspergillosis in non-neutropenic patients in Swiss teaching hospitals.

Clin Microbiol Infect 2011; 17: 1366-1371 ABSTRACT: Invasive aspergillosis (IA) is a live-threatening opportunistic infection that is best described in haematological patients with prolonged neutropenia or graft-versus-host disease. Data on IA in non-neutropenic patients are limited. The aim of this study was to establish the incidence, disease manifestations and outcome of IA in non-neutropenic patients diagnosed in five Swiss university hospitals during a 2-year period. Case identification was based on a comprehensive screening of hospital records. All cases of proven and probable IA were retrospectively analysed. Sixty-seven patients were analysed (median age 60 years; 76% male). Sixty-three per cent of cases were invasive pulmonary aspergillosis (IPA), and 17% of these were disseminated aspergillosis. The incidence of IPA was 1.2/10 000 admissions. Six of ten cases of extrapulmonary IA affected the brain. There were six cases of invasive rhinosinusitis, six cases of chronic pulmonary aspergillosis, and cases three of subacute pulmonary aspergillosis. The most frequent underlying condition of IA was corticosteroid treatment (57%), followed by chronic lung disease (48%), and intensive-care unit stays (43%). In 38% of patients with IPA, the diagnosis was established at autopsy. Old age was the only risk factor for post-mortem diagnosis, whereas previous solid organ transplantation and chronic lung disease were associated with lower odds of post-mortem diagnosis. The mortality rate was 57%.

A non-interventional phase IV Belgian survey to assess the antiviral effectiveness of pegylated interferon-alpha-2b and ribavirin treatment according to the stage of liver fibrosis in previously untreated patients with genotype 1/4/5/6 chronic hepatitis C (PRACTICE).

BACKGROUND AND STUDY AIMS: This was an observational, non-interventional, multicenter, phase IV study, in patients with genotype 1/4/5/6 chronic hepatitis C (CHC). The primary objectives were to evaluate SVR in patients with no or minimal fibrosis (METAVIR F0-F1) versus well established fibrosis (F2-F4), and to estimate response on Weeks 12, 24 and 48 on treatment in previously untreated patients with genotypes 1/4/5/6 CHC. PATIENTS AND METHODS: 538 patients treated with pegylated interferon alfa 2b 1.5 mcg/kg in combination with ribavirin 800-1200 mg/day were enrolled in 55 sites in Belgium and Luxembourg, 505 being considered for the analysis. 40% of the patients were female and 60% male, the average age was 47.5 years, 10.5% were 65 or older. RESULTS: SVR was observed in 35% of the patients, EVR in 68%, of which pEVR in 33% and cEVR in 35%. SVR was observed in 43% of the low fibrosis group (F0, F1) and 30% of the high fibrosis group (F2, F3, F4) (p = 0.005). SVR rates were 34% for genotype 1, 37% for genotype 4, and 47% for genotype 5 (NS). Multivariate analysis showed that EVR and baseline METAVIR score are independent prognostic factors for SVR. CONCLUSIONS: This trial confirms that fibrosis stage and early viral response are the most important key-factors to predict sustained response, suggesting that the earlier patients are treated, the better the outcome. Non-invasive techniques enable us to closely monitor progression of fibrosis, allowing a better selection of patients for antiviral treatment in the DAA-era.

[Archives de la Parole]. , Chanson fantaisiste en mēwātī / [Sir George Grierson], éd. ; Linguistic survey of India ; [Hassaina], voix ; accompagnement instrumental (harmonium indien et tabla)

[Traditions. Asie. Inde. Province de Delhi. Delhi]

[Archives de la Parole]. , Fortune favours the brave : in Bhojpuri of Shahabad (récit, fable) / [Sir George Grierson], éd. ; Linguistic survey of India ; [Hari Sankar Nath], voix

[Traditions. Asie. Inde. Bihar]

[Archives de la Parole]. , The covetous Brahmin [and his reward] : in Oriya - Récit - Indo-Aryen - Ling[uistic] Survey of India / [Sir George Grierson], éd. ; Linguistic survey of India ; [Bepin Chandra Patra], voix

[Traditions. Asie. Inde. Orissa]

[Archives de la Parole]. , Special text in santali / [Sir George Grierson], éd. ; Linguistic survey of India ; Voix parlée, homme

[Traditions. Asie. Inde. Chotā Nāgpur]

[Archives de la Parole]. , A kahani : in Mundari / [Sir George Grierson], éd. ; Linguistic survey of India ; Voix parlée, homme

[Traditions. Asie. Inde. Chotā Nāgpur]

[Archives de la Parole]. , Special text in mundari / [Sir George Grierson], éd. ; Linguistic survey of India ; Voix parlée, homme

[Traditions. Asie. Inde. Chotā Nāgpur]

[Archives de la Parole]. , The Monkey and the Cats : in Bhojpuri of Shahabad / [Sir George Grierson], éd. ; Linguistic survey of India ; [Radha Mohan Prasad Srivastava], voix

[Traditions. Asie. Inde. Bihar]

[Archives de la Parole]. , Parable of the prodigal son : in Nagpuria Bhojpuri / [Sir George Grierson], éd. ; Linguistic survey of India ; [Shiva Sahay Lal], voix

[Traditions. Asie. Inde. Bihar]

[Archives de la Parole]. , La parabole de l'enfant prodigue : Dravidien, Tamoul (groupe de l'Inde péninsulaire, Province de Madras) / [Sir George Grierson], éd. ; Linguistic survey of India ; [Krishnamacharya Ranga Nath], voix

[Traditions. Asie. Inde. Province de Madras [i.e. Chennai]. Etat du Tamil Nadu. Thanjavur]

[Archives de la Parole]. , [Parable of the prodigal son] : récit en tamoul / [Sir George Grierson], éd. ; Linguistic survey of India ; Voix parlée, homme

[Traditions. Asie. Inde. Province de Madras [i.e. Chennai]]

[Archives de la Parole]. , [Parable of the prodigal son] : récit en tamoul / [Sir George Grierson], éd. ; Linguistic survey of India ; Voix parlée, homme

[Traditions. Asie. Inde. Province de Madras [i.e. Chennai]. État du Tamil Nadu]

[Archives de la Parole]. , [Parable of the prodigal son] : récit en télougou / [Sir George Grierson], éd. ; Linguistic survey of India ; Voix parlée, homme

[Traditions. Asie. Inde. Province de Madras [i.e. Chennai]]

[Archives de la Parole]. , [Parable of the prodigal son] : récit tamoul / [Sir George Grierson], éd. ; Linguistic survey of India ; Voix parlée, homme

[Traditions. Asie. Inde. Province de Madras [i.e. Chennai]. Région de Kanara]