IL28B polymorphisms predict response to therapy among chronic hepatitis C patients with HCV genotype 4.

Summary.  Genetic polymorphisms near IL28B are associated with spontaneous and treatment-induced clearance of hepatitis C virus (HCV). Our objective was to assess the predictive value of IL28B polymorphisms in the treatment of chronic hepatitis C of patients with HCV genotypes 4, for which data are currently limited. We analysed the association of IL28B polymorphisms with the virological response to treatment among 182 naïve chronic hepatitis C patients with HCV genotype 4, all from Syria. Associations of alleles with the response patterns were evaluated by univariate analysis and multivariate logistic regression, accounting for all relevant covariates. Sustained virological response (SVR) was achieved in 26% of rs8099917 TG/GG carriers compared with 60% of TT carriers (P < 0.0001) and 35% of rs12979860 CT/TT carriers compared with 62% of CC carriers (P = 0.0011). By multivariate analysis, the association between rs8099917 and SVR remained significant (OR = 0.19, 95% CI 0.07-0.50, for TG/GG vs TT, P = 0.0007), with the only significant covariate being advanced fibrosis (OR = 0.13, 95% CI 0.04-0.37, P = 0.0002). In conclusion, IL28B polymorphisms are the strongest predictors of response to therapy among chronic hepatitis C patients with HCV genotype 4.

Chronic Disease Connections, January 2015

IDPH has a new grant-funded program, the Health Promotion and Chronic Disease Control Partnership. This publication, Chronic Disease Connections, will be part of the communication strategy between IDPH staff and healthcare system providers throughout the state as we partner to help patients control their diabetes and high blood pressure. This is just one of the major objectives for the funding. The CDC would like to see that more patients are aware that they have pre-diabetes, diabetes or high blood pressure and that health systems are maximizing evidence-based strategies to assist patients with achieving control. Over the coming months you will hear more about the new program and how you can become involved.

Chronic Disease Connections, February 2015

IDPH has a new grant-funded program, the Health Promotion and Chronic Disease Control Partnership. This publication, Chronic Disease Connections, will be part of the communication strategy between IDPH staff and healthcare system providers throughout the state as we partner to help patients control their diabetes and high blood pressure. This is just one of the major objectives for the funding. The CDC would like to see that more patients are aware that they have pre-diabetes, diabetes or high blood pressure and that health systems are maximizing evidence-based strategies to assist patients with achieving control. Over the coming months you will hear more about the new program and how you can become involved.

Chronic Disease Connections, March 2015

IDPH has a new grant-funded program, the Health Promotion and Chronic Disease Control Partnership. This publication, Chronic Disease Connections, will be part of the communication strategy between IDPH staff and healthcare system providers throughout the state as we partner to help patients control their diabetes and high blood pressure. This is just one of the major objectives for the funding. The CDC would like to see that more patients are aware that they have pre-diabetes, diabetes or high blood pressure and that health systems are maximizing evidence-based strategies to assist patients with achieving control. Over the coming months you will hear more about the new program and how you can become involved.

Chronic Disease Connections, April 2015

IDPH has a new grant-funded program, the Health Promotion and Chronic Disease Control Partnership. This publication, Chronic Disease Connections, will be part of the communication strategy between IDPH staff and healthcare system providers throughout the state as we partner to help patients control their diabetes and high blood pressure. This is just one of the major objectives for the funding. The CDC would like to see that more patients are aware that they have pre-diabetes, diabetes or high blood pressure and that health systems are maximizing evidence-based strategies to assist patients with achieving control. Over the coming months you will hear more about the new program and how you can become involved.

Tailored thoracomyoplasty as a valid treatment option for chronic postlobectomy empyema.

BACKGROUND: Chronic post-lobectomy empyema is rare but may require space obliteration for infection control. We report our experience by using a tailored thoracomyoplasty for this specific indication with respect to infection control and functional outcome. METHODS: We retrospectively analyzed 17 patients (11 men, 6 women) with chronic postlobectomy empyema who were treated by thoracomyoplasty in our institution between 2000 and 2011. All patients underwent an initial treatment attempt by use of chest tube drainage and antibiotics except those with suspicion of pleural aspergillosis (n = 6). In 5 patients, bronchus stump insufficiency was identified at preoperative bronchoscopy. A tailored thoracoplasty was combined with a serratus anterior-rhomboid myoplasty, which also served to close a bronchopleural fistula, if present. The first rib was resected in 11 of 17 patients. RESULTS: The 90-day mortality was 11.7%. Thoracomyoplasty was successful in all surviving patients with respect to infection control, space obliteration, and definitive closure of bronchopleural fistula, irrespective of the type of infection, the presence of a bronchopleural fistula, or whether a first rib resection was performed. Postlobectomy pulmonary function testing before and after thoracoplasty revealed a mean predicted FEV(1) of 63.0% ± 8.5% and 51.5% ± 4.2% (p = 0.01) and a mean predicted DLCO of 59.8% ± 11.6% and 54.5% ± 12.5%, respectively. Postoperative shoulder girdle dysfunction and scoliosis were prevented in patients willing to undergo intense physiotherapy. CONCLUSIONS: Tailored thoracomyoplasty represents a valid option for patients with chronic postlobectomy empyema without requiring a preceding open window thoracostomy. Space obliteration and infection control were equally obtained with and without first rib resection.