TY  - JOUR
A1  - Liang, Xu-Jing
A1  - Huang, Si-Min
A1  - Li, Jian-Ping
A1  - Zhu, Xian-Nv
A1  - Lu, Yong-Ping
A1  - Hocher, Berthold
A1  - Chen, You-Peng
T1  - Hepatic impairment induced by scrub typhus is associated with new onset of renal dysfunction
JF  - Clinical laboratory : the peer reviewed journal for clinical laboratories and laboratories related to blood transfusion
N2  - Background: Scrub typhus is a potentially fatal infectious disease caused by Orientia tsutsugamushi. There is little attention given to hepatic impairment in the adults with scrub typhus. This study investigated the incidence and the prognostic implications of hepatic impairment in patients with scrub typhus.
 Methods: We retrospectively reviewed a total of 143 adult patients with scrub typhus who were admitted between January 1999 and December 2010 in Guangdong province, China. The patients were divided into three groups, e.g., normal, mild, and moderate to severe groups based on the elevated serum ALT and/or total bilirubin levels. Furthermore, clinical characteristics and prognosis of the patient groups were compared.
 Results: 109 patients (76.2%) had abnormal liver function. Among the patients with hepatic impairment 45 cases (31.4%), 54 cases (37.8%), and 10 cases (7.0%) had mild, moderate, and severe hepatic damage, respectively. The moderate to severe hepatic impairment group had higher levels of serum creatinine compared with that of normal hepatic function. The incidence of new onset of renal dysfunction - defined as peak serum creatinine >= 176 mu mol/L during hospital stay with no evidence of renal disease prior hospitalization - was 0% in the mild hepatic impairment group, 8.9% in the moderate hepatic impairment group, and 21.9% in the severe hepatic impairment group, (p = 0.005 for trend). Additionally, the patients with hepatic impairment (n = 109) had higher incidences of episodes of thrombocytopenia (45.9% vs. 8.82%, p < 0.001), hypoalbuminemia (50.5% vs. 11.8%, p < 0.001), new onset of renal dysfunction (16.5% vs. 0.0%, p = 0.011), and electrocardiogram abnormality (28.4% vs. 8.82%, p = 0.019) than the patients without hepatic impairment.
 Conclusions: The degree of hepatic impairment induced by scrub typhus is associated with new onset of renal dysfunction.
KW  - hepatic impairment
KW  - renal dysfunction
KW  - complication
KW  - outcome
KW  - scrub typhus
Y1  - 2014
U6  - https://doi.org/10.7754/Clin.Lab.2013.121203
SN  - 1433-6510
VL  - 60
IS  - 1
SP  - 63
EP  - 68
PB  - Clin Lab Publ., Verl. Klinisches Labor
CY  - Heidelberg
ER  - 
TY  - JOUR
A1  - Lu, Yong-Ping
A1  - Lung, Xu-Jing
A1  - Xiao, Xiao-Min
A1  - Huang, Si-Min
A1  - Liu, Zhi-Wei
A1  - Li, Jian
A1  - Hocher, Berthold
A1  - Chen, You-Peng
T1  - Telbivudine during the second and third trimester of pregnancy interrupts HBV intrauterine transmission: a systematic review and meta-analysis
JF  - Clinical laboratory : the peer reviewed journal for clinical laboratories and laboratories related to blood transfusion
N2  - Beckground: Evaluate the efficacy and safety of telbivudine during the 2nd and 3rd trimester of pregnancy in intrauterine transmission of hepatitis B virus (HBV). Based on the principle of Cochrane systematic reviews, a database was constructed from Medline, EMBASE, Cochrane Library, the US National Science Digital Library (NSDL), the China Biological Medicine Database (CBM-disc), and contact with Chinese experts in the field from November 2006 to February 2013.
 Results: Either the Mantel-Haenszel or Inverse Variance fixed-effects model or Mantel-Haenszel or Inverse Variance random-effects model was applied for all analyses indicated by odds ratio (OR) and 95% confidence interval (CI). The meta-analysis based on new onset of HBsAg seropositivity of infants at 6 - 12 months postpartum revealed that the control group had an intrauterine transmission rate of 8.25 - 42.31%. This rate was reduced to 0 - 14.29% in the telbivudine treatment group (OR 0.09, 95% CI 0.04 - 0.22, including seven trials, p < 0.001). The rates of intrauterine transmission based on new onset of HBV DNA seropositivity of infants at 6 - 12 months postpartum were 8.25 - 19.23% in the control group and 0 - 3.57% in the treatment group (OR 0.07, 95% CI 0.02 - 0.22, p < 0.001, including only five trials, since two trials had no data on HBV DNA in infants). With the exception of CK elevations, adverse effect frequencies were similar in both groups.
 Conclusions: Telbivudine is an effective and safe drug for preventing intrauterine transmission of HBV.
KW  - telbivudine
KW  - meta-analysis
KW  - intrauterine
KW  - transmission of hepatitis B virus (HBV)
KW  - clinical studies
KW  - safety efficacy
Y1  - 2014
U6  - https://doi.org/10.7754/Clin.Lab.2013.130408
SN  - 1433-6510
VL  - 60
IS  - 4
SP  - 571
EP  - 586
PB  - Clin Lab Publ., Verl. Klinisches Labor
CY  - Heidelberg
ER  -