- Email: [email protected]
Passive-active immunisation in newborns from greek HBV carrier mothers
313
ATENOLOL IN PORTAL HYPERTENSION: AN ULTRASONOGRAPHIC AND HEMODYNAMIC STUDY M. Zoli, G. Marchesini, Cristina Dondi, A. Marzocchl,'° Cinzia Marrozzlnl," .o F. Cassani, E. Pisi Istituto di Patologia Medica I e Istituto di Cardiologia °, Universit~ di Bologna, Policlinico S. Orsola, Via Massarenti 9, 1-40138 Bologna, Italy.
The role of ultrasonography in "the evaluation of the effects of B-blocklng therapy on portal pressure and on splanchnic vein calibers was assessed in I0 cirrhotic subjects before and after atenolol treatment (IOO mg/day)." All patients had previously bled from large oesophageal varices. The caliber of splanchnic veins was measured by a real-time equipment (Aloka SSD-250), while the portal pressure was assessed during hepatic vein catheterization as the wedged pressure (WHVP) or the gradient between wedged and free pressure (WHVP-FHVP)(Swan-Ganz 7 F catheter). Following treatment the cardiac index decreased by 22 ± SE 3% (p <.O01), the WHVP and the gradient WHVP-FHVP decreased by 14 ± 3 and 34 ± 4% respectively (p <.OO1). As to the calibers of splanchnic veins, the splenic vein at hilus fell from 13.0 ± 1.2 mm to 10.9 ± 1.3 (p <.O01), the superior mesenteric vein from 12.5 ± 0.3 to 9.7 ± 0.4 (p<.OOl), while the portal vein was less markedly reduced. A significant caliber response to breathing was observ ed after treatment. The % decrease of WHVP significantly correlated with the % decrease of both the caliber of the splenic vein at hilus (r=.706) and the caliber of the superior mesenteric vein (r=.658). The response to therapy is largely variable, and in about 30% of patients the IQI~VP decreased by less than 10%. Ultrasonography is able to pick up these patients. Abd~ minal ultrasonography may be routinely carried out as a non-invasive and easy-to-repeat technique in cirrhotic patients under B-blocking therapy.
314
PASSIVE-ACTIVE IMMUNISATION IN NEWBORNS FROMGREEKHBV CARRIER MOTHERS. l.Zouboulis-Vafiadis~ S.Papadakou-La~o~anni, V.Kouvelis* and S.Hadzi~annis** 1st Dept. of Propedeutic Medecine, University of Athens. *"Mitera" Maternity Hospital, ** 2nd Dep. of Internal Medecine, Hipokration Gen. Hospital, Athens, Greece.
Infants born from Hepatitis B surface antigen (HBsAg) positive women are often infected in the perinatal period and are at risk to become chronic HBV carriers. The purpose of this study was to examine this risk in a greek population and to evaluate the eff~cac~ qf an HB vaccine (5 ~g HEVAC-B Pasteur) in comblnat~on with RB i~unOgloSulin CHBIG, 100 UI) in preventing maternal-infant transmission. 24 newborns (two born from HBeAg(+) and 22 from antiHBe(+) mothers) were given one dose of the vaccine and the HBIG shorthly after birth, followed by three doses of the vaccine at 1st, 2d and 12th month. Blood samples were taken at birth and one month after each dose and tested for HBsAq, antiHBc and antiHBs by RIA. Three babies (two born to HBeAg(+) and one bor~ to antiHBe{+) mothers) were HBsAg(+) at birth, but none developed a carrier state. All babies/were antiHBc(+) at birth with progressively, there after, declining t i t e r s . In all samples antiHBs was detected in increasing t i t e r s during the follow-up period. These preliminary results indicate that passive-active immunisation is efficacious in interrupting perinatal transmission of HBV infection.
$157
ATENOLOL IN PORTAL HYPERTENSION: AN ULTRASONOGRAPHIC AND HEMODYNAMIC STUDY M. Zoli, G. Marchesini, Cristina Dondi, A. Marzocchl,'° Cinzia Marrozzlnl," .o F. Cassani, E. Pisi Istituto di Patologia Medica I e Istituto di Cardiologia °, Universit~ di Bologna, Policlinico S. Orsola, Via Massarenti 9, 1-40138 Bologna, Italy.
The role of ultrasonography in "the evaluation of the effects of B-blocklng therapy on portal pressure and on splanchnic vein calibers was assessed in I0 cirrhotic subjects before and after atenolol treatment (IOO mg/day)." All patients had previously bled from large oesophageal varices. The caliber of splanchnic veins was measured by a real-time equipment (Aloka SSD-250), while the portal pressure was assessed during hepatic vein catheterization as the wedged pressure (WHVP) or the gradient between wedged and free pressure (WHVP-FHVP)(Swan-Ganz 7 F catheter). Following treatment the cardiac index decreased by 22 ± SE 3% (p <.O01), the WHVP and the gradient WHVP-FHVP decreased by 14 ± 3 and 34 ± 4% respectively (p <.OO1). As to the calibers of splanchnic veins, the splenic vein at hilus fell from 13.0 ± 1.2 mm to 10.9 ± 1.3 (p <.O01), the superior mesenteric vein from 12.5 ± 0.3 to 9.7 ± 0.4 (p<.OOl), while the portal vein was less markedly reduced. A significant caliber response to breathing was observ ed after treatment. The % decrease of WHVP significantly correlated with the % decrease of both the caliber of the splenic vein at hilus (r=.706) and the caliber of the superior mesenteric vein (r=.658). The response to therapy is largely variable, and in about 30% of patients the IQI~VP decreased by less than 10%. Ultrasonography is able to pick up these patients. Abd~ minal ultrasonography may be routinely carried out as a non-invasive and easy-to-repeat technique in cirrhotic patients under B-blocking therapy.
314
PASSIVE-ACTIVE IMMUNISATION IN NEWBORNS FROMGREEKHBV CARRIER MOTHERS. l.Zouboulis-Vafiadis~ S.Papadakou-La~o~anni, V.Kouvelis* and S.Hadzi~annis** 1st Dept. of Propedeutic Medecine, University of Athens. *"Mitera" Maternity Hospital, ** 2nd Dep. of Internal Medecine, Hipokration Gen. Hospital, Athens, Greece.
Infants born from Hepatitis B surface antigen (HBsAg) positive women are often infected in the perinatal period and are at risk to become chronic HBV carriers. The purpose of this study was to examine this risk in a greek population and to evaluate the eff~cac~ qf an HB vaccine (5 ~g HEVAC-B Pasteur) in comblnat~on with RB i~unOgloSulin CHBIG, 100 UI) in preventing maternal-infant transmission. 24 newborns (two born from HBeAg(+) and 22 from antiHBe(+) mothers) were given one dose of the vaccine and the HBIG shorthly after birth, followed by three doses of the vaccine at 1st, 2d and 12th month. Blood samples were taken at birth and one month after each dose and tested for HBsAq, antiHBc and antiHBs by RIA. Three babies (two born to HBeAg(+) and one bor~ to antiHBe{+) mothers) were HBsAg(+) at birth, but none developed a carrier state. All babies/were antiHBc(+) at birth with progressively, there after, declining t i t e r s . In all samples antiHBs was detected in increasing t i t e r s during the follow-up period. These preliminary results indicate that passive-active immunisation is efficacious in interrupting perinatal transmission of HBV infection.
$157