Robert J. Kania

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BACKGROUND/AIMS Interferon a (IFN) is the only agent currently approved by the FDA for the treatment of chronic viral hepatitis due to hepatitis C (HCV). Unfortunately, less than half the patients with HCV treated with IFN respond. Worse yet, half or more of those who do respond relapse when the agent is withdrawn. MATERIALS AND METHODS In this(More)
Access to the gastric remnant and duodenum is lost after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Traditionally, a percmaneous transhepatic access to the common bile duct has been used to manage choledocholithiasis and duct strictures. We present a novel method of laparoscopic transgastric endoscopic retrograde cholangiopancreatography for(More)
OBJECTIVE To determine whether individuals with concurrent active psychiatric disease and chronic hepatitis C virus (HCV) can be treated safely and effectively with interferon-alpha. DESIGN Prospective, open label study. SETTING Tertiary referral hospital. PATIENTS Thirty-one consecutive patients with co-existent chronic HCV and a psychiatric illness.(More)
BACKGROUND/AIMS We performed a prospective nonrandomized clinical trial to demonstrate that Interferon (IFN) treatment of individuals with chronic hepatitis C virus (HCV) positive hepatitis (CH-C) and serologic and/or histologic evidence of autoimmune dysregulation is feasible and whether the benefits of successfully treating CH-C are outweighed by the risk(More)
BACKGROUND/AIMS Interferon is the only approved therapy for chronic hepatitis occurring as a consequence of an infection with the hepatitis C virus. Because interferon is expensive, has a large number of untoward effects and its efficacy is not guaranteed, many physicians limit their use of this therapy to those with histologically advanced but not(More)
The purpose of this study was to evaluate the effectiveness and safety of lamivudine treatment in patients with advanced and end-stage liver disease caused by hepatitis B. Nine cases of advanced or end-stage liver disease due to hepatitis B infection were treated with lamivudine. Four received liver transplants while receiving lamivudine. Moreover, each of(More)
Herpes simplex hepatitis (HSH) occurring in pregnant women must be differentiated from acute fatty liver of pregnancy (AFLP) and the HELLP syndrome (hemolysis, elevated liver function tests, and low platelets), two diseases which are relatively more common hepatic disorders unique to pregnancy (1). All three, however, are relatively unusual. In contrast to(More)
Treatment of chronic hepatitis B virus (HBV) infection in an individual with periarteritis nodosum is described. A combination of famciclovir, granulocyte macrophage colony stimulating factor (GM-CSF) and interferon alpha 2b was utilized. The periarteritis, but not the HBV infection, responded to immunosuppressive therapy consisting of cyclophosphamide and(More)
BACKGROUND Hepatitis C virus (HCV) is a health problem that is common in adults. Because screening of blood and blood products for HCV has only been possible recently, older adults are more likely than younger adults to have HCV. Despite the higher prevalence of HCV in older adults, few are treated. This failure to treat is a result of the concern that the(More)
An open label trial of GM-CSF plus high-dose interferon (IFN) alpha 2b was performed in eight patients with chronic hepatitis B infection and 16 patients with chronic hepatitis C, who either failed to clear virus with 6 months of daily high-dose IFN (5 MU daily) therapy (n = 22) or were considered untreatable because of advanced disease and leukopenia (n =(More)