Summary
Background
Liver fibrosis is often accompanied by steatosis, particularly in patients with non‐alcoholic fatty liver disease (NAFLD), and its non‐invasive characterisation is of utmost ...importance. Vibration‐controlled transient elastography is the non‐invasive method of choice; however, recent research suggests that steatosis may influence its diagnostic performance. Controlled Attenuation Parameter (CAP) added to transient elastography enables simultaneous assessment of steatosis and fibrosis.
Aim
To determine how to use CAP in interpreting liver stiffness measurements.
Methods
This is a secondary analysis of data from an individual patient data meta‐analysis on CAP. The main exclusion criteria for the current analysis were unknown aetiology, unreliable elastography measurement and data already used for the same research question. Aetiology‐specific liver stiffness measurement cut‐offs were determined and used to estimate positive and negative predictive values (PPV/NPV) with logistic regression as functions of CAP.
Results
Two thousand and fifty eight patients fulfilled the inclusion criteria (37% women, 18% NAFLD/NASH, 42% HBV, 40% HCV, 51% significant fibrosis ≥ F2). Youden optimised cut‐offs were only sufficient for ruling out cirrhosis (NPV of 98%). With sensitivity and specificity‐optimised cut‐offs, NPV for ruling out significant fibrosis was moderate (70%) and could be improved slightly through consideration of CAP. PPV for significant fibrosis and cirrhosis were 68% and 55% respectively, despite specificity‐optimised cut‐offs for cirrhosis.
Conclusions
Liver stiffness measurement values below aetiology‐specific cut‐offs are very useful for ruling out cirrhosis, and to a lesser extent for ruling out significant fibrosis. In the case of the latter, Controlled Attenuation Parameter can improve interpretation slightly. Even if cut‐offs are very high, liver stiffness measurements are not very reliable for ruling in fibrosis or cirrhosis.
Linked ContentThis article is linked to Hassan and Tapper and Karlas et al papers. To view these articles visit https://doi.org/10.1111/apt.14584 and https://doi.org/10.1111/apt.14632.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract Objectives To assess the safety and efficacy of percutaneous cryoablation (CA) of soft-tissue tumours desmoid tumours (DTs), vascular malformations (VMs), and abdominal wall endometriosis ...(AWE). Methods This systematic review of studies published before January 2024 encompassed a detailed analysis of CA techniques and technical aspects for the treatment of soft-tissue tumours. Data concerning CA efficacy, complication rates, and other relevant metrics were extracted and included for analysis. Results The analysis included 27 studies totalling 554 CA procedures. For DT (13 studies, 393 sessions), CA showed an average pain reduction of 79 ± 17% (range: 57-100) and a lesion volume decrease of 71.5 ± 9.8% (range: 44-97). VM (4 studies, 58 sessions) had a 100% technical success rate and an average pain reduction of 72 ± 25% (range: 63-85). The average pain reduction for AWE (6 studies, 103 sessions) was 82 ± 13% (range: 62-100). Overall, the complication rate for CA was low, with minor adverse events (AEs) in about 20% of patients and major events in less than 5% of patients. Conclusions Showing substantial efficacy in pain reduction and lesion volume decrease, as well as low incidence of severe AE, CA presents as a highly effective and safe alternative for the treatment of soft-tissue tumours. Advances in knowledge CA is effective and safe in treating soft-tissue tumours, particularly DT, VM, and AWE.
Introduction: Chest X-rays are commonly used to assess the severity in patients that present in the emergency department with suspected COVID-19 pneumonia, but in clinical practice quantitative ...scales are rarely employed. Aims: To evaluate the reliability and validity of two semi-quantitative radiological scales in patients hospitalized for COVID-19 pneumonia (BRIXIA score and RALE score).
Accordingly with the principles of the circular economy, mixed plastic wastes can be recycled also by thermoforming, getting new non-oriented fibers composite materials. This study highlights the ...mechanical behavior of new composite material plates containing recycled glass fibers as reinforcing element and ABS-PMMA mixture as matrix, as well as an efficient way to convert a manufacturing process wastes in a product. The mechanical behavior of new composite material plates was evidenced by tensile, flexural and compression tests. In addition a surface morphology analysis was performed.
To describe the current state of the art about the main cognitive deficits that appear in patients affected with narcolepsy with cataplexy (NT1).
The majority of the studies have found that the most ...impaired cognitive functions are attention (especially maintenance of attention or sustained attention), speed of information processing and executive functions (in particular, verbal fluency and resistance to the stimuli interference). These data indicate the difficulty to use the available cognitive resources of the patient. These alterations are similar to those present in other hypersomnias, although they might differ in intensity. Moreover, most of the studies emphasize a high prevalence of different depressive and anxious disorders. It has been suggested that predisposition to anxiety could be part of the characteristic phenotype of these patients. Anxiety could act either as a trigger for the disease or a consequence of the disease.
Cognitive deficits in patients with NT1 appear in long lasting and/or monotonous tasks and in high cognitive demanding tasks. The presence of depressive symptomatology, together with excessive daytime sleepiness in these patients could affect their performance in neuropsychological test, and it might be related to their subjective perception of the cognitive deficits.
In recycling, according to principles of Directive 2008/98/EC of the European Parliament and of the Council on waste, research is upheld for achieving innovative technologies for reuse and keep as ...long it is possible, in economic chain, a waste. The aim of this research is to study and test a new composite material based on fiberglass waste mixed with organic resins with large application in the industry but not limited to this. Fiberglass is a material widely used for reinforcement of composite materials. As waste, fiberglass was less studied for ways to be reused. Filling fiberglass mixed with organic resins as PMMA and epoxy resins possess proper physical features for thermoforming. Three mixes are studied: fiberglass with PMMA, fiberglass with PMMA and rubber granules or sawdust. Samples will be tested for to define the mechanical and chemical behavior to have a complete description of the material. Analyzing the results can be concluded that mixes are suitable for board production, with improved features, compared with equivalent products on the market.
A survey highlighting the most recent palladium catalytic systems produced and their performances for progress in direct synthesis of indole backbones by heterocarbocyclization of reactive substrates ...is provided. The discussion is developed in relation with the principles of sustainable chemistry concerning atom and mass economy. In this respect, the general convergent character of the syntheses is of particular interest (one-pot, domino, cascade or tandem reactions), and the substrates accessibility and reactivity, together with the final waste production, are also important. This
critical review
clearly indicates that the development of ligand chemistry, mainly phosphines and carbenes, in the last few decades gave a significant impetus to powerful functionalization of indoles at virtually all positions of this ubiquitous backbone (118 references).
Ligand chemistry has given a significant impetus to produce functionalized indoles by assisting novel powerful palladium-catalysed intra- and intermolecular cyclizations.