Risk predictors of advanced hepatic fibrosis in patients with nonalcoholic fatty liver disease - a survey in a university hospital in Brazil

ABSTRACT Objective: Describe the clinical profile of patients with biopsy-proven non-alcoholic fatty liver disease (NAFLD) and analyze the risk predictors of hepatic fibrosis in outpatient follow-up at a university hospital. Subjects and methods: Demographic, clinical and laboratory data of a cohort of 143 patients with biopsy-proven NAFLD were retrospectively analysed under univariate analyses. Diagnostic accuracy, determined by AUROC, was evaluated for variables that showed a significant difference in univariate comparison analysis and diagnostic performances were determined by sensitivity and specificity. Results: The mean age of studied patients were 48 years, 66.4% of them were women. Age, presence of diabetes mellitus, hypertension, metabolic syndrome and laboratory variables such as AST/ALT ratio, GGT, platelet count and fasting glucose were significantly associated with advanced fibrosis. FIB-4 and NAFLD fibrosis score (AUROC 0.82 and 0.89, respectively) outperformed APRI (AUROC 0.73) for advanced liver fibrosis and cirrhosis (P of 0.04). Conclusion: In our study, metabolic syndrome, diabetes, hypertension, AST/ALT ratio, GGT, platelet count and fasting glucose were associated with hepatic fibrosis in patients with NAFLD. The non-invasive tests FIB-4 and NAFLD fibrosis score showed the best accuracy to stratify disease severity.

Desenvolvimento da morfologia derivacional nos primeiros anos do ensino fundamental / Morphological awareness development in the first years of primary education

Consciência morfológica é a habilidade de refletir sobre os morfemas. Essa habilidade está relacionada à aquisição da leitura e da escrita. A maioria dos estudos nessa área foca no desenvolvimento da morfologia flexional. Menos se sabe sobre a morfologia derivacional. Este estudo verificou o desenvolvimento da morfologia derivacional. Trinta e sete crianças de primeiro e terceiro ano responderam a uma tarefa de decisão lexical que exigia que a criança julgasse um par de palavras com base na morfologia da língua portuguesa. Os resultados mostraram que as crianças de primeiro ano fizeram julgamentos ao nível de chance. As crianças de terceiro ano tiveram desempenho acima do nível de chance. No entanto, não houve diferença estatisticamente significativa entre as séries escolares. Esses resultados contradizem os usualmente encontrados na literatura. O tipo de tarefa e a natureza do sistema escolar são apontados como possíveis explicações para as diferenças nos resultados.

Morphological awareness is the ability to reflect upon a word´s morphemes. This ability is related to reading and spelling acquisition. Most studies carried out in the Portuguese language have focused on the development of flexional morphology. Less is known about derivational morphology. This study looked at the development of derivational morphology. Thirty-seven children from grades one and three were given a lexical decision task that required judging a pair of words on the basis of Portuguese language morphology. The results showed that first grade children made the judgments at random levels. Third grade children had above random performance. However, no grade effects were found for comparisons between grades. These results are different from the ones usually found in the literature. The type of task used and the nature of the school system are possible explanation for differences in performance.