ABSTRACT
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Subject(s)
Humans , Pancreatitis/etiology , Gastrostomy/adverse effects , Pancreatitis/diagnosisSubject(s)
Duodenum , Enteral Nutrition/adverse effects , Foreign-Body Migration/complications , Gastrostomy/instrumentation , Pancreatitis/etiology , Postoperative Complications/etiology , Acute Disease , Female , Humans , Middle Aged , Mitochondrial Myopathies/complications , Mitochondrial Myopathies/therapySubject(s)
Cecal Neoplasms/complications , Crohn Disease/complications , Granular Cell Tumor/complications , Biomarkers, Tumor/analysis , Cecal Neoplasms/diagnosis , Cecal Neoplasms/pathology , Cecal Neoplasms/surgery , Granular Cell Tumor/diagnosis , Granular Cell Tumor/pathology , Granular Cell Tumor/surgery , Humans , Incidental Findings , Intestinal Perforation/etiology , Male , Middle AgedABSTRACT
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Subject(s)
Male , Middle Aged , Humans , Crohn Disease/pathology , Cecal Neoplasms/pathology , Granular Cell Tumor/pathologySubject(s)
Esophageal Neoplasms/therapy , Granular Cell Tumor/therapy , Adult , Aged , Esophageal Neoplasms/diagnosis , Female , Granular Cell Tumor/diagnosis , Humans , MaleABSTRACT
BACKGROUND AND OBJECTIVE: Several models for the prediction of liver fibrosis have been developed which consist of the measurement of routine laboratory data: a) a model combining platelets, gamma-glutamil-transpeptidase, cholesterol and age (Forns model), and b) a model using an aspartate-aminotransferase to platelet ratio index (APRI). Our study was aimed to compare both non-invasive methods to predict mild fibrosis (F0-F1) or to confirm advanced fibrosis (F3, F4) in patients with chronic hepatitis C. PATIENTS AND METHOD: We included 199 patients with chronic hepatitis. The average age (standard deviation) was 41 (11) years (16-66), and there were 117 men and 82 women. We found a genotype 1 in 108 patients (54.2%), 45 had a non-1 genotype (22.6%), and 46 (23.1%) had an unknown genotype. Mild fibrosis stage (F0-F1) was found in 96 patients, F2 in 52 and advanced fibrosis (F3-F4) in 51 patients. We calculated the APRI and the Forns's index. RESULTS: Patients infected with genotype 1 were older (44 [11] vs 36 [4.3] years; p = 0.001), presented higher levels of cholesterol (179 [40] vs 160 [42] mg/dl; p = 0.05) and lower levels of alanine-aminotransferase (112 [86] vs 169 [87] IU/l; p = 0.03). The Forns's model predicted mild fibrosis (F0-F1) in 71.4% while the APRI model did it in 72.7%. The Forns's model confirmed advanced fibrosis in 78.6% against 54.2% from the APRI one. The predictive capacity in both models increased when analyzing patients with the genotype 1. Moreover, the predictive capacity of advanced fibrosis or exclusion of significant fibrosis reached more than 90% when both models were used together in patients with a genotype 1. CONCLUSIONS: Non-invasive methods for the prediction of liver fibrosis can be very useful in clinical practice, mainly in patients with genotype 1 when the two methods are used together.
Subject(s)
Hepatitis C, Chronic/blood , Liver Cirrhosis/diagnosis , Severity of Illness Index , Adolescent , Adult , Aged , Biomarkers , Biopsy, Needle , Blood Chemical Analysis , Female , Hepatitis C, Chronic/pathology , Hepatitis C, Chronic/therapy , Humans , Liver/pathology , Liver/virology , Liver Cirrhosis/blood , Liver Cirrhosis/therapy , Liver Function Tests , Male , Middle Aged , Predictive Value of Tests , Sensitivity and SpecificityABSTRACT
FUNDAMENTO Y OBJETIVO: Recientemente se han desarrollado 2 modelos de cálculo de fibrosis utilizando parámetros bioquímicos analizados en la práctica habitual: a) las plaquetas, la gammaglutamiltranspeptidasa, el colesterol y la edad (índice Forns) y b) el cociente aspartato ahh aminotransferasa/plaquetas (APRI). El objetivo de nuestro estudio ha sido comparar la utilidad de ambos métodos no invasivos para detectar fibrosis leve (F0-F1) o fibrosis avanzada (F3-F4) en pacientes con hepatitis C crónica. PACIENTES Y MÉTODO: Incluimos a 199 pacientes (117 varones y 82 mujeres) con hepatitis crónica C, con una edad media (desviación estándar) de 41 (11) años (extremos, 16-66). Un totalde 108 pacientes (54,2%) eran de genotipo 1, 45 de genotipo no 1 (22,6%), y en 46 (23,1%)se desconocía el genotipo. La distribución de los pacientes según el estadio de fibrosis fue:leve (F0-F1) en 96 pacientes, F2 en 52 y avanzado (F3-F4) en 51. Calculamos el resultado delíndice APRI y del índice de Forns. RESULTADOS: Los pacientes infectados por el genotipo 1 eran mayores (media de 44 [11] frente a 36 [4,3] años; p = 0,001), presentaban valores más altos de colesterol (media de 179 [40]frente a 160 [42] mg/dl; p = 0,05) e inferiores de alaninaminotransferasa (media de 112 [86]frente a 169 [87] UI/l; p = 0,03). El modelo de Forns predijo fibrosis leve (F0-F1) en el 71,4%mientras que el modelo APRI lo consigue en un 72,7%. El modelo de Forns predice fibrosis avanzada en el 78,6% frente al 54,2% del modelo APRI. La capacidad predictiva de ambos modelos aumentó al analizar de forma separada el grupo de pacientes con hepatitis C de genotipo1, sobre todo cuando se utilizaron de forma conjunta, demostrando una capacidad de predecir fibrosis leve (F0-F1) del 95,2% y de detectar fibrosis avanzada del 91,7%.CONCLUSIONES: Los métodos bioquímicos no invasivos para la predicción de la fibrosis pueden ser muy útiles en la práctica clínica, sobre todo en el grupo de pacientes con hepatitis C genotipo1, cuando se utilizan ambos modelos de forma conjunta
BACKGROUND AND OBJECTIVE: Several models for the prediction of liver fibrosis have been developed which consist of the measurement of routine laboratory data: a) a model combining platelets,gamma-glutamil-transpeptidase, cholesterol and age (Forns model), and b) a model using an aspartate-aminotransferase to platelet ratio index (APRI). Our study was aimed to compareboth non- invasive methods to predict mild fibrosis (F0-F1) or to confirm advanced fibrosis (F3,F4) in patients with chronic hepatitis C.PATIENTS AND METHOD: We included 199 patients with chronic hepatitis. The average age (standard deviation) was 41 (11) years (16-66), and there were 117 men and 82 women. We founda genotype 1 in 108 patients (54.2%), 45 had a non-1 genotype (22.6%), and 46 (23.1%)had an unknown genotype. Mild fibrosis stage (F0-F1) was found in 96 patients, F2 in 52 and advanced fibrosis (F3-F4) in 51 patients. We calculated the APRI and the Fornss index. RESULTS: Patients infected with genotype 1 were older (44 [11] vs 36 [4.3] years; p = 0.001),presented higher levels of cholesterol (179 [40] vs 160 [42] mg/dl; p = 0.05) and lower levels of alanine-aminotransferase (112 [86] vs 169 [87] IU/l; p = 0.03). The Fornss model predicted mild fibrosis (F0-F1) in 71.4% while the APRI model did it in 72.7%. The Fornss model confirmed advanced fibrosis in 78.6% against 54.2% from the APRI one. The predictive capacity in both models increased when analyzing patients with the genotype 1. Moreover, the predictive capacity of advanced fibrosis or exclusion of significant fibrosis reached more than 90%when both models were used together in patients with a genotype 1.CONCLUSIONS: Non-invasive methods for the prediction of liver fibrosis can be very useful in clinical practice, mainly in patients with genotype 1 when the two methods are used together
