scholarly journals Prospective screening of liver fibrosis in a primary care cohort using systematic calculation of fib-4 in routine results

2021 ◽  
Author(s):  
Philippe Halfon ◽  
Christelle Ansaldi ◽  
Guillaume Penaranda ◽  
Laurent Chiche ◽  
Patrick Dukan ◽  
...  
Keyword(s):  
Primary Care ◽  
Liver Fibrosis ◽  
Blood Analysis ◽  
Public Health Issue ◽  
Systematic Calculation ◽  
The Public ◽  
For Profit ◽  
Primary Care Population ◽  
Non Invasive ◽  
Routine Blood

AbstractBackground & AimLiver fibrosis screening in primary care population is a major public health issue. The FIB-4 index is a simple non-invasive fibrosis test combining age, transaminases, platelets count, developed for the diagnosis of advanced fibrosis. The aim of our study was to evaluate the interest of liver fibrosis screening using systematic calculation of FIB-4 in routine blood analysis.MethodsBetween December 2018 and May 2019, we conducted a prospective screening of liver fibrosis in 134 158 patients during a medical check-up including routine blood analysis. Among these patients, 29 707 had transaminases and platelets counts available and benefited from an automatic calculation of FIB-4. Results were obtained from 21 French clinical laboratories in the Bouches du Rhône region.ResultsAmong the 29 707 patients, 2160 (7.3%) had significant fibrosis (FIB-4>2.67). Individual investigation of patients with FIB-4>2.67 allowed to screen 1267 (1267/2160: 59%) patients who were not managed for any liver disease.ConclusionsThis work demonstrates the interest of FIB-4 for the screening of liver fibrosis in primary care population. Our study strongly supports this easy-to-implement strategy using a simple Fib-4 measure resulting from the use of available routine test results.FundingThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.Clinical Registering NumberMR-0314071019 (INDS: French National Institute for Medical Data)

scholarly journals Prospective screening of liver fibrosis in a primary care cohort using systematic calculation of fib-4 in routine results

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254939
Author(s):  
Philippe Halfon ◽  
Christelle Ansaldi ◽  
Guillaume Penaranda ◽  
Laurent Chiche ◽  
Patrick Dukan ◽  
...  
Keyword(s):  
Primary Care ◽  
Liver Fibrosis ◽  
Daily Practice ◽  
Blood Analysis ◽  
Public Health Issue ◽  
Advanced Fibrosis ◽  
Systematic Calculation ◽  
Primary Care Population ◽  
Non Invasive ◽  
Routine Blood

Background & aim Liver fibrosis screening in primary care population is a major public health issue. The FIB-4 index is a simple non-invasive fibrosis test combining age, transaminases, platelets count, developed for the diagnosis of advanced fibrosis. The aim of our study was to evaluate the interest of liver fibrosis screening using systematic calculation of FIB-4 in routine blood analysis. Methods Between December 2018 and May 2019, we conducted a prospective screening of liver fibrosis in 134 158 patients during a medical check-up including routine blood analysis. Among these patients, 29 707 had transaminases and platelets counts available and benefited from an automatic calculation of FIB-4. Results were obtained from 21 French clinical laboratories in the Bouches du Rhône region. Results Among the 29 707 patients, 2161 (7.3%) had a high risk of advanced fibrosis (FIB-4>2.67). Individual investigation of patients with FIB-4>2.67 allowed to screen 1268 (1268/2161: 58.7%) patients who were not managed for any liver disease. Conclusions This work demonstrates the interest of FIB-4 for the screening of liver fibrosis in primary care population. Although additional clinical validation study is required to determine the utility and applicability of Fib-4 to daily practice, our study strongly supports this easy-to-implement strategy using a simple Fib-4 measure resulting from the use of available routine test results.

scholarly journals The Presence of Diabetes Impacts Liver Fibrosis and Steatosis by Transient Elastography in a Primary Care Population

2021 ◽  
pp. 100336
Author(s):  
Hirsh D. Trivedi ◽  
Jaspreet Suri ◽  
Daheun Oh ◽  
Jeffrey Schwartz ◽  
Daniela Goyes ◽  
...  
Keyword(s):  
Primary Care ◽  
Liver Fibrosis ◽  
Transient Elastography ◽  
Primary Care Population

scholarly journals Integrating Egyptian mental health services into primary care: the policy maker's perspective

2010 ◽  
Vol 7 (1) ◽  
pp. 5-6 ◽  
Author(s):  
Nasser Loza
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Services ◽  
Service Provision ◽  
Service Providers ◽  
Psychiatric Nurses ◽  
The Public ◽  
For Profit ◽  
Not For Profit ◽  
Psychiatric Beds

Egypt has a population of roughly 80 million, served by about 9000 psychiatric beds, 1000 psychiatrists (one psychiatrist per 80 000 citizens), 1900 psychiatric nurses and about 200 clinical psychologists (Okasha, 2004). Service providers fall into three main sectors: public, private, and not-for-profit non-governmental organisations (NGOs). The public sector is managed essentially by the Ministry of Health and bears the brunt of service provision.

scholarly journals The Combination of Shear Wave Elastography and Elf Test in a Single Score Improves the Diagnostic Specificity for Liver Fibrosis Prediction

2021 ◽  
Author(s):  
Raffaele Liuzzi ◽  
Monica Ragucci ◽  
Peppino Mirabelli ◽  
Angelo Megna ◽  
Massimo De Luca ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Roc Analysis ◽  
Shear Wave Elastography ◽  
Normal Subjects ◽  
Public Health Issue ◽  
Diagnostic Specificity ◽  
Non Invasive ◽  
Disease Staging ◽  
Single Score

Abstract Background. Chronic liver diseases (CHDs) are an important public health issue. The presence of significant fibrosis is a hallmark for liver disease staging and prognosis. Aims. To develop a non-invasive score that can discriminate between patients with or without fibrosis in the aim to avoid liver biopsy.Methods. Forty patients with CHDs who received liver biopsy to stage fibrosis and 12 normal subjects performed also share wave elastography (SWE) and ELF-test. We chose two different outcome for histological fibrosis (F0-F1 vs F2-F4) and (F0-F2 vs F3-F4). ELF-test and SWE were independent predictors, categorized using ROC analysis. Two scores called SCORE1 and SCORE2 were devised.Results. The discriminatory values for SCORE1 were SWE>5.62 kPa and ELF-test >9.33 and for SCORE2 were SWE>7.04 kPa and ELF-test 9.33. SCORE1 specificity was 91.7% (CI 77.5-98.2%), significatively greater than obtained using SWE 63.9% (CI 46.2-79.2%; p=0.0013) or ELF-test 83.3% (CI 67.2-93.6%; p=0.1760) separately. SCORE2 specificity was 95.2% (CI 83.8-99.4%). This value was not-significatively greater than obtained using SWE or ELF-test 81.0% (CI 65.9-91.4%; p=0.0921) separately. Conclusion. SWE and ELF-test can be performed for non-invasive staging of liver fibrosis. Their use grouped in a single score increase the specificity for the prediction of histological fibrosis stage.

Hospitals: N.Y. Appellate Court Denies Move to Privatize Public Hospital

1999 ◽  
Vol 27 (2) ◽  
pp. 202-203
Author(s):  
Robert Chatham
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Public Health System ◽  
Municipal Hospital ◽  
The Public ◽  
Public Benefit ◽  
For Profit ◽  
Benefit Corporation ◽  
The City

The Court of Appeals of New York held, in Council of the City of New York u. Giuliani, slip op. 02634, 1999 WL 179257 (N.Y. Mar. 30, 1999), that New York City may not privatize a public city hospital without state statutory authorization. The court found invalid a sublease of a municipal hospital operated by a public benefit corporation to a private, for-profit entity. The court reasoned that the controlling statute prescribed the operation of a municipal hospital as a government function that must be fulfilled by the public benefit corporation as long as it exists, and nothing short of legislative action could put an end to the corporation's existence.In 1969, the New York State legislature enacted the Health and Hospitals Corporation Act (HHCA), establishing the New York City Health and Hospitals Corporation (HHC) as an attempt to improve the New York City public health system. Thirty years later, on a renewed perception that the public health system was once again lacking, the city administration approved a sublease of Coney Island Hospital from HHC to PHS New York, Inc. (PHS), a private, for-profit entity.

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