scholarly journals BAR, SOFT AND DRI POST-HEPATIC TRANSPLANTATION: WHAT IS THE BEST FOR SURVIVAL ANALYSIS?

Author(s):  
Fernando TORTEROLLI ◽  
Rafael Katsunori WATANABE ◽  
Fernando Issamu TABUSHI ◽  
Igor Luna PEIXOTO ◽  
Paulo Afonso Nunes NASSIF ◽  
...  

ABSTRACT Background: Liver transplantation is the treatment of choice for patients with terminal liver disease. The Balance of Risk Score (BAR), Survival Outcomes Following Liver Transplantation (SOFT) and Donor Risk Index (DRI) scores are predictive systems for post-transplant survival. Aim: To evaluate the most accurate score and the best cutoff point for each predictor in the brazilian population. Method: Retrospective cross-sectional study of 177 patients. Data on the recipient, donor and transplant were analyzed and the prognostic scores BAR, SOFT and DRI were calculated for each transplant. To determine the BAR and SOFT cutoff points associated with death in three months, ROC curves were adjusted. Results: The best cutoff point for BAR was 9 points with an area under the ROC curve=0.69 and for SOFT it was 12 points with an area under the ROC curve=0.73. The DRI score did not discriminate survival (p = 0.139). Conclusion: The SOFT score proved to be better than BAR for survival analysis post-hepatic transplantation and the DRI was not effective.

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 949
Author(s):  
Cecil J. Weale ◽  
Don M. Matshazi ◽  
Saarah F. G. Davids ◽  
Shanel Raghubeer ◽  
Rajiv T. Erasmus ◽  
...  

This cross-sectional study investigated the association of miR-1299, -126-3p and -30e-3p with and their diagnostic capability for dysglycaemia in 1273 (men, n = 345) South Africans, aged >20 years. Glycaemic status was assessed by oral glucose tolerance test (OGTT). Whole blood microRNA (miRNA) expressions were assessed using TaqMan-based reverse transcription quantitative-PCR (RT-qPCR). Receiver operating characteristic (ROC) curves assessed the ability of each miRNA to discriminate dysglycaemia, while multivariable logistic regression analyses linked expression with dysglycaemia. In all, 207 (16.2%) and 94 (7.4%) participants had prediabetes and type 2 diabetes mellitus (T2DM), respectively. All three miRNAs were significantly highly expressed in individuals with prediabetes compared to normotolerant patients, p < 0.001. miR-30e-3p and miR-126-3p were also significantly more expressed in T2DM versus normotolerant patients, p < 0.001. In multivariable logistic regressions, the three miRNAs were consistently and continuously associated with prediabetes, while only miR-126-3p was associated with T2DM. The ROC analysis indicated all three miRNAs had a significant overall predictive ability to diagnose prediabetes, diabetes and the combination of both (dysglycaemia), with the area under the receiver operating characteristic curve (AUC) being significantly higher for miR-126-3p in prediabetes. For prediabetes diagnosis, miR-126-3p (AUC = 0.760) outperformed HbA1c (AUC = 0.695), p = 0.042. These results suggest that miR-1299, -126-3p and -30e-3p are associated with prediabetes, and measuring miR-126-3p could potentially contribute to diabetes risk screening strategies.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jéssika M Siqueira ◽  
Jéssika D P Soares ◽  
Thaís C Borges ◽  
Tatyanne L N Gomes ◽  
Gustavo D Pimentel

AbstractCancer patients possess metabolic and pathophysiological changes and an inflammatory environment that leads to malnutrition. This study aimed to (i) determine whether there is an association between neutrophil-to-lymphocyte ratio (NLR) and nutritional risk, and (ii) identify the cut-off value of NLR that best predicts malnutrition by screening for nutritional risk (NRS 2002). This cross-sectional study included 119 patients with unselected cancer undergoing chemotherapy and/or surgery. The NRS 2002 was applied within 24 h of hospitalisation to determine the nutritional risk. Systemic inflammation was assessed by blood collection, and data on C-reactive protein (CRP), neutrophils, and lymphocytes were collected for later calculation of NLR. A receiver operating characteristic (ROC) curve was used to identify the best cut-point for NLR value that predicted nutritional risk. Differences between the groups were tested using the Student’s t-, Mann–Whitney U and Chi-Square tests. Logistic regression analyses were performed to assess the association between NLR and nutritional risk. The ROC curve showed the best cut-point for predicting nutritional risk was NLR > 5.0 (sensitivity, 60.9%; specificity, 76.4%). The NLR ≥ 5.0 group had a higher prevalence of nutritional risk than the NLR < 5.0 group (NLR ≥ 5.0: 73.6% vs. NLR < 5.0: 37.9%, p = 0.001). The NLR group ≥ 5.0 showed higher values of CRP and NLR than the NLR < 5.0 group. In addition, patients with NLR ≥ 5.0 also had higher NRS 2002 values when compared to the NLR < 5.0 group (NLR ≥ 5.0: 3.0 ± 1.1 vs. NLR < 5.0: 2.3 ± 1.2, p = 0.0004). Logistic regression revealed an association between NRS and NLR values. In hospitalised unselected cancer patients, systemic inflammation measured by NLR was associated with nutritional risk. Therefore, we highlight the importance of measuring the NLR in clinical practice, with the aim to detect nutritional risk.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ning An ◽  
Ji Sheng Lin ◽  
Qi Fei

Abstract Background To compare the validation of four tools for identifying painful new osteoporotic vertebral compression fractures (PNOVCFs) in older Chinese men: bone mineral density (BMD), Asian osteoporosis self-assessment tool (OSTA), World Health Organization fracture risk assessment tool (FRAX) (without BMD) and Beijing Friendship Hospital Osteoporosis Self-Assessment Tool (BFH-OSTM). Methods A cross sectional study was conducted from 2013 to 2019. A total of 846 men aged ≥50 were included and were divided into two groups: Fracture Group (patients with PNOVCFs underwent percutaneous vertebroplasty surgery) and Non-Fracture Group (community dwelled subjects for healthy examination). All subjects accepted a dual-energy X-ray BMD test and a structured questionnaire. The results of BMD, OSTA, FRAX and BFH-OSTM scores were assessed and receiver-operating characteristic (ROC) curves were generated to compare the validity of four tools for identifying PNOVCFs. Optimal cutoff points, sensitivity, specificity, and areas under the ROC curves (AUCs) were determined. Results There were significant differences including BMD T score (femoral neck, total hip and L1-L4), OSTA, FRAX and BFH-OSTM scores between Fracture group and Non-fracture group. Compared to BMD and OSTA, BFH-OSTM and FRAX had better predictive value, the sensitivity, specificity and AUC value are 0.841, 81.29%, 70.67% and 0.796, 74.85%, 78.52%, respectively. Compared with FRAX, the BFH-OSTM has a better AUC value. Conclusions Both BFH-OSTM and FRAX can be used to identify POVCFs, However, BFH-OSTM model may be a more simple and effective tool to identify the risk of POVCFs in Chinese elderly men.


2014 ◽  
Vol 17 (1) ◽  
pp. 243-254 ◽  
Author(s):  
Edineia Aparecida Gomes Ribeiro ◽  
Danielle Biazzi Leal ◽  
Maria Alice Altenburg de Assis

PURPOSE: To evaluate the accuracy of the body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) in detecting excess body fat among schoolchildren in Florianópolis, Santa Catarina. METHODS: Cross-sectional study with 2,772 schoolchildren aged seven to ten years. Receiver Operating Characteristic (ROC) curves were used to compare the diagnostic accuracy of the BMI, the WC and the WHtR in identifying children with excess body fat (defined as values that were equal to or higher than the 90th percentile of the standardized residuals obtained from the sum of the four skinfolds thickness). Likelihood ratio estimates were used to select, for each anthropometric index, the cut-off points that presented the highest association with excess body fat. RESULTS: The BMI, WC and WHtR performed well in detecting excess body fat, indicated by areas under the ROC curve (AUC) close to 1.0, with slightly higher AUC for the BMI in comparison to the WC and the WHtR concerning both sexes. Highly sensitive and specific cut-off points were derived for the three anthropometric indices. Sensitivity ranged from 85.7 to 92.9% for the BMI, from 78.6 to 89.7% for the WC, and from 78.6 to 89.2% for the WHtR. Specificity ranged from 83.2 to 91.4%, from 75.0 to 90.7%, and from 77.4 to 88.3% for the BMI, the WC and the WHtR, respectively. CONCLUSION: BMI, WC and WHtR can be used as diagnostic tests to identify excess body fat in children from seven to ten years of age.


2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Vanessa Silveira Faria ◽  
Ligia Neres Matos ◽  
Liana Amorim Correa Trotte ◽  
Helena Cramer Veiga Rey ◽  
Tereza Cristina Felippe Guimarães

ABSTRACT Objective: to verify the association between the prognostic scores and the quality of life of candidates for heart transplantation. Method: a descriptive cross-sectional study with a convenience sample of 32 outpatients applying to heart transplantation. The prognosis was rated by the Heart Failure Survival Score (HFSS) and the Seattle Heart Failure Model (SHFM); and the quality of life by the Minnesota Living With Heart Failure Questionnaire (MLHFQ) and the Kansas City Cardiomyopathy Questionnaire (KCCQ). The Pearson correlation test was applied. Results: the correlations found between general quality of life scores and prognostic scores were (HFSS/MLHFQ r = 0.21), (SHFM/MLHFQ r = 0.09), (HFSS/KCCQ r = -0.02), (SHFM/KCCQ r = -0.20). Conclusion: the weak correlation between the prognostic and quality of life scores suggests a lack of association between the measures, i.e., worse prognosis does not mean worse quality of life and the same statement is true in the opposite direction.


2018 ◽  
Author(s):  
Joelma Carvalho Santos ◽  
Andrea Dória Batista ◽  
Carla Maria Mola Vasconcelos ◽  
Roberto Souza Lemos ◽  
Valter Romão de Souza ◽  
...  

AbstractBackgroundARFI elastrography has been used as a noninvasive method to assess the severity of liver fibrosis in viral hepatitis, although with few studies in schistosomiasis mansoni. We aimed to evaluate the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point.Methodology/Principal findingsThis cross-sectional study included 358 adult schistosomotic patients subjected to US and pSWE on the right lobe. Two hundred two patients (62.0%) were women, with a median age of 54 (ranging 18-92) years. The pSWE measurements were compared to the US patterns of PPF, as gold standard, according to the Niamey classification. The performance of pSWE was calculated as the area under the ROC curve (AUC). Patients were further classified into two groups: 86 patients with mild PPF and 272 patients with significant PPF. The median pSWE of the significant fibrosis group was higher (1.40 m/s) than that of mild fibrosis group (1.14 m/s, p<0.001). AUC was 0.719 with ≤1.11 m/s as the best cutoff value for excluding significant PPF. Sensitivity and negative predictive values were 80.5% and 40.5%, respectively. Whereas, for confirming significant PPF, the best cutoff value was >1.39 m/s, with specificity of 86.1% and positive predictive value of 92.0%.Conclusions/SignificancepSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF.Author summaryIn the developing world, over 207 million people are infected with parasitic Schistosoma worms. Among the species of Schistosoma that infect humans Schistosoma mansoni is one of the most common causes of illness. Here, we investigated the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point. We examined 358 people from northeast of Brazil for Schistosoma infections. The present study showed that pSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF.


Author(s):  
Masood Dehghani

Introduction: The only option for treatment of end stage liver diseases is liver transplantation. Afzalipour Hospital in Kerman, Iran is the third largest liver transplantation center in Iran. In this study, the outcomes of this center have been studied during the past 5 years. Methods: In this cross-sectional study, the pre and post transplantation’s clinical, demographic and outcome data of all patients who received liver transplant at Afzalipour Hospital during the past 5 years have been collected and reviewed. SPSS software ver. 16 was used to analyze the data. Results: Forty-three patients have received liver transplantation during this time interval. The 3-year survival rate of patients was 77%. The most common cause of death was primary nonfunction graft after transplantation. The most common complication was acute rejection (15%), all of which were successfully treated with corticosteroids. Conclusion:  Due to increment of cases of acute and chronic liver failure in the community and since the final treatment of these cases is liver transplantation, so there is need to develop liver transplant centers in the future. Quantitative and qualitative study of the activity of centers based liver transplant in Iran is necessary to set up successful centers.


2020 ◽  
Vol 27 (3) ◽  
Author(s):  
Daiane Roncato Cardozo ◽  
Sinara Laurini Rossato ◽  
Maria Rita Marques de Oliveira ◽  
Vera Mariza Henriques de Miranda Costa ◽  
Luiz Manoel de Moraes Camargo Almeida ◽  
...  

Abstract: The objective was to analyze the predictive power of indicators of the perception of food and nutritional insecurity comparing beneficiary and non - beneficiary families of the Bolsa Família Program, through a cross - sectional study with 150 families. Demographic, socioeconomic, food insecurity (Brazilian Food Insecurity Scale), nutritional status (Body Mass Index) and household consumption patterns were collected. The correlation between the demographic, socioeconomic, nutritional status and level of food insecurity were tested using the Pearson correlation coefficient; the association with Chi-square and ANOVA tests; and the prevalence ratio and 95% confidence intervals with Poisson Regression model. The predictive power of indicators of food insecurity was evaluated with the ROC curve. Patterns of food consumption, demographic and health characteristics were not significantly correlated with food insecurity. In the analyzes with the ROC curve, among the beneficiary families, the income derived only from the Bolsa Família and the Renda Cidadã Program with the Bolsa Família presented a better predictive power of food insecurity, covering the curve by 70%, followed by the difference between the income from wages and rent and gas (70%). The proportions of the total income of families spent on rent and gas had low predictive power (67%). Income components, mainly rent and gas spending, showed a better performance in the prediction of food insecurity among beneficiaries of Bolsa Família, and could be a complementary quantitative indicator to the Brazilian Scale of Food Insecurity.


2009 ◽  
Vol 13 (4) ◽  
pp. 488-495 ◽  
Author(s):  
Ahmet Selçuk Can ◽  
Emine Akal Yıldız ◽  
Gülhan Samur ◽  
Neslişah Rakıcıoğlu ◽  
Gülden Pekcan ◽  
...  

AbstractObjectiveTo identify the optimal waist:height ratio (WHtR) cut-off point that discriminates cardiometabolic risk factors in Turkish adults.DesignCross-sectional study. Hypertension, dyslipidaemia, diabetes, metabolic syndrome score ≥2 (presence of two or more metabolic syndrome components except for waist circumference) and at least one risk factor (diabetes, hypertension or dyslipidaemia) were categorical outcome variables. Receiver-operating characteristic (ROC) curves were prepared by plotting 1 − specificity on the x-axis and sensitivity on the y-axis. The WHtR value that had the highest Youden index was selected as the optimal cut-off point for each cardiometabolic risk factor (Youden index = sensitivity + specificity − 1).SettingTurkey, 2003.SubjectsAdults (1121 women and 571 men) aged 18 years and over were examined.ResultsAnalysis of ROC coordinate tables showed that the optimal cut-off value ranged between 0·55 and 0·60 and was almost equal between men and women. The sensitivities of the identified cut-offs were between 0·63 and 0·81, the specificities were between 0·42 and 0·71 and the accuracies were between 0·65 and 0·73, for men and women. The cut-off point of 0·59 was the most frequently identified value for discrimination of the studied cardiometabolic risk factors. Subjects classified as having WHtR ≥ 0·59 had significantly higher age and sociodemographic multivariable-adjusted odds ratios for cardiometabolic risk factors than subjects with WHtR < 0·59, except for diabetes in men.ConclusionsWe show that the optimal WHtR cut-off point to discriminate cardiometabolic risk factors is 0·59 in Turkish adults.


2021 ◽  
Author(s):  
Naoya Fujita ◽  
Yosuke Ono ◽  
Azusa Sano ◽  
Motohiro Kimata ◽  
Seigo Oyama ◽  
...  

Objective: Conventional diagnostic methods are limited in their ability to differentiate destructive thyroiditis from Graves’ disease. We hypothesised that serum diiodotyrosine (DIT) and monoiodotyrosine (MIT) levels could be biomarkers for differentiating destructive thyroiditis from Graves’ disease. Design: Patients with destructive thyroiditis (n = 13) and Graves’ disease (n = 22) were enrolled in this cross-sectional study. Methods: We assayed the serum DIT and MIT levels using liquid chromatography-tandem mass spectrometry. A receiver operating characteristic (ROC) curve analysis was used to determine the sensitivity and specificity of the serum DIT and MIT levels as biomarkers for differentiating destructive thyroiditis from Graves’ disease. Results: The serum DIT and MIT levels were significantly higher in patients with destructive thyroiditis than in those with Graves’ disease. The ROC curve analysis showed that the serum DIT levels (≥ 359.9 pg/mL) differentiated destructive thyroiditis from Graves’ disease, significantly, with 100.0% sensitivity and 95.5% specificity (P < .001). The diagnostic accuracy of the serum MIT levels (≥119.4 pg/mL) was not as high as that of the serum DIT levels (sensitivity, 84.6%; specificity, 77.3%; P = .001). Conclusions: The serum DIT levels may serve as a novel diagnostic biomarker for differentiating destructive thyroiditis from Graves’ disease.


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