Clinics最新文献

{"title":"Improvement of motor function in mice after implantation of mononuclear stem cells from human umbilical cord and placenta blood after 3 and 6 weeks of experimental spinal cord injury.","authors":"Thiego Pedro Freitas Araujo, Alexandre Fogaça Cristante, Raphael Martus Marcon, Gustavo Bispo Dos Santos, Maria Helena Alves Nicola, Alex Oliveira de Araujo, Fernando Barbosa Sanchez, Tarcísio Eloy Pessoa de Barros Filho","doi":"10.1016/j.clinsp.2024.100509","DOIUrl":"10.1016/j.clinsp.2024.100509","url":null,"abstract":"<p><strong>Study design: </strong>Experimental study utilizing with a standardized model (MASCIS Impactor) of Spinal Cord Injury (SCI) in Balb C mouse model with implantation of mononuclear stem cells derived from the human umbilical cord and placenta blood in the early chronic phase of SCI.</p><p><strong>Objectives: </strong>The aim of this study was to evaluate the nerve regeneration and motor functional recovery in Balb C mice with surgically induced paraplegia in response to the use of mononuclear stem cells, in early chronic phase (> 2 weeks and < 6 months), because there is yet potential of neuronal and functional recovery as the neuronal scar is not still completely established.</p><p><strong>Methods: </strong>Forty-eight mice were randomly assigned to 6 groups of 8 animals. Group 1 received the stem cells 3 weeks after the trauma, and Group 2 received them six weeks later. In Group 3, saline solution was injected at the site of the lesion 3 weeks after the trauma, and in Group 4, 6 weeks later. Group 5 underwent only spinal cord injury and Group 6 underwent laminectomy only. The scales used for motor assessment were BMS and MFS for 12 weeks.</p><p><strong>Results: </strong>The intervention groups showed statistically significant motor improvement. In the histopathological analysis, the intervention groups had a lower degree of injury (p < 0.05). Regarding axonal budding, the intervention groups showed increasing in axonal budding in the caudal portion (p < 0.05).</p><p><strong>Conclusions: </strong>The use of stem cells in mice in the chronic phase after 3 and 6 weeks of SCI brings functional and histopathological benefits to them.</p>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"100509"},"PeriodicalIF":2.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum progesterone measurement on the day of fresh embryo transfer and its correlation with pregnancy success rates: A prospective analysis.","authors":"Carla Maria Franco Dias, Suelen Maria Parizotto Furlan, Rui Alberto Ferriani, Paula Andrea de Albuquerque Salles Navarro","doi":"10.1016/j.clinsp.2024.100511","DOIUrl":"10.1016/j.clinsp.2024.100511","url":null,"abstract":"<p><p>Studies regarding serum Progesterone (P4) concentration and Clinical Pregnancy Rates (CPR) in fresh Embryo Transfer (ET) after Controlled Ovarian Stimulation Cycles (COS) remain inconclusive. To find a P4 cutoff point on fresh ET day associated with higher CPR, and to identify predictive factors of CPR and P4, the authors conducted a prospective cohort of 106 patients who underwent COS at a public IVF center. The luteal phase was supported with vaginal micronized progesterone (200 mg, 8/8h), beginning on oocyte retrieval day. The primary outcome was CPR beyond the 8^th week of pregnancy. A ROC curve was constructed to identify the best cutoff point correlated with higher CPR. Multivariate analysis evaluated predictive variables of CPR and P4 concentration. P4 levels showed no significant differences between pregnant and non-pregnant patients (67.12 ± 31.1 ng/mL vs. 64.17 ± 61.76, p = 0.7465). The cutoff point correlated with higher CPR was P4 ≥ 28.9 ng/mL (AUC 0.5654). Women's age (OR = 0.878; 95 % CI 0.774-0.995) and top-quality embryo transfer (OR = 2.89; 95 % CI 1.148-7.316) were associated with CPR. Women's age ≥ 40 years (OR = 0.0956; 95 % CI 0.0156-0.5851), poor response to COS (OR = 0.0964; 95 % CI 0.0155-0.5966), and follicles ≥ 10 mm (OR = 1.465; 95 % CI 1.013-2.117) were associated with the cutoff point. As the ROC curve was unsatisfactory, P4 ≥ 28.9 ng/mL should not be used to infer gestational success. In fresh ET, P4 concentration may merely reflect a woman's age and individual response to COS rather than being a reliable CPR predictor.</p>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"100511"},"PeriodicalIF":2.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of HepatIA: A computed tomography annotation platform and database for artificial intelligence training in hepatocellular carcinoma detection at a Brazilian tertiary teaching hospital.","authors":"Bruno Aragão Rocha, Lorena Carneiro Ferreira, Luis Gustavo Rocha Vianna, Ana Claudia Martins Ciconelle, João Martins Cortez Filho, Lucas Salume Lima Nogueira, Maurício Ricardo Moreira da Silva Filho, Claudia da Costa Leite, Cesar Higar Nomura, Giovanni Guido Cerri, Flair José Carrilho, Suzane Kioko Ono","doi":"10.1016/j.clinsp.2024.100512","DOIUrl":"10.1016/j.clinsp.2024.100512","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is a prevalent tumor with high mortality rates. Computed tomography (CT) is crucial in the non-invasive diagnosis of HCC. Recent advancements in artificial intelligence (AI) have shown significant potential in medical imaging analysis. However, developing these AI algorithms is hindered by the scarcity of comprehensive, publicly available liver imaging datasets.</p><p><strong>Objectives: </strong>This study aims to detail the tools, data organization, and database structuring used in creating HepatIA, a medical imaging annotation platform and database at a Brazilian tertiary teaching hospital. HepatIA supports liver disease AI research at the institution.</p><p><strong>Material and methods: </strong>The authors collected baseline characteristics and CT scans of 656 patients from 2008 to 2021. The database, designed using PostgreSQL and implemented with Django and Vue.js, includes 692 CT volumes from a four-phase abdominal CT protocol. Radiologists made segmentation annotations using the OHIF medical image viewer, incorporating MONAI Label for pre-annotation segmentation models. The annotation process included detailed descriptions of liver morphology and nodule characteristics.</p><p><strong>Results: </strong>The HepatIA database currently includes healthy individuals and those with liver diseases such as HCC and cirrhosis. The database dashboard facilitates user interaction with intuitive plots and histograms. Key patient demographics include 64% males and an average age of 56.89 years. The database supports various filters for detailed searches, enhancing research capabilities.</p><p><strong>Conclusion: </strong>A comprehensive data structure was successfully created and integrated with the IT systems of a teaching hospital, enabling research on deep learning algorithms applied to abdominal CT scans for investigating hepatic lesions such as HCC.</p>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"100512"},"PeriodicalIF":2.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11497422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revision knee arthroplasty using a modular system manufactured in Brazil. Clinical and radiographic results with a mean nine-year follow-up.","authors":"Francisco Fontes Cintra, Mauricio Etchebehere, Eduardo Rached, Giancarlo Cavenaghi, Paulo Eduardo Dias Rahal, Rodrigo Gonçalves Pagnano","doi":"10.1016/j.clinsp.2024.100508","DOIUrl":"10.1016/j.clinsp.2024.100508","url":null,"abstract":"<p><strong>Objective: </strong>To demonstrate the clinical and radiographic results of revision knee arthroplasty using a modular system manufactured in Brazil.</p><p><strong>Methods: </strong>Between November 2010 and January 2017, 31 revision knee arthroplasties were performed in 30 patients, using the MB-V system. Patients were assessed clinically and radiographically after a minimum follow-up of two years using the following scores: Knee Society Score (KSS), Knee Society Score ‒ Function (KSS ‒ Function), and Knee Society Roentgenographic Evaluation System (KSRES).</p><p><strong>Results: </strong>Among the patients, 19 were women. The mean age at surgery was 68 years. The mean follow-up was 9.1 years. There was no aseptic loosening in this period. The mean values of KSS, KSS-function, and KSRES were, respectively, 82, 77, and less than 4. One patient evolved with postoperative flexion instability. Two knees became infected, requiring the removal of the prosthesis and implantation of spacers loaded with antibiotics. One patient developed arthrofibrosis. One patient had a dislocation with full medial collateral avulsion and had to be re-operated with an insert exchange to a CCK liner and medial collateral reconstruction as proposed by Krakow.</p><p><strong>Conclusion: </strong>This implant had 93.5 % survivorship (no cases of aseptic failure) and good results in 27 out of 31 knees (87 % of the surgeries).</p>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"100508"},"PeriodicalIF":2.2,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IMP3, CDK4, MDM2 and β-catenin expression in Enchondroma and Central Chondrosarcoma: Diagnostic and prognostic utility.","authors":"Daniele Moraes Losada, Maurício Etchebehere, Francisco Fontes Cintra, Eliane Maria Ingrid Amstalden","doi":"10.1016/j.clinsp.2024.100483","DOIUrl":"10.1016/j.clinsp.2024.100483","url":null,"abstract":"<p><strong>Introduction: </strong>The role of IMP3, CDK4, MDM2 and β-catenin proteins in Enchondroma and Central Chondrosarcoma is not totally understood. The aim of this study is to evaluate the immunoexpression of these proteins, associating histological grade, clinical data and prognosis to these tumors.</p><p><strong>Methods: </strong>This is a retrospective-analytical study of 32 Enchondroma and 70 Central Chondrosarcoma.</p><p><strong>Results: </strong>IMP3, CDK4, MDM2 and β-catenin expression was observed in 22.82 %, 13.82 %, 17.17 % and in 8.8 % of cases, respectively. All Enchondromas positive for these immunomarkers were located in short tubular bones. The positivity for these antibodies is directly proportional to Chondrosarcoma's histological grade increase. No difference was found between Enchondroma and Chondrosarcoma, Grade 1 for IMP3, CDK4 and ß-catenin positivity. Significant metastasis outcome was observed for IMP3, CDK4, MDM2 and death for MDM2 expression.</p><p><strong>Conclusion: </strong>IMP3, CDK4, MDM2 and β-catenin expression in Enchondromas of short bones phenotypically characterizes these tumors. Their expression has not proven to be useful either as diagnostic markers of these neoplasms or in distinguishing between Enchondroma and Chondrosarcoma, Grade 1. The significant immunoexpression of IMP3, CDK4 and MDM2 in metastatic Chondrosarcoma and the lower survival in those with positivity for MDM2 suggest a possible association of these proteins with tumor aggressiveness.</p>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"100483"},"PeriodicalIF":2.2,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11490761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic characteristics and clinical-radiological correlation in patients with indications for Total Knee Arthroplasty: A cross-sectional study.","authors":"Diego Ubrig Munhoz, Andre Giardino Moreira da Silva, Pedro Nogueira Giglio, Camilo Partezani Helito, Riccardo Gomes Gobbi, Luís Eduardo Passarelli Tirico","doi":"10.1016/j.clinsp.2024.100503","DOIUrl":"10.1016/j.clinsp.2024.100503","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to correlate clinical symptoms and functionality, using the KOOS (Knee Injury and Osteoarthritis Outcome Score) and KSS (Knee Society Score System) scores, with the radiographic changes, using the Kellgren-Lawrence classification, in patients with knee osteoarthritis and indications for Total Knee Arthroplasty (TKA).</p><p><strong>Methods: </strong>120 patients (189 knees) with gonarthrosis and indications for TKA were included in the study. Demographic questionnaires were applied, and clinical and functional assessment was carried out using the KOOS and KSS scores. Knee radiographs were taken and graded according to Kellgren-Lawrence. The clinical scores were compared with the radiographic classification to establish a correlation between these two measurements. Statistical analysis was performed using the τ-Kendall correlation test.</p><p><strong>Results: </strong>Weak and inversely proportional correlations were found between the clinical scores and the radiographic classification. Among clinical scores evaluated, KSS showed the highest correlation with Kellgren-Lawrence classification (τ = -0.356; p < 0.001), followed by KOOS-quality of life (τ = -0.176; p = 0.004), KOOS-total score (τ = -0.166; p = 0.004), KOOS-function in daily living (τ = -0.160; p = 0.005) and KOOS-symptoms (τ = -0.159; p = 0.006). KOOS-pain (τ = -0.149; p = 0.01) and KOOS-sport and recreation function (τ = -0.142; p = 0.025) scores had the weakest correlations.</p><p><strong>Conclusion: </strong>There is a weak correlation between the clinical-functional scores of TKA candidates and their radiographic classification by Kellgren-Lawrence. Among clinical scores evaluated, KSS had the strongest negative correlation with the radiographic classification.</p>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"100503"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative changes of surgical approach and a second surgery after percutaneous endoscopic surgery for lumbar spinal stenosis.","authors":"LianSong Lu, ZhenShan Yuan, HaoJie Li, ShaoHua Sun","doi":"10.1016/j.clinsp.2024.100498","DOIUrl":"10.1016/j.clinsp.2024.100498","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the reasons for a second surgery after Percutaneous Endoscopic Surgery (PES) for lumbar spinal stenosis and to provide references for the choice of indications and appropriate surgical approach.</p><p><strong>Method: </strong>A total of 426 patients received PES for lumbar spinal stenosis. The postoperative, intraoperative, and postoperative data of the subjects were analyzed. The reasons for intraoperative difficulties, poor outcomes after surgery, and a second surgery were analyzed.</p><p><strong>Result: </strong>The surgical approach was changed in four out of 426 patients (0.94 %) during surgery, and 6 patients (1.4 %) received a second surgery; 3 out of 4 patients were intraoperatively shifted to PIED using the Delta endoscope, and 1 shifted to ordinary PIED. The reasons for the intraoperative change of surgical approach included severe hyperplasia and obscure anatomic structure in 3 patients and a dural sac tear with neural outflow in 1 patient. The reasons for a second surgery in 19 patients were as follows: nerve entrapment by bone fragments in 1 patient; nerve injury in 3 patients; lumbar instability in 3 patients; untreated or residual Lumbar Intervertebral Disc Herniation (LIDH) in 4 patients; recurrent LIDH in 1 patient; and inadequate decompression in 7 patients.</p><p><strong>Conclusion: </strong>Severe hyperplasia, obscure anatomic structure, lumbar instability, and nerve injury are the common reasons for a second surgery after PES for lumbar spinal stenosis. Appropriate indications and surgical approaches can be chosen based on the patient's situations and technical conditions.</p>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"100498"},"PeriodicalIF":2.2,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of body composition by dual-energy X-Ray absorptiometry in renal transplant patients, hemodialysis patients, and a control group of healthy subjects.","authors":"Martha Jocelyne Piñon-Ruiz, Maria-Raquel Huerta-Franco, Francisco-Miguel Vargas-Luna, Evelia Apolinar-Jimenez, Joel Máximo Soel Encalada","doi":"10.1016/j.clinsp.2024.100505","DOIUrl":"10.1016/j.clinsp.2024.100505","url":null,"abstract":"<p><strong>Background: </strong>The clinical findings of patients with Chronic Kidney Disease (CKD), which is characterized by malnutrition, sedentary lifestyle, uremia, and catabolism associated with dialysis produce changes in Body Composition (BC), causing increased Fat Mass (FM), decreased in both Lean Mass (LM) and Body Mineral Density (BMD), even despite uremic reversal after a Kidney Transplant (KT); immunosuppressive medications alter BC, increasing the risk of loss of the kidney transplant and cardiovascular diseases.</p><p><strong>Objective: </strong>To demonstrate whether there are differences in BC between a group of patients with KT and a group of patients on Hemodialysis (HD), when comparing them with a control group without the disease.</p><p><strong>Materials and methods: </strong>In the present observational study, with a comparative design; 125 patients were evaluated (46 with KT, 47 on HD, and 32 from the healthy control group). The BC was evaluated with the full-body Dual-Energy X-Ray Absorptiometry (DEXA) method.</p><p><strong>Results: </strong>The mean age and standard deviation (X±SD) of the study subjects were: 28.89 ± 5.76, 27.39 ± 5.04, and 29.63 ± 6.34 years for the HD, KT, and control subjects, respectively. The HD patients presented a total FM of 14.98 ± 6.96 kg in comparison with 20.1 ± 6.5 kg for the control group (p = 0.007), and 19.06 ± 7.94 kg for the group with KT (p = 0.02). The total LM was lower in the KT patients in comparison with the control group (p = 0.023). The content and total BMD were lower in both groups of patients with KT and HD.</p><p><strong>Conclusions: </strong>Although a comprehensive improvement in BC was expected after kidney transplantation, the results are not close to \"normal' values, when compared with those of healthy subjects of the same age.</p>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"100505"},"PeriodicalIF":2.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qiliqiangxin capsule alleviates cardiac hypertrophy and cardiac dysfunction by regulating miR-382-5p/ATF3 axis.","authors":"Bao Yin, XiaoTong Jiang, XinFeng Chang, ChunHua Song","doi":"10.1016/j.clinsp.2024.100496","DOIUrl":"10.1016/j.clinsp.2024.100496","url":null,"abstract":"<p><strong>Objective: </strong>Qiliqiangxin Capsule (QL) was investigated for its possible role in cardiac hypertrophy in this study.</p><p><strong>Methods: </strong>QL (0.5 mg/mL) was pre-treated in Neonatal Mouse Ventricular Cardiomyocytes (NMVCs) before induction of cardiomyocyte hypertrophy by Angiotensin II (Ang-II). Immunofluorescence staining for α-actinin was conducted to determine cell surface area. Atrial Natriuretic Peptide (ANP) and Brain Natriuretic Peptide (BNP) of hypertrophy markers were examined. Ang-II infusion was given to stimulate cardiac hypertrophy in mice. The cardiac function of mice was detected by echocardiography, and the pathological status of myocardial tissue was observed.</p><p><strong>Results: </strong>The surface of cardiomyocytes was enlarged by Ang-II, and ANP and BNP levels were increased. QL processing could save these changes. miR-382-5p was upregulated in Ang-II-treated NMVCs, and reducing miR-382-5p could further enhance the therapeutic effect of QL while elevating miR-382-5p weakened the protective effect of QL. QL could inhibit miR-382-5p expression to negatively regulate Activated Transcription Factor 3 (ATF3) expression. Enhancing ATF3 expression rescued miR-382-5p upregulation-mediated role in NMVCs. In addition, QL alleviated Ang-II-stimulated cardiac hypertrophy and cardiac dysfunction in mice.</p><p><strong>Conclusion: </strong>QL may alleviate cardiac hypertrophy and cardiac dysfunction via the miR-382-5p/ATF3 axis.</p>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"100496"},"PeriodicalIF":2.2,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11470416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver biopsy-proven non-alcoholic fatty liver disease predicts no impact on antiviral response in patients with chronic hepatitis B.","authors":"Miao-Yang Chen, Shun-Xin Li, Zhi-Xiang Du, Qing-Fang Xiong, Yan-Dan Zhong, Du-Xian Liu, Yong-Feng Yang","doi":"10.1016/j.clinsp.2024.100493","DOIUrl":"10.1016/j.clinsp.2024.100493","url":null,"abstract":"<p><strong>Objective: </strong>The role of Non-Alcoholic Fatty Liver Disease (NAFLD) on antiviral response in Chronic Hepatitis B (CHB) remains unclear. Previous studies mainly focus on the impact of the Non-Alcoholic Fatty Liver (NAFL) on antiviral efficacy, whereas the role of Non-Alcoholic Steatohepatitis (NASH) has not been highlighted. The authors aimed to investigate the association of NAFLD (NAFL and NASH), viral and histological characteristics with antiviral response.</p><p><strong>Methods: </strong>The authors collected data of treatment-naïve CHB patients who underwent liver biopsy. All these patients received antiviral monotherapy and 48-week follow-up. The antiviral response was evaluated by Kaplan-Meier analysis. Cox regression analysis identified the variables associated with antiviral response.</p><p><strong>Results: </strong>Overall, 120 treatment-naïve CHB patients were enrolled, with 49.2 % (59/120) of them were complicated by NAFLD. Male (Odd Ratio [OR = 4.222], 95 % Confidence Interval [95 % CI 1.620-11.003]) and overweight (OR = 8.709, 95 % CI 3.355-22.606) were independent predictors for concurrent NAFLD. After 48-week follow-up, the authors found that the overall antiviral response did not differ between CHB patients with and without concomitant NAFL/NASH (p > 0.05). High viral load (Hazard Ratio [HR = 0.522], 95 % CI 0.286-0.952), advanced fibrosis (HR = 2.426, 95 % CI 1.256-4.686), and moderate-to-severe interface hepatitis (HR = 2.541, 95 % CI 1.406-4.592) were significantly correlated with antiviral response after 8-week follow-up.</p><p><strong>Conclusion: </strong>Neither NAFL nor NASH had an impact on antiviral therapy for CHB. It was low hepatitis B load, advanced fibrosis, and moderate-to-severe interface hepatitis that contributed to the virological response.</p>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"79 ","pages":"100493"},"PeriodicalIF":2.2,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}