scholarly journals Hepatic fibrosis and factors associated with liver stiffness in HIV mono-infected individuals

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e2867
Author(s):  
Mihály Sulyok ◽  
Tamás Ferenci ◽  
Mihály Makara ◽  
Gábor Horváth ◽  
János Szlávik ◽  
...  
Keyword(s):  
Hepatic Fibrosis ◽  
Bayesian Model Averaging ◽  
Hepatitis Virus ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Model Averaging ◽  
Positive Association ◽  
Cross Sectional Study ◽  
Cross Sectional

BackgroundLiver disease has become an important cause of morbidity and mortality even in those HIV-infected individuals who are devoid of hepatitis virus co-infection. The aim of this study was to evaluate the degree of hepatic fibrosis and the role of associated factors using liver stiffness measurement in HIV mono-infected patients without significant alcohol intake.MethodsWe performed a cross-sectional study of 101 HIV mono-infected patients recruited prospectively from March 1, 2014 to October 30, 2014 at the Center for HIV, St István and St László Hospital, Budapest, Hungary. To determine hepatic fibrosis, liver stiffness was measured with transient elastography. Demographic, immunologic and other clinical parameters were collected to establish a multivariate model. Bayesian Model Averaging (BMA) was performed to identify predictors of liver stiffness.ResultsLiver stiffness ranged from 3.0–34.3 kPa, with a median value of 5.1 kPa (IQR 1.7). BMA provided a very high support for age (Posterior Effect Probability-PEP: 84.5%), moderate for BMI (PEP: 49.3%), CD4/8 ratio (PEP: 44.2%) and lipodystrophy (PEP: 44.0%). For all remaining variables, the model rather provides evidence against their effect. These results overall suggest that age and BMI have a positive association with LS, while CD4/8 ratio and lipodystrophy are negatively associated.DiscussionOur findings shed light on the possible importance of ageing, overweight and HIV-induced immune dysregulation in the development of liver fibrosis in the HIV-infected population. Nonetheless, further controlled studies are warranted to clarify causal relations.

scholarly journals Role of Resilience in Burden and Perceived Public Stigma among Primary Caregivers of Psychiatric Patients

2021 ◽  
Vol 2 (2) ◽  
pp. 147-155
Author(s):  
Farah Saleem ◽  
Kehkashan Arouj ◽  
Sabir Zaman ◽  
Azmat Shaheen
Keyword(s):  
Psychological Health ◽  
Psychiatric Patients ◽  
Primary Caregivers ◽  
Positive Association ◽  
Cross Sectional Study ◽  
Public Stigma ◽  
Cross Sectional ◽  
Public And Private ◽  
Resilience Scale

The current study intended to find out the role of resilience on perceived public stigma and burden among primary caregivers of the psychiatric patients. The current study highlighted the psychological health of caregivers. A cross sectional study was conducted in region of Islamabad and Rawalpindi, Pakistan. A total of 250 caregivers participated in the study, whom 125 were male and 125 were female caregivers, age range was 25-60 years (M=31.61, SD=5.93). The data was collected from public and private hospitals.  Three scales were used for data collection. The resilience was measured through Urdu translated resilience scale, public stigma was assessed by using Urdu version of perceived public stigma, and Burden was measured through interview.  The result showed that resilience was negatively associated with burden and perceived public stigma (p< 0.01). Further, the multiple regression showed that resilience acted as moderator between public stigma and burden (? = -1.02, p< .001). The result supported a positive association between public stigma, burden and resilience among caregivers of psychiatric patients.

scholarly journals Liver stiffness by transient elastography accompanies illness severity in COVID-19

2020 ◽  
Vol 7 (1) ◽  
pp. e000445
Author(s):  
Maria Effenberger ◽  
Christoph Grander ◽  
Gernot Fritsche ◽  
Rosa Bellmann-Weiler ◽  
Frank Hartig ◽  
...  
Keyword(s):  
Liver Damage ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Gastrointestinal Symptoms ◽  
Severity Of Illness ◽  
Cross Sectional Study ◽  
Illness Severity ◽  
University Hospital ◽  
Cross Sectional ◽  
Severe Liver Damage

ObjectiveSevere liver damage is associated with worse outcome in COVID-19. Our aim was to explore the degree of liver damage, liver stiffness (LS) and severity of illness in patients with COVID-19.DesignWe investigated 32 patients with COVID-19 admitted to the University Hospital of Innsbruck in a prospective cross-sectional study. We performed laboratory testing, liver and spleen sonography and elastography to measure organ stiffness.Results12 patients (38%) showed elevated aminotransferases and gamma-glutamyltransferase levels. LS was positively correlated with elevated aminotransferase levels in patients with COVID-19 compared with those without elevated enzymes. Even mild liver damage raised LS significantly in COVID-19 as it was in patients with gastrointestinal symptoms. Furthermore, higher LS measurements were significantly associated with illness severity like pneumonia, need for mechanical ventilation, and even death.ConclusionTransient elastography is a useful and non-invasive tool to assess onset and severity of acute liver injury in patients with COVID-19 patients. Increased LS seems to be predictive for a more severe and complicated course of disease.

scholarly journals Dysregulation of the Immune System in HIV/HCV-Coinfected Patients According to Liver Stiffness Status

Cells ◽  
2018 ◽  
Vol 7 (11) ◽  
pp. 196 ◽  
Author(s):  
Pilar Garcia-Broncano ◽  
Luz Medrano ◽  
Juan Berenguer ◽  
Juan González-García ◽  
Mª Jiménez-Sousa ◽  
...  
Keyword(s):  
Transient Elastography ◽  
Liver Stiffness ◽  
Cross Sectional Study ◽  
T Cell Subsets ◽  
Cross Sectional ◽  
Plasma Cytokine ◽  
Advanced Cirrhosis ◽  
Healthy Donors ◽  
Tnf Α ◽  
Cytokine Levels

Background: Advanced cirrhosis is related to alterations in immunity. We aimed to evaluate the levels of peripheral CD4+ T cells (Tregs) and plasma cytokine in patients coinfected with human immunodeficiency virus and hepatitis C virus (HIV/HCV) according to liver fibrosis stages [evaluated as liver stiffness measure (LSM)] and their linear relationship. Methods: We performed a cross-sectional study on 238 HIV/HCV-coinfected patients (119 had <12.5 kPa, 73 had 12.5–25 kPa, and 46 had >25 kPa). Peripheral T-cell subsets were phenotyped by flow cytometry, plasma biomarkers were assessed by multiplex immunoassays, and LSM was assessed by transient elastography. Results: We found HIV/HCV-coinfected patients had higher values of CD4+ Tregs (p < 0.001), memory Tregs (p ≤ 0.001), and plasma cytokine levels [IFN-γ (p ≤ 0.05) and IL-10 (p ≤ 0.01)] compared with healthy donors and HIV-monoinfected patients. In the multivariate analysis, higher LSM values were associated with reduced levels of IL-10 (adjusted arithmetic mean ratio (aAMR) = 0.83; p = 0.019), IL-2 (aAMR = 0.78; p = 0.017), TNF-α (aAMR = 0.67; p < 0.001), and IL-17A (aAMR = 0.75; p = 0.006). When we focus on HIV/HCV-coinfected patients analyzed by LSM strata, patients with ≥25 kPa had lower values of IL-2 (aAMR = 0.66; p = 0.021), TNF-α (aAMR = 0.565; p = 0.003), and IL-17A (aAMR = 0.58; p = 0.003) than patients with <12.5 kPa. Conclusion: HIV/HCV-coinfected patients showed an immunosuppressive profile compared to healthy controls and HIV-monoinfected patients. Additionally, HIV/HCV-coinfected patients with advanced cirrhosis (LSM ≥ 25 kPa) had the lowest plasma values of cytokines related to Th1 (IL-2 and TNF-α) and Th17 (IL-17A) response.

Antiepileptic drugs are not independently associated with cognitive dysfunction

Neurology ◽  
2020 ◽  
Vol 94 (10) ◽  
pp. e1051-e1061 ◽  
Author(s):  
Emma Foster ◽  
Charles B. Malpas ◽  
Karena Ye ◽  
Benjamin Johnstone ◽  
Patrick W. Carney ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Antiepileptic Drugs ◽  
Cognitive Dysfunction ◽  
Seizure Frequency ◽  
Bayesian Model ◽  
Bayesian Model Averaging ◽  
Model Averaging ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Subjective Cognitive Function

ObjectiveTo test the hypothesis that individual antiepileptic drugs (AEDs) are not associated with cognitive impairment beyond other clinically relevant factors, we performed a cross-sectional study of patients admitted to an inpatient video-EEG monitoring unit.MethodsWe prospectively enrolled patients admitted to an inpatient specialist epilepsy program between 2009 and 2016. Assessments included objective cognitive function, quality of life subscales for subjective cognitive function, and questionnaires for anxiety and depressive symptoms. Bayesian model averaging identified predictors of cognitive function. Bayesian model selection approach investigated effect of individual AEDs on cognition. Conventional frequentist analyses were also performed.ResultsA total of 331 patients met inclusion criteria. Mean age was 39.3 years and 61.9% of patients were women. A total of 45.0% of patients were prescribed AED polypharmacy, 25.1% AED monotherapy, and 29.9% no AED. Age, seizure frequency, and a diagnosis of concomitant epilepsy and psychogenic nonepileptic seizure were predictors of objective cognitive function. Depression, anxiety, and seizure frequency were predictors of subjective cognitive function. Individual AEDs were not independently associated with impaired cognitive function beyond other clinically relevant variables.ConclusionsThis study found that no AED was independently associated with cognitive dysfunction. Significant determinants of objective and subjective cognitive dysfunction included seizure frequency and depression, respectively. These findings suggest that optimizing therapy to prevent seizures is not likely to occur at the expense of cognitive function.

scholarly journals Associations between handgrip strength and hypertension in relation to circulating CD34-positive cell levels among Japanese older men: a cross-sectional study

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Yuji Shimizu ◽  
Shin-Ya Kawashiri ◽  
Kenichi Nobusue ◽  
Hirotomo Yamanashi ◽  
Yasuhiro Nagata ◽  
...  
Keyword(s):  
Handgrip Strength ◽  
Positive Association ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Japanese Men ◽  
Vascular Homeostasis ◽  
Endothelial Repair ◽  
High Level

Abstract Background A positive association between handgrip strength and blood pressure has been reported. Since these factors are linked to the condition of the endothelium, the activity of endothelial repair might influence the association between handgrip strength and hypertension. Methods A cross-sectional study was conducted with 257 Japanese men aged 60–69 years who underwent an annual health checkup. As individuals with high level of circulating CD34-positive cells might show active endothelial repair, which plays an important role in vascular homeostasis, participants were stratified by circulating CD34-positive cell levels, using the median value of this population (0.96 cells/μL) as the cutoff. Results Independent of known cardiovascular risk factors, for participants with a high CD34-positive cell, handgrip strength is significantly positively associated with hypertension (odds ratio and 95% confidence interval of hypertension for 1 standard deviation increment of handgrip strength were 1.85 (1.19, 2.88) but not for participants with a low CD34-positive cell (0.91 (0.61, 1.37)). Conclusion The positive association between handgrip strength and hypertension is limited to high CD34-positive cells. This result may help clarify the role of vascular homeostasis in maintaining muscle strength.

scholarly journals Future Orientation and Political Participation: The Moderating Role of Political Trust

2021 ◽  
Vol 3 ◽  
Author(s):  
Mikkel Stein Knudsen ◽  
Henrik Serup Christensen
Keyword(s):  
Political Participation ◽  
Future Orientation ◽  
Political Trust ◽  
Positive Association ◽  
Cross Sectional Study ◽  
Decision Makers ◽  
Cross Sectional ◽  
Future Consequences ◽  
Moderating Role

Previous studies show consistent differences in how people evaluate future consequences and implications of this for a variety of phenomena. The implications for the individual propensity for taking part in different forms of political participation have received limited scholarly attention, however. This is unfortunate since it affects how people voice their concerns over future problems and thereby also whether and how decision-makers become aware of these concerns. We here examine this in a cross-sectional study conducted in Finland (N = 1,673). We apply the Considerations of Future Consequences (CFC) framework as a measure of individuals’ future orientation and distinguish between considerations of future consequences (CFC-future) and considerations of immediate consequences (CFC-Immediate). We study the direct associations with institutionalized and non-institutionalized political participation and the moderating role of political trust in shaping these associations. Our results show CFC-future has a positive association with both institutionalized and non-institutionalized political participation, while CFC-immediate has a negative association with participation. Political trust moderates the association with non-institutionalized political participation since the association is stronger for citizens with low political trust. This may suggest that citizens use particular participatory avenues to communicate their worries over future problems, and to which decision-makers must be attentive.

scholarly journals Liver Fibrosis and Steatosis in Virally Suppressed HIV-Infected Patients with Cytomegalovirus Seropositivity

2022 ◽  
Vol 22 (3) ◽  
pp. 180-187
Author(s):  
Chyntia Olivia Maurine Jasirwan ◽  
Adik Wibowo ◽  
Amal C Sjaaf ◽  
Gita Aprilicia ◽  
Dyah Purnamasari ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Clinical Presentation ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Human Herpesvirus ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Coefficient Corrélation ◽  
One Year

Background: Cytomegalovirus (CMV) is a human herpesvirus common in people with human immunodeficiency virus (HIV). In a patient with immunocompetence, long periodic asymptomatic CMV might affect to develop the abnormal liver function and contribute to non-AIDS defining morbidity, including chronic liver disease. This study aims to know the prevalence of liver fibrosis and steatosis in virally suppressed HIV infected patients with CMV reactive and summarize the correlation of clinical presentation with liver fibrosis and steatosis in these subjects.Method: A cross-sectional study in HIV Integrated Care Unit, Cipto Mangunkusumo Hospital, was conducted from April 2019 until June 2020. Subjects enrolled in this study were suppressed HIV patients aged between 30-40 years with positive IgG CMV and already using stable ART for at least one year. Transient elastography measured the liver stiffness. Patients with liver stiffness above 7 kPa were defined as having significant liver fibrosis. In addition, Spearman correlation was conducted to evaluate the correlation of clinical presentation of subjects related to liver fibrosis and steatosis. Results: A total of subjects was included in this study. Dominantly male (62.5%) with average age 38 ± 4.68 years. The median amount of CMV DNA was 466 (17-21284) copy/ml. Significant Fibrosis was found in 17/80 (21%) subjects. In this study, clinical parameters correlated with liver fibrosis were insulin, glucose fasting, Homa IR, triglyceride, HDL, and platelet. A medium positive correlation was found in insulin, and Homa IR, with coefficient correlation for insulin, was r = 0.475, p 0.001; and coefficient correlation for Homa IR was r = 0 .487, p 0.001.Conclusion: The prevalence of liver fibrosis was 12% in these subjects. In addition, insulin and Homa IR had a positive correlation with increasing liver fibrosis.

scholarly journals Association of Serum Magnesium with Blood Pressure in Patients with Hypertensive Crises: A Retrospective Cross-Sectional Study

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4213
Author(s):  
IfeanyiChukwu O. Onor ◽  
Lashira M. Hill ◽  
Modupe M. Famodimu ◽  
Mallory R. Coleman ◽  
Carolkim H. Huynh ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Primary Outcome ◽  
Serum Magnesium ◽  
Positive Association ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Hypertensive Crises

The role of magnesium in blood pressure has been studied among hypertensive patients; however, there is a dearth of studies exploring the role of magnesium in hypertensive crises. The primary objective of this study was to evaluate the relationship between serum magnesium and blood pressure in patients with hypertensive crises. This was a single-center, retrospective, chart review, cross-sectional study of patients with hypertensive crises. Patients were included if they were eighteen years of age or older, with an international classification disease ninth revision (ICD-9) code of 401.9 (hypertensive crises: emergency or urgency) and a documented magnesium level on their electronic medical record. The primary outcome of the study was the correlation between serum magnesium and blood pressure (systolic blood pressure and diastolic blood pressure) in patients with hypertensive crises. Two hundred and ninety-three patients were included in the study. The primary outcome result showed that serum magnesium was positively correlated with systolic blood pressure (r = 0.143, p = 0.014), but not diastolic blood pressure. Conclusion: This study found a significant positive association between magnesium and systolic blood pressure, but not diastolic blood pressure, among patients with hypertensive crises. This positive association of serum magnesium with systolic blood pressure was maintained after adjusting for covariates. This study’s findings suggest a potential role of magnesium in blood pressure among patients with hypertensive crises.

scholarly journals Prevalence of Elevated Liver Stiffness Among Potential Candidates for Bariatric Surgery in the United States

2022 ◽  
Author(s):  
Stefano Ciardullo ◽  
Mattia Pizzi ◽  
Pietro Pizzi ◽  
Alice Oltolini ◽  
Emanuele Muraca ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Liver Disease ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
The United States ◽  
Cross Sectional Study ◽  
Metabolic Dysfunction ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Using Data

Abstract Purpose Obesity represents a well-known risk factor for metabolic-dysfunction associated fatty liver disease (MAFLD) and its progression towards cirrhosis. The aim of this study is to estimate the proportion of potential candidates to a bariatric surgery intervention that has an elevated liver stiffness on vibration-controlled transient elastography (VCTE). Materials and Methods This is a cross-sectional study performed using data obtained during the 2017–2018 cycle of the National Health and Nutrition Examination Survey. Potential candidates for a bariatric surgery intervention from the general US population were identified by applying criteria from international guidelines. All included participants were evaluated by VCTE. A controlled attenuation parameter (CAP) value ≥ 288 dB/m was considered indicative of steatosis while liver stiffness measurement (LSM) was considered elevated if ≥ 9.7 kPa. Multivariable logistic regression models were fitted to identify independent predictors of both outcomes. Results A total of 434 participants were included (mean age 42.9 ± 0.6 years; 54.4% women). Among them, 76.7% (95% CI 71.7–81.0) had steatosis, while 23.1% (95% CI 17.8–29.3) had an elevated LSM. Male sex, older age, γ-glutamyltranspeptidase levels, and body mass index (BMI) were independent predictors of steatosis, while BMI was the only independent predictor of elevated LSM. Non-Hispanic black participants were protected from both outcomes, while other ethnicities were not. Conclusion The prevalence of elevated LSM is high in potential candidates for a bariatric surgery intervention. Accurate screening for occult advanced liver disease might be indicated in this patient population. Graphical abstract

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