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Estimation of visceral fat is useful for the diagnosis of significant fibrosis in patients with non-alcoholic fatty liver disease

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World Journal of Gastroenterology 2020年第42期26卷 6658-6668页

作者： marta hernández-conde Elba Llop Carlos Fernández Carrillo Beatriz Tormo Javier Abad Luis Rodriguez Christie Perelló marta López Gomez JoséLuis Martínez-Porras Natalia Fernández Puga Maria Trapero-Marugan Enrique Fraga Carlos Ferre Aracil JoséLuis Calleja Panero Gastroenterology and Hepatology Department IDIPHISAHospital Universitario Puerta de Hierro-MajadahondaMadrid 28222Spain Centro de Investigación Biomédica en Red en elÁrea temática de Enfermedades Hepáticas Instituto de Salud Carlos IIIMadrid 28029Spain

BACKGROUND Obesity is a risk factor for non-alcoholic fatty liver disease(NAFLD),although obese patients with NAFLD do not always develop significant *** distribution of body fat could predict the risk of NAFLD *** To investigate the role of bioelectrical impedance-estimated visceral fat(VF)in assessing NAFLD *** In this cross-sectional study,patients with biopsy-proven NAFLD were prospectively *** patients underwent anthropometric evaluation,blood tests and bioelectrical impedance *** Between 2017 and 2020,119 patients were included[66.4%male,56 years(SD 10.7),62.2%obese,61.3%with metabolic syndrome].Sixty of them(50.4%)showed significant fibrosis(≥F2)in liver ***,VF and metabolic syndrome were associated with significant fibrosis(61 years vs 52 years,16.4 vs 13.1,73.3%vs 49.2%,respectively;P<0.001 for all).In the multivariate analysis,VF and age were independently associated with significant fibrosis(VF,OR:1.11,95%CI:1.02-1.22,P=0.02;age,OR:1.08,95%CI:1.03-1.12,P<0.01).A model including these variables showed and area under the receiver operating characteristic curve(AUROC)of 0.75,which was not inferior to transient elastography or NAFLD fibrosis score *** developed a nomogram including age and VF for assessing significant fibrosis in routine *** VF is a surrogate marker of liver fibrosis in patients with *** impedance analysis is an inexpensive and simple method that can be combined with age to guide patient referral when other resources may be unavailable.

关键词： Non-alcoholic fatty liver disease Visceral fat Liver fibrosis Bioimpedanciometry Metabolic syndrome Obesity

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Effectiveness of sacubitril-varsartan versus angiotensin converting enzyme inhibitors in patients hospitalized for acute heart failure:a retrospective cohort study of the RICA registry

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Journal of Geriatric Cardiology 2022年第11期19卷 802-810页

作者： Llanos Soler-Rangel Manuel Méndez-Bailón JoséPérez-Silvestre JoséMaría Fernández-Rodríguez Beatriz Cuesta García Adrián Argüelles-Curto Álvaro González-Franco Alicia conde-Martel Sara Carrascosa-García marta Sánchez-Marteles JoséManuel Cerqueiro-González Noel Lorenzo-Villalba Manuel Montero-Pérez-Barquero Llanos Soler-Rangel Servicio de Medicina InternaHospital Universitario Infanta SofíaFIIB HUIS HHENMadridSpain Servicio de Medicina Interna Hospital Clínico San CarlosInstituto de Investigación San Carlos(IdISSC)Spain Servicio de Medicina Interna Consorcio Hospital General Universitario de ValenciaSpain Servicio de Medicina Interna Hospital Carmen y Severo OchoaCangas del NarceaAsturiasSpain Servicio de Medicina Interna Hospital Universitario Central de AsturiasOviedoSpain Servicio de Medicina Interna Hospital Universitario de Gran Canaria Dr NegrínSpain Servicio de Medicina Interna Hospital Clínico Universitario Lozano Blesa de ZaragozaZaragozaSpain Hospital Universitario Lucus Augusti de Lugo LugoSpain Service de Médecine Interne Diabète et Maladies MétaboliquesHôpitaux Universitaires de StrasbourgFrance Servicio de Medicina Interna IMIBIC/Hospital Universitario Reina SofíaCórdobaSpain

BACKGROUND Sacubitril-valsartan has been shown to reduce hospitalizations and mortality in patients with heart failure(HF)and reduced ejection *** PIONEER-HF trial demonstrated that initiation of the drug during acute HF hospitalization reduced NT-proBNP levels and a post-hoc analysis of the trial found a reduction in HF hospitalizations and ***-life studies in the elderly population are *** aim of our study was to assess the effectiveness of sacubitril-valsartan versus angiotensin converting enzyme inhibitors(ACEI)in elderly patients who initiate this treatment during hospitalization for acute *** We conducted a retrospective cohort study using the Spanish acute heart failure registry(RICA)comparing rehospitalizations and deaths at 3 months and 1 year among patients aged 70 years or older who had initiated treatment with sacubitrilvalsartan during hospitalization for acute HF versus those treated with *** One hundred and ninety-nine patients hospitalized between October 2016 and November 2020 were included,with a median age of 82 years and high rate of *** these,107 were treated with sacubitril-valsartan and 92 with *** adjusted OR for readmission for HF at 3 months was 0.906(95%CI:0.241-3.404)and for the combined variable readmission for HF or death at 3 months was 0.696(95%CI:0.224-2.167).The adjusted OR for HF readmission at one year was 0.696(95%CI:0.224-2.167).and for the combined variable HF readmission or death at one year 0.724(95%CI:0.325-1.612).CONCLUSION Treatment with sacubitril-valsartan initiated early in hospitalization for HF in elderly patients with high comorbidity was associated with a trend towards a reduction in readmissions and death due to HF compared to treatment with ACEI,which did not reach statistical significance either at 3 months or 1 year of follow-up.

关键词： patients initiated admission

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Incidenee and time-varying predictors of HIV and sexually transmitted infections among male sex workers in Mexico City

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Infectious Diseases of Poverty 2021年第1期10卷 36-45页

作者： Karla Y.Ganley marta Wilson-Barthes Andrew R.Zullo Sandra G.Sosa-Rubi Carlos J.conde-Glez Santa Garcia-Cisneros Mark N.Lurie Brandon D.L.Marshall Don Operario Kenneth H.Mayer Omar Galarraga Department of Narrative Medicine Columbia UniversityNew YorkNYUSA Department of Epidemiology School of Public HealthBrown UniversityProvide neeRlUSA Department of Health Services Policyand PracticeSchool of Public HealthBrown University121 South Main StreetBox G-121S-2ProvidenceRl 02912USA National Institute of Public Health(INSP) CuernavacaMorelosMexico Department of Behavioral and Social Science School of Public HealthBrown UniversityProvidenceRlUSA Fenway Health and Harvard University BostonMAUSA.

Background:Male sex workers are at high-risk for acquisition of sexually transmitted infections(STIs),including human immunodeficiency virus(HIV).We quantified incidence rates of STIs and identified their time-varying predictors among male sex workers in Mexico ***:From January 2012 to May 2014,male sex workers recruited from the largest HIV clinic and community sites in Mexico City were tested for chlamydia,gonorrhea,syphilis,hepatitis,and HIV at baseline,6-months,and *** nee rates with 95%bootstrapped confide nee limits were *** examined potential timevarying predictors using generalized estimating equations for a population averaged ***:Among 227 male sex workers,median age was 24 and baseline HIV prevalence was 32%.Incidence rates(per 100 person-years)were as follows:HIV[5.23;95%confidence interval(CI):2.15-10.31],chlamydia(5.15;95%CI:2.58-9.34),gonorrhea(3.93;95%CI:1.88-7.83),syphilis(13.04;95%CI:8.24-19.94),hepatitis B(2.11;95%CI:0.53-4.89),hepatitis C(0.95;95%CI:0.00-3.16),any STI except HIV(30.99;95%CI:21.73-40.26),and any STI including HIV(50.08;95%CI:37.6062.55).In the multivariable-adjusted model,incident STI(excluding HIV)were lower among those who reported consistently using condoms during anal and vaginal intercourse(odds ratio=0.03,95%CI:0.00-0.68)compared to those who reported inconsistently using condoms during anal and vaginal ***:Incidence of STIs is high among male sex workers in Mexico *** condom use is an important protective factor for STIs,and should be an important comp on ent of interventions to prevent incide nt infect i ons.

关键词： Male sex worker Men who have sex with men HIV Sexually transmitted infection Transmission Risk factor Mexico

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