Continuous wavelet transform ridge extraction for spectral interferometry imaging

The combination of wavelength multiplexing and spectral interferometry allows for the encoding of multidimensional information and its transmission over a mono-dimensional channel; for example, measurements of a surface's topography acquired through a monomode fiber in a small endoscope. The local depth of the imaged object is encoded in the local spatial frequency of the signal measured at the output of the fiber-decoder system. We propose a procedure to retrieve the depth-map by determining the signal's instantaneous frequency. First, we compute its continuous, complex-valued, wavelet transform (CWT). The frequency signature at every position is contained in the resulting scalogram. We then extract the ridge of maximal response by use of a dynamic programming algorithm thus directly recovering the object's topography. We present results that validate this procedure based on both simulated and experimental data

A phase II study of human allogeneic liver-derived progenitor cell therapy for acute-on-chronic liver failure and acute decompensation

Malaltia hepàtica alcohòlica; Cèl·lules mare; Medicina regenerativa del fetgeEnfermedad hepática alcohólica; Células madre; Medicina regenerativa del higadoAlcoholic liver disease; Stem cell; Liver regenerative medicineBackground & Aims Human allogeneic liver-derived progenitor cells (HALPC, HepaStem®; Promethera Biosciences, Mont-Saint-Guibert, Belgium) are an advanced therapy medicinal product that could potentially alleviate systemic inflammation and ameliorate liver function in patients with acute-on-chronic liver failure (ACLF) or acute decompensation of cirrhosis (AD). Methods This open-label phase II study was conducted in 9 centres in Belgium, Spain, and Bulgaria between 2016 and 2019. The primary objective was to assess the safety of HALPC therapy up to Day 28 and the secondary objectives were to assess its safety and preliminary efficacy up to Month 3. Results The 24 treated patients (mean age: 51 years) were mostly male with an alcoholic cirrhosis. On pre-infusion Day 1, 15 patients had ACLF and 9 patients had AD. Two of the 3 initial patients treated with high HALPC doses (∼5×106 cells/kg body weight [BW]) had severe adverse bleeding events attributed to treatment. In 21 patients subsequently treated with lower HALPC doses (0.6 or 1.2×106 cells/kg BW, 1 or 2 times 7 days apart), no serious adverse events were related to treatment, and the other adverse events were in line with those expected in patients with ACLF and AD. Overall, markers of systemic inflammation and altered liver function decreased gradually for the surviving patients. The Day-28 and Month-3 survival rates were 83% (20/24) and 71% (17/24), and at Month 3, no patient had ACLF. Conclusions The treatment of patients with ACLF or AD with up to 2 doses of 1.2×106 HALPC/kg BW appeared safe. The results of this study support the initiation of a proof-of-concept study in a larger cohort of patients with ACLF to further confirm the safety and evaluate the efficacy of HALPC therapy

Continuous wavelet transform ridge extraction for spectral interferometry imaging

The combination of wavelength multiplexing and spectral interferometry allows for the encoding of multidimensional information and its transmission over a mono-dimensional channel; for example, measurements of a surface's topography acquired through a monomode fiber in a small endoscope. The local depth of the imaged object is encoded in the local spatial frequency of the signal measured at the output of the fiber-decoder system. We propose a procedure to retrieve the depth-map by determining the signal's instantaneous frequency. First, we compute its continuous, complex-valued, wavelet transform (CWT). The frequency signature at every position is contained in the resulting scalogram. We then extract the ridge of maximal response by use of a dynamic programming algorithm thus directly recovering the object's topography. We present results that validate this procedure based on both simulated and experimental data

Etiology, management, and outcome of the Budd-Chiari syndrome

Background: The Budd-Chiari syndrome (BCS) is hepatic venous outflow obstruction. What is known about the syndrome is based on small studies of prevalent cases. Objective: To characterize the causes and treatment of incident BCS. Design: Consecutive case series of patients with incident BCS, enrolled from October 2003 to October 2005 and followed until May 2006. Setting: Academic and nonacademic hospitals in France, Spain, Italy, Great Britain, Germany, Belgium, the Netherlands, Portugal, and Switzerland. Patients: Persons older than 16 years with definite hepatic outflow obstruction diagnosed by imaging. Persons with hepatic outflow obstruction due to heart failure, sinusoidal obstruction syndrome, cancer, or liver transplantation were excluded. Measurements: Signs and symptoms; laboratory and imaging findings; diagnosis; treatment; and overall, transplantation-free, and intervention-free survival. Results: 163 incident cases of BCS were identified. Median follow-up was 17 months (range, 0.1 to 31 months). Most patients (84%) had at least 1 thrombotic risk factor, and many (46%) had more than 1; the most common was myeloproliferative disorders (49% of 103 tested patients). Patients were mainly treated with anticoagulation (140 patients [86%]), transjugular intrahepatic portosystemic shunting (56 patients [34%]), or liver transplantation (20 patients [12%]), and 80 patients (49%) were managed noninvasively. Only 3 patients underwent surgical shunting. The survival rate was 87% (95% CI, 82% to 93%) at 1 year and 82% (CI, 75% to 88%) at 2 years. Limitation: Treatment was not standardized across all centers, and data on important clinical variables were missing for some patients. Conclusion: Most patients with BCS have at least 1 thrombotic risk factor, and many have more than 1; myeloproliferative disorders are most common. One- and 2-year survival rates are good with contemporary management, which includes noninvasive therapies (anticoagulation and diuretics) and invasive techniques. Transjugular intrahepatic portosystemic shunting seems to have replaced surgical shunting as the most common invasive therapeutic procedure. Primary Funding Source: Fifth Framework Programme of the European Commission

Impact of safety-related dose reductions or discontinuations on sustained virologic response in HCV-infected patients: Results from the GUARD-C Cohort

BACKGROUND: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. METHODS: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. RESULTS: SVR24 rates were 46.1% (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1, 2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced 651 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with 651 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not 655. CONCLUSIONS: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginterferon alfa-2a/ribavirin

What is the optimal duration of therapy in patients with hepatitis C genotype 2 or 3 infection? A review

Pegylated interferon plus ribavirin is the standard treatment for chronic hepatitis C (HCV). Even if genotype 2 and 3 patients only request a treatment of 24 weeks, this treatment remains very costly and difficult to tolerate due to numerous side effects. Recently several studies focused on the possibility of further reducing treatment duration in chronic HCV genotype 2 and 3 patients without compromising sustained virological response (SVR). Based on the available data, patients presenting a negative PCR at week 4 named a rapid virological response (RVR) probably are the best candidates to benefit from shorter treatment duration. In contrast patients without RVR should at least be treated for 24 weeks and retrospective data suggest that a more intensive or prolonged therapy for 48 weeks could be necessary. However, at this moment it remains impossible to propose general recommendations for all patients with genotype 2 and 3. Therefore more randomized prospective trials are needed to clarify several issues that are discussed in this review article.SCOPUS: re.jinfo:eu-repo/semantics/publishe

L'hépatite C chez la femme en âge de procréer. Etat de la question

Chronic hepatitis C (VHC) is a worldwide public health issue. The mother-to-child transmission could be the main cause of hepatitis C infection in children. Despite the risk of histological injuries, chronic hepatitis C is not a contra-indication to pregnancy. In patients with VHC, there is no evidence that the outcome could be modified. In co-infected patients (VIH-VHC), a caesarean should be proposed taking into account the significant risk of mother-to-child transmission. Breast-feeding is not contra-indicated. Systematic screening of VHC, discussed in this article, could be proposed in woman planning a pregnancy.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Long-term (7-year-) treatment with lamivudine monotherapy in HBV-associated glomerulonephritis

Glomerulonephritis (GN) is an uncommon but well-described complication of chronic hepatitis B virus (HBV) infection. HBV-related membranous nephropathy (MN) may lead to renal failure in 1/3 of the patients and spontaneous remission is rare. There is no standard therapy for HBV-associated MN. We report a case of a 28-year-old man with HBV-associated MN due to pre-core HBV mutant with complete remission under an on-going 7-year lamivudine monotherapy. ©2008 Dustri-Verlag Dr. K. Feistle.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Imagerie par interférométrie spectrale multiplexée en longueur d'onde

Revue de l'electricité et de l'electronique (1) :2–

A lady with NASH and choreoathetosis

We describe a case of acquired hepatocerebral degeneration (AHD) presenting with confusion and worsening memory problems since her discharge from the gastroenterology units. Cases of AHD are rare and are frequently confused with hepatic encephalopathy and Wilson's disease. There are no proven pharmacological therapies for AHD. Information regarding the effect of orthotopic liver transplant on AHD is limited and conflicting. Most patients eventually die from the systemic complications of cirrhotic liver failure including infection, hepatic coma and hepatocellular carcinoma.SCOPUS: ar.jinfo:eu-repo/semantics/publishe