Prospective comparative study of spiral computer tomography and magnetic resonance imaging for detection of hepatocellular carcinoma

BACKGROUND: Hepatocellular carcinoma (HCC) is often detected at a relatively late stage when tumour size prohibits curative surgery. Screening to detect HCC at an early stage is performed for patients at risk. AIM: The aim of this study was to compare prospectively the diagnostic accuracy and classification for management of the two state of the art secondline imaging techniques: triphasic spiral computer tomography (CT) and super paramagnetic iron oxide (SPIO) enhanced magnetic resonance imaging (MRI). PATIENTS: Sixty one patients were evaluated between January 1996 and January 1998. Patients underwent CT and MRI within a mean interval of 6.75 days. METHODS: CT and MRI were evaluated blindly for the presence and number of lesions, characterisation of these lesions, and classification for management. For comparison of the data on characterisation, the CT and MRI findings were compared with histopathological studies of the surgical specimens and/or follow up imaging. Data of patients not lost to follow up were available to January 2001. RESULTS: SPIO enhanced MRI detected more lesions and overall smaller lesions than triphasic spiral CT (number of lesions 189 v 124; median diameter 1.0 v 1.8 cm; Spearman rank's correlation coefficient 0.63, p<0.001). There was no significant difference in accuracy between CT and MRI for lesion characterisation. The agreement in classification for management was very good (weighted kappa 0.91, 95% CI 0.83-0.99). CONCLUSION: SPIO enhanced MRI detects more and smaller lesions, but both techniques are comparable in terms of classification for management. SPIO enhanced MRI may be preferred as there is no exposure to ionising radiation

Multi-Omics Analysis Reveals MicroRNAs Associated With Cardiometabolic Traits

MicroRNAs (miRNAs) are non-coding RNA molecules that regulate gene expression. Extensive research has explored the role of miRNAs in the risk for type 2 diabetes (T2D) and

Translation and validation of the Revised Dental Beliefs Survey (DBS-R) in China

Patient perceptions of behaviours and attitudes of dentists are associated with dental fear and poor dental attendance in Western countries. However, there is a paucity of research exploring patient perceptions of the dentist in China. One reason for this may be the lack of a valid and reliable scale in Chinese (Standard Mandarin) to measure this. This study aimed to translate the Revised Dental Beliefs Survey (DBS-R) into Chinese and then explore the reliability and validity of this measure (both the short and longer versions) in a Chinese population. We translated the DBS-R using the forwards-backwards method and pilot tested it on a small sample of adults in China. Following this, 480 Chinese adults completed the newly translated scale, as well as well as a standardised dental anxiety questionnaire (the Modified Dental Anxiety Scale Chinese version) to test convergent validity. 109 participants completed the DBS-R again 2 weeks later for test-retest reliability. Both versions of the Chinese DBS-R were internally consistent and demonstrated convergent validity; test-retest reliability was also good. Both versions of the scale performed similarly, but for now we would suggest the 28-item version may be superior as items relating to the technical competence of the dentist appear important to Chinese adults

Risk factors for urological symptoms in a cohort of users of the HIV protease inhibitor indinavir sulfate: The ATHENA cohort

Background: Nephrolithiasis is a well-known complication of indinavir treatment and may result in urological symptoms ranging from renal colic to renal insufficiency. Objective: To obtain further knowledge regarding the incidence and risk factors of urological symptoms associated with indinavir sulfate use. Methods: This study was performed in the ATHENA (AIDS Therapy Evaluation National AIDS Therapy Evaluation Centre) cohort of patients infected with human immunodeficiency virus (HIV) receiving antiretroviral therapy in the Netherlands. The incidence rate of urological symptoms was assessed in a subcohort of 1219 patients starting HIV protease inhibitor treatment after 1996. Urological symptoms were defined as an initial report of nephrolithiasis, renal colic, flank pain, hematuria, renal insufficiency, or nephropathy. Using multivariate Cox regression analysis, risk factors for urological symptoms during indinavir treatment were subsequently studied among the subset of 644 patients who started indinavir treatment after 1996. Results: The incidence of urological symptoms was 8.3 per 100 treatment-years for indinavir vs 0.8 per 100 treatment-years for other HIV protease inhibitors. Risk factors for urological symptoms during indinavir treatment were low weight (relative risk [RR], 2.1; 95% confidence interval [CI], 1.1-3.9), low lean body mass (RR, 1.7;95% CI, 1.0-2.9), undetectable HIV-1 RNA when starting indinavir treatment (RR, 3.2;95% CI, 1.5-6.0), prior treatment change because of intolerance (RR, 2.4;95% CI, 1.2-5.1), indinavir regimens of 1000 mg or more twice daily (RR, 3.1;95% CI, 1.3-8.2), and warm environmental temperatures (RR, 3.9;95% CI, 1.7-8.8). Risk estimates were highest among patients with a low lean body mass. Conclusion: Increased alertness for urological symptoms is warranted for patients starting indinavir treatment, particularly among those with a low lean body mass, during indinavir regimens of 1000 mg or more twice daily, and in warm weather environments

Plasma tau, neurofilament light chain and amyloid-beta levels and risk of dementia; a population-based cohort study

CSF biomarkers, including total-tau, neurofilament light chain (NfL) and amyloid-b, are increasingly being used to define and stage Alzheimer’s disease. These biomarkers can be measured more quickly and less invasively in plasma and may provide important information for early diagnosis of Alzheimer’s disease. We used stored plasma samples and clinical data obtained from 4444 nondemented participants in the Rotterdam study at baseline (between 2002 and 2005) and during follow-up until January 2016. Plasma concentrations of total-tau, NfL, amyloid-b40 and amyloid-b42 were measured using the Simoa NF-lightVR and N3PA assays. Associations between biomarker plasma levels and incident all-cause and Alzheimer’s disease dementia during follow-up were assessed using Cox proportional-hazard regression models adjusted for age, sex, education, cardiovascular risk factors and APOE e4 status. Moreover, biomarker plasma levels and rates of change over time of participants who developed Alzheimer’s disease dementia during follow-up were compared with age and sex-matched dementia-free control subjects. During up to 14 years follow-up, 549 participants developed dementia, including 374 cases wit