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Aims. We aim to evaluate, through a meta-analysis, the ability of contrastenhanced ultrasound' (CEUS) hepatic vein arrival-time (HVAT) in predicting liver cirrhosis in patients with diffuse chronic liver diseases (LD). Material and Methods. We reviewed for inclusion all the studies which assess the diagnostic performance of HVAT in patients having unequivocal clinical signs or liver biopsy findings of cirrhosis who underwent CEUS. After testing for variability of the diagnostic threshold and a summary receiver operating characteristic curve (sROC) was constructed, pooled weighted estimates of sensitivity and specificity were calculated. Using a random-effects model, meta-regression was performed to explore sources of heterogeneity and explain differences between studies. Results. Out of 21 eligible studies, 8 were included in the meta-analysis with pooled 389 subjects (mean age 52.7±6.5). Individual data were analyzed in 372 patients (HCV 40.86%, HBV 4.56%, alcoholic LD 4.04%, non-alcoholic LD 3.22%, other etiologies 47.32%), with a cirrhosis prevalence of 40.32% (35.34% Child A, 27.33% Child B, 10% Child C, 27.33% not classified). With no variability of the diagnostic threshold (Spearman correlation coefficient: 0,071, p=0.86), pooled weighted estimates of sensitivity were 0.90 [95% CI: 0.84-0.94] and of specificity were 0.85 (95% CI: 0.83-0.92), with an AUROC of 0.95 in predicting liver cirrhosis. We found no statistically significant differences among different Child-Pugh classes (p=0.7). Variation across studies was 13.8% due to heterogeneity. The overall performance of HVAT was influenced by quality scores (p=0.01) and prevalence of cirrhosis (p=0.02), regardless of age, disease etiology, contrast agent used or ultrasound acquisition technique (p>0.05). Conclusions. Contrast-enhanced HVAT is a non-invasive method which allows a reliable assessment of liver cirrhosis. It has no ability in distinguishing between Child-Pugh classes. [ABSTRACT FROM AUTHOR]

No matter what the nature of the liver injury may be, it seems that the pattern inflammation - necrosis - cure (fibrosis) - regeneration (cirrhosis) - dysplasia - hepatocarcinoma is always the same. [ABSTRACT FROM AUTHOR]

In the last few years the concept Information Technology (IT) became a catalyst in different areas of activities, including those of education in the field of medicine. In this context, the implementation of eDoctoral-campus portal reflects the change of paradigm regarding the teaching and learning methods within the doctoral programs. The portal represents a cohesive assembly of eLearning, eAssessment, Content Management System (CMS), videoconference and forum models. [ABSTRACT FROM AUTHOR]

Aims: The goal of the study was to evaluate the efficacy of regular ultrasound and laboratory follow-up for early detection of HCC and to identify parameters correlated to a higher risk of developing HCC and mortality in patients with cirrhosis. Patients and methods: One hundred and two patients (62 males and 40 females, age 55±9,6 years) with Child's A and B cirrhosis and no evidence of HCC were followed up in an 6-years prospective surveillance program with testing by ultrasound and alpha-fetoprotein (AFP) every 6 months. Results: The median follow up was 46 (±16) months. The annual incidence of HCC was 6,4%. Eighteen HCCs were detected during the follow-up. At the time of diagnosis, ultrasound detected the focal lesions in all the patients whereas AFP was below normal levels in 50% of patients. HCC was unifocal in 14 patients and multifocal in four. In 12 cases, the tumors were unifocal, less than 3 cm in diameter without portal thrombosis or metastasis. By multivariable analysis, the risk of HCC was associated with increased AFP level (p=0,012). The risk factors of mortality were represented by increased AFP (p=0,01), bilirubin level ( p=0,026), prothrombin time (p=0,07). Conclusion: In this study, screening was useful to detect early hepatocellular carcinoma, but only ultrasound was effectively to identify potentially curative tumors in patients with cirrhosis. The incidence of HCC was related to increased AFP and death was closely related to AFP and poor liver function. [ABSTRACT FROM AUTHOR]