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To evaluate the prognostic value of sequential dual-phase CBCT (DP-CBCT) imaging performed during degradable starch microsphere TACE (DSM-TACE) session in predicting the HCC’s response to treatment, evaluate with modify response evaluation criteria in solid tumours (mRECIST) at 1-month multi-detector CT (MDCT) follow-up. Between January and May 2018, 24 patients (68.5 ± 8.5 year [45–85]) with HCC lesions (n = 96 [average 4/patient]) were prospectively enrolled. Imaging assessment included: pre-procedural MDCT, intra-procedural DP-CBCT performed before first and second DSM-TACEs and 1-month follow-up MDCT. Lesions’ attenuation/pseudo-attenuation was defined as average value measured on ROIs (HU for MDCT; arbitrary unit called HU* for CBCT). Lesions’ attenuation modification was correlated with the post-procedural mRECIST criteria at 1-month MDCT. Eighty-two DSM-TACEs were performed. Lesion’s attenuation values were: pre-procedural MDCT arterial phase (AP) 107.00 HU (CI 95% 100.00–115.49), venous phase (VP) 85.00 HU (CI 95% 81.13–91.74); and lesion’s pseudo-attenuation were: first CBCT-AP 305.00 HU* (CI 95% 259.77–354.04), CBCT-VP 155.00 HU* (CI 95% 135.00–163.34). For second CBCT were: -AP 210.00 HU* (CI 95% 179.47–228.58), -VP 141.00 HU* (CI 95% 125.47–158.11); and for post-procedural MDCT were: -AP 95.00 HU (CI 95% 81.35–102.00), -VP 83.00 HU (CI 95% 78.00–88.00). ROC curve analysis showed that a higher difference pseudo-attenuation between first and second DP-CBCTs is related to treatment response. The optimal cut-off value of the difference between first and second CBCT-APs to predict complete response, objective response (complete + partial response) and overall disease control (objective response + stable disease) were > 206 HU* (sensitivity 80.0%, specificity 81.7%), > 72 HU* (sensitivity 79.5%, specificity 83.0%) and > − 7 HU* (sensitivity 91.6%, specificity 65.4%), respectively. DP-CBCT can predict intra-procedurally, by assessing lesion pseudo-attenuation modification, the DSM-TACE 1-month treatment outcome.

BACKGROUND: Many factors affect survival in haemodialysis (HD) patients. Our aim was to study whether quality of clinical care may affect survival in this population, when adjusted for demographic characteristics and co-morbidities. METHODS: We studied survival in 553 patients treated by chronic HD during March 2001 in 21 dialysis facilities in western Switzerland. Indicators of quality of care were established for anaemia control, calcium and phosphate product, serum albumin, pre-dialysis blood pressure (BP), type of vascular access and dialysis adequacy (spKt/V) and their baseline values were related to 3-year survival. The modified Charlson co-morbidity index (including age) and transplantation status were also considered as a predictor of survival. RESULTS: Three-year survival was obtained for 96% of the patients; 39% (211/541) of these patients had died. The 3-year survival was 50, 62 and 69%, respectively, in patients who had 0-2, 3 and >or=4 fulfilled indicators of quality of care (test for linear trend, P < 0.001). In a Cox multivariate analysis model, the absence of transplantation, a higher modified Charlson's score, decreased fulfilment of indicators of good clinical care and low pre-dialysis systolic BP were independent predictors of death. CONCLUSION: Good clinical care improves survival in HD patients, even after adjustment for availability of transplantation and co-morbidities.

Background and aims Whether Fibroscan thresholds can be immediately adopted for none, some or all other shear wave elastography techniques has not been tested. The aim of the present study was to test the concordance of the findings obtained from 7 of the most recent ultrasound elastography machines with respect to Fibroscan. Methods Sixteen hepatitis C virus-related patients with fibrosis ≥2 and having reliable results at Fibroscan were investigated in two intercostal spaces using 7 different elastography machines. Coefficients of both precision (an index of data dispersion) and accuracy (an index of bias correction factors expressing different magnitudes of changes in comparison to the reference) were calculated. Results Median stiffness values differed among the different machines as did coefficients of both precision (range 0.54–0.72) and accuracy (range 0.28–0.87). When the average of the measurements of two intercostal spaces was considered, coefficients of precision significantly increased with all machines (range 0.72–0.90) whereas of accuracy improved more scatteredly and by a smaller degree (range 0.40–0.99). Conclusions The present results showed only moderate concordance of the majority of elastography machines with the Fibroscan results, preventing the possibility of the immediate universal adoption of Fibroscan thresholds for defining liver fibrosis staging for all new machines.

Men living at high altitudes in Peru compared to sea level counterparts have erythrocytosis (hemoglobin 16-21 g/dl) or excessive erythrocytosis (hemoglobin>21 g/dl). High testosterone (T) levels in men at high altitude (HA) were associated with excessive erythrocytosis. High androgen levels could be due to a low aromatase activity or to an elevated rate of conversion from precursors to testosterone. The aim of this study was to evaluate aromatase activity and rate of conversion from precursors to testosterone before and after administration of the aromatase enzyme inhibitor letrozole (5 mg/day) for a 5-day period to men at HA and at sea level (SL). The response to short term aromatase inhibition was assessed in 30 adult men living at sea level, 31 native men at HA with erythrocytosis (Hb 16-21 g/dl), and 35 men at HA with excessive erythrocytosis (Hb>21 g/dl). Serum hormone levels, estradiol/testosterone, testosterone/androstenedione, and testosterone/dehydroepiandrosterone sulfate (DHEAS) ratios were measured. Men with erythrocytosis had lower basal serum T/androstenedione ratios than men with excessive erythrocytosis at HA and men at sea level. Men at HA with excessive erythrocytosis had higher T/DHEAS ratios than men with erythrocytosis and than those at sea level before and after letrozole administration. After letrozole administration, both groups of men at high altitude (with erythrocytosis or with excessive erythrocytosis) showed lower aromatase activities than those at sea level. In conclusion, higher serum testosterone levels in men with excessive erythrocytosis were associated with an increased rate of conversion from DHEAS to testosterone rather than to a lower aromatase activity.

The purpose of this study was to analyze in which physical capabilities boys and girls are closer or distant. An additional objective was to find which of the body fat, physical activity, and somatotype factors have a greater effect on prepubescent children's physical fitness. This was a cross-sectional study involving 312 children (10.8 ± 0.4 years). The physical fitness assessment employed sets of aerobic fitness, strength, flexibility, speed, agility, and balance. The boys presented higher values in all selected tests, except tests of balance and flexibility, in which girls scored better. Gender differences in the physical fitness were greatest in the explosive strength of upper (p ≤ 0.01, η(p)(2) = 0.09) and lower limbs (p ≤ 0.01, η(p)(2) = 0.08), although with a medium-size effect of gender, and smaller in the abdominal (p > 0.05, η(p)(2) = 0.007) and upper limbs (p > 0.05, η(p)(2) = 0.003) muscular endurance, and trunk extensor strength and flexibility (p > 0.05, η(p)(2) = 0.001). The endomorphic (p ≤ 0.01, η(p)(2) = 0.26) in the girls, and the ectomorphic (p ≤ 0.01, η(p)(2) = 0.31) and mesomorphic (p ≤ 0.01, η(p)(2) = 0.26) in the boys, had the high-sized effect on the physical fitness. The physical activity in the girls, and the endomorphic and body fat in the boys, did not have a significant effect. These findings can help in the planning of activities that take into account the success and motivation of both boys and girls and thus increase levels of physical activity and physical fitness at school. However, in prepubescent children, one cannot neglect the influence of genetic determinism, observed from the morphoconstitutional point of view.

International audience; AIM: The aim of the present study was to analyse the effects of training performed on a rotating, motorised platform (the Huber/SpineForce device from LPG Systems, Valence, France) intended to improve, postural control and muscle function.SUBJECTS: Twelve healthy adults (divided into a sedentary group and an active group) took part in a two-month training programme (involving three sessions a week) on the SpineForce whole body rehabilitation device.METHOD: Instrumental assessment of postural control (on a Satel platform) and muscle function (on a Cybex Norm) was performed before and after training. Postural control in various conditions was measured using a position parameter (the mean anteroposterior position of the centre of foot pressure [CoP]) and two stability parameters (maximum CoP displacement and CoP sway area). Assessment of the muscle function was performed during knee and spine extension and featured maximum voluntary isometric contraction (MVIC), root mean square (RMS) and neuromuscular efficiency (MVIC/RMS) measurements.RESULTS: For static postural control, we observed a more forward CoP position in the maximum backward inclination condition (p

INTRODUCTION: With 3-dimensional scanning, the image of 1 digital dental cast can be superimposed on another to observe growth or treatment changes; however, this requires stable references. The palatal rugae were considered reliable points for detecting dental changes on the cast's occlusal plane, but is this the case in the vertical plane? Our aims were to assess the long-term stability of the palatal rugae in the vertical dimension, relate them to possible maxillary incisor posteruptive movements, and validate them as references for the evaluation of longitudinal dental changes. METHODS: Four-year longitudinal lateral cephalograms and dental casts of 10 adults and 13 adolescents were used. The median palatal contour of each cast and marks corresponding to each ruga were superimposed on the palate of the cephalograms. Changes in rugae positions during the observation period were measured with respect to the palatal plane. RESULTS: Vertical changes were greater for the first rugae (closest to the incisors), less for the second, and even less for the third (farthest from the incisors). The adolescents showed greater vertical changes in rugae position than the adults. There were no statistically significant differences in the anteroposterior changes between the groups. The maxillary central incisor and the first ruga had vertical displacements proportional to the increase of the subject's lower anterior facial height. CONCLUSIONS: We found vertical displacement of the maxillary incisor and the rugae during the 4 years of observation in adolescents and adults. The third ruga, the farthest from the incisors, can be used as a reliable reference to assess longitudinal dental changes mainly when growth changes are less prominent.