Showing papers by "Carlo Filice published in 2012"

Performance of Real-Time Strain Elastography, Transient Elastography, and Aspartate-to-Platelet Ratio Index in the Assessment of Fibrosis in Chronic Hepatitis C

Abstract: OBJECTIVE The purpose of this article is to evaluate the diagnostic performance of transient elastography, real-time strain elastography, and aspartate-to-platelet ratio index in assessing fibrosis in patients with chronic hepatitis C by using histologic Metavir scores as reference standard SUBJECTS AND METHODS Consecutive patients with chronic hepatitis C scheduled for liver biopsy were enrolled Liver biopsy was performed on the same day as transient elastography and real-time strain elastography Transient elastography and real-time strain elastography were performed in the same patient encounter by a single investigator using a medical device based on elastometry and an ultrasound machine, respectively Diagnostic performance was assessed by using receiver operating characteristic curves and area under the receiver operating characteristic curve (AUC) analysis RESULTS One hundred thirty patients (91 men and 39 women) were analyzed The cutoff values for transient elastography, real-time strain el

Serum Cytokine Profile by ELISA in Patients with Echinococcal Cysts of the Liver: A Stage-Specific Approach to Assess Their Biological Activity

Abstract: To investigate the usefulness of serum cytokine dosage in the clinical management of cystic echinococcosis (CE), we analyzed serum levels of Th1 and Th2 cytokines in patients with hepatic CE in different cyst stages, CE1-2 (active), CE3a-3b (transitional), and CE4-5 (inactive). Ex vivo assessment of Th1 (IFN-γ) and Th2 (IL-4, IL-13, and IL-10) cytokines in sera was carried out using ELISA. IL-10 was undetectable in all serum samples of patients and controls, while a few sera contained measurable amounts of IFN-γ, IL-4, and IL-13. No statistically significant difference was found between the percentages of positive samples for each cytokine and the different groups analyzed (patients/controls, stage, number, location, and size of the cyst, serology, and sex of patients), with the exception of the association of IL-4 and IL-13 with the cyst stage. Overall, this investigation showed many limits of serum cytokine dosage as a marker of biological activity of echinococcal cysts. Because of low sensitivity and lack of specificity of this test, we believe that other ways to evaluate ex vivo biological activity of the cysts should be explored.

Assessment of liver stiffness with transient elastography by using S and M probes in healthy children

Abstract: We read with great interest the article by Engelmann etal. [2] in the February 2012 issue of EJP and wouldlike to raise an important issue in relation to their work.In their study, the authors investigated the feasibility oftransient elastography (TE) in healthy children to definenormal values of liver stiffness. Examinations were per-formed by using two types of probes (S or M) depend-ing on thorax circumference and according to themanufacturer recommendations. By using the appropri-ate probe, normal liver stiffness values were 4.40, 4.73,and 5.1 kPa, respectively, in three age groups—namely0–5, 6–11, and 12–18 years. Eighty percent of measure-ments were performed with the S probe and 20 % withthe M probe.Unfortunately, the utilization of different probes (S orM) introduces a severe bias that limits the results of thestudy. Indeed, the values obtained with different probesare not comparable due to technical aspects, such asfocal length, vibration amplitude, and depth of measure-ment [5]. In adults, it has been demonstrated that TEresults obtained by using M and XL probes are system-atically different because of the different region of inter-est [1, 3, 5]. Myers et al. [5] have found that, in patientswho were studied with both probes, the values obtainedwith XL probe were 1–2 kPa lower than that obtainedwith the M probe. It can be inferred that similar differ-ences could also be expected between the S and Mprobes, and this aspect should be taken into accountand thoroughly investigated. On the other hand, in arecent study, in which the results of TE measurementsobtained with an XL probe were compared to that ofliver biopsy, it was found that there was an overestima-tion of liver fibrosis with the XL probe [4].References

ShearWave™ Elastography Improves the Assessment of Liver Fibrosis

Abstract: This material is reproduced with permission of John Wiley & Sons, Inc. from Accuracy of real-time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: a pilot study. Ferraioli G, Tinelli C, Dal Bello B, Zicchetti M, Filice G, Filice C; Liver Fibrosis Study Group. Hepatology. 2012 Dec;56(6):2125-33. Copyright© 2012, the American Association for the Study of Liver Diseases (AASLD)