Fibrosis In Children Research Articles

Low skeletal muscle mass and liver fibrosis in children with cerebral palsy

The purpose of the study was to conduct a nutritional and metabolic assessment of children with cerebral palsy, including an investigation of liver status, body composition, and bone mineral density. In this cross-sectional study we included 22 children with cerebral palsy. By using ultrasound, transient elastography, dual x-ray absorptiometry (DXA) scan, blood samples, anthropometric measurements, and a three-day diet registration, the nutritional and metabolic status was evaluated. Liver fibrosis and steatosis were found in four patients (18.2%), all with severe motor impairments, low skeletal muscle mass, and epilepsy. All patients with liver involvement had normal liver-related blood samples. Decreased bone mineral density was found in 26.3%, and 91.0% had low skeletal muscle mass. Fat mass and muscle mass were significantly lower in the patients with severe motor impairments compared to the patients with less severe motor impairments. Within the children classified as ‘underweight’ or ‘normal’ according to body mass index, body fat determined by DXA scan was normal or high in 50% of these patients.Conclusions: This study is the first to report liver fibrosis and steatosis in children with cerebral palsy. Possible causes of liver fibrosis and/or steatosis are altered body composition with low skeletal muscle mass, decreased mobility and medical drug intake. Further investigations of liver involvement and risk factors are needed.What is Known:• Children and adolescents with cerebral palsy are at risk of malnutrition and altered body composition, both of which can lead to fatty liver disease.• It is unknown whether children with cerebral palsy are at increased risk of metabolic disturbances such as fatty liver disease.What is New:• Altered body composition and low skeletal muscle mass, regardless of ambulation is present in 91% of the children with cerebral palsy.• Liver fibrosis and/or steatosis were found in 18.2% of the patients. Possible causes are altered body composition, decreased mobility and medical drug intake.

Non-invasive diagnosis of liver fibrosis in children with chronic hepatitis B by transient elastography

Background Chronic hepatitis B (CHB) is one of the most alarming global health problems. Children with CHB mostly remain asymptomatic but serious sequelae like cirrhosis and hepatocellular carcinoma may develop at any age. Liver biopsy, despite being the gold standard, is not preferable for the diagnosis of liver fibrosis because it is invasive and painful. Transient elastography, a noninvasive marker for fibrosis, could play an important role in this disease.
 Objective To observe the role of transient elastography in the assessment of the progression of liver damage in children with chronic hepatitis B.
 Methods This cross-sectional study was conducted at The Department of Paediatric Gastroenterology and Nutrition of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Based on the inclusion and exclusion criteria, there were a total of 55 cases of CHB. Besides proper clinical history, physical examination, and initial investigation, transient elastography was performed in all of the cases. Liver biopsy was taken in 20 patients with raised serum ALT level after taking proper consent. Elastographic findings were compared with clinical, biochemical, virological, and histological findings.
 Results The mean age was 11.46 (SD 3.6) years and 68.7% were male. Most (65.4%) of the patients were asymptomatic at presentation and biochemically normal. Liver stiffness measurements had positive but insignificant correlation with liver biopsy (r=0.43, P=0.06). Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy for transient elastography were 80%, 53.3%, 36.3%, 88%, and 60% respectively. Areas under the ROC curve were 0.76 (95%CI 0.47 to 1.0) for patients with significant fibrosis (F? 2). Using a cut off value of 8.05 kPa, patients with significant fibrosis were detected with a sensitivity, specificity of 80% and 53%, respectively.
 Findings of transient elastography were significantly associated with clinical findings like anaemia, jaundice, hepatosplenomegaly, stigmata of CLD and biochemical findings like serum ALT, AST as well as virological parameters.
 Conclusion Transient elastography has a limited role in confirming a diagnosis of significant fibrosis. But because of good sensitivity, transient elastography can be used as an initial presumptive diagnostic tool for assessing significant hepatic fibrosis. A cut off value of less than 8.05 in transient elastography can be used for exclusion of significant fibrosis.

Role of minor lymphocyte populations in development of liver fibrosis in children with glycogen storage disease

Glycogen storage disease (GSD) is a rare condition that changes the way the body uses and stores glycogen. Objective: to evaluate the content of small populations of lymphocytes and their ratios in children with hepatic forms of glycogen disease depending on the stage of liver fibrosis. 148 children with GSD at the age of Me=7,7 [3,9;11,8] were examined. The comparison group consisted of 54 healthy children. The stage of liver fibrosis was carried out on the FibroScan F502 device (EchoSence, France). Immunophenotyping of lymphocytes was performed on CYTOMICS FC500 (Beckman Coulter, USA). Indicators of lymphocyte populations were analyzed as a percentage of deviation from the age norm. In children with GSD, an increase in the degree of liver fibrosis was revealed from age (R=0.57). Treg content in children with GSD was at the lower limit of the age norm and did not depend on the stage of liver fibrosis. The content of Th17 and Thact lymphocytes was significantly higher than that of the comparison group at all stages of liver fibrosis, starting from stage F1. With an increase in the stage of liver fibrosis, there was an increase in the proportion of patients with Thact and Th17 content exceeding the upper limit of the normative values (PF0-F4=0.021 and PF0-F4=0.012, respectively). An increase in Th17/Treg and Thact/Treg ratios was revealed in patients with GSD relative to the comparison group in all age groups, the dynamics of Th17/Treg and Thact/Treg ratios was characterized by their increase with age. Analysis of indicators depending on the stage of liver fibrosis in children with GSD revealed a significant increase in the Thact/Treg ratio from stage F0 to stages F1, F2, F3 and F4 (PF0-F4=0.000). The Th17/Treg index increased from stage F0 to stages F1, F2, F3 (PF0-F3=0.000).
 An increase in the content of Thact and Th17 lymphocytes, as well as Th17/Treg and Thact/Treg indices with an increase in the stage of liver fibrosis can be used as an additional tool in assessing fibrotic changes in the liver. Immunological indicators objectively reflect the severity of the patient's condition with hepatic forms of GSD.

Nasal polyposis from cystic fibrosis in children - the experience of a single center.

Cystic fibrosis (CF) is the most common monogenic disease, characterized by clinically notable polymorphism. Respiratory disease is the main factor that influences the disease outcome and prognosis of the patient with CF, bacterial infections being responsible for severe exacerbations and rhinosinusitis a difficult complication, besides lung disease. The aim of the paper was to present a case series of CF-associated nasal polyposis and our management experience, providing new data for nasal and sinus complications. Patients attending the National Cystic Fibrosis Center, Timişoara, Romania, were evaluated for nasal polyposis. Besides clinical examination, endoscopy, and computed tomography (CT) was performed for comprehensive evaluation. Patients with persistent symptoms or with complicated sinusitis underwent surgical approach. Fourteen (18.18%) children were diagnosed with nasal polyposis and had surgery, with positive outcomes. One patient received Omalizumab for an associated, uncontrolled asthma with a subsequent substantial effect with the significant polyp reduction and lack of recurrence. Even if extremely difficult to manage, complicated nasal polyposis CF related might have an improved outcome and better life quality.

Evaluation of hepatic fibrosis by transient elastography in βthalassemia children before and after hematopoietic stem cell transplantation

Abstract Background Iron overload is a major concern in all patients with transfusion-dependent thalassemia (TDT). The liver, being a target for iron deposition is at risk of developing liver fibrosis or even cirrhosis. Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curative treatment in clinical practice, a process that is surrounded by several precautions and complications that may affect the liver condition as well. Aim To evaluate the degree of hepatic fibrosis in children with TDT before and after HSCT. Methodology Twenty-five children with TDT who underwent HSCT were investigated by serum ferritin in addition to the assessment of liver fibrosis using transient elastography by FibroScan and liver fibrosis scores before and 1-year after HSCT. Results Out of the 25 children enrolled, only 16 completed a 1-year post-transplantation follow-up period. Slightly increased liver stiffness values measured by FibroScan 1-year post-transplantation, but the patients were still having the same degree of fibrosis of the pre-transplant period. FIB-4 score and APRI also showed statistically significant increase post-transplant as compared to pre-transplantation. Conclusion Stationary degree of fibrosis in thalassaemic children after HSCT with slight increases in the liver stiffness values by transient elastography that necessitates longer follow-up of the fibrosis status of patients’ post-transplant. Transient elastography is considered a helpful noninvasive tool for assessment of the hepatic status before and after HSCT.

Role and significance of SIRT1 in regulating the LPS-activated pyroptosis pathway in children with congenital hydronephrosis

ObjectiveTo explore the characteristics and mechanism of sirtuin 1 (SIRT1) in lipopolysaccharide (LPS)-activated pyroptosis in the renal tissue of children with congenital hydronephrosis (CHn).MethodsWe detected the expression characteristics and clinical...

Using colistimethate sodium in complex therapy of cystic fibrosis in children under 6 years of age

Early and adequate antibacterial therapy of airway infections in patients with cystic fibrosis (CF) may lead to decrease in chronic inflammation, delay the worsening of pulmonary function, and prevent the selection of resistant bacteria. Inhaled forms of antibiotics, which can help to achieve high concentrations of drug in airways and minimize systemic adverse reactions, are particularly important when treating children under 6 years of age. Purpose. To evaluate effectiveness of combined therapy and tolerability of therapy with inhaled colistimethate sodium when treating exacerbations of infectious process in children with cystic fibrosis under 6 years of age. Methods. A retrospective analysis of medical records of patients with CF and infections caused by Pseudomonas aeruginosa who were admitted to pulmonology department of Federal State Autonomous Institution “National Medical Research Center for Children’s Health” of the Ministry of Health of the Russian Federation from June of 2021 to March of 2023 and who were treated with inhaled colistimethate sodium. Results. 20 courses of therapy in 17 patients with cystic fibrosis under 6 years of age were recorded. Mean duration of treatment was 10.4 days (4 – 19 days). There were no adverse reactions that led to discontinuation of the treatment. Clinical and microbiological effectiveness of the combined therapy was 60%. Conclusion. Therapy of exacerbations of airway infections caused by P. aeruginosa with inhaled colistimethate sodium was well tolerated by patients under 6 years of age. No adverse drug reactions were reported.

Analysis of clinical characteristics and risk factors of hepatic fibrosis in children with chronic hepatitis B combined with metabolic-related fatty liver disease

Objective: To compare the clinical and pathological features of children with chronic viral hepatitis B combined with metabolic-associated fatty liver disease (CHB-MAFLD) and chronic viral hepatitis B alone (CHB alone), and to further explore the effect of MAFLD on the progression of hepatic fibrosis in CHB. Methods: 701 initially treated CHB children confirmed by liver biopsy admitted to the Fifth Medical Center of the PLA General Hospital from January 2010 to December 2021 were collected continuously. They were divided into CHB-MAFLD and CHB-alone groups according to whether they were combined with MAFLD. A retrospective case-control study was conducted. CHB-MAFLD was used as the case group, and 1:2 propensity score matching was performed with the CHB alone group according to age and gender, including 56 cases in the CHB-MAFLD group and 112 cases in the CHB alone group. The body mass index (BMI), metabolic complications, laboratory indicators, and pathological characteristics of liver tissue were compared between the two groups. The related factors affecting liver disease progression in CHB were analyzed by a binary logistic regression model. The measurement data between groups were compared using the t-test and rank sum test. The χ (2) test was used for the comparison of categorical data between groups. Results: Alanine aminotransferase (ALT, P = 0.032) and aspartate aminotransferase (AST, P = 0.003) levels were lower in the CHB-MAFLD group than those in the CHB alone group, while BMI (P < 0.001), triglyceride (TG, P < 0.001), total cholesterol (P = 0.016) and the incidence of metabolic syndrome (P < 0.001) were higher in the CHB alone group. There were no statistically significant differences in HBsAg quantification or HBV DNA load between the two groups (P > 0.05). Histologically, the proportion of significant liver fibrosis (S2-S4) was higher in the CHB-MAFLD group than that in the CHB alone group (67.9% vs. 49.1%, χ (2) = 5.311, P = 0.021). Multivariate regression results showed that BMI (OR = 1.258, 95% CI: 1.145 ~ 1.381, P = 0.001) and TG (OR = 12.334, 95% CI: 3.973 ~ 38.286, P < 0.001) were the risk factors for hepatic steatosis occurrence in children with CHB. MAFLD (OR = 4.104, 95% CI: 1.703 ~ 9.889, P = 0.002), liver inflammation (OR = 3.557, 95% CI: 1.553 ~ 8.144, P = 0.003), and γ-glutamyl transferase (OR = 1.019, 95% CI: 1.001 to 1.038, P = 0.038) were independent risk factors for significant hepatic fibrosis in children with CH. Conclusion: MAFLD occurrence is related to metabolic factors in children with CHB. Additionally, the combination of MAFLD may promote liver fibrosis progression in CHB patients.

Diagnostic accuracy of shear wave elastography in evaluating renal fibrosis in children with chronic kidney disease: a comparative study with nuclear scan

BackgroundChronic kidney disease (CKD) is a significant health issue in pediatric patients due to fibrosis progression. Shear wave elastography (SWE) is a noninvasive technique used to assess fibrosis in CKD, but its efficacy needs to be better established. This study aimed to compare SWE with nuclear scan in assessing fibrosis in pediatric CKD patients.AimTo determine the area of scarring/fibrosis of each kidney using shear wave elastography in chronic kidney disease and compare it with technetium-99m dimercaptosuccinic acid (DMSA) results.MethodsA prospective study included 39 chronic kidney disease patients who underwent shear wave elastography and grayscale ultrasound. DMSA scans were performed to identify scar areas of the kidneys. Young modulus was recorded for each pole of both kidneys and compared with scar areas on DMSA. Thirty-nine age-matched controls underwent shear wave elastography to estimate the average elasticity value in the normal population.ResultsThirty-nine CKD patients underwent this study, with 10 females and 29 males. The median age was 6.5 years. The cutoff value of cortical thickness ≤ 10.2 predicted scar on DMSA with a sensitivity of 79% and a specificity of 77%. The cutoff value of elasticity value ≥ 5.57 kPa predicted scar on DMSA with a sensitivity of 87% and a specificity of 96%. Median SWE values were significantly higher with the scar on DMSA (12.6 kPa) compared to no scar on DMSA (4.1 kPa). The controls mean values and standard deviation were 2.42 kPa and 0.45 kPa, respectively.ConclusionsShear wave elastography has revealed that patients with chronic kidney disease exhibit higher values in the areas where scarring has occurred, compared to non-scarred areas. Fortunately, integrating shear wave elastography into routine ultrasonography assessments is a straightforward and painless process that requires no additional preparation from the patient. Not only is this method time efficient, but it also eliminates the need for potentially risky radiation exposure from radionuclide tests in the future.

Cardiac imaging and biomarkers for assessing myocardial fibrosis in children with hypertrophic cardiomyopathy

Myocardial fibrosis, as diagnosed on cardiac magnetic resonance imaging (cMRI) by late gadolinium enhancement (LGE), is associated with adverse outcomes in adults with hypertrophic cardiomyopathy (HCM), but its prevalence and magnitude in children with HCM have not been established. We investigated: (1) the prevalence and extent of myocardial fibrosis as detected by LGE cMRI; (2) the agreement between echocardiographic and cMRI measurements of cardiac structure; and (3) whether serum concentrations of N-terminal pro hormone B-type natriuretic peptide (NT-proBNP) and cardiac troponin-T are associated with cMRI measurements. A cross-section of children with HCM from 9 tertiary-care pediatric heart centers in the U.S. and Canada were enrolled in this prospective NHLBI study of cardiac biomarkers in pediatric cardiomyopathy (ClinicalTrials.gov Identifier: NCT01873976). The median age of the 67 participants was 13.8 years (range 1-18 years). Core laboratories analyzed echocardiographic and cMRI measurements, and serum biomarker concentrations. In 52 children with non-obstructive HCM undergoing cMRI, overall low levels of myocardial fibrosis with LGE >2% of left ventricular (LV) mass were detected in 37 (71%) (median %LGE, 9.0%; IQR: 6.0%, 13.0%; range, 0% to 57%). Echocardiographic and cMRI measurements of LV dimensions, LV mass, and interventricular septal thickness showed good agreement using the Bland-Altman method. NT-proBNP concentrations were strongly and positively associated with LV mass and interventricular septal thickness (P < .001), but not LGE. Low levels of myocardial fibrosis are common in pediatric patients with HCM seen at referral centers. Longitudinal studies of myocardial fibrosis and serum biomarkers are warranted to determine their predictive value for adverse outcomes in pediatric patients with HCM.

Nuclear transcription factor kB (NF-kB) activity in lymphocyte populations in children with Wilson-Konovalov disease

Wilson's disease (WD) is a rare hereditary disease caused by a deficiency of the ATF7B transporter. The accumulation of copper can cause damage to organs and cells, mainly the liver. Copper exposure can modulate cytokine synthesis through molecular and cellular signaling pathways, including the nuclear transcription factor NF-kB pathway. NF-kB is the main regulator of inflammation and cell death, acts as a central link between liver damage, fibrosis and hepatocellular carcinoma. An excess of NF-kB-dependent cytokine response stimulates inflammatory reactions, but excessive inhibition of NF-kB can negatively affect the viability of hepatocytes. Method of flow cytometry with visualization — Amnis ImageStreamX allows to evaluate the activity of NF-kB (% of activated cells in cell populations). The aim: to evaluate the activity of NF-kB in lymphocyte populations in children with WD disease. Immunophenotyping of lymphocytes and assessment of the level of translocation of NF-kB were performed in 52 children with WD and in 25 children of comparison group. The mass concentration of copper in daily urine was determined by atomic absorption method using the AAnalyst 800 spectrometer. In children with WD, the content of cells with NF-kB translocation varied from 5 to 90% depending on the lymphocyte population; the highest level was detected in B cells — 57.5 (37-68) %. A significant difference in distributions of the number of cells with NF-kB translocation between WD and healthy children was shown (F-criterion, p &lt; 0.01). In most cases, children with WD are characterized by a decrease in the activity of NF-kB in populations of B cells (in 43% of cases), T helper cells (48%), T cytotoxic (44%) and Th17 lymphocytes (41%). In children with WD, the concentration of copper varied from 9.7 to 2582 mcg/day, Me = 616 (210-1173). A direct relationship was obtained between the copper content in urine and the level of translocation of NF-kB in B lymphocytes, r = 0.34, p = 0.016. The activity of the NF-kB correlates with biochemical markers of the severity of liver damage (ALT, AST, GGT) and with copper content in urine. The study of the NF-kB signaling pathway seems promising for a better understanding of the pathogenetic mechanisms of the formation of inflammation and liver fibrosis in children with WD.

SAT-434 - Evaluating the prevalence of liver fibrosis in children with non-alcoholic fatty liver disease using transient elastography, Dutch Fibrokids cohort

SAT-434 - Evaluating the prevalence of liver fibrosis in children with non-alcoholic fatty liver disease using transient elastography, Dutch Fibrokids cohort

FRI-486 - Use of magnetic resonance elastography for accurate staging of liver fibrosis in children with autoimmune hepatitis

FRI-486 - Use of magnetic resonance elastography for accurate staging of liver fibrosis in children with autoimmune hepatitis

Informative value of laboratory markers in assessing the stage of liver fibrosis in children with type 1 autoimmune hepatitis

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A Systematic Review of Cystic Fibrosis in Children: Can Non-Medical Therapy Options Lead to a Better Mental Health Outcome?

Cystic fibrosis (CF) is a chronic disorder that begins at an early age, so it is crucial to be aware of the physical and emotional burden placed on individuals suffering from it and their families. It significantly impacts an individual's life; therefore, it is essential to acknowledge the effects of the disease on physical and mental health. Our systematic review aims to highlight the areas of life affected by cystic fibrosis and evaluate various non-medical treatment options that may support the mental health of CF patients. We selected PubMed, Google Scholar, and MEDLINE (Medical Literature Analysis and Retrieval System Online) as our databases. We initially found 146,095 articles and narrowed the number of articles down using filters, exclusion and inclusion criteria, and various combinations of Medical Subheadings (MeSH) and key terms. We decided to use a final count of nine articles for our systematic review. The studies we included highlighted the negative impact of cystic fibrosis on mental health, like depression and anxiety, as well as on sleep, physical health, and overall quality of life. Several non-medical interventions, such as logotherapy, psychological interventions, complementary and alternative medicine, and many more, have been shown to enhance the mental health of many participants. Studies suggested that such therapy options may greatly benefit individuals with cystic fibrosis and their current treatment plan. This review indicates that non-medical therapy options can enhance the mental health of individuals suffering from cystic fibrosis and that it is crucial to bring more attention to preventing and treating mental health issues in cystic fibrosis patients. However, as current data is limited, more research with a larger number of participants over an extended period of time is necessary to better evaluate the efficacy of non-medical interventions on mental health.

Багатофакторна модель прогнозування тяжкого перебігу та ураження органів і систем при Лайм-бореліозі в дітей

Lyme disease (tick-borne borreliosis, Lyme borreliosis - LB) is a multisystem zoonotic disease transmitted by the bite of infected ticks. Purpose - to develop a mathematical model for predicting the risk of severity of the course (PRSC) of LB by the risk factor for the development of disseminated LB in children who have had a tick attack. Materials and methods. To build a model for PRSC of LB using multivariate regression analysis, 121 children with LB aged 13±3 years (from 1 to 18 years) were examined, including 51 boys and 70 girls. Groups of patients: 78 children with erythema migrans, 16 - with Lyme arthritis, 27 - with nervous system lesions. The quality of the prognostic model was checked by the Neigelkerk criterion (R2), and the acceptability of the model was assessed using ANOVA analysis of variance. Serological examination of patients bitten by ticks was performed by enzyme-linked immunosorbent assay. To detect immunoglobulins of classes M (IgM) and G (IgG) to B. burgdorferi s.l. complex, test systems from Euroimmun AG (Germany) were used. IgM antibodies were determined by the test system Anti-Borrelia burgdorferi ELISA, IgG - by Anti-Borrelia plus VIsE ELIS. Blood samples with intermediate and positive results of the first stage of work were examined by immune blotting: IgM antibodies were detected using the system Anti-Borrelia EUROLINE Borrelia RN-AT (IgM), and IgG antibodies - Anti-Borrelia EUROLINE RN-AT. Results. The method of multivariate regression analysis for predicting the severe course and damage to organs and systems in children with LB, taking into account the factors and variants of the disease itself, allows to develop a mathematical model of PRSC of LB and to improve the effectiveness of treatment. Thus, all prerequisites have been created for high-quality preventive measures and reducing the risk of severe pulmonary disease. The initial data for predicting the severity of pulmonary disease were 28 factors. According to the results of the regression analysis, 24 factors were included in the model for predicting the severity of the course of pulmonary disease. Conclusions. For the first time, a multivariate regression model for PRSC of LB for pulmonary fibrosis in children was built. The weighting coefficients of each of the factors of the onset and progression of LB were taken into account: 0-10 points indicate the development of a localized stage (primary effect stage), while 11 or more points indicate a disseminated (generalized) stage. The results of the study make it possible to further develop standardized scales of the severity of LB and possible organ and system damage. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Evaluating the non-invasive tools for assessment of liver fibrosis in children with intrahepatic cholestasis prior to partial biliary diversion: tertiary-center experience

BackgroundThe liver biopsy is an essential element of evaluating progression of liver disease in children with Progressive Familial Intrahepatic Cholestasis (PFIC) and Allagille Syndrome (AGS). Several noninvasive techniques, including radiological imaging and blood biomarkers assay, can be used to evaluate liver stiffness.ObjectivesTo identify whether liver Transient elastography (FibroScan) and AST/PLT Ratio Index (APRI) could be reliable tools to assess the degree of fibrosis prior to partial biliary diversion (PBD).MethodsA prospective cohort in which all patients with PFIC and AGS who underwent PBD from July 2019 to July 2021 were included. Preoperative liver functions, pelvic-abdominal ultrasonography and FibroScan assessments were performed while intraoperative liver biopsy was obtained.ResultsEight patients with chronic cholestatic liver disease who were candidates for PBD due to intractable pruritus were enrolled, including PFIC (n = 6; 75%), and AGS (n = 2; 25%). The liver FibroScan results were similar to the liver biopsy histopathological assessment in 87.5% of cases. APRI ranged from 0.1 to 3.2 (median = 1.2). In four cases (50%), APRI was consistent with histological evaluation of liver samples. The FibroScan results were in concordance with APRI results in three patients (37.5%).ConclusionThe current cohort demonstrated that fibroScan was consistent with histopathology in 87.5% of patients, highlighting its value in determining the degree of liver fibrosis prior to surgery, whereas the APRI was only consistent with histopathology in half of cases.

Magnetic resonance elastography in evaluation of liver fibrosis in children with chronic liver disease

BackgroundMagnetic resonance elastography (MRE) has been used to stage liver fibrosis in adults. We aimed to assess the agreement between the Ishak scoring system and magnetic resonance elastography-measured liver stiffness (MRE-LS) in children. This study included all the children who underwent abdominal MRE and liver biopsies between February 2018 and January 2021. The correlation between MRE-LS and Ishak fibrosis stage, MRE parameters, and clinical and biochemical markers affecting this relationship was investigated.ResultsA total of 52 patients (31 male; a median age of 11.8 years) were included in the study. The MRE-LS values were significantly different between Ishak fibrosis stages (p = 0.036). With a cut-off value of 2.97 kilopascals, MRE-LS had sensitivity, specificity, PPV, NPV and accuracy values of 90.9%, 82.9%, 58.8%, 97.1%, and 84.6%, respectively, for differentiating mild/moderate fibrosis (F0, 1, 2, 3) from severe fibrosis (F ≥ 4). Although MRE-LS was moderately correlated with Ishak fibrosis score and histological activity index and weakly correlated with aspartate aminotransferase, hepatic steatosis, and R2*, only Ishak fibrosis score was a significant predictor of MRE-LS. MRE-measured spleen stiffness was weakly correlated with the Ishak fibrosis score.ConclusionsMRE has high sensitivity and specificity for evaluating liver fibrosis in children. MRE may be used to evaluate liver fibrosis in pediatric patients.

Clinical study of the value of shear wave elastography in evaluating the degree of liver fibrosis in children.

To explore the clinical application of shear wave elastography (SWE) in evaluating the degree of liver fibrosis in children. To explore the value of SWE in assessing liver fibrosis in children, the correlation between elastography values and the METAVIR grade of liver fibrosis in children with biliary system or liver diseases was studied. Children with significant liver enlargement were enrolled, and the fibrosis grade was analyzed to explore the value of SWE in assessing the degree of liver fibrosis in the presence of significant liver enlargement. A total of 160 children with bile system or liver diseases were recruited. The areas under the receiver operating characteristic curve (AUROCs) for liver biopsy from stage F1 to F4 were 0.990, 0.923, 0.819, and 0.884. According to the degree of liver fibrosis at liver biopsy, there was a high correlation between the SWE value and the degree of liver fibrosis (correlation coefficient 0.74). There was no significant correlation between the Young's modulus value of the liver and the degree of liver fibrosis (correlation coefficient 0.16). Supersonic SWE can generally accurately evaluate the degree of liver fibrosis in children with liver disease. However, When the liver is significantly enlarged, SWE can only evaluate liver stiffness based on Young's modulus values, and the degree of liver fibrosis must still be determined by pathologic biopsy.

Effect of nanoparticle macroalgae in the treatment of fatty liver disease using logistic regression, and support vector machine

One of the major health issues facing people worldwide is liver fibrosis. Liver fibrosis may be brought on by long-term exposure to harmful substances, medicines, and microorganisms. The development of liver fibrosis in children was particularly worrying due to their longer life-span, which was possibly related to a great risk of developing long-term complications. Marine algae species have provided a biological variety in the research phase of novel approaches to the treatment of numerous ailments. Marine macroalgae have recently been the subject of research due to their rich bioactive chemical composition and potential for the production of various nutraceuticals. Macroalgae are potentially excellent sources of bioactive substances with particular and distinct biological activity when compared to their terrestrial equivalents. Macroalgae in diverse marine cases offer a few biologically active metabolites, comprising sterols, polyunsaturated fatty acids, carotenoids, oligosaccharides, polysaccharides, proteins, polyphenols, vitamins, and minerals. Accordingly, there is great interest in their high potential for supporting immunomodulatory, antimicrobial, antidiabetic, antitumoral, anti-inflammatory, antiangiogenic, and neuroprotective properties. Using an experimental model, the current research intends to collect data on the therapeutic value of macroalgae nanoparticles for fatty liver disease. The researchers' goal of predicting illnesses from the extensive medical datasets is quite difficult. The purpose of this research is to assess the protective effects of a seaweed, Padina pavonia (PP), on liver fibrosis caused by carbon tetrachloride (CCl4). This research presents two models of logistic regression (LR) and support vector machines (SVM) for predicting the likelihood of liver disease incidence. The performance of the model was evaluated using a dataset. PP macro-algae considerably reduce the high blood concentrations of aminotransferases, alkaline phosphatases, and lactate dehydrogenases, as well as causing a considerable (p < 0.05) decrease in serum bilirubin levels. In addition to improving kidney function (urea and creatinine), algal extracts enhance fat metabolism (triglycerides and cholesterol). With an accuracy rate of 70.2%, a sensitivity of 92.3%, a specificity of 74.7%, a type I error of 9.1%, and a type II error of 21.0%, the predictive model has demonstrated excellent performance. The model validated laboratory tests' ability to predict illness (age; direct bilirubin (DB), total proteins (TP), and albumin (ALB). These classifier methods are compared on the basis of their execution time and classification accuracy.