5 resultados para diagnostic accuracy

em Archivo Digital para la Docencia y la Investigación - Repositorio Institucional de la Universidad del País Vasco


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Background: Non-alcoholic fatty liver disease (NAFLD) is caused by abnormal accumulation of lipids within liver cells. Its prevalence is increasing in developed countries in association with obesity, and it represents a risk factor for non-alcoholic steatohepatitis (NASH), cirrhosis and hepatocellular carcinoma. Since NAFLD is usually asymptomatic at diagnosis, new non-invasive approaches are needed to determine the hepatic lipid content in terms of diagnosis, treatment and control of disease progression. Here, we investigated the potential of magnetic resonance imaging (MRI) to quantitate and monitor the hepatic triglyceride concentration in humans. Methods: A prospective study of diagnostic accuracy was conducted among 129 consecutive adult patients (97 obesity and 32 non-obese) to compare multi-echo MRI fat fraction, grade of steatosis estimated by histopathology, and biochemical measurement of hepatic triglyceride concentration (that is, Folch value). Results: MRI fat fraction positively correlates with the grade of steatosis estimated on a 0 to 3 scale by histopathology. However, this correlation value was stronger when MRI fat fraction was linked to the Folch value, resulting in a novel equation to predict the hepatic triglyceride concentration (mg of triglycerides/g of liver tissue = 5.082 + (432.104 * multi-echo MRI fat fraction)). Validation of this formula in 31 additional patients (24 obese and 7 controls) resulted in robust correlation between the measured and estimated Folch values. Multivariate analysis showed that none of the variables investigated improves the Folch prediction capacity of the equation. Obese patients show increased steatosis compared to controls using MRI fat fraction and Folch value. Bariatric surgery improved MRI fat fraction values and the Folch value estimated in obese patients one year after surgery. Conclusions: Multi-echo MRI is an accurate approach to determine the hepatic lipid concentration by using our novel equation, representing an economic non-invasive method to diagnose and monitor steatosis in humans.

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[EN] The objective of this study was to determine whether a short training program, using real foods, would decreased their portion-size estimation errors after training. 90 student volunteers (20.18±0.44 y old) of the University of the Basque Country (Spain) were trained in observational techniques and tested in food-weight estimation during and after a 3-hour training period. The program included 57 commonly consumed foods that represent a variety of forms (125 different shapes). Estimates of food weight were compared with actual weights. Effectiveness of training was determined by examining change in the absolute percentage error for all observers and over all foods over time. Data were analyzed using SPSS vs. 13.0. The portion-size errors decreased after training for most of the foods. Additionally, the accuracy of their estimates clearly varies by food group and forms. Amorphous was the food type estimated least accurately both before and after training. Our findings suggest that future dietitians can be trained to estimate quantities by direct observation across a wide range of foods. However this training may have been too brief for participants to fully assimilate the application.