Hepatitis C Virus positivity prediction from serum samples using NIRS and L1-penalized classification.

AIMS: The hepatitis C virus (HCV) has developed a strategy to coexist with its host resulting in varying degrees of tissue and cell damage, which generate different pathological phenotypes, such as varying degrees of fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). However, there is no integrated information that can predict the evolutionary course of the infection. We propose to combine Near-infrared spectroscopy (NIRS) and machine learning techniques to provide a predictive model. In this work, we propose to discriminate HCV positivity in biobank patient serum samples. METHODS: 126 serum samples from 38 HCV patients in different stages of the disease were obtained from the Biobank of Hospital Universitario Fundación Alcorcon. NIRS spectrum was captured by a FT-NIRS Spectrum 100 (Perkin Elmer) device in reflectance mode. For each patient, the HCV positivity was identified (PCR) and labeled as detectable =1 and undetectable =0. We propose an L1-penalized logistic regression model to classify each spectrum as positive (1) or negative (0) for HCV presence (x). The regularization parameter is selected using 5- fold cross-validation. The penalized model will induce sparsity in the solution so that only a few relevant wavelengths will be different from zero. RESULTS: L1-penalized logistic regression model provided 167 wavelengths different from zero. The accuracy on an independent test set was 0.78. CONCLUSIONS: We present a straightforward promising approach to detect HCV positivity from patient serum samples combining NIRS and machine learning techniques. This result is encouraging to predict HCV progression, among other applications. Clinical relevance- We presented a simple while promising approach to use machine learning and NIRS to analyze viral presence on sample serums.

Evaluation of myopic cornea lenticules. A histochemical and clinical correlation.

In this work, we have analyzed the main clinical and corneal histological parameters that may be associated to the spherical equivalent (SE), age and gender of individuals with myopic refractive errors. For this purpose, 108 cornea stroma lenticules were obtained from patients subjected to ReLEx-SMILE myopia correction. Histological analyses were carried out and histochemistry and immunohistochemistry were used to quantify key histological components of the cornea stroma, including mature collagen fibers, reticular and elastic fibers, glycoproteins, proteoglycans, type-V collagen and several crystallins. Clinical and histological data were analyzed to determine their association with SE, age and gender. Results showed a significant correlation between the age range of the patients and the expression of crystallins CRY-α-A, CRY-λ1 and type-V collagen and between CRY-λ1 and corneal thickness, spherical diopters (D) and SE, although correlation between CRY-λ1 and SE was non-significant when age was controlled. Comparison of cases with low myopia and high/moderate myopia found statistical differences for D and lenticule thickness and diameter. The binary logistic regression analysis allowed us to construct a model using two clinical parameters (D and lenticule thickness). Parameters showing significant correlation with the age were the corneal radius, keratometry reading (K), OZ, CRY-α-A and type-V collagen, whereas SE, lenticule thickness, OZ, CRY-λ1 and type-V collagen showed statistically significant differences between the youngest and the oldest patients. A binary logistic regression analysis model was generated including 3 variables (D, cornea radius and OZ). No gender differences were found. The specific clinical and histological modifications found to be associated to the SE and age could be useful for a better understanding of the mechanisms involved in the genesis or progression of myopia and could establish the basement for future therapeutic options.

Prevalencia y características clínicas de la esteatohepatitis no alcohólica en una población con hipertensión arterial esencial / Prevalence and clinical features of non-alcoholic steatohepatitis in a hypertensive population

Objetivo: El hígado graso no alcohólico es una enfermedad hepática crónica caracterizada por el depósito de grasa en los hepatocitos. En su evolución puede generar inflamación, denominada esteatohepatitis no alcohólica (EHNA), y fibrosis. La EHNA se ha asociado con el síndrome metabólico (SM) y con otros factores de riesgo cardiovascular. Nuestro objetivo ha sido analizar las características epidemiológicas de la EHNA en una población hipertensa, con alta prevalencia de SM, y valorar cuáles son los posibles factores que se asocian con la EHNA. Métodos: Se han utilizado los datos de 3.473 pacientes de la Unidad de Hipertensión del Hospital Universitario de Móstoles en un estudio retrospectivo, observacional y transversal. La EHNA se definió como la presencia de esteatosis hepática determinada mediante ecografía abdominal, junto con el aumento de alanina aminotransferasa y/o aspartato aminotransferasa mayor o igual a 1,5 veces el valor superior de la normalidad, en ausencia de otras causas de hepatopatía: consumo de alcohol, hepatitis autoinmune, farmacológica, vírica o hemocromatosis. Se realizaron análisis univariantes para evaluar la relación de cada variable con la variable dependiente, un estudio multivariante mediante regresión logística y un análisis de la varianza para estudiar la relación del número de factores de SM con la presencia de EHNA. Resultados: La cohorte final incluyó 2.242 pacientes (51,3% varones), de los cuales 255 (11,4%) presentaban criterios de EHNA (71% varones). El 52,6% presentaba SM (69,4% en el grupo de EHNA frente al 50,5% sin EHNA, p=0,001). La prevalencia de diabetes mellitus tipo 2 fue de 11,5% (16,5% en el grupo con EHNA frente al 10,8% de los pacientes sin EHNA, p=0,01). En el análisis multivariado, el perímetro abdominal, la presencia de SM (como variable categórica), el índice de masa corporal, la diabetes mellitus tipo 2, la edad, la insulina plasmática basal y la ferritinemia se asociaron de forma independiente con la presencia de EHNA. El análisis de la varianza reveló que la EHNA y los niveles de transaminasas se correlacionaron también de forma significativa con el número de factores de SM. Conclusiones: En nuestra población, tanto el SM como la diabetes mellitus tipo 2 y varios factores relacionados con el SM se asociaron de manera independiente con la presencia de EHNA. La EHNA puede así representar también la manifestación hepática del SM en los pacientes con hipertensión arterial esencial

Objective: Non-alcoholic fatty liver is a chronic liver disease in which fat is deposited in the liver, causing an inflammation called non-alcoholic steatohepatitis (NASH), and fibrosis. NASH is associated with metabolic syndrome (MS) and other cardiovascular risk factors. The aim of this study was to analyse the epidemiological features of NASH within a hypertensive population, with a high prevalence of MS, and to determine the features related to NASH. Methods: The computerised records were collected from 3,473 patients from Mostoles University Hospital's Hypertension Unit in order to perform a retrospective, cross-sectional study. NASH was considered as ultrasound-detected fatty liver disease along with serum levels of alanine aminotransferase or aspartate aminotransferase 1.5 times above normal values, having ruled out other causes of liver disease: alcohol abuse, autoimmune hepatitis, drug toxicity, virus and hemochromatosis. A univariate, multivariate, and ANOVA analysis were performed to assess the effect of the studied features on the response of interest. Results: The cohort included 2,242 patients (51.3% men). NASH was present in 255 patients (11.4%) of whom 71% were men. MS was detected in 52.6% of patients (69.4% in the NASH group, and 50.5% in the non-NASH group, P=.001). Prevalence of type 2 diabetes mellitus was 11.5% (16.5% in the NASH group, and 10.8% in the non-NASH group, P=.01). In a multivariate analysis, waist circumference, MS, body mass index, type 2 diabetes mellitus, age, fasting serum insulin, and serum ferritin were associated with NASH. ANOVA revealed that NASH and transaminases were also significantly associated with components of metabolic syndrome. Conclusions: In the population studied, MS, type 2 diabetes mellitus, and several components of MS were independently associated with NASH. Therefore, NASH can be considered as the liver manifestation of MS in patients with arterial hypertension

[Prevalence and clinical features of non-alcoholic steatohepatitis in a hypertensive population]. / Prevalencia y características clínicas de la esteatohepatitis no alcohólica en una población con hipertensión arterial esencial.

OBJECTIVE: Non-alcoholic fatty liver is a chronic liver disease in which fat is deposited in the liver, causing an inflammation called non-alcoholic steatohepatitis (NASH), and fibrosis. NASH is associated with metabolic syndrome (MS) and other cardiovascular risk factors. The aim of this study was to analyse the epidemiological features of NASH within a hypertensive population, with a high prevalence of MS, and to determine the features related to NASH. METHODS: The computerised records were collected from 3,473 patients from Mostoles University Hospital's Hypertension Unit in order to perform a retrospective, cross-sectional study. NASH was considered as ultrasound-detected fatty liver disease along with serum levels of alanine aminotransferase or aspartate aminotransferase 1.5 times above normal values, having ruled out other causes of liver disease: alcohol abuse, autoimmune hepatitis, drug toxicity, virus and hemochromatosis. A univariate, multivariate, and ANOVA analysis were performed to assess the effect of the studied features on the response of interest. RESULTS: The cohort included 2,242 patients (51.3% men). NASH was present in 255 patients (11.4%) of whom 71% were men. MS was detected in 52.6% of patients (69.4% in the NASH group, and 50.5% in the non-NASH group, P=.001). Prevalence of type 2 diabetes mellitus was 11.5% (16.5% in the NASH group, and 10.8% in the non-NASH group, P=.01). In a multivariate analysis, waist circumference, MS, body mass index, type 2 diabetes mellitus, age, fasting serum insulin, and serum ferritin were associated with NASH. ANOVA revealed that NASH and transaminases were also significantly associated with components of metabolic syndrome. CONCLUSIONS: In the population studied, MS, type 2 diabetes mellitus, and several components of MS were independently associated with NASH. Therefore, NASH can be considered as the liver manifestation of MS in patients with arterial hypertension.

Cystatin C as a predictor of cardiovascular outcomes in a hypertensive population.

Calculating the estimated glomerular filtration rate (eGFR) using creatinine-based equations may underestimate cardiovascular risk. Cystatin C-based eGFR may be a stronger prognostic biomarker than creatinine-based eGFR when assessing cardiovascular outcomes and mortality. Our aim was to determine whether levels of serum cystatin C, as an estimator of GFR, had a higher predictive value than creatinine-based eGFR for incident cardiovascular disease among hypertensive patients. We retrospectively analyzed the records of 2016 hypertensive patients from the Hypertension Unit at Mostoles University Hospital between 2006 and 2016. We calculated the eGFR using 3 CKD-EPI equations. The outcomes we included in our study were cardiovascular death, non-cardiovascular death, stroke, incident heart failure, and myocardial infarction. We used the Cox regression hazard model to estimate the hazard ratio. Our analysis found that, in terms of cardiovascular morbidity and mortality, both cystatin C-based eGFR (HR 2.88, 95% CI 1.86-4.47, P<0.0001) showed a higher prognostic value than creatinine-based eGFR (HR 2.83, 95% CI 1.73-4.63, P<0.0001). In terms of all-cause mortality, cystatin C-based eGFR (HR 4.24, 95% CI 2.38-7.53, P<0.0001) showed a higher prognostic value than creatinine-based eGFR (HR 2.77, 95% CI 1.43-5.36, P<0.0001). Our findings suggest that both cystatin C-based eGFRs may be stronger predictors of all-cause mortality and cardiovascular events in our hypertensive cohort when compared to creatinine-based eGFR, and may improve the risk assessment in certain populations.

[Neuroretinitis. Clinical cases]. / Neurorretinitis. Casos clínicos.

OBJECTIVE: Evaluate the etiology and the most frequent funduscopic alterations of the neuroretinitis. METHODS: We present the case of a woman 24 years old with a bilateral decrease of visual sharpness (AV), painless and progressive, the funduscopic examination of which reveals a bilateral optical disc edema, with no hemorrhages or exudates, retina edema of the posterior pole and phlebitic areas. The systematic study was normal except for the hemogram (18,000/mm(3) leucocytes with 79% neutrophils) and the positive serology next to a Chlamydia. We also present the case of a 64 years old woman with a decrease of AV at the right eye of one week duration. At the back of the eye a macular star can be seen, and papilla edema. A systematic study gave normal results and positive serology at Bartonella henselae. RESULTS: The illness produced by a cat scratch is the most common cause of neuroretinitis. The customary findings are a loss of AV, discromatopsia, afferent papillary defects and abnormality on the visual field. Other frequent findings at the back of the eye are hemorrhagic nerve fibers, cotton-like exudates, papilla edema, macular star and glassy inflammation. The roll of antibiotic therapy is questionable. Oral ciprofloxacine seems to give good results.

Neurorretinitis. Casos clínicos / Neuroretinitis. Clinical cases

Objetivo: Describir la etiología y las alteraciones funduscópicas más frecuentes de las neurorretinitis.Métodos: Presentamos el caso de una mujer de 24años con disminución de la agudeza visual (AV)bilateral, indolora y progresiva cuyo examen funduscópicomostraba un edema de disco óptico bilateralsin hemorragias ni exudados, edema retinianoen polo posterior y zonas de flebitis. El estudio sistémicofue normal excepto el hemograma(18.000/mm3 leucocitos con 79% de neutrófilos) yla serología positiva frente a Chlamydia. Presentamostambién el caso de una mujer de 64 años deedad con disminución de la AV en el ojo derecho de1 semana evolución. En el fondo de ojo (FO) seaprecia una estrella macular y edema de papila.Resultó estudio sistémico normal y serología positivaa Bartonella henselae.Resultados: La enfermedad por arañazo de gato esla causa más común de neurorretinitis. Los hallazgoshabituales consisten en una pérdida de AV, discromatopsia,defecto pupilar aferente y anormalidadesen el campo visual. Otros hallazgos frecuentesen el FO son hemorragias en la capa de fibras nerviosas,exudados algodonosos, edema de papila,estrella macular e inflamación vítrea. El papel de laterapia antibiótica es cuestionable. Parece que elciprofloxacino oral tiene buenos resultados(AU)

Objective: Evaluate the etiology and the most frequentfunduscopic alterations of the neuroretinitis.Methods:We present the case of a woman 24 yearsold with a bilateral decrease of visual sharpness(AV), painless and progressive, the funduscopicexamination of which reveals a bilateral optical discedema, with no hemorrhages or exudates, retinaedema of the posterior pole and phlebitic areas. Thesystematic study was normal except for the hemogram(18,000/mm3 leucocytes with 79% neutrophils)and the positive serology next to a Chlamydia.We also present the case of a 64 years oldwoman with a decrease of AV at the right eye of oneweek duration. At the back of the eye a macular starcan be seen, and papilla edema. A systematic studygave normal results and positive serology at Bartonellahenselae.Results: The illness produced by a cat scratch is themost common cause of neuroretinitis. The customaryfindings are a loss of AV, discromatopsia,afferent papillary defects and abnormality on thevisual field. Other frequent findings at the back ofthe eye are hemorrhagic nerve fibers, cotton-likeexudates, papilla edema, macular star and glassyinflammation. The roll of antibiotic therapy is questionable.Oral ciprofloxacine seems to give goodresults(AU)

[Treatment of conjunctival intraepithelial neoplasia with topical mitomycin C 0.02%]. / Tratamiento de las neoplasias conjuntivales intraepiteliales con colirio de mitomicina C al 0,02%

PURPOSE: To evaluate the efficacy of topical mitomycin C (MMC) 0.02% in treating conjunctival intraepithelial neoplasia (CIN). METHODS: Three patients with CIN were treated with topical MMC 0.02%. Our follow-up period was twelve months (range 8-18 months). RESULTS: CIN was resolved in all three cases without modifying the normal corneal and conjunctival architecture. CONCLUSIONS: Topical MMC 0.02% four times daily during two weeks is a useful alternative tool for the surgical management of CIN.