POSTERS liver on ultrasound has a good accuracy for predicting NASH in patients with gallstones. Based on these results, we propose that gallstones patients who have preoperative evidence of both insulin resistance and fatty liver on ultrasound are considered to undergo a needle liver biopsy during cholecystectomy for early diagnosis of NASH at high-risk patients. P1035 ELF TEST IS A RELIABLE NON INVASIVE TEST FOR FIBROSIS IN NAFLD SUBJECTS L. Miele1 , T. De Michele2 , M.A. Isgro` 3 , G. Marrone1 , C. Cefalo1 , M. Biolato1,4 , G.L. Rapaccini5 , A. Gasbarrini1 , C. Zuppi2 , A. Grieco1 . 1 Internal Medicine, 2 Laboratory Medicine, Catholic University, 3 Laboratory Medicine, Catholic University of Rome, 4 Catholic University, 5 Internal Medicine, Catholic University of Rome, Rome, Italy E-mail: [email protected] Background and Aims: The identification of fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) is important for prognosis and selection of patients candidates for therapeutic interventions. The reference standard for detecting liver fibrosis is liver biopsy; however, such an invasive procedure, it can be painful and hazardous, and assessment subjective and prone to sampling error. Recently, the serum Enhanced Liver Fibrosis (ELF) Test has been developed for staging liver fibrosis in patients with chronic liver diseases. The aim of our study was to evaluate the ELF Test performance in predicting fibrosis stage in an independent adult cohort of NAFLD patients. Methods: 82 patients (mean age 46 years) with suspected NAFLD were enrolled undergoing percutaneous liver biopsy and serum sampling. Fibrosis was assessed and scored by using the modified Brunt classification (F0 = no fibrosis; F1 = perisinusoidal/periportal; F2 = perisinusoidal and portal/periportal; F3 = bridging fibrosis; F4 = cirrhosis). The ELF test was determined in all patients by means of an algorithm combining hyaluronic acid, aminoterminal propeptide of type III collagen and tissue inhibitor of metalloproteinase 1. Diagnostic accuracy was assessed determining the area under receiver operating characteristic curves (AUCs). Results: The distribution of fibrosis stages in our cohort was as follows: F0 = 7.3% (n = 6), F1 = 39.0% (n = 32), F2 = 35.4% (n = 29), F3 = 6.1% (n = 5), F4 = 12.2% (n = 10). The ELF Test had an AUC of 0.988 (95% confidence interval [CI] 0.967–1.008; P < 0.001) for distinguishing cirrhosis, 0.948 (CI 0.883–1.014; P < 0.001) for severe fibrosis, 0.682 (CI 0.568–0.797; P = 0.005) for significant fibrosis and 0.658 (CI 0.401–0.915; P = 0.200) for any fibrosis. ELF scores were significantly higher in patients with severe fibrosis/cirrhosis in respect to ones with no/mild/moderate fibrosis (median 11.26 vs. 8.53; P < 0.001). Severe fibrosis and cirrhosis were correctly identified in 91% of patients. Conclusions: In our cohort of NAFLD patients, the ELF test was able to discriminate severe fibrosis and cirrhosis with an excellent diagnostic accuracy. It may result useful for the selection of cases with more advanced fibrosis stage and for therapeutic follow-up, thus avoiding liver biopsy. P1036 OBESITY, T2DM, METABOLIC SYNDROME INFLUENCE MORTALITY IN NAFLD IN A COHORT OF MEXICAN PATIENTS L.A. Perez-Arredondo1 , P. Cordero-Perez1 , G. Alarcon-Galvan1,2 , R.F. Martinez-Macias1 , A. Silvera-Linares1 , L.E. Munoz-Espinosa1 . 1 Liver Unit Department of Internal Medicine, 2 Pathology Department, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico E-mail: [email protected] Background and Aims: The spectrum of non alcoholic fatty liver disease (NAFLD) comprises non alcoholic fatty liver (NAFL), non alcoholic steatohepatitis (NASH) and cirrhosis. Recently, it has been S736

positioning as one of the most frequent causes of chronic liver disease (CLD). Mexico has the second highest worldwide prevalence of obesity and type 2 diabetes mellitus (T2DM) is present in 14% of general population. The aim of this study was to evaluate the influence that metabolic factors had in the natural history of NAFLD in Mexican patients. Methods: NAFLD diagnosis was made in patients who drank

Development of a teicoplanin loading regimen that rapidly achieves target serum concentrations in critically ill patients with severe infections.

We performed high-dose loading (12 mg/kg every 12 h for 48 h; 4 doses total) of teicoplanin (TEIC) in patients with severe methicillin-resistant Staph...
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