Background The impact of marijuana on the general population is largely unknown. The present study aimed to assess the association between marijuana use and liver steatosis and fibrosis in the general United States population utilizing data from the National Health and Nutrition Examination Survey (NHANES). Methods This cross-sectional study was performed with data from the 2017–2018 cycle of NHANES. The target population comprised adults in the NHANES database with reliable vibration controlled transient elastography (VCTE) results. The median values of the controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were used to evaluate liver steatosis and fibrosis, respectively. After adjusting for relevant confounders, a logistic regression analysis was used to assess the association between marijuana use and liver steatosis and fibrosis. Results A total of 2622 participants were included in this study. The proportions of never marijuana users, past users, and current users were 45.9%, 35.0%, and 19.1%, respectively. Compared to never marijuana users, past and current users had a lower prevalence of liver steatosis (P = 0.184 and P = 0.048, respectively). In the alcohol intake-adjusted model, current marijuana use was an independent predictor of a low prevalence of liver steatosis in people with non-heavy alcohol intake. The association between marijuana use and liver fibrosis was not significant in univariate and multivariate regression. Conclusion In this nationally representative sample, current marijuana use is inversely associated with steatosis. The pathophysiology is unclear and needs further study. No significant association was established between marijuana use and liver fibrosis, irrespective of past or current use.
Background: Recommendations for surveillance after stereotactic body radiation therapy (SBRT) for early stage non–small cell lung cancer (NSCLC) are not well defined. Recently, PET response criteria in solid tumors (PERCIST) have been proposed as a new standardized method to assess radiotherapeutic response both quantitatively and metabolically. The aim of this study was to evaluate therapeutic response following Stereotactic Body Radiotherapy in early-stage Non-Small Cell Lung Cancer patients by comparing PERCIST with the currently widely used RECIST.Methods: Forty-nine patients with early-stage Non-Small Cell Lung Cancer who had been prescribed Stereotactic Body Radiotherapy were studied. Responses of lesion were evaluated using CT and 18F-FDG PET according to the RECIST and PERCIST methods. PET-CT scans were obtained before SBRT and 3 to 6 months after SBRT. Associations between overall survival and clinicopathologic results (histology, tumor location, tumor size, lymphatic invasion, clinical stage, radiotherapeutic responses in RECIST and PERCIST) were statistically analyzed. Median patient follow-up was 30 months.Results: Thirteen patients had stage IA, 9 stage IB, 10 stage IIA, and 17 stage IIB biopsy-proven NSCLC. Three-year overall survival was 79.6%. CT scans indicated 3 regional recurrences. PET/d-chest indicated 3 regional recurrences and distant metastasis. Significant differences were observed in response classification between RECIST and PERCIST (Wilcoxon signed-rank test, P=0.0041). Uni-variate analysis showed that clinical stage, RECIST and PERCIST were significant factors associated with overall survival, whilst by multivariate analysis PERCIST was the only predictor of overall survival. SMD, PMD/PMR, CMR in PERCIST criteria was indicative of a 9.900-fold increase in the risk of overall survival in early NSCLC patients [RR 9.900 (95% CI 1.040, 21.591), P=0.001].Conclusion: RECIST based on the anatomic size reduction rate did not demonstrate correlation between radiotherapeutic response and prognosis in patients with early-stage NSCLC receiving SBRT. However, PERCIST was shown as the strongest independent predictor of outcomes. PERCIST might be considered more suitable for evaluation of NSCLC tumour response to SBRT than RECIST.
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