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Background and objectives. Virus hepatitis may lead to nephropathy as one of its multiple extrahepatic manifestations. Proteinuria by dipstick, a simple test in practice, is a useful and cardinal sign of underlying renal abnormalities. The aim of this study was to elucidate the impact of hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infections on the occurrence of proteinuria amongst adults.
Designandsetting. A prospective, cross‐sectional, community‐based study was conducted in an HBV/HCV endemic area of southern Taiwan. Eligible subjects aged 40–65 years (n = 9934) underwent testing of hepatitis B surface antigen (HBsAg), HCV antibody (anti‐HCV) and other related biochemical profiles. Urinalysis with repeated dipstick for proteinuria detection was performed.
Results. Anti‐HCV‐positive rate amongst proteinuria subjects was significantly higher than nonproteinuria subjects (9.6% vs. 6.2%, P < 0.001). By contrast, HBsAg‐positive rate did not differ between subjects with and without proteinuria (13.0% vs. 13.8%, P = 0.57). Prevalence of proteinuria amongst anti‐HCV‐positive subjects (10.2%) was significantly higher than that in HBsAg‐positive subjects (6.4%, P =0.004) and in HBsAg‐negative or anti‐HCV‐negative subjects (7.0%, P = 0.004). The difference persisted even after excluding diabetics. Multivariate logistic regression analyses showed that diabetes was the most important significant factor associated with proteinuria, followed by hypertension, anti‐HCV seropositivity, body mass index, age and triglyceride levels.
Conclusion. We demonstrated the significant association between proteinuria and HCV, but not HBV, infection in this HBV/HCV‐endemic area.
Background and Purpose
The importance of collateralization for maintaining adequate cerebral perfusion is increasingly recognized. However, measuring collateral flow noninvasively has proved elusive. The aim of this study was to assess correlations among (1) baseline perfusion and arterial transit time artifact, (2) cerebrovascular reactivity (CVR), and (3) the presence of collateral vessels on digital subtraction angiography (DSA).
Materials and Methods
The relationship between the presence of collateral vessels on arterial-spin-labeling (ASL) MRI and DSA was compared to blood-oxygenation-level-dependent (BOLD) MRI measures of hypercapnic cerebrovascular reactivity (CVR) in patients with symptomatic intracranial stenosis (n=18). DSA maps were reviewed by a neuroradiologist and assigned the following scores: 1) collaterals to the periphery of the ischemic site; 2) complete irrigation of the ischemic bed via collateral flow; 3) normal antegrade flow. ASL maps were scored according to 0) low signal; 1) moderate signal with arterial transit artifact (ATA); 2) high signal with ATA; 3) normal signal.
Results
In regions with normal-to-high signal on ASL, collateral vessel presence on DSA strongly correlated with declines in CVR as measured on BOLD MRI (p<0.001), most notably in patients with non-atherosclerotic disease. There was a trend toward increasing CVR with increases in the degree of collateralization on DSA (p=0.082).
Conclusion
Collateral vessels may have fundamentally different vasoreactivity properties than healthy vessels, a finding that is observed most prominently in non-atherosclerotic disease and to a lesser extent in atherosclerotic disease.
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