Prevalence of hepatic dysfunction in paediatric patients with Fontan circulation
Bibliographic record
Abstract
Introduction Hepatic dysfunction is a well-known complication and is frequently referred to as Fontan-associated liver disease. The aim of the study is to assess liver dysfunction in children and adolescents with Fontan circulation. Material and methods The study was an observational analytical study conducted on 30 patients who underwent Fontan operation more than 2 years before inclusion in the study and who were followed up at the Paediatric Cardiology Unit, Cairo University Children’s Hospital. All patients were subjected to echocardiography, laboratory investigations, abdominal ultrasound, and liver elastography. Results The median patient age was 13 years (inter-quartile range [IQR] 10–16.32), and the median follow-up duration after the Fontan operation was 5 years (IQR 3.83–9). Global longitudinal strain was lower in 26 (86.7%), and the single ventricle ejection fraction was reduced in 23 (76.7%); however, no correlation was found with time interval since Fontan. None of the patients had ascites clinically or by ultrasound examination. Gamma-glutamyl transferase was elevated in 28 (93.33%), which was significantly higher in the systemic right ventricle group. Abdominal ultrasound revealed periportal enhancement in 6 (20%), which was significantly higher in the hepatitis C virus exposed group (p = 0.006). Superior mesenteric artery resistance index was decreased in 27 (90%), which was significantly lower in the systemic left ventricle group (p = 0.01). The liver stiffness values did not correlate with time interval since Fontan (p = 0.09). Conclusions Liver disease is prevalent in Fontan patients. Non-invasive measures such as laboratory tests, ultrasound, and elastography should be implemented with consideration for hepatology consultation. Fontan-associated liver disease screening is important in the monitoring of Fontan patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".