Given a passage with a context and an answer, construct a question on the basis of the information present in the passage. Construct the question in such a way that (i) it is unambiguous, (ii) it is answerable from the passage, (iii) its answer is unique (iv) it answer uses text phrases from the passage. Avoid creating questions that (i) can't be answered correctly without actually understanding the passage and (ii) uses the same words or phrases given in the passage.
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Question: Context: Corticosteroids are a critical component of therapy for acute lymphoblastic leukemia (ALL) but are associated with late effects, such as osteoporosis. Risk factors remain poorly defined. Because CRHR1 polymorphisms have been associated with other corticosteroid effects, our goal was to define whether CRHR1 polymorphisms predict which patients with ALL are likely to develop bone mineral deficits.', 'The mean bone mineral density z scores of 309 long-term survivors of ALL were determined by quantitative computed tomography of the trabecular lumbar spine. We analyzed whether CRHR1 genotypes, adjusted for sex, ALL treatment regimen, and weight, could predict bone density.', 'We found that three single nucleotide polymorphisms (SNPs), all in linkage disequilibrium, were associated with bone density in a sex-specific manner. Bone density was lower in males (P = .001), in nonblack patients (P < .08), in those who were not overweight (P < .001), and in those who received intensive antimetabolites and glucocorticoids (P < .001). After adjustment for these features, the G allele at the rs1876828 SNP was associated with lower z scores (P = .02) in males but tended to have the opposite association in females (P = .09).
Answer: CRHR1 polymorphisms may impact the risk of bone density deficits in patients treated with corticosteroids and antimetabolites in a sex-specific manner.

Answer: Do cRHR1 polymorphisms predict bone density in survivors of acute lymphoblastic leukemia?


Question: Context: The aim of this study was to visualize early stage prostate cancer (Cap) in a clinical setting. In previous studies, the results of magnetic resonance imaging (MRI) for screening Cap have rarely been confirmed by well-designed multisite prostate biopsy.', 'The prostate glands of 90 men with elevated prostate-specific antigen (PSA) were imaged by dynamic contrast-enhanced MRI (DCE-MRI) before transrectal ultrasound-guided 14-cores prostate biopsy. Each core was divided into three subcore fractions (total of 42 fractions) to generate a histological localization diagram, which was compared with localization-visualized DCE-MRI.', "The detection rate of Cap in 57 patients with PSA < 10.0 ng/ml was 36.8% as determined by the initial biopsy. DCE-MRI uncovered 92.9% of the clinically significant Caps and its specificity was 96.2% for the first biopsy session. One case with positive DCE-MRI and a negative primary biopsy was positive with additional biopsies. All of 26 DCE-MRI positive cases had significant Cap, and two of eight patients with histological Cap and negative or equivocal imaging had significant cancer. In total, 9 of 20 cases with DCE-MRI stage T2 underwent radical prostatectomy. All of them had organ-confined disease, although 33-77% (mean 63%) of them were expected to be rated T3 or higher by Partin's table.
Answer: DCE-MRI can identify early stage Cap with high sensitivity and specificity, and can predict the histological grade to some extent. DCE-MRI prior to biopsy should be applied to younger patients with surgical indications. Otherwise, we recommend the definitive diagnosis of Cap by utilizing DCE-MRI alone.

Answer: Is dynamic contrast-enhanced magnetic resonance imaging ( DCE-MRI ) a useful modality for the precise detection and staging of early prostate cancer?


Question: Context: Liver stiffness measurement (LSM) by transient elastography (TE, FibroScan) is a validated method for noninvasively staging liver fibrosis. Most hepatic complications occur in patients with advanced fibrosis. Our objective was to determine the ability of LSM by TE to predict hepatic complications and mortality in a large cohort of patients with chronic liver disease.', 'In consecutive adults who underwent LSM by TE between July 2008 and June 2011, we used Cox regression to determine the independent association between liver stiffness and death or hepatic complications (decompensation, hepatocellular carcinoma, and liver transplantation). The performance of LSM to predict complications was determined using the c-statistic.', 'Among 2,052 patients (median age 51 years, 65% with hepatitis B or C), 87 patients (4.2%) died or developed a hepatic complication during a median follow-up period of 15.6 months (interquartile range, 11.0-23.5 months). Patients with complications had higher median liver stiffness than those without complications (13.5 vs. 6.0 kPa; P<0.00005). The 2-year incidence rates of death or hepatic complications were 2.6%, 9%, 19%, and 34% in patients with liver stiffness <10, 10-19.9, 20-39.9, and ≥40 kPa, respectively (P<0.00005). After adjustment for potential confounders, liver stiffness by TE was an independent predictor of complications (hazard ratio [HR] 1.05 per kPa; 95% confidence interval [CI] 1.03-1.06). The c-statistic of liver-stiffness for predicting complications was 0.80 (95% CI 0.75-0.85). A liver stiffness below 20 kPa effectively excluded complications (specificity 93%, negative predictive value 97%); however, the positive predictive value of higher results was sub-optimal (20%).
Answer: Liver stiffness by TE accurately predicts the risk of death or hepatic complications in patients with chronic liver disease. TE may facilitate the estimation of prognosis and guide management of these patients.

Answer:
Does liver stiffness by transient elastography predict liver-related complications and mortality in patients with chronic liver disease?