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JOURNAL ARTICLE
Xiao Cheng, Yujun Tang, Qinjun He, Jiankang Song, Kunyuan Wang, Hui Li, Jing Huang, Weibin Wang, Junying Li, Haiyu Wang, Minghan Tu, Jinzhang Chen, Guosheng Yuan, Shuai Kang, Hongyan Liu, Xiaoyong Zhang, Wenfan Luo, Yali Ji, Xiaoqin Lan, Ling Zhou, Qintao Lai, Xiaoqin Luo, Qiaoping Wu, Damei Zhou, Yingqi Tan, Jinjun Chen, Xiaofeng Zhang
BACKGROUND: Esophagogastroduodenoscopy (EGD) is required to screen for high-risk varices (HRV) in patients with hepatocellular carcinoma (HCC), especially since overall survival rates have dramatically improved with new systemic therapies. AIM: To assess the Baveno VI and Baveno VII algorithms' ability to rule out HRV in hepatitis B virus (HBV)-related HCC METHODS: We prospectively enrolled consecutive patients with HBV related, compensated cirrhosis and newly diagnosed HCC who underwent liver stiffness measurement, spleen stiffness measurement (SSM) using a 100-Hz shear wave frequency, and EGD...
December 28, 2023: Alimentary Pharmacology & Therapeutics
#22
JOURNAL ARTICLE
Ahmed Ehab, Axel T Kempa, Harald Englert, Shaza Almasri Bittar, Aida M Yousef, Heba Wagih Abdelwahab
INTRODUCTION: Obstructive sleep apnea syndrome (OSAS) is a clinical condition characterised by repeated periods of partial or full obstruction of airflow throughout sleep, with impairment of the quality of life and increased mortality with socioeconomic impacts. CPAP therapy is a simple and effective treatment option for OSAS patients. To overcome the clinical and prognostic limitations of AHI-as a sole index of OSAS-the Baveno classification was recently set out and introduced into clinical practice...
December 15, 2023: Advances in Respiratory Medicine
#23
JOURNAL ARTICLE
Yiheng Zhang, Xu Liu, Shu Li, Chunlei Lin, Qian Ye, Yuying Wang, Juanli Wu, Yushuang Zhang, Han Gao, Tao Li, Yundong Qu, Yan Wang
BACKGROUND: Antiviral therapy improves the clinical outcomes of patients with HBV-related cirrhosis. In this study, we aimed to evaluate the incidence rate of HCC in patients with HBV-related recompensated, compensated, or decompensated cirrhosis based on the latest Baveno VII criteria. METHODS: In this two-center retrospective study, HBV-related patients with cirrhosis were enrolled and treated with first-line nucleos(t)ide analogues therapy for at least 12 months...
January 1, 2024: Hepatology Communications
#24
REVIEW
Càndid Villanueva, Victor Sapena, Gin-Ho Lo, Yeon Seok Seo, Hasnain Ali Shah, Virendra Singh, Dhiraj Tripathi, Michael Schepke, Cristian Gheorghe, Daniell Q Bonilha, Rome Jutabha, Huay-Min Wang, Susana G Rodrigues, Anna Brujats, Han Ah Lee, Zahid Azam, Pramod Kumar, Peter C Hayes, Tilman Sauerbruch, Wen-Chi Chen, Speranta Iacob, Ermelindo D Libera, Dennis M Jensen, Edilmar Alvarado, Ferran Torres, Jaume Bosch
BACKGROUND & AIMS: Non-selective β-blockers (NSBBs) and endoscopic variceal-ligation (EVL) have similar efficacy preventing first variceal bleeding. Compensated and decompensated cirrhosis are markedly different stages, which may impact treatment outcomes. We aimed to assess the efficacy of NSBBs vs EVL on survival in patients with high-risk varices without previous bleeding, stratifying risk according to compensated/decompensated stage of cirrhosis. METHODS: By systematic review, we identified RCTs comparing NSBBs vs EVL, in monotherapy or combined, for primary bleeding prevention...
February 2024: Alimentary Pharmacology & Therapeutics
#25
JOURNAL ARTICLE
Mohamed A Elfeki, Ashwani K Singal, Patrick S Kamath
PURPOSE: Non-selective beta blockers remain pharmacotherapy of choice for prevention of first episode of variceal bleeding (primary prevention) and for prevention of its recurrence after initial hemostasis (secondary prophylaxis). This review will update the current and emerging pharmacological therapies for portal hypertension. RECENT FINDINGS: Data have emerged on carvedilol in preventing hepatic decompensation and improving patient survival among patients with clinically significant portal hypertension...
March 2023: Current Hepatology Reports
#26
JOURNAL ARTICLE
Binu V John, Yangyang Dang, David E Kaplan, Janice H Jou, Tamar H Taddei, Seth A Spector, Paul Martin, Dustin R Bastaich, Hann-Hsiang Chao, Bassam Dahman
BACKGROUND & AIMS: Patients with cirrhosis secondary to chronic hepatitis C virus (HCV) are at risk for hepatocellular carcinoma (HCC) despite a sustained virological response (SVR). We examined whether post-SVR liver stiffness measurement (LSM) could be used to stratify HCC risk. METHODS: This was a retrospective cohort study of 1850 participants identified from the Veterans Health Administration, with HCV cirrhosis and SVR, followed up over 5099 person-years, from the time of post-SVR elastography until death, HCC, or the end of the study...
December 5, 2023: Clinical Gastroenterology and Hepatology
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JOURNAL ARTICLE
Loreta A Kondili, Alberto Zanetto, Maria Giovanna Quaranta, Luigina Ferrigno, Valentina Panetta, Vincenza Calvaruso, Anna Linda Zignego, Maurizia R Brunetto, Giovanni Raimondo, Elisa Biliotti, Donatella Ieluzzi, Andrea Iannone, Salvatore Madonia, Liliana Chemello, Luisa Cavalletto, Carmine Coppola, Filomena Morisco, Francesco Barbaro, Anna Licata, Alessandro Federico, Federica Cerini, Marcello Persico, Maurizio Pompili, Alessia Ciancio, Fabio Piscaglia, Luchino Chessa, Andrea Giacometti, Pietro Invernizzi, Giuseppina Brancaccio, Antonio Benedetti, Leonardo Baiocchi, Ivan Gentile, Nicola Coppola, Gerardo Nardone, Antonio Craxì, Francesco Paolo Russo
BACKGROUND & AIMS: Sustained virological response (SVR) by direct-acting antivirals (DAAs) may reverse the hypercoagulable state of HCV cirrhosis and the portal vein thrombosis (PVT) risk. We evaluated the incidence and predictive factors of de novo, non-tumoral PVT in patients with cirrhosis after HCV eradication. METHODS: Patients with HCV-related cirrhosis, consecutively enrolled in the multi-center ongoing PITER cohort, who achieved the SVR using DAAs, were prospectively evaluated...
November 30, 2023: United European Gastroenterology Journal
#28
JOURNAL ARTICLE
Amine Zoughlami, Jordana Serero, Stephen Congly, Irene Zhao, Julie Zhu, Alnoor Ramji, Curtis Cooper, Philip Wong, Robert Bailey, Carla S Coffin, Giada Sebastiani
BACKGROUND: Individuals infected with hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency (HIV) viruses can experience compensated advanced chronic liver disease (cACLD) leading to esophageal varices (EV). In patients at low risk of esophageal varices needing treatment (EVNT), non-invasive criteria based on liver stiffness measurement (LSM) with platelets, or fibrosis biomarkers, may avoid unnecessary screening esophagogastroduodenoscopies (EGD). These approaches have not been compared among people infected with HIV, HBV, and HCV patients...
October 2023: Canadian liver journal
#29
JOURNAL ARTICLE
Angelo Alves de Mattos, Angelo Zambam de Mattos, Giovana Dal Pozzo Sartori, Gustavo Tovo Both, Cristiane Valle Tovo
• In compensated cirrhosis, using non-invasive methods would exempt the patient from the need of an endoscopy. • The Baveno VII presented the "rule of 5" for Vibration-Controlled Transient Elastography; liver stiffness measurement ≤15 kPa and platelets >150.000/mm3 exclude clinically significant portal hypertension (CSPH), while when ≥25 kPa is highly suggestive of CSPH. • Spleen stiffness measurement has been proposed as a more specific technique to predict the presence of CSPH...
2023: Arquivos de Gastroenterologia
#30
JOURNAL ARTICLE
Romana Suša, Miloš Ratinac, Vojislav Ćupurdija, Ljiljana Novković, Mirjana Milojević-Ilić, Marina Petrović, Nebojša Igrutinović, Marko Vuleta, Ljiljana Timotijević, Olivera Kostić, Ivan Čekerevac
Background and Objectives: The Baveno classification represents a new approach to the assessment of the severity of OSA (Obstructive sleep apnea), which takes significant comorbidities into account: atrial fibrillation, arterial hypertension, heart failure, stroke, diabetes mellitus, and OSA symptoms expressed through the Epworth sleepiness scale (ESS). The authors believe that the Baveno classification facilitates a better stratification of patients with OSA and can be a good guide for deciding on the therapeutic approach and clinical monitoring of patients with OSA, compared to the AHI (apnea-hypopnea index) itself...
November 1, 2023: Medicina
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JOURNAL ARTICLE
Manuel Mendizabal, Guilherme Grossi Lopes Cançado, Agustín Albillos
The Baveno VII consensus workshop has provided several novel recommendations regarding the management of patients with clinically significant portal hypertension (CSPH). The expert panel summarized the existing data into simple clinical rules to aid clinicians in their clinical practice. The use of non-invasive tests (NITs), especially liver stiffness measurement (LSM), have gain an important role in daily practice. The use of LSM alone or in combination with platelet count can be used to rule-in and rule-out compensated advanced chronic liver disease (cACLD) and CSPH...
November 18, 2023: Annals of Hepatology
#32
JOURNAL ARTICLE
Jiqing Liu, Hangfei Xu, Weiyuan Liu, Hongmei Zu, Huiguo Ding, Fankun Meng, Jing Zhang
BACKGROUND: The advantages of spleen stiffness in prediction of high-risk varices (HRV) in cirrhosis patients have been confirmed. Recently, a new device utilizing a 100 Hz probe dedicated to spleen stiffness measurement (SSM) was developed. OBJECTIVES: To validate the clinical applicability of SSM@100 Hz in predicting HRV by comparing it with other non-invasive tests (NITs). DESIGN: A prospective cohort study. METHODS: A total of 171 cirrhosis patients who underwent esophagogastroduodenoscopy (EGD) examination were included in this study...
2023: Therapeutic Advances in Chronic Disease
#33
MULTICENTER STUDY
Gennaro D'Amico, Alexander Zipprich, Càndid Villanueva, Juan Antonio Sordà, Rosa Maria Morillas, Matteo Garcovich, Montserrat García Retortillo, Javier Martinez, Paul Calès, Mario D'Amico, Matthias Dollinger, Marta García-Guix, Esteban Gonzalez Ballerga, Emmanuel Tsochatzis, Isabel Cirera, Agustìn Albillos, Guillaume Roquin, Linda Pasta, Alan Colomo, Jorge Daruich, Nuria Canete, Jérôme Boursier, Marcello Dallio, Antonio Gasbarrini, Angelo Iacobellis, Giulia Gobbo, Manuela Merli, Alessandro Federico, Gianluca Svegliati Baroni, Pietro Pozzoni, Luigi Addario, Luchino Chessa, Lorenzo Ridola, Guadalupe Garcia-Tsao
BACKGROUND AND AIMS: The prognostic weight of further decompensation in cirrhosis is still unclear. We investigated the incidence of further decompensation and its effect on mortality in patients with cirrhosis. APPROACH AND RESULTS: Multicenter cohort study. The cumulative incidence of further decompensation (development of a second event or complication of a decompensating event) was assessed using competing risks analysis in 2028 patients. A 4-state model was built: first decompensation, further decompensation, liver transplant, and death...
April 1, 2024: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
#34
JOURNAL ARTICLE
Long Gao, Man-Biao Li, Jin-Yu Li, Yang Liu, Chao Ren, Dui-Ping Feng
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) is the standard second-line treatment option for individuals with complications of decompensated cirrhosis, such as variceal bleeding and refractory ascites. AIM: To investigate whether recompensation existed in TIPS-treated patients with decompensated cirrhosis according to Baveno VII criteria. METHODS: This retrospective analysis was performed on 64 patients who received TIPS for variceal bleeding or refractory ascites...
October 14, 2023: World Journal of Gastroenterology: WJG
#35
JOURNAL ARTICLE
Fengbin Zhang, Yonghe Zhou, Xin Li, Chunyan Wang, Jie Liu, Shuang Li, Shuting Zhang, Weiming Luo, Lili Zhao, Jia Li
Currently, most primary hospitals cannot routinely perform liver stiffness measurements (LSMs) and spleen stiffness measurements (SSMs), which are recommended by guidelines to exclude high-risk varices (HRVs). We tried to find more convenient indicators for HRV screening. We enrolled 213 cirrhosis patients as the training cohort (TC) and 65 primary biliary cirrhosis patients as the validation cohort (VC). We included indicators such as SSM by two-dimensional shear wave elastography, LSM by transient elastography, and other imaging and laboratory tests...
October 10, 2023: Diagnostics
#36
JOURNAL ARTICLE
Lorenz Balcar, Mattias Mandorfer, Virginia Hernández-Gea, Bogdan Procopet, Elias Laurin Meyer, Álvaro Giráldez, Lucio Amitrano, Candid Villanueva, Dominique Thabut, Luis Ibáñez Samaniego, Gilberto Silva-Junior, Javier Martinez, Joan Genescà, Christophe Bureau, Jonel Trebicka, Elba Llop Herrera, Wim Laleman, José María Palazón Azorín, Jose Castellote Alonso, Lise Lotte Gluud, Carlos Noronha Ferreira, Nuria Cañete, Manuel Rodríguez, Arnulf Ferlitsch, Jose Luis Mundi, Henning Grønbæk, Manuel Nicolas Hernandez Guerra, Romano Sassatelli, Alessandra Dell'Era, Marco Senzolo, Juan Gonzalez Abraldes, Manuel Romero-Gómez, Alexander Zipprich, Meritxell Casas, Helena Masnou, Massimo Primignani, Aleksander Krag, Frederik Nevens, Jose Luis Calleja, Christian Jansen, María Vega Catalina, Agustín Albillos, Marika Rudler, Edilmar Alvarado Tapias, Maria Anna Guardascione, Marcel Tantau, Rémy Schwarzer, Thomas Reiberger, Stig Borbjerg Laursen, Marta Lopez-Gomez, Alba Cachero, Alberto Ferrarese, Cristina Ripoll, Vincenzo La Mura, Jaime Bosch, Juan Carlos García-Pagán
BACKGROUND & AIMS: Pre-emptive transjugular intrahepatic portosystemic shunt (TIPS) is the treatment of choice for high-risk acute variceal bleeding (AVB; i.e., Child-Turcotte-Pugh [CTP] B8-9+active bleeding/C10-13). Nevertheless, some 'non-high-risk' patients have poor outcomes despite the combination of non-selective beta-blockers and endoscopic variceal ligation for secondary prophylaxis. We investigated prognostic factors for re-bleeding and mortality in 'non-high-risk' AVB to identify subgroups who may benefit from more potent treatments (i...
January 2024: Journal of Hepatology
#37
JOURNAL ARTICLE
Shinya Yokoyama, Yoji Ishizu, Takashi Honda, Norihiro Imai, Takanori Ito, Kenta Yamamoto, Hisanori Muto, Chiyoe Shirota, Takahisa Tainaka, Wataru Sumida, Satoshi Makita, Shunya Takada, Yoichi Nakagawa, Takuya Maeda, Masanao Nakamura, Masatoshi Ishigami, Hiroo Uchida, Hiroki Kawashima
AIMS: Biliary atresia (BA) is a congestive biliary disease that develops in the neonatal period or early infancy. It may present with portal hypertension and varices needing treatment (VNT) even after successful Kasai portoenterostomy. This study aimed to stratify the risk of VNT in children and adolescents with BA. METHODS: In this prospective cross-sectional study, we measured liver stiffness (LS) and spleen stiffness (SS) by two-dimensional shear wave elastography and checked for VNT endoscopically in 53 patients with BA who attended for follow-up between July 2018 and September 2022...
October 16, 2023: Hepatology Research: the Official Journal of the Japan Society of Hepatology
#38
JOURNAL ARTICLE
Syed Ahmed, Sanchit Sharma, Samagra Agarwal, Yu Jun Wong, Martin Putera, Anoop Saraya
BACKGROUND AND AIMS: Esophageal varices (EVs), irrespective of size, are the most-reliable indicators of clinically significant portal hypertension (CSPH) in patients with compensated advanced chronic liver disease (cACLD). While non-invasive tools (NITs) accurately identify those with varices needing treatment (VNTs), their role in identifying any EVs in patients with cACLD is not known. METHODS: Patients with cACLD with reliable liver stiffness measurements (LSM), blood parameters and gastroscopy were retrospectively recruited from a multinational cohort...
October 16, 2023: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
#39
JOURNAL ARTICLE
Atsushi Hiraoka, Fujimasa Tada, Hideko Ohama, Mai Fukumoto, Kana Matsuoka, Takuya Matsuda, Kosuke Nakatani, Emi Yanagihara, Hironobu Saneto, Hirofumi Izumoto, Taisei Murakami, Kei Onishi, Shogo Kitahata, Kozue Kanemitsu-Okada, Tomoe Kawamura, Taira Kuroda, Hideki Miyata, Eiji Tsubouchi, Masashi Hirooka, Masanori Abe, Bunzo Matsuura, Tomoyuki Ninomiya, Yoichi Hiasa
BACKGROUND/AIM: For predicting esophagogastric varices (EGV), the Virtual Baveno VII Consensus Workshop has proposed a combination of liver stiffness determination and platelet count measurement using a FibroScan®. However, that is not available at all institutions. The present study aimed to develop a simple method to predict development of EGV using only general blood examination results. MATERIALS/METHODS: A total of 1090 hepatocellular carcinoma (HCC) patients were enrolled, after excluding 956 with major portal vein tumor thrombus (Vp3/Vp4) or without upper gastrointestinal endoscopy examination results available...
October 11, 2023: Oncology
#40
JOURNAL ARTICLE
Maja Thiele, Stine Johansen, Mads Israelsen, Jonel Trebicka, Juan G Abraldes, Pere Gines, Aleksander Krag
Noninvasive tests (NITs) are used in all aspects of liver disease management. Their most prominent break-through since the millennium has been in advancing early detection of liver fibrosis, but their use is not limited to this. In contrast to the symptom-driven assessment of decompensation in patients with cirrhosis, NITs provide not only opportunities for earlier diagnoses but also accurate prognostication, targeted treatment decisions, and a means of monitoring disease. NITs can inform disease management and decision-making based on validated cutoffs and standardized interpretations as a valuable supplement to clinical acumen...
October 6, 2023: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
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