0000000000264238

AUTHOR

F. Simone

showing 8 related works from this author

The course of oesophagogastric varices in patients with cirrhosis after DAA-induced HCV clearance

2018

Background and aims: Use of direct acting antivirals (DAAs) has allowed to clear HCV in almost all patients even in the presence of advanced cirrhosis. Although it has been suggested that cirrhotic portal hypertension may regress after SVR, the ultimate effect of HCV clearance on the development and progression of oesophagogastric varices (OV) is still unexplored. We assessed in a prospective cohort of patients with cirrhosis the evolution of endoscopic features of portal hypertension induced by SVR obtained with DAAs. Method: 321 consecutive patients (mean age: 65.1 ± 10.5, males: 58%) with HCV Child-Pugh A cirrhosis treated with DAAs were enrolled between January 2015 and May 2016. All pa…

medicine.medical_specialtyCirrhosisHepatologybusiness.industryGastroenterologyHcv clearancemedicine.diseaseGastroenterologyInternal medicineoesophagogastric varices cirrhosis DAAmedicineIn patientVaricesbusiness
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Oesophagogastroduodenoscopy in patients with cirrhosis: Extending the range of detection beyond portal hypertension

2010

Background: Oesophagogastroduodenoscopy is currently recommended for the screening of varices in cirrhosis. In addition to the assessment of varices, oesophagogastroduodenoscopy can detect conditions that, while unrelated to portal hypertension, may require treatment. Aims: We evaluated in a large cohort of cirrhotic patients the prevalence of upper digestive findings other than oesophagogastric varices, the associations between upper gastrointestinal findings, portal hypertension and features of cirrhosis, and the incidence of new lesions in the course of a surveillance program. Methods: Analysis of the records of 611 consecutive cirrhotic patients undergoing oesophagogastroduodenoscopy fo…

Liver CirrhosisMalemedicine.medical_specialtyCirrhosisPepticPortal hypertensive gastropathyAdenocarcinomaEsophageal and Gastric VaricesGastroenterologyAsymptomaticHelicobacter InfectionsPolypsStomach NeoplasmsInternal medicineHypertension PortalPrevalenceHumansMedicineEndoscopy Digestive SystemStomach UlcerVascular DiseasesAgedMetaplasiaHelicobacter pyloriHepatologymedicine.diagnostic_testbusiness.industrycirrhosisIncidence (epidemiology)GastroenterologyMiddle Agedmedicine.diseaseEndoscopyDuodenal UlcerGastritisPortal hypertensionFemalemedicine.symptombusinessVaricesDigestive and Liver Disease
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Effectiveness of beta-blocker in primary prevention of variceal bleeding in patients with cirrhosis: A prospective evaluation by hepatic venous press…

2014

medicine.medical_specialtyVariceal bleedingCirrhosisHepatologybusiness.industrymedicine.drug_classPortal venous pressureGastroenterologymedicine.diseaseGastroenterologyProspective evaluationInternal medicinePrimary preventionMedicineIn patientbusinessBeta blockerDigestive and Liver Disease
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Modified spleen stiffness measurement by transient elastography is associated with presence of large oesophageal varices in patients with compensated…

2013

To evaluate the accuracy of liver transient elastography (TE), spleen TE and other noninvasive tests (AAR, APRI score, platelet count, platelet/spleen ratio) in predicting the presence and the size of oesophageal varices in compensated hepatitis C virus (HCV) cirrhosis, we studied 112 consecutive patients with compensated HCV cirrhosis who underwent biochemical tests, gastrointestinal endoscopy, liver TE and spleen TE by Fibroscan(®) (Echosens, Paris, France) using a modified software version with a range between 1.5 and 150 kPa. Spleen TE was not reliable in 16 patients (14.3%). Among the 96 patients with a valid measurement (69.8% men, mean age: 63.2 ± 9.5 years), 43.7% had no oesophageal…

AdultLiver CirrhosisMalemedicine.medical_specialtyCirrhosisHepatitis C virusSpleenmedicine.disease_causeEsophageal and Gastric VaricesGastroenterologySensitivity and SpecificityVaricose VeinsVirologyInternal medicinemedicineHumansProspective StudiesAgedUnivariate analysisHepatologybusiness.industrycirrhosisHepatitis CHepatitis C ChronicMiddle Agedmedicine.diseaseFibrosisInfectious Diseasesmedicine.anatomical_structureROC CurvePortal hypertensionElasticity Imaging TechniquesFemaleVaricesTransient elastographybusinessBiomarkersSpleen
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Effects of Eradicating Hepatitis C Virus Infection in Patients With Cirrhosis Differ With Stage of Portal Hypertension.

2016

Clearance of hepatitis C virus (HCV) via antiviral treatment changes the course of liver disease. We evaluated the benefit of sustained virologic response (SVR) in patients with HCV and cirrhosis without (stage 1) and with (stage 2) esophageal varices (EV).We performed a prospective cohort study of 444 patients with HCV and compensated cirrhosis (218 with stage 1 and 226 with stage 2 disease) treated with peg-interferon and ribavirin from June 2001 through December 2009 at the University of Palermo, Italy and followed for a median of 7.6 years (range, 1-12.6 years). We used Cox regression analysis to identify variables associated with appearance or progression of EVs, development of hepatoc…

Liver CirrhosisMaleCirrhosisSustained Virologic ResponseHepacivirusEsophaguGastroenterologyPolyethylene GlycolsLiver diseasechemistry.chemical_compound0302 clinical medicineEsophageal varicesProspective StudiesProspective cohort studyHazard ratioGastroenterologyvirus diseasesMiddle AgedPortal PressureHepatitis CRecombinant ProteinsIntention to Treat AnalysisItaly030220 oncology & carcinogenesisHepatocellular carcinoma030211 gastroenterology & hepatologyFemalemedicine.medical_specialtyInterferon alpha-2Lower riskEsophageal and Gastric VaricesAntiviral Agents03 medical and health sciencesInternal medicineHypertension PortalRibavirinmedicineHumansAgedProportional Hazards ModelsHepatologybusiness.industryRibavirinBleedingInterferon-alphaLong-Term Outcomemedicine.diseasedigestive system diseaseschemistrybusinessFollow-Up StudiesGastroenterology
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Quantification of fibrosis by collagen proportionate area predicts hepatic decompensation in hepatitis C cirrhosis.

2015

SummaryBackground It is unclear whether the course of cirrhosis and its prognosis are related to the amount of collagen in the liver. Aim To determine whether fibrosis, assessed by collagen proportionate area (CPA) in patients with compensated cirrhosis, is associated with the presence of oesophageal varices, and predict disease decompensation during the follow-up period. Methods We prospectively evaluated 118 consecutive patients with compensated cirrhosis to correlate fibrosis, assessed by CPA in liver biopsies, with the presence of oesophageal varices (OV) and with the rate of liver decompensation (LD) development during a median follow-up of 72 months. Results At baseline 38 (32.2%) pat…

Liver CirrhosisMalemedicine.medical_specialtyCirrhosisBiopsyEsophageal and Gastric VaricesGastroenterologySeverity of Illness IndexSex FactorsFibrosisInternal medicineHypertension PortalmedicineHumansPharmacology (medical)DecompensationProspective StudiesAgedHepatologyReceiver operating characteristicbusiness.industryProportional hazards modelGastroenterologyAge FactorsHepatitis CHepatitis C ChronicMiddle Agedmedicine.diseasePrognosisFibrosisCPAROC CurvePortal hypertensionFemaleCollagenbusinessVaricesLiver FailureAlimentary pharmacologytherapeutics
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Insulin resistance is a risk factor for esophageal varices in hepatitis C virus cirrhosis

2008

Indirect methods to predict the presence of esophageal varices (EV) in patients with cirrhosis are not sensitive enough to be used as a surrogate for endoscopy. We tested the effectiveness of liver stiffness measurement (LSM) by transient elastography and the presence of insulin resistance (IR), a marker associated with fibrosis progression, in the noninvasive prediction of portal hypertension. One hundred four consecutive patients with newly diagnosed Child A hepatitis C virus (HCV) cirrhosis underwent upper gastrointestinal endoscopy to search for EV. Clinical, anthropometric, biochemical, ultrasonographic, and metabolic features, including IR by the homeostasis model assessment (HOMA), a…

Liver CirrhosisMalemedicine.medical_specialtyCirrhosisEsophageal and Gastric VaricesGastroenterologyEsophageal varicesInsulin resistanceRisk FactorsDiabetes mellitusInternal medicineHypertension PortalmedicineHumansEndoscopy Digestive SystemProspective StudiesAgedHepatologyPlatelet Countbusiness.industryHepatitis CMiddle AgedHepatologymedicine.diseaseHepatitis CLiverROC CurveMultivariate AnalysisDisease ProgressionElasticity Imaging TechniquesPortal hypertensionFemaleInsulin ResistanceTransient elastographybusinessSpleenHepatology
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Fibrospleen: Measuring spleen stiffness by transient elastography increases accuracy of staging of liver fibrosis and of portal hypertension in chron…

2009

Pathologymedicine.medical_specialtyHepatologybusiness.industryLiver fibrosisGastroenterologySpleenmedicine.diseasemedicine.anatomical_structuremedicinePortal hypertensionViral hepatitisTransient elastographybusinessDigestive and Liver Disease
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