Search results for "Esophageal"

showing 10 items of 523 documents

Competing risks and prognostic stages of cirrhosis: A 25-year inception cohort study of 494 patients

2014

Summary Background Morphological, haemodynamic and clinical stages of cirrhosis have been proposed, although no definite staging system is yet accepted for clinical practice. Aim To investigate whether clinical complications of cirrhosis may define different prognostic disease stages. Methods Analysis of the database from a prospective inception cohort of 494 patients. Decompensation was defined by ascites, bleeding, jaundice or encephalopathy. Explored potential prognostic stages: 1, compensated cirrhosis without oesophago-gastric varices; 2, compensated cirrhosis with varices; 3, bleeding without other complications; 4, first nonbleeding decompensation; 5, any second decompensating event.…

Liver CirrhosisMaleCirrhosisSettore MED/09 - Medicina InternaDatabases Factualmedicine.medical_treatmentLiver transplantationGastroenterologyCohort StudiesModel for End-Stage Liver DiseaseAscitesEsophageal and Gastric VariceMedicinePharmacology (medical)Prospective StudiesProspective cohort studyLiver NeoplasmsGastroenterologyAscitesJaundiceMiddle AgedPrognosisLiver NeoplasmAsciteDisease ProgressionFemalemedicine.symptomHumanAdultmedicine.medical_specialtyCarcinoma HepatocellularPrognosiLiver CirrhosiJaundiceEsophageal and Gastric VaricesRisk AssessmentFollow-Up StudieInternal medicineHumansDecompensationAgedHepatologybusiness.industrymedicine.diseaseLiver TransplantationProspective StudieCohort StudiebusinessVaricesFollow-Up Studies
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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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A New Sampling Method for Spleen Stiffness Measurement Based on Quantitative Acoustic Radiation Force Impulse Elastography for Noninvasive Assessment…

2014

In our study, we evaluated the feasibility of a new sampling method for splenic stiffness (SS) measurement by Quantitative Acoustic Radiation Force Impulse Elastography (Virtual Touch Tissue Quantification (VTTQ)).We measured SS in 54 patients with HCV-related cirrhosis of whom 28 with esophageal varices (EV), 27 with Chronic Hepatitis C (CHC) F1–F3, and 63 healthy controls. VTTQ-SS was significantly higher among cirrhotic patients with EV (3.37 m/s) in comparison with controls (2.19 m/s,P<0.001), CHC patients (2.37 m/s,P<0.001), and cirrhotic patients without EV (2.7 m/s,P<0.001). Moreover, VTTQ-SS was significantly higher among cirrhotic patients without EV in comparison with bot…

Liver CirrhosisMaleGenetics and Molecular Biology (all)CirrhosisData InterpretationImmunology and Microbiology (all)lcsh:MedicineVarices assessementLikelihood ratios in diagnostic testingGastroenterologyBiochemistryEsophageal varicesComputer-AssistedUltrasonographymedicine.diagnostic_testAUROCMedicine (all)General MedicineHepatitis CStatisticalMiddle AgedHepatitis CCirrhosisData Interpretation StatisticalFemaleElastographyViral hepatitisAlgorithmsAged; Algorithms; Data Interpretation Statistical; Elastic Modulus; Esophageal and Gastric Varices; Female; Hepatitis C; Humans; Image Interpretation Computer-Assisted; Liver Cirrhosis; Male; Middle Aged; Reproducibility of Results; Sample Size; Sensitivity and Specificity; Spleen; Stress Mechanical; Biochemistry Genetics and Molecular Biology (all); Immunology and Microbiology (all); Medicine (all)medicine.medical_specialtyArticle SubjectEsophageal and Gastric VaricesStressSensitivity and SpecificityGeneral Biochemistry Genetics and Molecular BiologyInternal medicineElastic ModulusImage Interpretation Computer-AssistedmedicineHumansAcoustic radiation forceImage InterpretationAgedGeneral Immunology and Microbiologybusiness.industrylcsh:RReproducibility of Resultsmedicine.diseaseMechanicalEndoscopySample SizeClinical StudyStress MechanicalbusinessSpleen
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Serological Tests Do Not Predict Residual Fibrosis in Hepatitis C Cirrhotics with a Sustained Virological Response to Interferon

2016

BACKGROUND AND AIM: Liver biopsy (LB) has lost popularity to stage liver fibrosis in the era of highly effective anti-hepatitis C virus (HCV) therapy, yet diagnosis of persistent cirrhosis may have important implications following HCV eradication. As performance of serological non-invasive tests (NITs) to predict residual fibrosis in non-viremic HCV patients is unknown, we investigated accuracy of NITs to predict residual fibrosis in cirrhotics after a sustained virological response (SVR) to interferon (IFN). METHODS: Thirty-eight patients with a pre-treatment histological diagnosis of cirrhosis and a 48–104 months post-SVR LB were tested with APRI, CDS, FIB-4, FibroQ, Forns Score, GUCI Ind…

Liver CirrhosisMalePathologyCirrhosisBiopsylcsh:MedicineHepacivirusPathology and Laboratory MedicineGastroenterology0302 clinical medicineEsophageal varicesFibrosisOutcome Assessment Health CareMedicine and Health Scienceslcsh:ScienceSerodiagnosisMultidisciplinarymedicine.diagnostic_testLiver DiseasesHepatitis CMiddle AgedHepatitis C3. Good healthSerologyCirrhosisLiver030220 oncology & carcinogenesisLiver biopsyHepatocellular carcinomaHost-Pathogen InteractionsLiver FibrosisElasticity Imaging Techniques030211 gastroenterology & hepatologyFemaleAnatomyResearch Articlemedicine.medical_specialtyHistologySurgical and Invasive Medical ProceduresGastroenterology and HepatologyAntiviral Agents03 medical and health sciencesDiagnostic MedicineInternal medicineBiopsymedicineHumansSerologic TestsAspartate AminotransferasesAgedbusiness.industryPlatelet Countlcsh:RBiology and Life Sciencesmedicine.diseaseFibrosisROC Curvelcsh:QInterferonsTransient elastographybusinessBiomarkersDevelopmental BiologyPLoS ONE
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Survival and prognostic indicators in compensated and decompensated cirrhosis

1986

Six-year survival of cirrhosis was assessed in a series of 1155 consecutive patients (751 men, 404 women). Among the men, 33% were alcoholics and 18% were HBsAg positive; corresponding figures for the women were 15% and 6%, respectively. Features of decompensation at first presentation were observed in 63% of the patients. Six-year survival was 54% in compensated and 21% in decompensated patients. No significant differences in survival were found between alcoholics and nonalcoholics. Leading causes of death were liver failure (49%), hepatocellular carcinoma (22%), and bleeding (13%). The prognostic role of 21 variables was evaluated separately in compensated and decompensated patients by th…

Liver CirrhosisMaleRiskmedicine.medical_specialtyHBsAgCarcinoma HepatocellularCirrhosisPhysiologyGastroenterologySex FactorsEsophageal varicesLiver Cirrhosis AlcoholicInternal medicinemedicineHumansDecompensationProspective StudiesRetrospective StudiesProthrombin timeHepatitis B Surface Antigensmedicine.diagnostic_testbusiness.industryLiver NeoplasmsGastroenterologyMiddle AgedHepatologyPrognosismedicine.diseaseSurgeryHepatocellular carcinomaRelative riskRegression AnalysisFemalebusinessFollow-Up StudiesDigestive Diseases and Sciences
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Role of IL-28B and inosine triphosphatase polymorphisms in efficacy and safety of Peg-Interferon and ribavirin in chronic hepatitis C compensated cir…

2013

Genetic factors can influence the outcome of antiviral therapy in chronic hepatitis C (HCV). We evaluated the role of interleukin-28B single nucleotide polymorphisms (SNPs) and inosine triphosphatase (ITPA) gene variants in HCV cirrhosis treated with Peg-Interferon and ribavirin. A prospective cohort of 233 patients with compensated cirrhosis received 1-1.5 μg/kg/week of Peg-Interferon alpha-2b plus 1000-1200 mg/day of RBV for 48 weeks. A sustained virologic response (SVR) was achieved in 27% of patients. On multivariate logistic analysis, the absence of oesophageal varices (OR 3.64 CI 95% 1.27-10.44 P = 0.016), infection with genotype 2 or 3 (OR 4.06, CI 95% 1.08-15.26, P = 0.038), C/C all…

Liver CirrhosisMaleSettore MED/07 - Microbiologia E Microbiologia ClinicaAnemia HemolyticGenotypeHepacivirusInterferon alpha-2Esophageal and Gastric VaricesAntiviral AgentsPolymorphism Single NucleotidePolyethylene GlycolsSettore BIO/13 - Biologia ApplicataRibavirinHumanschronic hepatitis C cirrhosis IL-28B inosine triphosphatase sustained virologic responseProspective StudiesPyrophosphatasesGenetic Association StudiesAgedSettore MED/12 - GastroenterologiaDose-Response Relationship DrugInterleukinsInterferon-alphaSequence Analysis DNAHepatitis C ChronicMiddle AgedRecombinant ProteinsLogistic ModelsTreatment OutcomeMultivariate AnalysisDrug Therapy CombinationFemaleInterferonsJournal of viral hepatitis
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Non-invasive prediction of esophageal varices by stiffness and platelet in non-alcoholic fatty liver disease cirrhosis.

2018

Background & Aims: Baveno VI and expanded Baveno VI criteria can avoid the need for esophagogastroduodenoscopy (EGD) to screen for varices needing treatment (VNT) in a substantial proportion of compensated patients with viral and/or alcoholic cirrhosis. This multicenter, cross-sectional study aims to validate these criteria in patients with compensated cirrhosis due to non-alcoholic fatty liver disease (NAFLD), accounting for possible differences in liver stiffness measurement (LSM) values between M and XL probes. Methods: We assessed 790 patients with NAFLD-related compensated cirrhosis who had EGD within six months of a reliable LSM, measured by FibroScan® using M and/or XL probe. Baveno …

Liver CirrhosisMalemedicine.medical_specialtyAlcoholic liver diseaseCirrhosisVariceEsophageal and Gastric VaricesGastroenterology03 medical and health sciences0302 clinical medicineEsophageal varicesBaveno; Cirrhosis; NAFLD; Stiffness; Varices; Aged; Cross-Sectional Studies; Elasticity Imaging Techniques; Endoscopy Digestive System; Esophageal and Gastric Varices; Female; Humans; Liver Cirrhosis; Male; Middle Aged; Non-alcoholic Fatty Liver Disease; Platelet CountNon-alcoholic Fatty Liver DiseaseInternal medicineNAFLDmedicineHumansEndoscopy Digestive SystemBavenoScreening proceduresAgedCirrhosimedicine.diagnostic_testHepatologyEsophagogastroduodenoscopybusiness.industryPlatelet CountFatty liverHepatologyMiddle Agedmedicine.disease3. Good healthCross-Sectional Studies030220 oncology & carcinogenesisStiffneElasticity Imaging Techniques030211 gastroenterology & hepatologyFemaleVaricesbusinessJournal of hepatology
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Sustained virologic response prevents the development of esophageal varices in compensated, Child-Pugh class A hepatitis C virus-induced cirrhosis. A…

2010

The incidence of de novo development of esophageal varices (EV) in patients with compensated liver cirrhosis has been determined by few studies in the short term and never in the long term. The aims of the present study were to determine the incidence and the risk factors associated with the development of EV and to assess whether antiviral treatment and achievement of sustained virologic response (SVR) may prevent de novo EV development in patients with HCV-induced cirrhosis. We studied 218 patients with compensated EV-free, HCV-induced cirrhosis consecutively enrolled between 1989 and 1992 at three referral centers in Milan, Italy. Endoscopic surveillance was performed at 3-year intervals…

Liver CirrhosisMalemedicine.medical_specialtyCarcinoma HepatocellularCirrhosisEsophageal and Gastric VaricesAntiviral AgentsGastroenterologyLiver diseaseEsophageal varicesRisk FactorsInternal medicinemedicineHumansProspective StudiesProspective cohort studyAgedHepatologybusiness.industryIncidenceLiver NeoplasmsHazard ratiovirus diseasesHepatitis CHepatitis C ChronicMiddle AgedHepatologymedicine.diseasedigestive system diseasesDiscontinuationItalyFemalebusinessFollow-Up StudiesCirrhosis HCV
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Is Transient Elastography Needed for Noninvasive Assessment of High-Risk Varices? The REAL Experience

2019

INTRODUCTION: The Baveno VI consensus guidelines and an expanded algorithm suggest that transient elastography (TE) and platelet (PLT) count can be used to identify patients with cirrhosis who can avoid esophagogastroduodenoscopy (EGD). The primary aims of this study were to assess the ability of a simple algorithm, which uses only laboratory parameters, to predict medium/large esophageal varices (EV) in patients with hepatitis C virus (HCV) and cirrhosis from the Rete Sicilia Selezione Terapia-HCV (RESIST-HCV) cohort and to compare the performance of the algorithm with Baveno VI and Expanded Baveno VI criteria. The secondary aim was to assess the role of TE in ruling out large EV. METHODS:…

Liver CirrhosisMalemedicine.medical_specialtyCirrhosisBAVENO VI CRITERIA PORTAL-HYPERTENSION CONSENSUS WORKSHOP LIVER STIFFNESS PLATELET COUNT CIRRHOSIS DIAGNOSIS;Esophageal and Gastric Varices03 medical and health sciences0302 clinical medicineRESIST-HCVmedicineesophageal varicesHumansBaveno VIEndoscopy Digestive SystemSerum AlbuminAgedHepatologymedicine.diagnostic_testPlatelet CountEsophagogastroduodenoscopybusiness.industryfungiGastroenterologyReproducibility of Resultsfood and beveragesHepatitis C ChronicMiddle Agedmedicine.diseasetransient elastographyEndoscopyLogistic ModelsCIRRHOSIS PORTAL HYPERTENSION VARICES STIFFNESS030220 oncology & carcinogenesistransient elastography esophageal varices HCV RESIST-HCV Baveno VIMultivariate AnalysisHCVElasticity Imaging TechniquesFemale030211 gastroenterology & hepatologyRadiologyGastrointestinal HemorrhagebusinessVaricesTransient elastographyAlgorithms
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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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