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1.

001-es BibID:BIBFORM075755
035-os BibID:(WoS)000458773000011 (Scopus)85058002826
Első szerző:Fernández, Javier
Cím:Multidrug-resistant bacterial infections in patients with decompensated cirrhosis and with ACLF across Europe / Javier Fernández, Verónica Prado, Jonel Trebicka, Alex Amoros, Thierry Gustot, Reiner Wiest, Carme Deulofeu, Elisabet Garcia, Juan Acevedo, Valentin Fuhrmann, François Durand, Cristina Sánchez, Maria Papp, Paolo Caraceni, Victor Vargas, Rafael Bañares, Salvatore Piano, Martin Janicko, Agustin Albillos, Carlo Alessandria, German Soriano, Tania M. Welzel, Wim Laleman, Alexander Gerbes, Andrea De Gottardi, Manuela Merli, Minneke Coenraad, Faouzi Saliba, Marco Pavesi, Rajiv Jalan, Pere Ginès, Paolo Angeli, Vicente Arroyo, the European Foundation for the Study of Chronic Liver Failure (EF Clif)
Dátum:2019
ISSN:0168-8278
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Journal of Hepatology. - 70 : 3 (2019), p. 398-411. -
További szerzők:Prado, Verónica Trebica, Jonel Amoros, Alex Gustot, Thierry Wiest, Reiner Deulofeu, Carme Garcia, Elisabet Acevedo, Juan Fuhrmann, Valentin Durand, François Sánchez, Cristina Papp Mária (1975-) (belgyógyász, gasztroenterológus) Caraceni, Paolo Vargas, Victor Bañares, Rafael Piano, Salvatore Janicko, Martin Albillos, Agustin Alessandria, Carlo Soriano, German Welzel, Tania M. Laleman, Wim Gerbes, Alexander Gottardi, Andrea De Merli, Manuela Coenraad, Minneke Saliba, Faouzi Pavesi, Marco Jalan, Rajiv Ginès, Pere Angeli, Paolo Arroyo, Vicente The European Foundation for the Study of Chronic Liver Failure (EF Clif)
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2.

001-es BibID:BIBFORM111426
035-os BibID:(WoS)001046245400001 (Scopus)85164978593
Első szerző:Moreau, Richard
Cím:EASL Clinical Practice Guidelines on acute-on-chronic liver failure / Richard Moreau, Marta Tonon, Aleksander Krag, Paolo Angeli, Marina Berenquer, Annalisa Berzigotti, Javier Fernandez, Claire Francoz, Thierry Gustot, Rajiv Jalan, Maria Papp, Jonel Trebicka
Dátum:2023
ISSN:0168-8278
Megjegyzések:Acute-on-chronic liver failure (ACLF), which has described relatively recently (2013), is a severe form of acutly decompensated cirrhosis characterized by the existence of organ system failures(s) and a high risk of short-term mortality. ACLF is caused by an excessive systemic inflammatory response triggered by precipitants that are clinically apparent (e.g., proven microbial infection with sepsis, severe alcohol-related hepatitis) or not. Since the description of ACLF, some important studies have suggested that patients with ACLF may benefit from liver transplantation and because of this, should be urgently stabilised for transplantation by receiving appropriate treatment of identified precipitants, and full general management, including support of organ systems in the intensive care unit (ICU). The objective of the present CPGs is to provide recommendations to help clinicians recognise ACLF, make triage decisions (ICU vs. no ICU), identify and manage acute precipitants, identify organ systems that require support or replacement, define potential criteria for futility of intensive care, and identify potential indicators for liver transplantation. Based on an in-depth review of the relevant literature we provide recommendations to navigate clinical dilemmas followed by supporting text. The recommendations are graded according to the Oxford Centre for Evidence-Based Medicine system and categorized as 'weak' or 'strong'. We aim to provide the best available evidence to aid the clinical decision-making process in the management of patients with ACLF.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Journal Of Hepatology. - 79 : 2 (2023), p. 461-491. -
További szerzők:Tonon, Marta Krag, Aleksander Angeli, Paolo Berenquer, Marina Berzigotti, Annalisa Fernández, Javier Francoz, Claire Gustot, Thierry Jalan, Rajiv Papp Mária (1975-) (belgyógyász, gasztroenterológus) Trebica, Jonel
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3.

001-es BibID:BIBFORM117716
Első szerző:Torp, Nikolaj
Cím:Personalised human albumin in patients with cirrhosis and ascites : design and rationale for the ALB-TRIAL - a study protocol of a randomised clinical biomarker validation trial / Nikolaj Torp, Mads Israelsen, Minneke Coenraad, Maria Papp, Debbie L. Shawcross, Marko Korenjak, Paolo Angeli, Wim Laleman, Adria Juanola, Pere Gines, Jonel Trebicka, Alexander Krag, MINCROB-PREDICT Consortium
Dátum:2024
ISSN:2044-6055
Megjegyzések:Abstract Introduction; Human albumin is used in the treatment of complications of cirrhosis. However, the use of long-term human albumin administration is costly and resource demanding for both patients and healthcare systems. A precision medicine approach with biomarkers to predict human albumin treatment response, so called predictive biomarkers, could make this a viable treatment option in patients with cirrhosis and ascites. Methods and analysis; ALB-TRIAL is a multinational, double-blind, placebo-controlled randomised controlled rial. We aim to validate a predictive biomarker, consisting of a panel of circulating metabolites, to predict the treatment response to human albumin in patients with cirrhosis and ascites. All enrolled patients are stratified into a high- or low expected effect stratum of human albumin based on the biomarker outcome. After stratification, patients in each group are randomised into either active treatment (20% human albumin) or corresponding placebo (0.9% NaCl) every 10th day for 6 months. The primary outcome is the cumulative number of liver-related events (composite of decompensation episodes, transjugular intrahepatic shunt insertion, liver transplantation and death). Key secondary outcomes include time-to-event analysis of primary outcome components, an analysis of the total healthcare burden and a health economic analysis. Ethics and dissemination; The trial obtained ethical- and regulatory approval in Denmark, Germany, the Netherlands, Belgium, Hungary and Spain through the Clinical Trials Information System (CTIS) from 13 February 2023, while United Kingdom approvals from the Health Regulatory Authority (HRA), Medicines and Healthcare products Regulatory Agency (MHRA) and Research Ethics Committee (REC) are pending. Findings will be published in peer-reviewed journals, presented at conferences, communicated to relevant stakeholders and in the public registry of CTIS, following trial completion.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
cirrhosis
biomarker
RCT
validation
ascites
albumin
personalised medicine protocol
Megjelenés:BMJ Open. - "Accepted by Publisher" (2024). -
További szerzők:Israelsen, Mads Coenraad, Minneke Papp Mária (1975-) (belgyógyász, gasztroenterológus) Shawcross, Debbie L. Korenjak, Marko Angeli, Paolo Laleman, Wim Juanola, Adria Ginès, Pere Trebica, Jonel Krag, Aleksander MINCROB-PREDICT Consortium
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4.

001-es BibID:BIBFORM088130
035-os BibID:(WoS)000640696100013 (Scopus)85101877901
Első szerző:Trebica, Jonel
Cím:PREDICT identifies Precipitating Events Associated with Clinical Course of Acutely Decompensated Cirrhosis / Jonel Trebicka, Javier Fernandez, Maria Papp, Paolo Caraceni, Wim Laleman, Carmine Gambino, Ilaria Giovo, Frank Erhard Ushcner, Christian Jansen, Cesar Jimenez, Rajeshwar Mookerjee, Thierry Gustot, Agustin Albillos, Rafael Banares, Peter Jarcuska, Christian Steib, Thomas Reiberger, Juan Acevedo, Pietro Gatti, Debbie Shawcross, Stefan Zeuzem, Alexander Zipprich, Salvatore Piano, Thomas Berg, Tony Bruns, Karen V. Danielsen, Minneke Coenraad, Manuela Merli, Rudolf Stauber, Heinz Zoller, Jose Presa Ramos, Cristina Sole, German Soriano, Andrea de Gottardi, Henning Groenbaek Faouzi, Saliba Trautwein, Christian Haluk, Tarik Kani, Sven Francque, Stephen Ryder, Pierre Nahon, Manuel Romero Gomez, Hans Van Vlierberghe, Claire Francoz, Michael Manns, Elisabet Garcia, Manuel Tufoni, Alex Amoros, Marco Pavesi, Cristina Sanchez, Michael Praktiknjo, Anna Curto, Carla Pitarch, Antonella Putignano, Esau Moreno, William Bernal, Ferran Aquilar, Joan Claria, Paolo Ponzo, Zsuzsanna Vitalis, Giacomo Zaccherini, Boglarka Balogh, Alexander Gerbes, Victor Vargas, Carlo Alessandria, Mauro Bernardi, Pere Gines, Richard Moreau, Paolo Angeli, Rajiv Jalan, Vicente Arroyo
Dátum:2021
ISSN:0168-8278
Megjegyzések:ABSTRACT Introduction: Acute decompensation (AD) of cirrhosis may present without acute-onchronic liver failure (ACLF) (AD-No ACLF), or with ACLF-phenotype (AD-ACLF) defined by organ failure(s). Precipitating events may induce AD. This multicenter,prospective, observational PREDICT Study (NCT03056612) analyzes and characterizes the precipitants leading to both AD-phenotypes. Patients and Methods: The PREDICT study included 1273 non-electively hospitalized patients with AD (No-ACLF=1071; ACLF=202). Medical history, clinical and laboratory data were carefully collected at enrolment and during 90-days follow up, focused on the characteristics of precipitants, specifically induction of organ dysfunction/failure and/or systemic inflammation, chronology, intensity, and relationship to outcome in both AD phenotypes. Results: Among different clinical events, four distinct events were precipitants consistently related to AD, including proven bacterial infections, severe alcoholic hepatitis, gastrointestinal (GI) bleeding with shock and toxic encephalopathy. Among patients in the AD-No ACLF cohort and the AD-ACLF cohort with precipitants (38% and 71%, respectively), almost all (96% and 97%, respectively) showed proven bacterial infection and severe alcoholic hepatitis, either alone or in combination with other events. Interestingly, in both AD-phenotypes, proven bacterial infections and severe alcoholic hepatitis had a similar association withsurvival, and the number of precipitants was associated with significantly increased 90-day mortality, in paralleled by surrogates of systemic inflammation confirming a valid definition of precipitating events. Importantly, adequate first-line antibiotic treatment of proven bacterial infections was associated with lower ACLF development rate and higher 90-day survival. Conclusions: This study identified precipitating events that are significantly associated with a distinct clinical course and prognosis of patients with AD and specific preventive and therapeutic strategies targeting these events may improve outcome in decompensated cirrhosis.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
chronic liver disease
non-elective admission
acute complications
outcome
risk factors
Megjelenés:Journal of Hepatology. - 74 : 5 (2021), p. 1097-1108. -
További szerzők:Fernández, Javier Papp Mária (1975-) (belgyógyász, gasztroenterológus) Caraceni, Paolo Laleman, Wim Gambino, Carmine Giovo, Ilaria Uschner, Frank Erhard Jansen, Christian Jimenez, Cesar Mookerjee, Rajeshwar Gustot, Thierry Albillos, Agustin Bañares, Rafael Jarcuska, Peter Steib, Christian Reiberger, Thomas Acevedo, Juan Gatti, Pietro Shawcross, Debbie Zeuzem, Stefan Zipprich, Alexander Piano, Salvatore Berg, Thomas Bruns, Tony Danielsen, Karen V. Coenraad, Minneke Merli, Manuela Stauber Rudolf Zoller, Heinz Ramos, José Sole, Cristina Soriano, German Gottardi, Andrea De Faouzi, Henning Groenbaek Trautwein, Saliba Haluk, Christian Kani, Tarik Francque, Sven Ryder, Stephen Nahon, Pierre Gomez, Manuel Romero Vlierberghe, Hans Van Francoz, Claire Manns, Michael P. Garcia, Elisabet Tufoni, Manuel Amoros, Alex Pavesi, Marco Sánchez, Cristina Praktiknjo, Michael Curto, Anna Pitarch, Carla Putignano, Antonella Moreno, Esau Bernal, William Aquilar, Ferran Claria, Joan Ponzo, Paolo Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Zaccherini, Giacomo Balogh Boglárka (1993-) (belgyógyász) Gerbes, Alexander Vargas, Victor Alessandria, Carlo Bernardi, Mauro Ginès, Pere Moreau, Richard Angeli, Paolo Jalan, Rajiv Arroyo, Vicente
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5.

001-es BibID:BIBFORM086407
035-os BibID:(WoS)000572079900019 (Scopus)85088972261
Első szerző:Trebica, Jonel
Cím:The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology / Jonel Trebicka, Javier Fernandez, Papp Mária, Paolo Caraceni, Wim Laleman, Carmine Gambino, Ilaria Giovo, Frank Erhard Uschner, Cesar Jimenez, Rajeshwar Mookerjee, Thierry Gustot, Agustin Albillos, Rafael Banares, Martin Janicko, Christian Steib, Thomas Reiberger, Juan Acevedo, Pietro Gatti, William Bernal, Stefan Zeuzem, Alexander Zipprich, Salvatore Piano, Thomas Berg, Tony Bruns, Lise Lotte Gluud, Minneke Coenraad, Manuela Merli, Rudolf Stauber, Heinz Zoller, Ana Cristino, Cristina Sole, Germán Soriano, Andrea de Gottardi, Henning Groenbaek, Faouzi Saliba, Christian Trautwein, Osman Cavit Özdogan, Francque Sven, Stephen Ryder, Pierre Nahon, Manuel Romero-Gomez, Hans Van Vlierberghe, Claire Francoz, Michael Manns, Elisabet Garcia, Manuel Tufoni, Alex Amoros, Marco Pavesi, Cristina Sanchez, Anna Curto, Carla Pitarch, Antonella Putignano, Esau Moreno, Debbie Showcross, Ferran Aguilar, Joan Claria, Paolo Ponzo, Christian Jansen, Vitális Zsuzsanna, Giacomo Zaccherini, Balogh Boglárka, Victor Vargas, Sara Montagnese, Carlo Alessandria, Mauro Bernardi, Pere Gines, Rajiv Jalan, Richard Moreau, Paolo Angeli, Vicente Arroyo
Dátum:2020
ISSN:0168-8278
Megjegyzések:Background/Aims:Acute decompensation (AD) of cirrhosis is defined by the acute development of ascites, gastrointestinal hemorrhage, hepatic encephalopathy, i nfection or any combination of these, requiring hospitalization. The presence of organ failure(s) in patients with AD defines acute-on-chronic liver failure (ACLF), while their absence defines AD. We designed the PREDICT study, a European, prospective, observational study, to characterize the clinical course of AD and predict ACLF . Methods:A total of 1071 patients with AD were enrolled to collect detailed pre-specified information on the 3-month period prior to enrollment, and clinical and laboratory data at enrollment. Patients were then closely followed-up for 3 months. The 12-month outcomes (liver transplantation, and death) were also recorded. Results:Three groups of patients were identified: Pre-ACLF patients (n=218), who developed ACLF and had 3-month and 1-year mortality rates of 53.7% and 67.4%, respectively. Unstable decompensated cirrhosis (UDC) patients (n = 233) required ?1 readmission but not developing ACLF and had 21.0% and 35.6% mortality rates. Stable decompensated cirrhosis (SDC) patients (n = 620) who were neither readmitted, nor developed ACLF and showed a 1-year mortality of only 9.5%. The 3 groups differed significantly in the grade and course of systemic inflammation (high-grade at enrollment with aggravation during follow-up in pre-ACLF; low-grade at enrollment with subsequent steady-course in UDC; and low-grade at enrollment with subsequent improvement in the SDC) and prevalence of surrogates of severe portal hypertension throughout the study (high in UDC versus low in pre-ACLF and SDC). Conclusions:Acute decompensation without ACLF is a heterogeneous condition with three different clinical courses and two major pathophysiological mechanisms: systemic inflammation and portal hypertension. Prediction of ACLF development remains a major future task.(ClinicalTrials.gov number, NCT03056612)
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Chronic liver disease
non-elective admission
acute complications
Outcome
Risk factors
Megjelenés:Journal of Hepatology. - 73 (2020), p. 842-854. -
További szerzők:Fernández, Javier Papp Mária (1975-) (belgyógyász, gasztroenterológus) Caraceni, Paolo Laleman, Wim Gambino, Carmine Giovo, Ilaria Uschner, Frank Erhard Jimenez, Cesar Mookerjee, Rajeshwar Gustot, Thierry Albillos, Agustin Bañares, Rafael Janicko, Martin Steib, Christian Reiberger, Thomas Acevedo, Juan Gatti, Pietro Bernal, William Zeuzem, Stefan Zipprich, Alexander Piano, Salvatore Berg, Thomas Bruns, Tony Gluud, Lise Lotte Coenraad, Minneke Merli, Manuela Stauber Rudolf Zoller, Heinz Cristino, Ana Sole, Cristina Soriano, German Gottardi, Andrea De Groenbaek, Henning Saliba, Faouzi Trautwein, Christian Özdogan, Osman Cavit Sven, Francque Ryder, Stephen Nahon, Pierre Romero-Gomez, Manuel Vlierberghe, Hans Van Francoz, Claire Manns, Michael P. Garcia, Elisabet Tufoni, Manuel Amoros, Alex Pavesi, Marco Sánchez, Cristina Curto, Anna Pitarch, Carla Putignano, Antonella Moreno, Esau Showcross, Debbie Aguilar, Ferran Claria, Joan Ponzo, Paolo Jansen, Christian Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Zaccherini, Giacomo Balogh Boglárka (1993-) (belgyógyász) Vargas, Victor Montagnese, Sara Alessandria, Carlo Bernardi, Mauro Ginès, Pere Jalan, Rajiv Moreau, Richard Angeli, Paolo Arroyo, Vicente
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6.

001-es BibID:BIBFORM107811
035-os BibID:(Scopus)85160261108 (WoS)000941419200001
Első szerző:Weiss, Emmanuel
Cím:Sympathetic nervous activation, mitochondrial dysfunction, and outcome in acutely decompensated cirrhosis : the metabolomic prognostic models (CLIF-C MET) / Emmanuel Weiss, Carlos De La PeNa-Ramirez, Ferran Aguilar, Juan-José Lozano, Cristina Sánchez, Patricia Sierra, Pedro Izquierdo-Bueno, Juan Manuel Diaz, FranCois Fenaille, Florence Castelli, Thierry Gustot, Wim Laleman, Agustín Albillos, Carlo Alessandria, Marco Domenicali, Paolo Caraceni, Salvatore Piano, Faouzi Saliba, Stefan Zeuzem, Alexander Gerbes, Julia Wendom, Christian Jansen, Wenyi Gu, Maria Papp, Rajeshwar P. Mookerjee, Carmine Gambino, Cesar Jiménez, Ilaria Giovo, Giacomo Zaccherini, Manuela Merli, Antonella Putignano, Frank Erhard Uschner, Thomas Berg, Tony Bruns, Christian Trautwein, Alexander Zipprich, Rafael BaNares, José Presa, Joan Genesca, Victor Vargas, Javier Fernández, Mauro Bernardi, Paolo Angeli, Rajiv Jalan, Joan Claria, Christophe Junot, Richard Moreau, Jonel Trebicka, Vicente Arroyo, Canonic And Predict 22 Study Investigators
Dátum:2023
ISSN:0017-5749
Megjegyzések:ABSTRACT BACKGROUND AND AIMS. Current prognostic scores of patients with acutely decompensated cirrhosis (AD), particularly those with ACLF, underestimate the risk of mortality. This is probably because systemic inflammation (SI), the major driver of AD/ACLF, is not reflected in the scores. SI induces metabolic changes which impair delivery of the necessary energy for the immune reaction. This investigation aimed to identify metabolites associated with short-term (28-day) death and to design metabolomic prognostic models. METHODS. Two prospective multi-center large cohorts from Europe for investigating ACLF and development of ACLF, CANONIC (discovery, n=831) and PREDICT validation, n=851) were explored by untargeted serum metabolomics to identify and validate metabolites which could allow improved prognostic modelling. RESULTS. Three prognostic metabolites strongly associated with death were selected to build the models. 4-hydroxy-3-methoxyphenylglycol sulphate is a norepinephrine derivate, which may derive from the brainstem response to systemic inflammation. Additionally, galacturonic acid and hexanoylcarnitine are associated with mitochondrial dysfunction. Model 1 included only these three prognostic metabolites and age. Model 2 was built around 4-hydroxy-3-methoxyphenylglycol sulphate, hexanoylcarnitine, bilirubin, INR, and age. In the discovery cohort, both models were more accurate in predicting death within 7, 14 and 28 days after admission compared to MELDNa score (C-index: 0.9267, 0.9002 and 0.8424, and 0.9369, 0.9206 and 0.8529, with model 1 and model 2, respectively). Similar results were found in the validation cohort (C-index: 0.9399, 0.8339 and 0.7912, and 0.9471, 0.8566 and 0.8101, with model 1 and model 2, respectively). Also, in ACLF, model 1 and model 2 outperformed MELDNa after 7, 14 25 and 28 days after admission for prediction of mortality.CONCLUSIONS. Models including metabolites (CLIF-C MET) reflecting SI, mitochondrial dysfunction and sympathetic system activation are better predictors of short-term mortality than scores based only on organ dysfunction (e.g., MELDNa), especially in patients with ACLF.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Gut. - 72 : 8 (2023), p. 1581-1591. -
További szerzők:de la Pena-Ramirez, Carlos Aguilar, Ferran Lozano, Juan-José Sánchez, Cristina Sierra, Patricia Izquierdo-Bueno, Pedro Diaz, Juan Manuel Fenaille, Francois Castelli, Florence Gustot, Thierry Laleman, Wim Albillos, Agustin Alessandria, Carlo Domenicali, Marco Caraceni, Paolo Piano, Salvatore Saliba, Faouzi Zeuzem, Stefan Gerbes, Alexander Wendom, Julia Jansen, Christian Gu, Wenyi Papp Mária (1975-) (belgyógyász, gasztroenterológus) Mookerjee, Rajeshwar P. Gambino, Carmine Jimenez, Cesar Giovo, Ilaria Zaccherini, Giacomo Merli, Manuela Putignano, Antonella Uschner, Frank Erhard Berg, Thomas Bruns, Tony Trautwein, Christian Zipprich, Alexander Bañares, Rafael Presa, José Genesca, Joan Vargas, Victor Fernández, Javier Bernardi, Mauro Angeli, Paolo Jalan, Rajiv Claria, Joan Junot, Christophe Moreau, Richard Trebica, Jonel Arroyo, Vicente CANONIC and PREDICT 22 study investigators
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