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2. Correction: LiverScreen project: study protocol for screening for liver fibrosis in the general population in European countries

Author

Graupera, Isabel, Thiele, Maja, Ma, Ann T., Serra-Burriel, Miquel, Pich, Judit, Fabrellas, Núria, Caballeria, Llorenç, de Knegt, Robert J., Grgurevic, Ivica, Reichert, Mathias, Roulot, Dominique, Schattenberg, Jörn M., Pericas, Juan M., Angeli, Paolo, Tsochatzis, Emmanuel A., Guha, Indra Neil, Garcia-Retortillo, Montserrat, Morillas, Rosa M., Hernández, Rosario, Hoyo, Jordi, Fuentes, Matilde, Madir, Anita, Juanola, Adrià, Soria, Anna, Juan, Marta, Carol, Marta, Diaz, Alba, Detlefsen, Sönke, Toran, Pere, Pera, Guillem, Fournier, Céline, Llorca, Anne, Newsome, Phillip N., Manns, Michael, de Koning, Harry J., Serra-Burriel, Feliu, Cucchietti, Fernando, Arslanow, Anita, Korenjak, Marko, van Kleef, Laurens, Falcó, Josep Lluis, Kamath, Patrick S., Karlsen, Tom H., Castera, Laurent, Lammert, Frank, Krag, Aleksander, and Ginès, Pere

Published
2023
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3. Development, validation, and prognostic evaluation of a risk score for long-term liver-related outcomes in the general population: a multicohort study

Author

Alvarez, Marifé, Andersen, Peter, Angeli, Paolo, Ardèvol, Alba, Arslanow, Anita, Beggiato, Luca, Ben Abdesselam, Zahia, Bennett, Lucy, Boutouria, Bajiha, Brocca, Alessandra, Broquetas, M. Teresa, Caballeria, Llorenç, Calvino, Valeria, Camacho, Judith, Capdevila, Aura, Carol, Marta, Castera, Laurent, Cervera, Marta, Cucchietti, Fernando, de Fuentes, Anna, de Knegt, Rob, de Koning, Harry J, Detlefsen, Sonke, Diaz, Alba, Diéguez Bande, José, Esnault, Vanessa, Fabrellas, Núria, Falcó, Josep Lluis, Fernández, Rosa, Fournier, Céline, Fuentes, Matilde, Galle, Peter, García, Edgar, García-Retortillo, Montserrat, Garrido, Esther, Ginès, Pere, Gordillo Medina, Rosa, Gratacós-Ginès, Jordi, Graupera, Isabel, Grgurevic, Ivica, Guha, Indra Neil, Guix, Eva, Hansen, Johanne Kragh, Harris, Rebecca, Hernández Boluda, Elena, Hernández-Ibañez, Rosario, Hoyo, Jordi, Ikram, Arfan, Incicco, Simone, Israelsen, Mads, Juan, Marta, Juanola, Adrià, Kaiser, Ralf, Kamath, Patrick S, Karlsen, Tom H, Kjærgaard, Maria, Korenjak, Marko, Krag, Aleksander, Krawczyk, Marcin, Laboulaye, Philippe, Lambert, Irina, Lammert, Frank, Langkjær Sørensen, Simon, Laserna-Jiménez, Cristina, Lazaro Pi, Sonia, Ledain, Elsa, Levy, Vincent, Lindvig, Katrine Prier, Llorca, Anne, Londoño, Vanessa, Loyer, Guirec, Ma, Ann T., Madir, Anita, Manns, Michael, Marshall, Denise, Martí, M. Lluïsa, Martínez, Sara, Martínez Sala, Ricard, Masa-Font, Roser, Møller Jensen, Jane, Morillas, Rosa M, Muñoz, Laura, Nadal, Ruth, Napoleone, Laura, Navarrete, JM, Newsome, Phillip N, Nielsen, Vibeke, Pérez, Martina, Pericás-Pulido, Juan Manuel, Piano, Salvatore, Pich, Judit, Pose, Elisa, Presas Escobet, Judit, Reichert, Matthias, Riba, Carlota, Roulot, Dominique, Rubio, Ana Belén, Sánchez-Morata, Maria, Schattenberg, Jörn, Serra-Burriel, Miquel, Serra-Burriel, Feliu, Skovborg Just, Louise, Sonneveld, Milan, Soria, Anna, Stern, Christiane, Such, Patricia, Thiele, Maja, Tonon, Marta, Toran, Pere, Torrejón, Antoni, Tsochatzis, Emmanuel A, van Kleef, Laurens, van Wijngaarden, Paulien, Velázquez, Vanessa, Viu, Ana, Weber, Susanne Nicole, Wildsmith, Tracey, Pera, Guillem, Reichert, Mathias, Pericàs, Juan M, Schattenberg, Jörn M, Tsochatztis, Emmanuel A, Garcia-Retortillo, Montserrat, Hernández, Rosario, Expósito, Carmen, Martínez, Alba, Detlefsen, Sönke, Martini, Andrea, Ma, Ann T, Pich, Judith, Bonfill, Eva, Navarrete, J M, Hernáez, Rubén, Allen, Alina, de Knegt, Robert J, and Wong, Vincent Wai-Sun

Published
2023
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5. LiverScreen project: study protocol for screening for liver fibrosis in the general population in European countries

Author

Graupera, Isabel, Thiele, Maja, Ma, Ann T., Serra-Burriel, Miquel, Pich, Judit, Fabrellas, Núria, Caballeria, Llorenç, de Knegt, Robert J., Grgurevic, Ivica, Reichert, Mathias, Roulot, Dominique, Schattenberg, Jörn M., Pericas, Juan M., Angeli, Paolo, Tsochatzis, Emmanuel A., Guha, Indra Neil, Garcia-Retortillo, Montserrat, Morillas, Rosa M., Hernández, Rosario, Hoyo, Jordi, Fuentes, Matilde, Madir, Anita, Juanola, Adrià, Soria, Anna, Juan, Marta, Carol, Marta, Diaz, Alba, Detlefsen, Sönke, Toran, Pere, Pera, Guillem, Fournier, Céline, Llorca, Anne, Newsome, Phillip N., Manns, Michael, de Koning, Harry J., Serra-Burriel, Feliu, Cucchietti, Fernando, Arslanow, Anita, Korenjak, Marko, van Kleef, Laurens, Falcó, Josep Lluis, Kamath, Patrick S., Karlsen, Tom H., Castera, Laurent, Lammert, Frank, Krag, Aleksander, and Ginès, Pere

Published
2022
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8. Validation of Baveno VII criteria for clinically significant portal hypertension by two-dimensional shear wave elastography

Author

He, Ruiling, primary, Liu, Chuan, additional, Grgurevic, Ivica, additional, Guo, Ying, additional, Xu, Huixiong, additional, Liu, Jiacheng, additional, Liu, Yunfang, additional, Wang, XiaoYan, additional, Shi, Hongmei, additional, Madir, Anita, additional, Podrug, Kristian, additional, Zhu, Yuli, additional, Hua, Yongli, additional, Wang, Kun, additional, Wen, Jing, additional, Su, Meiqin, additional, Zhang, Qun, additional, Li, Jie, additional, and Qi, Xiaolong, additional

Published
2023
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9. Development, validation, and prognostic evaluation of a risk score for long-term liver-related outcomes in the general population: a multicohort study

Author

Serra-Burriel, Miquel, primary, Juanola, Adrià, additional, Serra-Burriel, Feliu, additional, Thiele, Maja, additional, Graupera, Isabel, additional, Pose, Elisa, additional, Pera, Guillem, additional, Grgurevic, Ivica, additional, Caballeria, Llorenç, additional, Piano, Salvatore, additional, van Kleef, Laurens, additional, Reichert, Mathias, additional, Roulot, Dominique, additional, Pericàs, Juan M, additional, Schattenberg, Jörn M, additional, Tsochatztis, Emmanuel A, additional, Guha, Indra Neil, additional, Garcia-Retortillo, Montserrat, additional, Hernández, Rosario, additional, Hoyo, Jordi, additional, Fuentes, Matilde, additional, Expósito, Carmen, additional, Martínez, Alba, additional, Such, Patricia, additional, Madir, Anita, additional, Detlefsen, Sönke, additional, Tonon, Marta, additional, Martini, Andrea, additional, Ma, Ann T, additional, Pich, Judith, additional, Bonfill, Eva, additional, Juan, Marta, additional, Soria, Anna, additional, Carol, Marta, additional, Gratacós-Ginès, Jordi, additional, Morillas, Rosa M, additional, Toran, Pere, additional, Navarrete, J M, additional, Torrejón, Antoni, additional, Fournier, Céline, additional, Llorca, Anne, additional, Arslanow, Anita, additional, de Koning, Harry J, additional, Cucchietti, Fernando, additional, Manns, Michael, additional, Newsome, Phillip N, additional, Hernáez, Rubén, additional, Allen, Alina, additional, Angeli, Paolo, additional, de Knegt, Robert J, additional, Karlsen, Tom H, additional, Galle, Peter, additional, Wong, Vincent Wai-Sun, additional, Fabrellas, Núria, additional, Castera, Laurent, additional, Krag, Aleksander, additional, Lammert, Frank, additional, Kamath, Patrick S, additional, Ginès, Pere, additional, Alvarez, Marifé, additional, Andersen, Peter, additional, Ardèvol, Alba, additional, Beggiato, Luca, additional, Ben Abdesselam, Zahia, additional, Bennett, Lucy, additional, Boutouria, Bajiha, additional, Brocca, Alessandra, additional, Broquetas, M. Teresa, additional, Calvino, Valeria, additional, Camacho, Judith, additional, Capdevila, Aura, additional, Cervera, Marta, additional, de Fuentes, Anna, additional, de Knegt, Rob, additional, Detlefsen, Sonke, additional, Diaz, Alba, additional, Diéguez Bande, José, additional, Esnault, Vanessa, additional, Falcó, Josep Lluis, additional, Fernández, Rosa, additional, García, Edgar, additional, García-Retortillo, Montserrat, additional, Garrido, Esther, additional, Gordillo Medina, Rosa, additional, Guix, Eva, additional, Hansen, Johanne Kragh, additional, Harris, Rebecca, additional, Hernández Boluda, Elena, additional, Hernández-Ibañez, Rosario, additional, Ikram, Arfan, additional, Incicco, Simone, additional, Israelsen, Mads, additional, Kaiser, Ralf, additional, Kjærgaard, Maria, additional, Korenjak, Marko, additional, Krawczyk, Marcin, additional, Laboulaye, Philippe, additional, Lambert, Irina, additional, Langkjær Sørensen, Simon, additional, Laserna-Jiménez, Cristina, additional, Lazaro Pi, Sonia, additional, Ledain, Elsa, additional, Levy, Vincent, additional, Lindvig, Katrine Prier, additional, Londoño, Vanessa, additional, Loyer, Guirec, additional, Ma, Ann T., additional, Marshall, Denise, additional, Martí, M. Lluïsa, additional, Martínez, Sara, additional, Martínez Sala, Ricard, additional, Masa-Font, Roser, additional, Møller Jensen, Jane, additional, Muñoz, Laura, additional, Nadal, Ruth, additional, Napoleone, Laura, additional, Navarrete, JM, additional, Nielsen, Vibeke, additional, Pérez, Martina, additional, Pericás-Pulido, Juan Manuel, additional, Pich, Judit, additional, Presas Escobet, Judit, additional, Reichert, Matthias, additional, Riba, Carlota, additional, Rubio, Ana Belén, additional, Sánchez-Morata, Maria, additional, Schattenberg, Jörn, additional, Serra-Burriel, Miquel, additional, Skovborg Just, Louise, additional, Sonneveld, Milan, additional, Stern, Christiane, additional, Tsochatzis, Emmanuel A, additional, van Wijngaarden, Paulien, additional, Velázquez, Vanessa, additional, Viu, Ana, additional, Weber, Susanne Nicole, additional, and Wildsmith, Tracey, additional

Published
2023
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11. Use of biochemical parameters for non-invasive screening of oesophageal varices in comparison to elastography-based approach in patients with compensated advanced chronic liver disease

Author

Pastrovic, Frane, Madir, Anita, Podrug, Kristian, Lucijanic, Marko, Bokun, Tomislav, Zelenika, Marko, Mustapic, Sanda, Unic, Adriana, Derek, Lovorka, Grgurevic, Ivica, Pastrovic, Frane, Madir, Anita, Podrug, Kristian, Lucijanic, Marko, Bokun, Tomislav, Zelenika, Marko, Mustapic, Sanda, Unic, Adriana, Derek, Lovorka, and Grgurevic, Ivica

Abstract

Oesophageal varices are routinely diagnosed by esophagogastroduodenoscopy (EGD), and their bleeding has high mortality. We aimed to evaluate diagnostic performance of biochemical tests in comparison to elastography-based approaches, as non-invasive alternatives to EGD, for ruling-out high risk oesophageal varices (HRV). Retrospective analysis of patients (N = 861) who underwent liver stiffness measurement (LSM) by transient elastography (TE) in a single centre over 5-year period, with available results of EGD (within 3 months from LSM). Only patients with suspicion of compensated advanced chronic liver disease (cACLD) defined by LSM ≥ 10 kPa were included comprising the final cohort of 73 subjects. Original and expanded Baveno VI criteria (B6C), controlled attenuation parameter (CAP), platelet count (PLT), aspartate aminotransferase to PLT ratio index (APRI), Fibrosis-4 index (FIB4), model for end stage liver disease (MELD) score were evaluated against the results of EGD that served as the reference method. Analysed patients had median age 62 years, 59/73 (0.81) were males, 54/73 (0.74) had alcoholic/non-alcoholic fatty liver disease, and 21/73 (0.29) had HRV. In multivariate logistic regression analysis only LSM and PLT were independently associated with HRV. The best performing tests for ruling-out HRV (% of spared EGD; % of missed HRV) were respectively: LSM < 20 kPa (53.4%; 0%), B6C (38%; 0%), Expanded B6C (47.9%; 4.8%); PLT > 214x109/L (21.9%; 0%); FIB4 ≤ 1.8 (21.4%; 0%), APRI ≤ 0.34 (12.3%; 0%). CAP, MELD = 6 alone or combined with PLT > 150(x109/L) did not show acceptable performance. The best performing biochemical tests for ruling-out HRV in our cohort of patients were PLT and FIB-4, but they were still outperformed by elastography-based approaches.

Published
2022

12. LiverScreen project:study protocol for screening for liver fibrosis in the general population in European countries

Author

Graupera, Isabel, Thiele, Maja, Ma, Ann T., Serra-Burriel, Miquel, Pich, Judit, Fabrellas, Núria, Caballeria, Llorenç, de Knegt, Robert J., Grgurevic, Ivica, Reichert, Mathias, Roulot, Dominique, Schattenberg, Jörn M., Pericas, Juan M., Angeli, Paolo, Tsochatzis, Emmanuel A., Guha, Indra Neil, Garcia-Retortillo, Montserrat, Morillas, Rosa M., Hernández, Rosario, Hoyo, Jordi, Fuentes, Matilde, Madir, Anita, Juanola, Adrià, Soria, Anna, Juan, Marta, Carol, Marta, Diaz, Alba, Detlefsen, Sönke, Toran, Pere, Fournier, Céline, Llorca, Anne, Newsome, Phillip N., Manns, Michael, de Koning, Harry J., Serra-Burriel, Feliu, Cucchietti, Fernando, Arslanow, Anita, Korenjak, Marko, van Kleef, Laurens, Falcó, Josep Lluis, Kamath, Patrick S., Karlsen, Tom H., Castera, Laurent, Lammert, Frank, Krag, Aleksander, Ginès, Pere, Graupera, Isabel, Thiele, Maja, Ma, Ann T., Serra-Burriel, Miquel, Pich, Judit, Fabrellas, Núria, Caballeria, Llorenç, de Knegt, Robert J., Grgurevic, Ivica, Reichert, Mathias, Roulot, Dominique, Schattenberg, Jörn M., Pericas, Juan M., Angeli, Paolo, Tsochatzis, Emmanuel A., Guha, Indra Neil, Garcia-Retortillo, Montserrat, Morillas, Rosa M., Hernández, Rosario, Hoyo, Jordi, Fuentes, Matilde, Madir, Anita, Juanola, Adrià, Soria, Anna, Juan, Marta, Carol, Marta, Diaz, Alba, Detlefsen, Sönke, Toran, Pere, Fournier, Céline, Llorca, Anne, Newsome, Phillip N., Manns, Michael, de Koning, Harry J., Serra-Burriel, Feliu, Cucchietti, Fernando, Arslanow, Anita, Korenjak, Marko, van Kleef, Laurens, Falcó, Josep Lluis, Kamath, Patrick S., Karlsen, Tom H., Castera, Laurent, Lammert, Frank, Krag, Aleksander, and Ginès, Pere

Abstract

Background: The development of liver cirrhosis is usually an asymptomatic process until late stages when complications occur. The potential reversibility of the disease is dependent on early diagnosis of liver fibrosis and timely targeted treatment. Recently, the use of non-invasive tools has been suggested for screening of liver fibrosis, especially in subjects with risk factors for chronic liver disease. Nevertheless, large population-based studies with cost-effectiveness analyses are still lacking to support the widespread use of such tools. The aim of this study is to investigate whether non-invasive liver stiffness measurement in the general population is useful to identify subjects with asymptomatic, advanced chronic liver disease. Methods: This study aims to include 30,000 subjects from eight European countries. Subjects from the general population aged ≥ 40 years without known liver disease will be invited to participate in the study either through phone calls/letters or through their primary care center. In the first study visit, subjects will undergo bloodwork as well as hepatic fat quantification and liver stiffness measurement (LSM) by vibration-controlled transient elastography. If LSM is ≥ 8 kPa and/or if ALT levels are ≥1.5 x upper limit of normal, subjects will be referred to hospital for further evaluation and consideration of liver biopsy. The primary outcome is the percentage of subjects with LSM ≥ 8kPa. In addition, a health economic evaluation will be performed to assess the cost-effectiveness and budget impact of such an intervention. The project is funded by the European Commission H2020 program. Discussion: This study comes at an especially important time, as the burden of chronic liver diseases is expected to increase in the coming years. There is consequently an urgent need to change our current approach, from diagnosing the disease late when the impact of interventions may be limited to diagnosing the disease earlier, when the patient i

Published
2022

13. Use of biochemical parameters for non-invasive screening of oesophageal varices in comparison to elastography-based approach in patients with compensated advanced chronic liver disease

Author

Lucijanic, Marko, primary, Madir, Anita, additional, Grgurevic, Ivica, additional, Derek, Lovorka, additional, Unic, Adriana, additional, Mustapic, Sanda, additional, Zelenika, Marko, additional, Bokun, Tomislav, additional, Pastrovic, Frane, additional, and Podrug, Kristian, additional

Published
2022
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14. Additional file 3 of LiverScreen project: study protocol for screening for liver fibrosis in the general population in European countries

Author

Graupera, Isabel, Thiele, Maja, Ma, Ann T., Serra-Burriel, Miquel, Pich, Judit, Fabrellas, Núria, Caballeria, Llorenç, de Knegt, Robert J., Grgurevic, Ivica, Reichert, Mathias, Roulot, Dominique, Schattenberg, Jörn M., Pericas, Juan M., Angeli, Paolo, Tsochatzis, Emmanuel A., Guha, Indra Neil, Garcia-Retortillo, Montserrat, Morillas, Rosa M., Hernández, Rosario, Hoyo, Jordi, Fuentes, Matilde, Madir, Anita, Juanola, Adrià, Soria, Anna, Juan, Marta, Carol, Marta, Diaz, Alba, Detlefsen, Sönke, Toran, Pere, Fournier, Céline, Llorca, Anne, Newsome, Phillip N., Manns, Michael, de Koning, Harry J., Serra-Burriel, Feliu, Cucchietti, Fernando, Arslanow, Anita, Korenjak, Marko, van Kleef, Laurens, Falcó, Josep Lluis, Kamath, Patrick S., Karlsen, Tom H., Castera, Laurent, Lammert, Frank, Krag, Aleksander, and Ginès, Pere

Abstract

Additional file 3. Participant information sheet.

Published
2022
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15. Additional file 1 of LiverScreen project: study protocol for screening for liver fibrosis in the general population in European countries

Author

Graupera, Isabel, Thiele, Maja, Ma, Ann T., Serra-Burriel, Miquel, Pich, Judit, Fabrellas, Núria, Caballeria, Llorenç, de Knegt, Robert J., Grgurevic, Ivica, Reichert, Mathias, Roulot, Dominique, Schattenberg, Jörn M., Pericas, Juan M., Angeli, Paolo, Tsochatzis, Emmanuel A., Guha, Indra Neil, Garcia-Retortillo, Montserrat, Morillas, Rosa M., Hernández, Rosario, Hoyo, Jordi, Fuentes, Matilde, Madir, Anita, Juanola, Adrià, Soria, Anna, Juan, Marta, Carol, Marta, Diaz, Alba, Detlefsen, Sönke, Toran, Pere, Fournier, Céline, Llorca, Anne, Newsome, Phillip N., Manns, Michael, de Koning, Harry J., Serra-Burriel, Feliu, Cucchietti, Fernando, Arslanow, Anita, Korenjak, Marko, van Kleef, Laurens, Falcó, Josep Lluis, Kamath, Patrick S., Karlsen, Tom H., Castera, Laurent, Lammert, Frank, Krag, Aleksander, and Ginès, Pere

Abstract

Additional file 1. LiverScreen Project recruiting centers.

Published
2022
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16. Additional file 2 of LiverScreen project: study protocol for screening for liver fibrosis in the general population in European countries

Author

Graupera, Isabel, Thiele, Maja, Ma, Ann T., Serra-Burriel, Miquel, Pich, Judit, Fabrellas, Núria, Caballeria, Llorenç, de Knegt, Robert J., Grgurevic, Ivica, Reichert, Mathias, Roulot, Dominique, Schattenberg, Jörn M., Pericas, Juan M., Angeli, Paolo, Tsochatzis, Emmanuel A., Guha, Indra Neil, Garcia-Retortillo, Montserrat, Morillas, Rosa M., Hernández, Rosario, Hoyo, Jordi, Fuentes, Matilde, Madir, Anita, Juanola, Adrià, Soria, Anna, Juan, Marta, Carol, Marta, Diaz, Alba, Detlefsen, Sönke, Toran, Pere, Fournier, Céline, Llorca, Anne, Newsome, Phillip N., Manns, Michael, de Koning, Harry J., Serra-Burriel, Feliu, Cucchietti, Fernando, Arslanow, Anita, Korenjak, Marko, van Kleef, Laurens, Falcó, Josep Lluis, Kamath, Patrick S., Karlsen, Tom H., Castera, Laurent, Lammert, Frank, Krag, Aleksander, and Ginès, Pere

Abstract

Additional file 2. Safety assessment, Data collection and processing, Quality control and regulatory considerations.

Published
2022
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20. FibroScan-AST Score Predicts 30-Day Mortality or Need for Mechanical Ventilation among Patients Hospitalized with COVID-19

Author

Zelenika, Marko, primary, Lucijanic, Marko, additional, Bokun, Tomislav, additional, Bozin, Tonci, additional, Barisic Jaman, Mislav, additional, Tjesic Drinkovic, Ida, additional, Pastrovic, Frane, additional, Madir, Anita, additional, Luksic, Ivica, additional, Piskac Zivkovic, Nevenka, additional, Luetic, Kresimir, additional, Krznaric, Zeljko, additional, Ostojic, Rajko, additional, Filipec Kanizaj, Tajana, additional, Bogadi, Ivan, additional, Virovic Jukic, Lucija, additional, Kukla, Michal, additional, and Grgurevic, Ivica, additional

Published
2021
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21. Prognostic Factors in Primary Biliary Cholangitis: A Retrospective Study of Joint Slovak and Croatian Cohort of 249 Patients

Author

Gazda, Jakub, primary, Drazilova, Sylvia, additional, Janicko, Martin, additional, Grgurevic, Ivica, additional, Filipec Kanizaj, Tajana, additional, Koller, Tomas, additional, Bodorovska, Beatrica, additional, Bozin, Tonci, additional, Mijic, Maja, additional, Rob, Zrinka, additional, Mikolasevic, Ivana, additional, Madir, Anita, additional, Kucinsky, Branislav, additional, and Jarcuska, Peter, additional

Published
2021
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22. Characteristics of patients with primary biliary cholangitis in a tertiary hospital facility

Author

Madir, Anita, Grgurević, Ivica, Filipec Kanižaj, Tajana, and Markeljević, Jasenka

Subjects
therapy, data, characteristics, prevalence, PBC, patients
Abstract

Uvod: Primarni bilijarni kolangitis (PBC) je progresivna, autoimuna bolest jetre, kroničnog tijeka i nedovoljno poznate etiologije. Bolest se aktivira kada osobe s genetskom predispozicijom budu izložene štetnim čimbenicima iz okoliša. U zadnje vrijeme, opisuje se porast prevalencije i incidencije primarnog bilijarnog kolangitisa u cijelom svijetu. Epidemiološki gradijent pokazuje pad prevalencije u smjeru zapad-istok i sjever-jug. Trenutno nema objavljenih podataka o incidenciji, prevalenciji ili demografskim značajkama oboljelih od PBC-a u Hrvatskoj. Glavni cilj ovog istraživanja bio je prikazati epidemiološke, kliničke i demografske karakteristike PBC bolesnika liječenih u Kliničkoj bolnici Dubrava. ----- Metode: Provedeno je retrospektivno istraživanje bolničke baze podataka za period od 2007. do 2017. godine. Identificirano je 46 PBC pacijenata s dostupnom medicinskom dokumentacijom. Analizirani su demografski, klinički i epidemiološki podatci, odgovor na terapiju nakon 12 mjeseci korištenja, te klinički ishod bolesti. Lošim kliničkim ishodom smatrani su: smrt, razvoj raka jetre, potreba za transplantacijom jetre ili jetrena dekompenzacija. Za procjenu incidencije i prevalencije uzeti su u obzir samo bolesnici s prebivalištem na geografskom području odgovornosti KB Dubrava. ----- Rezultati: Uključeni bolesnici bili su pretežito ženskog spola (87%) s medijanom starosti od 57,5 godina, a 68,8% ih je bilo u ranom kliničkom stadiju bolesti. Analizom bolesnika s prebivalištem na području odgovornosti KBD (N=38) izračunata je prevalencija od 11,47 bolesnika na 100,000 stanovnika i godišnja incidencija od 0,54 na 100,000 stanovnika. Svi bolesnici liječeni su ursodeoksikolnom kiselinom (UDCA). Među 32 bolesnika za koje su bili dostupni podatci nakon 12 mjeseci terapije, povoljan biokemijski odgovor zabilježen je u njih 25 (78%). Čimbenici povezani s uspjehom liječenja bili su redovito uzimanje terapije (P = 0,007) i niska inicijalna koncentracija IgM-a (P = 0,009). Loš klinički ishod zabilježen je u 5 bolesnika. U multivarijatnoj analizi osteoporoza je bila jedini čimbenik neovisno povezan s lošim ishodom bolesti (HR = 9,27; P = 0,031). ----- Zaključak: PBC je rijetka bolest, koja u opisanoj kohorti pogađa pretežito žene, srednje dobi, a većina ih ima blagi klinički stadij i dobru prognozu. Iako zemljopisno ograničeno, ovo istraživanje pruža prve epidemiološke podatke o PBC-u u Hrvatskoj i time nadopunjuje PBC kartu Europe., Introduction: Primary biliary cholangitis (PBC) is a chronic and progressive cholestatic liver disease of unknown etiology. Nowadays, PBC is considered an autoimmune disease activated by environmental factors in individuals with a genetic predisposition. Prevalence and incidence rates of PBC appear to increase worldwide. The epidemiological gradient shows a decline in prevalence from West to East and from North to South. There are no published data on incidence, prevalence or demographic characteristics of patients with primary biliary cholangitis (PBC) in Croatia. The aim of this study was to show the epidemiological and demographic characteristics of PBC patients treated at Dubrava Clinical Hospital. ----- Methods: A retrospective search of the hospital´s database was conducted. Data from 2007 to 2017 were reviewed during the study. 46 PBC patients with retrievable medical records were identified. Epidemiologic data were restricted to patients from the hospital´s catchment area. Statistical analysis involving the entire cohort included descriptive data as well as response to therapy after 12 months and a survival analysis. Risk factors for an adverse outcome were identified. An adverse outcome was defined as a composite event (ascites, variceal bleeding, encephalopathy), or HCC, liver transplantation and death. ----- Results: Most patients were female (87%) with a median age of disease onset of 57.5 years. The cohort included 38 patients (83%) from the hospital´s catchment area resulting in the prevalence of 11.47/100.000 and incidence of 0.54/100.000 inhabitants per year. From 32 patients analyzed concerning the response to therapy, 78% responded well. Adherence to therapy (P=0.007) and low IgM concentration at diagnosis (P=0.009) were associated with therapy success. An adverse outcome was reported in five patients. Among factors related to shorter event-free survival, osteoporosis remained relevant in multivariate analysis after adjusting for age (HR=9.27; P=0.031). ----- Conclusion: Despite some drawbacks, this study gives pioneer insights into the epidemiological data of PBC in the southeast corner of Europe, therefore complementing the PBC map of Europe.

Published
2020

28. Use of biochemical parameters for non-invasive screening of oesophageal varices in comparison to elastography-based approach in patients with compensated advanced chronic liver disease.

Author

Pastrovic F, Madir A, Podrug K, Lucijanic M, Bokun T, Zelenika M, Mustapic S, Unic A, Derek L, and Grgurevic I

Subjects
Aspartate Aminotransferases, Female, Humans, Liver Cirrhosis complications, Liver Cirrhosis diagnosis, Male, Middle Aged, Retrospective Studies, Severity of Illness Index, Elasticity Imaging Techniques methods, End Stage Liver Disease complications, Esophageal and Gastric Varices complications, Esophageal and Gastric Varices diagnosis
Abstract

Introduction: Oesophageal varices are routinely diagnosed by esophagogastroduodenoscopy (EGD), and their bleeding has high mortality. We aimed to evaluate diagnostic performance of biochemical tests in comparison to elastography-based approaches, as non-invasive alternatives to EGD, for ruling-out high risk oesophageal varices (HRV)., Material and Methods: Retrospective analysis of patients (N = 861) who underwent liver stiffness measurement (LSM) by transient elastography (TE) in a single centre over 5-year period, with available results of EGD (within 3 months from LSM). Only patients with suspicion of compensated advanced chronic liver disease (cACLD) defined by LSM ≥ 10 kPa were included comprising the final cohort of 73 subjects. Original and expanded Baveno VI criteria (B6C), controlled attenuation parameter (CAP), platelet count (PLT), aspartate aminotransferase to PLT ratio index (APRI), Fibrosis-4 index (FIB4), model for end stage liver disease (MELD) score were evaluated against the results of EGD that served as the reference method., Results: Analysed patients had median age 62 years, 59/73 (0.81) were males, 54/73 (0.74) had alcoholic/non-alcoholic fatty liver disease, and 21/73 (0.29) had HRV. In multivariate logistic regression analysis only LSM and PLT were independently associated with HRV. The best performing tests for ruling-out HRV (% of spared EGD; % of missed HRV) were respectively: LSM < 20 kPa (53.4%; 0%), B6C (38%; 0%), Expanded B6C (47.9%; 4.8%); PLT > 214x10 9 /L (21.9%; 0%); FIB4 ≤ 1.8 (21.4%; 0%), APRI ≤ 0.34 (12.3%; 0%). CAP, MELD = 6 alone or combined with PLT > 150(x10 9 /L) did not show acceptable performance., Conclusion: The best performing biochemical tests for ruling-out HRV in our cohort of patients were PLT and FIB-4, but they were still outperformed by elastography-based approaches., Competing Interests: Potential conflict of interest None declared., (Croatian Society of Medical Biochemistry and Laboratory Medicine.)

Published
2022
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