Author
Nuria Cañete
Bio: Nuria Cañete is an academic researcher from Autonomous University of Barcelona. The author has contributed to research in topics: Cirrhosis & Telaprevir. The author has an hindex of 13, co-authored 37 publications receiving 589 citations.
Papers
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University of Barcelona1, Iuliu Hațieganu University of Medicine and Pharmacy2, Hospital General Universitario Gregorio Marañón3, University of Alcalá4, Autonomous University of Barcelona5, University of Toulouse6, Autonomous University of Madrid7, Katholieke Universiteit Leuven8, University of Copenhagen9, Medical University of Vienna10, Aarhus University Hospital11, University of Padua12, University of Alberta13, Martin Luther University of Halle-Wittenberg14, University of Milan15, Odense University Hospital16, University of Bonn17, University of Bern18
TL;DR: In this paper, a multicenter, international, observational study including 671 patients from 34 centers admitted for acute variceal bleeding (AVB) and high-risk of treatment failure was conducted.
132 citations
Shanghai Jiao Tong University1, Goethe University Frankfurt2, Hospital General Universitario Gregorio Marañón3, University of Barcelona4, Iuliu Hațieganu University of Medicine and Pharmacy5, University of Paris6, University of Alcalá7, Autonomous University of Barcelona8, University of Toulouse9, Autonomous University of Madrid10, Katholieke Universiteit Leuven11, University of Copenhagen12, Medical University of Vienna13, Aarhus University Hospital14, University of Padua15, University of Alberta16, Martin Luther University of Halle-Wittenberg17, University of Bonn18, Odense University Hospital19, University of Bern20, Complutense University of Madrid21
TL;DR: This large multi-center international real-life study identified ACLF as at admission an independent predictor of rebleeding and mortality in AVB and pTIPS may be considered in ACLF patients with AVB, although the presented data need to be independently validated.
103 citations
TL;DR: Almost 50% of the cirrhotic patients with ascites developed some type of functional renal failure during the follow-up period; renal failure was associated with worse prognosis.
89 citations
University of Barcelona1, Iuliu Hațieganu University of Medicine and Pharmacy2, Fourth Military Medical University3, University of Paris4, Hospital Universitario Insular de Gran Canaria5, Autonomous University of Barcelona6, University of Bern7, Katholieke Universiteit Leuven8, University of Bonn9, ISMETT10, Martin Luther University of Halle-Wittenberg11, Hospital General Universitario Gregorio Marañón12, University of Alcalá13, Autonomous University of Madrid14, University of Copenhagen15, St John of God Health Care16, Aarhus University Hospital17, University of Padua18, Odense University Hospital19, Nanchang University20, Southern Medical University21, Xi'an Jiaotong University22, Sun Yat-sen University23, Nanjing University24, Shandong University25, Zhejiang University26, Zhengzhou University27, First Affiliated Hospital of Xinjiang Medical University28, Kunming Medical University29
TL;DR: A meta-analysis of data from 1327 patients with cirrhosis, acute variceal bleeding, and Child-Pugh score between 10-13 points or CP-B+AB found that preemptive TIPS increased the proportion who survived for 1 year, in both subgroups separately, compared with drugs plus endoscopy.
73 citations
TL;DR: Peptic ulcer rebleeding virtually does not occur in patients with complicated ulcers after H. pylori eradication, and maintenance anti-ulcer (antisecretory) therapy is not necessary if eradication is achieved.
72 citations
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TL;DR: This guidance provides a data-supported approach to risk stratification, diagnosis, and management of patients with cirrhosis and portal hypertension (PH), varices, and variceal hemorrhage (VH), and statements are based on the following.
1,397 citations
TL;DR: In patients with cirrhosis, infections increase mortality 4-fold; 30% of patients die within 1 month after infection and another 30% die by 1 year; prospects with prolonged follow-up evaluation and to evaluate preventative strategies are needed.
929 citations
Zhengzhou University1, The Royal Marsden NHS Foundation Trust2, University of Bern3, Policlinico Umberto I4, University of Paris5, University of Pavia6, Goethe University Frankfurt7, University of Bergen8, University of Erlangen-Nuremberg9, Erasmus University Rotterdam10, University of Bologna11, University of Medicine and Pharmacy of Craiova12, King's College London13, University of Southern Denmark14
TL;DR: The first update of the 2013 EFSUMB (European Federation of Societies for Ultrasound in Medicine and Biology) Guidelines and Recommendations on the clinical use of elastography is presented, focused on the assessment of diffuse liver disease.
Abstract: We present here the first update of the 2013 EFSUMB (European Federation of Societies for Ultrasound in Medicine and Biology) Guidelines and Recommendations on the clinical use of elastography with a focus on the assessment of diffuse liver disease. The short version provides clinical information about the practical use of elastography equipment and interpretation of results in the assessment of diffuse liver disease and analyzes the main findings based on published studies, stressing the evidence from meta-analyses. The role of elastography in different etiologies of liver disease and in several clinical scenarios is also discussed. All of the recommendations are judged with regard to their evidence-based strength according to the Oxford Centre for Evidence-Based Medicine Levels of Evidence. This updated document is intended to act as a reference and to provide a practical guide for both beginners and advanced clinical users.
740 citations
TL;DR: This review discusses recently identified information about renal failure in cirrhosis and clinical interventions that may assist in the prevention and management of this complication.
Abstract: Renal failure, a challenging complication of cirrhosis, is one of the most important risk factors for liver transplantation. In recent years, substantial progress has been made toward understanding the pathogenesis and natural history of renal failure in cirrhosis. This review discusses recently identified information about renal failure in cirrhosis and clinical interventions that may assist in the prevention and management of this complication.
692 citations
TL;DR: This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy and addresses the diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH).
Abstract: This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the diagnosis and management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH). Main Recommendations
MR1. ESGE recommends immediate assessment of hemodynamic status in patients who present with acute upper gastrointestinal hemorrhage (UGIH), with prompt intravascular volume replacement initially using crystalloid fluids if hemodynamic instability exists (strong recommendation, moderate quality evidence). MR2. ESGE recommends a restrictive red blood cell transfusion strategy that aims for a target hemoglobin between 7 g/dL and 9 g/dL. A higher target hemoglobin should be considered in patients with significant co-morbidity (e. g., ischemic cardiovascular disease) (strong recommendation, moderate quality evidence). MR3. ESGE recommends the use of the Glasgow-Blatchford Score (GBS) for pre-endoscopy risk stratification. Outpatients determined to be at very low risk, based upon a GBS score of 0 – 1, do not require early endoscopy nor hospital admission. Discharged patients should be informed of the risk of recurrent bleeding and be advised to maintain contact with the discharging hospital (strong recommendation, moderate quality evidence). MR4. ESGE recommends initiating high dose intravenous proton pump inhibitors (PPI), intravenous bolus followed by continuous infusion (80 mg then 8 mg/hour), in patients presenting with acute UGIH awaiting upper endoscopy. However, PPI infusion should not delay the performance of early endoscopy (strong recommendation, high quality evidence). MR5. ESGE does not recommend the routine use of nasogastric or orogastric aspiration/lavage in patients presenting with acute UGIH (strong recommendation, moderate quality evidence). MR6. ESGE recommends intravenous erythromycin (single dose, 250 mg given 30 – 120 minutes prior to upper gastrointestinal [GI] endoscopy) in patients with clinically severe or ongoing active UGIH. In selected patients, pre-endoscopic infusion of erythromycin significantly improves endoscopic visualization, reduces the need for second-look endoscopy, decreases the number of units of blood transfused, and reduces duration of hospital stay (strong recommendation, high quality evidence). MR7. Following hemodynamic resuscitation, ESGE recommends early (≤ 24 hours) upper GI endoscopy. Very early ( MR8. ESGE recommends that peptic ulcers with spurting or oozing bleeding (Forrest classification Ia and Ib, respectively) or with a nonbleeding visible vessel (Forrest classification IIa) receive endoscopic hemostasis because these lesions are at high risk for persistent bleeding or rebleeding (strong recommendation, high quality evidence). MR9. ESGE recommends that peptic ulcers with an adherent clot (Forrest classification IIb) be considered for endoscopic clot removal. Once the clot is removed, any identified underlying active bleeding (Forrest classification Ia or Ib) or nonbleeding visible vessel (Forrest classification IIa) should receive endoscopic hemostasis (weak recommendation, moderate quality evidence). MR10. In patients with peptic ulcers having a flat pigmented spot (Forrest classification IIc) or clean base (Forrest classification III), ESGE does not recommend endoscopic hemostasis as these stigmata present a low risk of recurrent bleeding. In selected clinical settings, these patients may be discharged to home on standard PPI therapy, e. g., oral PPI once-daily (strong recommendation, moderate quality evidence). MR11. ESGE recommends that epinephrine injection therapy not be used as endoscopic monotherapy. If used, it should be combined with a second endoscopic hemostasis modality (strong recommendation, high quality evidence). MR12. ESGE recommends PPI therapy for patients who receive endoscopic hemostasis and for patients with adherent clot not receiving endoscopic hemostasis. PPI therapy should be high dose and administered as an intravenous bolus followed by continuous infusion (80 mg then 8 mg/hour) for 72 hours post endoscopy (strong recommendation, high quality evidence). MR13. ESGE does not recommend routine second-look endoscopy as part of the management of nonvariceal upper gastrointestinal hemorrhage (NVUGIH). However, in patients with clinical evidence of rebleeding following successful initial endoscopic hemostasis, ESGE recommends repeat upper endoscopy with hemostasis if indicated. In the case of failure of this second attempt at hemostasis, transcatheter angiographic embolization (TAE) or surgery should be considered (strong recommendation, high quality evidence). MR14. In patients with NVUGIH secondary to peptic ulcer, ESGE recommends investigating for the presence of Helicobacter pylori in the acute setting with initiation of appropriate antibiotic therapy when H. pylori is detected. Re-testing for H. pylori should be performed in those patients with a negative test in the acute setting. Documentation of successful H. pylori eradication is recommended (strong recommendation, high quality evidence). MR15. In patients receiving low dose aspirin for secondary cardiovascular prophylaxis who develop peptic ulcer bleeding, ESGE recommends aspirin be resumed immediately following index endoscopy if the risk of rebleeding is low (e. g., FIIc, FIII). In patients with high risk peptic ulcer (FIa, FIb, FIIa, FIIb), early reintroduction of aspirin by day 3 after index endoscopy is recommended, provided that adequate hemostasis has been established (strong recommendation, moderate quality evidence).
611 citations