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Article: Humoral Immune Response after COVID-19 mRNA Vaccination in Patients with Liver Cirrhosis: A Prospective Real-Life Single Center Study.

Biliotti, Elisa / Caioli, Alessandro / Sorace, Chiara / Lionetti, Raffaella / Milozzi, Eugenia / Taibi, Chiara / Visco Comandini, Ubaldo / Maggi, Fabrizio / Puro, Vincenzo / D'Offizi, Gianpiero

Biomedicines

2023 Volume 11, Issue 5

Abstract: Coronavirus-disease-2019 (COVID-19) mRNA vaccination effectively reduces mortality and morbidity in cirrhotic patients, but the immunogenicity and safety of vaccination have been partially characterized. The study aimed to evaluate humoral response, ... ...

Abstract	Coronavirus-disease-2019 (COVID-19) mRNA vaccination effectively reduces mortality and morbidity in cirrhotic patients, but the immunogenicity and safety of vaccination have been partially characterized. The study aimed to evaluate humoral response, predictive factors, and safety of mRNA-COVID-19 vaccination in cirrhotic patients compared to healthy subjects. A prospective, single-center, observational study enrolled consecutive cirrhotic patients who underwent mRNA-COVID-19 vaccination from April to May 2021. Anti-spike-protein (anti-S) and nucleocapsid-protein (anti-N) antibodies were evaluated before the first (T0) and the second (T1) doses and 15 days after completing the vaccination. An age and sex-matched healthy reference group was included. The incidence of adverse events (AEs) was assessed. In total, 162 cirrhotic patients were enrolled, 13 were excluded due to previous SARS-CoV-2 infection; therefore, 149 patients and 149 Health Care Workers (HCWs) were included in the analysis. The seroconversion rate was similar in cirrhotic patients and HCWs at T1 (92.5% vs. 95.3%,
Language	English
Publishing date	2023-04-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines11051320
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Article ; Online: "Real world" efficacy of bulevirtide in HBV/HDV-related cirrhosis including people living with HIV: Results from the compassionate use programme at INMI Spallanzani in Rome, Italy.

Visco Comandini, Ubaldo / De Santis, Emanuela / De Maria, Francesco / Lionetti, Raffaella / Taibi, Chiara / Montalbano, Marzia / Rianda, Alessia / Piccolo, Paola / De Ponte, Chiara / Mazzotta, Stefania / Caioli, Alessandro / Garbuglia, Anna Rosa / Maggi, Fabrizio / D'Offizi, Gianpiero

HIV medicine

2023 Volume 24, Issue 10, Page(s) 1075–1082

Abstract: Objectives: We describe the preliminary results of bulevirtide compassionate use in patients with hepatitis B and delta virus (HBV/HDV)-related cirrhosis and clinically significant portal hypertension, including those living with HIV.: Methods: We ... ...

Abstract	Objectives: We describe the preliminary results of bulevirtide compassionate use in patients with hepatitis B and delta virus (HBV/HDV)-related cirrhosis and clinically significant portal hypertension, including those living with HIV. Methods: We conducted a prospective observational study of consecutive patients. Clinical evaluation, liver function tests, bile acid levels, HDV-RNA, HBV-DNA, hepatitis B surface antigen, and liver and spleen stiffness were assessed at baseline and after treatment months 1, 2, 3, 4, 6, 9, and 12. HIV-RNA and CD4+/CD8+ count were assessed in people living with HIV. The first drug injection was administered under nurse supervision, and counselling was provided and adherence reviewed at each visit. Results: In total, 13 patients (61.5% migrants) were enrolled. The median treatment duration was 11 months. At month 6, mean alanine aminotransferase (ALT) levels fell by 64.5% and mean liver and spleen stiffness decreased by 8.6 and 0.9 kPa, respectively. The mean baseline HDV-RNA was 3.34 log IU/mL and 5.10 log IU/mL in people without and with HIV (n = 5) (p = 0.28), respectively. A similar mean decline was observed in both groups: -2.06 log IU/mL and -1.93 log IU/mL, respectively (p = 0.87). A combined response (undetectable HDV RNA or ≥ -2 log IU/mL decline vs. baseline, with ALT normalization) was achieved in 66% of subjects without and in 60% of patients with HIV. Patients with HIV showed persistently undetectable HIV-RNA and a progressive increase in CD4+/CD8+ cells during treatment. No patient discontinued bulevirtide because of adverse effects. Conclusions: Preliminary results suggest that bulevirtide is feasible and well-tolerated in populations with difficult-to-treat conditions, such as those with HIV/HBV/HDV co-infection and migrants, when special attention is given to patient education. HDV-RNA decline during treatment was similar in people living with and without HIV.
MeSH term(s)	Humans ; Compassionate Use Trials ; Hepatitis B virus/genetics ; HIV Infections/complications ; HIV Infections/drug therapy ; Italy ; Liver Cirrhosis/drug therapy ; RNA ; Rome
Chemical Substances	bulevirtide ; RNA (63231-63-0)
Language	English
Publishing date	2023-06-07
Publishing country	England
Document type	Observational Study ; Journal Article
ZDB-ID	2001932-4
ISSN	1468-1293 ; 1464-2662
ISSN (online)	1468-1293
ISSN	1464-2662
DOI	10.1111/hiv.13518
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Article ; Online: Third dose of SARS-CoV2 mRNA vaccination produces robust persistent cellular and humoral immune responses in liver transplant recipients.

Montalbano, Marzia / Piccolo, Paola / Lionetti, Raffaella / Visco-Comandini, Ubaldo / Agrati, Chiara / Grassi, Germana / Meschi, Silvia / Matusali, Giulia / Conte, Federica / Angelone, Federica / Ettorre, Giuseppe Maria / Guglielmo, Nicola / Maggi, Fabrizio / Francalancia, Massimo / Mereu, Tiziana / Puro, Vincenzo / Girardi, Enrico / D'Offizi, Gianpiero

Liver international : official journal of the International Association for the Study of the Liver

2023 Volume 43, Issue 5, Page(s) 1120–1125

Abstract: Weaker responses have been described after two doses of anti-SARS-CoV2 vaccination in liver transplant recipients (LTRs). At the Italian National Institute for Infectious Diseases, 122 LTRs (84% males, median age 64 years) were tested for humoral and ... ...

Abstract	Weaker responses have been described after two doses of anti-SARS-CoV2 vaccination in liver transplant recipients (LTRs). At the Italian National Institute for Infectious Diseases, 122 LTRs (84% males, median age 64 years) were tested for humoral and cell-mediated immune response after a third doses of anti-SARS-CoV2 mRNA vaccines. Humoral response was measured by quantifying anti-receptor binding domain and neutralizing antibodies; cell-mediated response was measured by quantifying IFN-γ after stimulation of T cells with SARS-CoV-2-specific peptides. Humoral and cellular responses improved significantly compared to the second vaccine dose; 86.4% of previous non-responders to the first 2 vaccine doses (N = 22) became responders. Mycophenolate mofetil-containing regimens were not associated with lower response rates to a third vaccine; shorter time since transplantation (<6 years) was associated with lower humoral and cellular responses to third vaccine. Protective antibodies against Omicron variant were detected in 60% of patients 12 weeks after third vaccine dose.
MeSH term(s)	Male ; Humans ; Middle Aged ; Female ; Immunity, Humoral ; Liver Transplantation ; COVID-19/prevention & control ; SARS-CoV-2 ; Vaccination ; RNA, Messenger ; Antibodies, Viral ; Transplant Recipients
Chemical Substances	RNA, Messenger ; Antibodies, Viral
Language	English
Publishing date	2023-04-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2102783-3
ISSN	1478-3231 ; 1478-3223
ISSN (online)	1478-3231
ISSN	1478-3223
DOI	10.1111/liv.15557
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Article ; Online: Anti-HEV IgG Avidity Testing: Utility for Diagnosing Acute and Resolved Genotype 3 Infections.

Minosse, Claudia / Lapa, Daniele / Coppola, Antonio / Rapagna, Federica / D'Offizi, Gianpiero / Taibi, Chiara / Lionetti, Raffaella / Capobianchi, Maria Rosaria / McPhee, Fiona / Garbuglia, Anna Rosa

Viruses

2021 Volume 13, Issue 2

Abstract: European Association of the Study of the Liver (EASL) guidelines specify HEV RNA, as well as anti-HEV IgG and IgM as positive markers for acute HEV infection. HEV RNA assay sensitivity limitations may lead to false negative test results in patients with ... ...

Abstract	European Association of the Study of the Liver (EASL) guidelines specify HEV RNA, as well as anti-HEV IgG and IgM as positive markers for acute HEV infection. HEV RNA assay sensitivity limitations may lead to false negative test results in patients with low levels of viremia. Moreover, anti-HEV IgM positivity is not a reliable indicator for distinguishing between acute and resolved infections given the ability of this antibody to persist several months after a resolved infection. Our study aims were to assess HEV IgG avidity for diagnosing acute and resolved infections, regardless of the anti-HEV IgM serostatus, and examine assay reliability when evaluating different genotype 3 (GT3) HEV subtypes. Patient serum samples (
MeSH term(s)	Antibody Affinity ; Female ; Hepatitis Antibodies/blood ; Hepatitis Antibodies/immunology ; Hepatitis E/blood ; Hepatitis E/diagnosis ; Hepatitis E/immunology ; Hepatitis E/virology ; Hepatitis E virus/genetics ; Hepatitis E virus/immunology ; Humans ; Immunoglobulin G/blood ; Immunoglobulin G/immunology ; Immunoglobulin M/blood ; Immunoglobulin M/immunology ; Male ; Phylogeny ; RNA, Viral/genetics
Chemical Substances	Hepatitis Antibodies ; Immunoglobulin G ; Immunoglobulin M ; RNA, Viral
Language	English
Publishing date	2021-02-03
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2516098-9
ISSN	1999-4915 ; 1999-4915
ISSN (online)	1999-4915
ISSN	1999-4915
DOI	10.3390/v13020236
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Article ; Online: Lymphofollicular lesions associated with monkeypox (Mpox) virus proctitis.

Mazzotta, Valentina / Scorzolini, Laura / Falasca, Laura / Lionetti, Raffaella / Aguglia, Camilla / Kontogiannis, Dimitra / Colombo, Daniele / Colavita, Francesca / De Palo, Maria Grazia / Carletti, Fabrizio / Mondi, Annalisa / Pinnetti, Carmela / Maffongelli, Gaetano / Garbuglia, Anna Rosa / Baldini, Francesco / Corpolongo, Angela / Maggi, Fabrizio / D'Offizi, Gianpiero / Girardi, Enrico /

Vaia, Francesco / Nicastri, Emanuele / Del Nonno, Franca / Antinori, Andrea

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases

2023 Volume 130, Page(s) 48–51

Abstract: In the recent 2022 monkeypox (Mpox) global outbreak, cases have been mostly documented among men who have sex with men. Proctitis was reported in almost 14% of cases. In this study, four Mpox-confirmed cases requiring hospitalizations for severe ... ...

Abstract	In the recent 2022 monkeypox (Mpox) global outbreak, cases have been mostly documented among men who have sex with men. Proctitis was reported in almost 14% of cases. In this study, four Mpox-confirmed cases requiring hospitalizations for severe proctitis were characterized by clinical, virological, microbiological, endoscopic, and histological aspects. The study showed the presence of lymphofollicular lesions associated with Mpox virus rectal infection for the first time.
MeSH term(s)	Male ; Humans ; Mpox (monkeypox) ; Monkeypox virus ; Homosexuality, Male ; Sexual and Gender Minorities ; Proctitis/drug therapy
Language	English
Publishing date	2023-02-27
Publishing country	Canada
Document type	Case Reports
ZDB-ID	1331197-9
ISSN	1878-3511 ; 1201-9712
ISSN (online)	1878-3511
ISSN	1201-9712
DOI	10.1016/j.ijid.2023.02.021
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Article: Cumulative incidence of solid and hematological De novo malignancy after liver transplantation in a multicentre cohort.

Lucidi, Cristina / Biolato, Marco / Lai, Quirino / Lattanzi, Barbara / Lenci, Ilaria / Milana, Martina / Lionetti, Raffaella / Liguori, Antonio / Angelico, Mario / Tisone, Giuseppe / Avolio, Alfonso Wolfango / Agnes, Salvatore / Rossi, Massimo / Grieco, Antonio / Merli, Manuela

Annals of hepatology

2021 Volume 24, Page(s) 100309

Abstract: Background: Recent innovations in the field of liver transplantation have led to a wealth of new treatment regimes, with potential impact on the onset of de novo malignancies (DNM). The aim of this multicenter cohort study was to provide contemporary ... ...

Abstract	Background: Recent innovations in the field of liver transplantation have led to a wealth of new treatment regimes, with potential impact on the onset of de novo malignancies (DNM). The aim of this multicenter cohort study was to provide contemporary figures for the cumulative incidences of solid and hematological DNM after liver transplantation. Methods: We designed a retrospective cohort study including patients undergoing LT between 2000 and 2015 in three Italian transplant centers. Cumulative incidence was calculated by Kaplan-Meyer analysis. Results: The study included 789 LT patients with a median follow-up of 81 months (IQR: 38-124). The cumulative incidence of non-cutaneous DNM was 6.2% at 5-years, 11.6% at 10-years and 16.3% at 15-years. Post-Transplant Lymphoproliferative Disorders (PTLD) were demonstrated to have a cumulative incidence of 1.0% at 5-years, 1.6% at 10-years and 2.2% at 15-years. Solid Organ Tumors (SOT) demonstrated higher cumulative incidences - 5.3% at 5-years, 10.3% at 10-years and 14.4% at 15-years. The most frequently observed classifications of SOT were lung (rate 1.0% at 5-years, 2.5% at 10-years) and head & neck tumors (rate 1.3% at 5-years, 1.9% at 10-years). Conclusions: Lung tumors and head & neck tumors are the most frequently observed SOT after LT.
MeSH term(s)	Adolescent ; Adult ; Aged ; Female ; Humans ; Incidence ; Italy ; Kaplan-Meier Estimate ; Liver Diseases/etiology ; Liver Diseases/pathology ; Liver Diseases/surgery ; Liver Transplantation ; Male ; Middle Aged ; Neoplasms/diagnosis ; Neoplasms/epidemiology ; Postoperative Complications/diagnosis ; Postoperative Complications/epidemiology ; Proportional Hazards Models ; Retrospective Studies ; Young Adult
Language	English
Publishing date	2021-01-20
Publishing country	Mexico
Document type	Journal Article ; Multicenter Study
ZDB-ID	2188733-0
ISSN	1665-2681
ISSN	1665-2681
DOI	10.1016/j.aohep.2021.100309
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Article ; Online: High prevalence of asymptomatic SARS-CoV-2 infection in a cohort of liver transplant recipients in central Italy.

Visco-Comandini, Ubaldo / Castilletti, Concetta / Lionetti, Raffaella / Meschi, Silvia / Montalbano, Marzia / Rianda, Alessia / Taibi, Chiara / Sorace, Chiara / Guglielmo, Nicola / Piccolo, Paola / Paci, Paola / Ettorre, Giuseppe Maria / Gianpiero, D'Offizi

Journal of liver transplantation

2021 Volume 5, Page(s) 100064

Abstract: Asymptomatic subjects account for 25 to 45% of SARS-CoV-2 infections, and in particular, subjects on mild immunosuppressive therapy may have symptoms masked and could spread virus for an extended period of time. To determine the cumulative incidence of ... ...

Abstract	Asymptomatic subjects account for 25 to 45% of SARS-CoV-2 infections, and in particular, subjects on mild immunosuppressive therapy may have symptoms masked and could spread virus for an extended period of time. To determine the cumulative incidence of symptomatic and asymptomatic SARS-CoV-2 infections and associated risk factors, we conducted a prospective clinical and serological survey in a cohort of 278 liver transplant recipients (LTRs) from Central Italy. Three different serology tests were performed every 4 months in 259 LTRs between April 2020 and April 2021: one based on raw extract of whole SARS-CoV-2 virus and two on specific viral antigens (nucleoprotein and receptor binding domain) to detect specific IgG, IgM and IgA. Hundred fifteen LTRs who reported symptoms or close contact with a SARS-CoV-2-positive subject, or had a positive serological result underwent molecular testing by standard screening procedures (RT-PCR on naso-pharyngeal swab). Thirty-one past or active SARS-CoV-2 infections were identified: 14 had positive molecular test (64% symptomatic), and 17 had positive serology only (18% symptomatic). SARS-CoV-2 infection was not statistically related to gender, age, obesity, diabetes, renal impairment, type of anti-rejection therapy or time from transplant. Asymptomatic SARS-CoV-2 cases (61.3%) were more frequent in males and in those with glomerular filtrate rate >50 ml/min. Overall, the addition of repeated serology to standard diagnostic molecular protocols increased detection of SARS-CoV-2 infection from 5.1% to 10.9%. Anti-SARS-CoV-2 seroprevalence among our LTRs (11.2%) is comparable to the general population of Central Italy, considered a medium-impact area. Only one asymptomatic subject (6%) was found to carry SARS-CoV-2 in respiratory tract at the time of serological diagnosis.
Language	English
Publishing date	2021-12-18
Publishing country	France
Document type	Journal Article
ISSN	2666-9676
ISSN (online)	2666-9676
DOI	10.1016/j.liver.2021.100064
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Article ; Online: Trends in liver transplantation for primary sclerosing cholangitis.

Morelli, Maria Cristina / Gambato, Martina / Martini, Silvia / Carrai, Paola / Toniutto, Pierluigi / Giannelli, Valerio / Donato, Francesca / Lenci, Ilaria / Pasulo, Luisa / Mazzarelli, Chiara / Ferrarese, Alberto / Rendina, Maria / Grieco, Antonio / Lanza, Alfonso Galeota / Baroni, Gianluca Svegliati / De Maria, Nicola / Marenco, Simona / Mameli, Laura / Ponziani, Francesca Romana /

Vitale, Giovanni / Burra, Patrizia / Viganò, Raffaella / Fornasiere, Ezio / Catanzaro, Elisa / Marrone, Giuseppe / Milana, Martina / Calleri, Alberto / Scorzoni, Chiara / Frassanito, Gabriella / Lionetti, Raffaella / Dibenedetto, Clara

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

2024

Abstract: Background: Primary sclerosing cholangitis is a cholestatic disease with a low prevalence in Italy. Indications for liver transplantation and the time of listing are not stated.: Aim: We performed a national survey to investigate the listing criteria, ...

Abstract	Background: Primary sclerosing cholangitis is a cholestatic disease with a low prevalence in Italy. Indications for liver transplantation and the time of listing are not stated. Aim: We performed a national survey to investigate the listing criteria, comorbidities, and outcomes. Methods: In April 2022, we surveyed liver transplantation in primary sclerosing cholangitis nationwide for the last 15 years. Results: From 2007 to 2021, 445 patients were included on waiting lists, and 411 had undergone liver transplants. The median age at transplantation was 46 years (males 63.9%); 262 patients (59%) presented an inflammatory bowel disease. Transplants increased over the years, from 1.8 % in 2007 to 3.0 % in 2021. Cholangitis (51%) and hepatic decompensation (45%) were the main indications for listing. The disease recurred in 81 patients (20%). Patient survival after the first transplant was 94 %, 86% and 84% at one, five, and ten years. Twenty-four died in the first year (50% surgical complications, 25% infections); 33 between one to five years (36% recurrence, 21% cholangiocarcinoma recurrence) and nine after five years (56% de novo cancer, 44% recurrence). Conclusions: Primary sclerosing cholangitis has been an increasing indication for transplantation in Italy. Cholangitis and decompensation were the main indications for listing. Recurrence and cancer were the leading causes of death.
Language	English
Publishing date	2024-01-16
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1459373-7
ISSN	1878-3562 ; 1125-8055
ISSN (online)	1878-3562
ISSN	1125-8055
DOI	10.1016/j.dld.2024.01.175
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Article ; Online: Superiority of the new sex-adjusted models to remove the female disadvantage restoring equity in liver transplant allocation.

Liver international : official journal of the International Association for the Study of the Liver

2023 Volume 44, Issue 1, Page(s) 103–112

Abstract: Background and aims: Model for End-stage Liver Disease (MELD) and MELDNa are used worldwide to guide graft allocation in liver transplantation (LT). Evidence exists that females are penalized in the present allocation systems. Recently, new sex-adjusted ...

Abstract	Background and aims: Model for End-stage Liver Disease (MELD) and MELDNa are used worldwide to guide graft allocation in liver transplantation (LT). Evidence exists that females are penalized in the present allocation systems. Recently, new sex-adjusted scores have been proposed with improved performance respect to MELD and MELDNa. GEMA-Na, MELD 3.0, and sex-adjusted MELDNa were developed to improve the 90-day dropout prediction from the list. The present study aimed at evaluating the accuracy and calibration of these scores in an Italian setting. Methods: The primary outcome of the present study was the dropout from the list up to 90 days because of death or clinical deterioration. We retrospectively analysed data from 855 adults enlisted for liver transplantation in the Lazio region (Italy) (2012-2018). Ninety-day prediction of GEMA-Na, MELD 3.0 and sex-adjusted MELDNa with respect to MELD and MELDNa was analysed. Brier score and Brier Skill score were used for accuracy, and the Greenwood-Nam-D'Agostino test was used to evaluate the calibration of the models. Results: GEMA-Na (concordance = .82, 95% CI = .75-.89), MELD 3.0 (concordance = .81, 95% CI = .74-.87) and sex-adjusted MELDNa (concordance = .81, 95% CI = .74-.88) showed the best 90-day dropout prediction. GEMA-Na showed a higher increase in accuracy with respect to MELD (p = .03). No superiority was shown with respect to MELDNa. All the tested scores showed a good calibration of the models. Using GEMA-Na instead of MELD would potentially save one in nine dropouts and could save one dropout per 285 patients listed. Conclusions: Validation and reclassification of the sex-adjusted score GEMA-Na confirm its superiority in predicting short-term dropout also in an Italian setting when compared with MELD.
MeSH term(s)	Adult ; Female ; Humans ; End Stage Liver Disease/surgery ; Liver Transplantation ; Prognosis ; Retrospective Studies ; Severity of Illness Index ; Waiting Lists ; Gender Equity
Language	English
Publishing date	2023-09-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	2102783-3
ISSN	1478-3231 ; 1478-3223
ISSN (online)	1478-3231
ISSN	1478-3223
DOI	10.1111/liv.15735
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Article ; Online: Pitfalls in the reporting of upper endoscopy features in cirrhotic patients.

Cucchiarelli, Silvia / Santopaolo, Francesco / Lamazza, Antonietta / Lionetti, Raffaella / Lenci, Ilaria / Manzia, Tommaso Maria / Angelico, Mario / Milana, Martina / Baiocchi, Leonardo

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

2018 Volume 51, Issue 3, Page(s) 382–385

Abstract: Background: Upper endoscopy is the main tool for the accurate assessment of the risk of bleeding in cirrhotic patients.: Aim: To evaluate the diagnostic accuracy of upper endoscopy, in cirrhotic subjects, during common clinical practice.: Methods: ...

Abstract	Background: Upper endoscopy is the main tool for the accurate assessment of the risk of bleeding in cirrhotic patients. Aim: To evaluate the diagnostic accuracy of upper endoscopy, in cirrhotic subjects, during common clinical practice. Methods: 120 endoscopic reports produced in different hospitals in our region were retrospectively and randomly selected. After a general evaluation, aimed at assessing the description of various endoscopic features, reports were evaluated by four expert endoscopists and four expert hepatologists. Experts were asked to fill in a questionnaire for each single endoscopic procedure, regarding the diagnostic accuracy of the report. Results: Endoscopic reports lacked descriptions of the size of esophageal varices and red signs in 14% and 29% of cases respectively. Presence (or absence) of gastric varices or portal hypertensive gastropathy were not reported in 62% and 34% of cases respectively. According to expert endoscopists 41% of the reports were incomplete, while, according to hepatologists, reports were incomplete and inadequate for clinical purposes in 36% of cases. Conclusion: Our study clearly evidenced a significant lack of information in reports on upper endoscopy in cirrhotic patients, and supports the prompt adoption of corrective strategies.
MeSH term(s)	Data Accuracy ; Endoscopy, Gastrointestinal ; Esophageal and Gastric Varices/diagnosis ; Gastrointestinal Hemorrhage/diagnosis ; Humans ; Hypertension, Portal/diagnosis ; Liver Cirrhosis/complications ; Retrospective Studies ; Stomach Diseases/diagnosis
Language	English
Publishing date	2018-08-18
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1459373-7
ISSN	1878-3562 ; 1125-8055
ISSN (online)	1878-3562
ISSN	1125-8055
DOI	10.1016/j.dld.2018.08.014
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