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  1. Article: Portal pressure reductions induced by nonselective beta-blockers improve outcomes and decrease mortality in patients with cirrhosis with and without ascites.

    Turco, Laura / García-Tsao, Guadalupe

    Clinical liver disease

    2022  Volume 20, Issue 1, Page(s) 1–4

    Abstract: Content available: Audio Recording. ...

    Abstract Content available: Audio Recording.
    Language English
    Publishing date 2022-06-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2657644-2
    ISSN 2046-2484
    ISSN 2046-2484
    DOI 10.1002/cld.1210
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  2. Article ; Online: Carvedilol as the new non-selective beta-blocker of choice in patients with cirrhosis and portal hypertension.

    Turco, Laura / Reiberger, Thomas / Vitale, Giovanni / La Mura, Vincenzo

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

    2023  Volume 43, Issue 6, Page(s) 1183–1194

    Abstract: Portal hypertension (PH) is the most common complication ofcirrhosis and represents the main driver of hepatic decompensation. The overarching goal of PH treatments in patients with compensated cirrhosis is to reduce the risk of hepatic decompensation (i. ...

    Abstract Portal hypertension (PH) is the most common complication ofcirrhosis and represents the main driver of hepatic decompensation. The overarching goal of PH treatments in patients with compensated cirrhosis is to reduce the risk of hepatic decompensation (i.e development of ascites, variceal bleeding and/or hepatic encephalopathy). In decompensated patients, PH-directed therapies aim at avoiding further decompensation (i.e. recurrent/refractory ascites, variceal rebleeding, recurrent encephalopathy, spontaneous bacterial peritonitis or hepatorenal syndrome) and at improving survival. Carvedilol is a non-selective beta-blocker (NSBB) acting on hyperdynamic circulation/splanchnic vasodilation and on intrahepatic resistance. It has shown superior efficacy than traditional NSBBs in lowering PH in patients with cirrhosis and may be, therefore, the NSBB of choice for the treatment of clinically significant portal hypertension. In primary prophylaxis of variceal bleeding, carvedilol has been demonstrated to be more effective than endoscopic variceal ligation (EVL). In patients with compensated cirrhosis carvedilol achieves higher rate of hemodynamic response than propranolol, resulting in a decreased risk of hepatic decompensation. In secondary prophylaxis, the combination of EVL with carvedilol may prevent rebleeding and non-bleeding further decompensation better than that with propranolol. In patients with ascites and gastroesophageal varices, carvedilol is safe and may improve survival, as long as no impairment of the systemic hemodynamic or renal dysfunction occurs, with maintained arterial blood pressure as suitable safety surrogate. The target dose of carvedilol to treat PH should be 12.5 mg/day. This review summarizes the evidence behind Baveno-VII recommendations on the use of carvedilol in patients with cirrhosis.
    MeSH term(s) Humans ; Carvedilol/therapeutic use ; Propranolol ; Esophageal and Gastric Varices/etiology ; Esophageal and Gastric Varices/complications ; Ascites/etiology ; Ascites/complications ; Gastrointestinal Hemorrhage/drug therapy ; Gastrointestinal Hemorrhage/etiology ; Adrenergic beta-Antagonists/therapeutic use ; Hypertension, Portal/complications ; Hypertension, Portal/drug therapy ; Liver Cirrhosis
    Chemical Substances Carvedilol (0K47UL67F2) ; Propranolol (9Y8NXQ24VQ) ; Adrenergic beta-Antagonists
    Language English
    Publishing date 2023-04-17
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2102783-3
    ISSN 1478-3231 ; 1478-3223
    ISSN (online) 1478-3231
    ISSN 1478-3223
    DOI 10.1111/liv.15559
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1632: Show issues Location:
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  3. Article ; Online: Portal Hypertension: Pathogenesis and Diagnosis.

    Turco, Laura / Garcia-Tsao, Guadalupe

    Clinics in liver disease

    2019  Volume 23, Issue 4, Page(s) 573–587

    Abstract: Portal hypertension (PH) is an increase in the pressure gradient between portal vein and inferior vena cava. Increased resistance occurs at different levels within the portal venous system, followed by increased portal venous inflow. PH is the main ... ...

    Abstract Portal hypertension (PH) is an increase in the pressure gradient between portal vein and inferior vena cava. Increased resistance occurs at different levels within the portal venous system, followed by increased portal venous inflow. PH is the main driver of cirrhosis decompensation. Varices on endoscopy or portosystemic collaterals on imaging indicate PH. Although its cause is determined mostly via noninvasive tests, the gold standard to measure portal pressure in cirrhosis and determine its severity is hepatic vein catheterization with determination of the hepatic venous pressure gradient. Measuring portal pressure is essential in proof-of-concept studies of portal pressure-lowering drugs.
    MeSH term(s) Ascites/etiology ; Bacterial Translocation ; Budd-Chiari Syndrome/complications ; Catheterization ; Coloring Agents ; Elasticity Imaging Techniques ; Endoscopy, Digestive System ; Endothelium, Vascular/physiopathology ; Esophageal and Gastric Varices/diagnosis ; Esophageal and Gastric Varices/etiology ; Esophageal and Gastric Varices/physiopathology ; Heart Diseases/complications ; Hepatic Stellate Cells ; Hepatic Veins ; Hepatic Veno-Occlusive Disease/complications ; Humans ; Hypertension, Portal/diagnosis ; Hypertension, Portal/etiology ; Hypertension, Portal/physiopathology ; Indocyanine Green ; Inflammation ; Liver/diagnostic imaging ; Liver Cirrhosis/complications ; Magnetic Resonance Imaging ; Neovascularization, Pathologic ; Portal Pressure ; Splanchnic Circulation ; Spleen/diagnostic imaging ; Thrombosis ; Vascular Resistance
    Chemical Substances Coloring Agents ; Indocyanine Green (IX6J1063HV)
    Language English
    Publishing date 2019-11-25
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1472315-3
    ISSN 1557-8224 ; 1089-3261
    ISSN (online) 1557-8224
    ISSN 1089-3261
    DOI 10.1016/j.cld.2019.07.007
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    Se 1870: Show issues Location:
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  4. Article ; Online: Reply to: "Underestimation of portal pressures by wedge hepatic venous pressures in patients with non-alcoholic steatohepatitis related cirrhosis- Possibilities and implications".

    Ferrusquía-Acosta, José / Turco, Laura / Hernández-Gea, Virginia

    Journal of hepatology

    2020  Volume 74, Issue 3, Page(s) 757–758

    MeSH term(s) Humans ; Liver Cirrhosis/etiology ; Non-alcoholic Fatty Liver Disease/etiology ; Portal Pressure
    Language English
    Publishing date 2020-12-30
    Publishing country Netherlands
    Document type Letter ; Comment
    ZDB-ID 605953-3
    ISSN 1600-0641 ; 0168-8278
    ISSN (online) 1600-0641
    ISSN 0168-8278
    DOI 10.1016/j.jhep.2020.12.001
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2027: Show issues Location:
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  5. Article ; Online: Congeners-Specific Intestinal Absorption Of Microcystins In An

    Turco, Laura / Santori, Nicoletta / Buratti, Franca M / Dorne, Jean-Lou C M / Testai, Emanuela

    Frontiers in toxicology

    2022  Volume 4, Page(s) 883063

    Abstract: Microcystins constitute a group of over 200 variants and are increasingly considered as emerging toxins in food and feed safety, particularly with regards to sea-food and fish consumption. Toxicity of MCs is congener-specific, being characterised by ... ...

    Abstract Microcystins constitute a group of over 200 variants and are increasingly considered as emerging toxins in food and feed safety, particularly with regards to sea-food and fish consumption. Toxicity of MCs is congener-specific, being characterised by different acute potencies, likely related to the differential activity of metabolic enzymes and transporters proteins involved in their cellular uptake. However, the active transport of MCs across intestinal membranes has not been fully elucidated. Our results, obtained using a fit for purpose 3D human reconstructed intestinal epithelium, provide new information on the complex mechanisms involved in the absorption of 5 MC variants': it is indeed characterised by the equilibrium between uptake and extrusion, since the selected congeners are substrates of both influx and efflux proteins. In the range of tested nominal concentrations (10-40 µM) fully representative of relevant exposure scenarios, none of the active tested transporters were saturated. The comparison of permeability (Papp) values of MCs variants highlighted a dose independent relationship for MC-LR, -YR and -RR (Papp x 10
    Language English
    Publishing date 2022-08-05
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2673-3080
    ISSN (online) 2673-3080
    DOI 10.3389/ftox.2022.883063
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  6. Article ; Online: Molecular and Clinical Links between Drug-Induced Cholestasis and Familial Intrahepatic Cholestasis.

    Vitale, Giovanni / Mattiaccio, Alessandro / Conti, Amalia / Berardi, Sonia / Vero, Vittoria / Turco, Laura / Seri, Marco / Morelli, Maria Cristina

    International journal of molecular sciences

    2023  Volume 24, Issue 6

    Abstract: Idiosyncratic Drug-Induced Liver Injury (iDILI) represents an actual health challenge, accounting for more than 40% of hepatitis cases in adults over 50 years and more than 50% of acute fulminant hepatic failure cases. In addition, approximately 30% of ... ...

    Abstract Idiosyncratic Drug-Induced Liver Injury (iDILI) represents an actual health challenge, accounting for more than 40% of hepatitis cases in adults over 50 years and more than 50% of acute fulminant hepatic failure cases. In addition, approximately 30% of iDILI are cholestatic (drug-induced cholestasis (DIC)). The liver's metabolism and clearance of lipophilic drugs depend on their emission into the bile. Therefore, many medications cause cholestasis through their interaction with hepatic transporters. The main canalicular efflux transport proteins include: 1. the bile salt export pump (BSEP) protein (
    MeSH term(s) Adult ; Humans ; Cholestasis/chemically induced ; Cholestasis/genetics ; Cholestasis/metabolism ; Hepatocytes/metabolism ; Bile/metabolism ; Bile Acids and Salts/metabolism ; Cholestasis, Intrahepatic/chemically induced ; Cholestasis, Intrahepatic/genetics ; Cholestasis, Intrahepatic/metabolism
    Chemical Substances Bile Acids and Salts
    Language English
    Publishing date 2023-03-18
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms24065823
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  7. Article: Correction: The Role of Anticoagulation in Treating Portal Hypertension.

    Turco, Laura / Schepis, Filippo / Villa, Erica

    Current hepatology reports

    2018  Volume 17, Issue 4, Page(s) 511

    Abstract: This corrects the article DOI: 10.1007/s11901-018-0406-x.]. ...

    Abstract [This corrects the article DOI: 10.1007/s11901-018-0406-x.].
    Language English
    Publishing date 2018-11-16
    Publishing country United States
    Document type Published Erratum
    ZDB-ID 2813071-6
    ISSN 2195-9595 ; 2195-9595 ; 1540-3416
    ISSN (online) 2195-9595
    ISSN 2195-9595 ; 1540-3416
    DOI 10.1007/s11901-018-0443-5
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  8. Article: The Role of Anticoagulation in Treating Portal Hypertension.

    Turco, Laura / Schepis, Filippo / Villa, Erica

    Current hepatology reports

    2018  Volume 17, Issue 3, Page(s) 200–208

    Abstract: Purpose of review: To revise experimental and clinical data supporting a less traditional role of anticoagulation for treating portal hypertension in patients with cirrhosis.: Recent findings: Portal hypertension is the main driver of complications ... ...

    Abstract Purpose of review: To revise experimental and clinical data supporting a less traditional role of anticoagulation for treating portal hypertension in patients with cirrhosis.
    Recent findings: Portal hypertension is the main driver of complications such as ascites, variceal hemorrhage, and hepatic encephalopathy, with inflammation as a key component. The traditional view of cirrhosis as a pro-hemorrhagic condition has recently changed, prothrombotic complications being recognized as frequently as the hemorrhagic ones. Several data indicate a close relationship between inflammation, prothrombotic status, worsening of hepatic fibrosis, and portal hypertension both in animal models and in patients with chronic liver disease. These findings indicate that anticoagulation may represent a potent tool to act on fibrogenesis and therefore consequently to treat portal hypertension. All anticoagulants have good to optimal safety profiles and can be used in patients with advanced chronic liver disease with confidence.
    Summary: Anticoagulation has a role as a pleiotropic treatment of portal hypertension in cirrhosis.
    Language English
    Publishing date 2018-06-18
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2813071-6
    ISSN 2195-9595 ; 2195-9595 ; 1540-3416
    ISSN (online) 2195-9595
    ISSN 2195-9595 ; 1540-3416
    DOI 10.1007/s11901-018-0406-x
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  9. Article ; Online: Prevention and Management of Bleeding Risk Related to Invasive Procedures in Cirrhosis.

    Schepis, Filippo / Turco, Laura / Bianchini, Marcello / Villa, Erica

    Seminars in liver disease

    2018  Volume 38, Issue 3, Page(s) 215–229

    Abstract: Cirrhosis represents the end stage of chronic liver disease and its transition from a compensated to a decompensated status is mainly driven by portal hypertension and systemic inflammation. Although relevant modifications in the evaluation of the ... ...

    Abstract Cirrhosis represents the end stage of chronic liver disease and its transition from a compensated to a decompensated status is mainly driven by portal hypertension and systemic inflammation. Although relevant modifications in the evaluation of the coagulative balance in cirrhosis across its natural history have occurred and alterations in routine indices of hemostasis have lost their role as indicators of the hemorrhagic risk of patients with liver cirrhosis, these are still perceived as prone to bleed when admitted to invasive procedures. This view, which is still present in guidelines addressing the management of bleeding risk, makes preprocedural transfusion of plasma and platelets still an ongoing clinical practice. In this review, we describe the limitations of both bleeding risk assessment in cirrhotic patients admitted to radiologic and endoscopic invasive procedures and evaluate whether preventive strategies indicated by current guidelines can affect the procedure-related hemorrhagic events.
    MeSH term(s) Biopsy/adverse effects ; Blood Coagulation ; Endoscopy, Digestive System/adverse effects ; Endoscopy, Digestive System/standards ; Hemorrhage/blood ; Hemorrhage/etiology ; Hemorrhage/prevention & control ; Hemorrhage/therapy ; Hemostatic Techniques/adverse effects ; Hemostatic Techniques/standards ; Humans ; Liver Cirrhosis/blood ; Liver Cirrhosis/complications ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/therapy ; Practice Guidelines as Topic ; Radiography, Interventional/adverse effects ; Radiography, Interventional/standards ; Risk Assessment ; Risk Factors ; Treatment Outcome
    Language English
    Publishing date 2018-07-24
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 603177-8
    ISSN 1098-8971 ; 0272-8087
    ISSN (online) 1098-8971
    ISSN 0272-8087
    DOI 10.1055/s-0038-1660523
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1752: Show issues Location:
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  10. Article: Genetics in Familial Intrahepatic Cholestasis: Clinical Patterns and Development of Liver and Biliary Cancers: A Review of the Literature.

    Vitale, Giovanni / Mattiaccio, Alessandro / Conti, Amalia / Turco, Laura / Seri, Marco / Piscaglia, Fabio / Morelli, Maria Cristina

    Cancers

    2022  Volume 14, Issue 14

    Abstract: The family of inherited intrahepatic cholestasis includes autosomal recessive cholestatic rare diseases of childhood involved in bile acids secretion or bile transport defects. Specific genetic pathways potentially cause many otherwise unexplained ... ...

    Abstract The family of inherited intrahepatic cholestasis includes autosomal recessive cholestatic rare diseases of childhood involved in bile acids secretion or bile transport defects. Specific genetic pathways potentially cause many otherwise unexplained cholestasis or hepatobiliary tumours in a healthy liver. Lately, next-generation sequencing and whole-exome sequencing have improved the diagnostic procedures of familial intrahepatic cholestasis (FIC), as well as the discovery of several genes responsible for FIC. Moreover, mutations in these genes, even in the heterozygous status, may be responsible for cryptogenic cholestasis in both young and adults. Mutations in FIC genes can influence serum and hepatic levels of bile acids. Experimental studies on the
    Language English
    Publishing date 2022-07-14
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers14143421
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